67 research outputs found
Psychological Distress in Morbid Obesity in Relation to Weight History
Background: Very few data are available on psychological
distress in morbidly obese subjects in relation
to the history of their weight. In subjects with childhood
obesity, psychological distress might be better
than in adult-onset obesity, because of progressive
adaptation to the social stigma.
Methods: Psychological distress was tested in relation
to BMI at age 20 years (BMI-20), weight history
and somatic co-morbidities in 632 treatment-seeking,
morbidly obese participants from the QUOVADIS
cohort (130 men, 502 women; mean age 45.5 years).
The number of dieting attempts/year, BMI increase
and cumulative BMI loss since age 20 were calculated
as weight cycling parameters.The Symptom Check
List-90 (SCL-90), the Psychological General Well-
Being (PGWB), the Binge-Eating Scale, and the
ORWELL-97 questionnaire were used to score psychometry
and health-related quality of life (HRQL).
Complications were quantitatively assessed by a
modified Charlson\u2019s score.
Results: BMI-20 was normal in 35% of cases and >35
kg/m2 in only 14%. Psychometric scores were not different
in relation to BMI-20, when corrected for age,
with the exception of the General Health scale of
PGWB, showing a greater distress in subjects with
normal BMI-20. In most cases, the prevalence of
pathological results of questionnaires showed a Jshaped
curve, with participants with normal BMI-20 or
those with Class II-III obesity in early adulthood having
the highest prevalence of psychological/psychiatric
distress and poor HRQL.Weight cycling was a risk factor
for binge-eating, depression and interpersonal
sensitivity in SCL-90, whereas somatic co-morbidities
adversely affected most SCL-90 and all PGWB scales.
Conclusion: Weight cycling and somatic co-morbidities,
but not age of onset of obesity, are the main
factors negatively influencing psychological health in
treatment-seeking, morbidly obese subjects
Cure indicators and prevalence by stage at diagnosis for breast and colorectal cancer patients: A population‐based study in Italy
People alive many years after breast (BC) or colorectal cancer (CRC) diagnoses are increasing. This paper aimed to estimate the indicators of cancer cure and complete prevalence for Italian patients with BC and CRC by stage and age. A total of 31 Italian Cancer Registries (47% of the population) data until 2017 were included. Mixture cure models allowed estimation of net survival (NS); cure fraction (CF); time to cure (TTC, 5-year conditional NS >95%); cure prevalence (who will not die of cancer); and already cured (prevalent patients living longer than TTC). 2.6% of all Italian women (806,410) were alive in 2018 after BC and 88% will not die of BC. For those diagnosed in 2010, CF was 73%, 99% when diagnosed at stage I, 81% at stage II, and 36% at stages III-IV. For all stages combined, TTC was >10 years under 45 and over 65 years and for women with advanced stages, but <= 1 year for all BC patients at stage I. The proportion of already cured prevalent BC women was 75% (94% at stage I). Prevalent CRC cases were 422,407 (0.7% of the Italian population), 90% will not die of CRC. For CRC patients, CF was 56%, 92% at stage I, 71% at stage II, and 35% at stages III-IV. TTC was <= 10 years for all age groups and stages. Already cured were 59% of all prevalent CRC patients (93% at stage I). Cancer cure indicators by stage may contribute to appropriate follow-up in the years after diagnosis, thus avoiding patients' discrimination
MRX87 family with Aristaless X dup24bp mutation and implication for polyAlanine expansions
<p>Abstract</p> <p>Background</p> <p>Cognitive impairments are heterogeneous conditions, and it is estimated that 10% may be caused by a defect of mental function genes on the X chromosome. One of those genes is <it>Aristaless related homeobox </it>(<it>ARX</it>) encoding a polyA-rich homeobox transcription factor essential for cerebral patterning and its mutations cause different neurologic disorders. We reported on the clinical and genetic analysis of an Italian family with X-linked mental retardation (XLMR) and intra-familial heterogeneity, and provided insight into its molecular defect.</p> <p>Methods</p> <p>We carried out on linkage-candidate gene studies in a new MRX family (MRX87). All coding regions and exon-intron boundaries of ARX gene were analysed by direct sequencing.</p> <p>Results</p> <p>MRX87 patients had moderate to profound cognition impairment and a combination of minor congenital anomalies. The disease locus, MRX87, was mapped between DXS7104 and DXS1214, placing it in Xp22-p21 interval, a hot spot region for mental handicap. An in frame duplication of 24 bp (ARXdup24) in the second polyAlanine tract (polyA_II) in ARX was identified.</p> <p>Conclusion</p> <p>Our study underlines the role of ARXdup24 as a critical mutational site causing mental retardation linked to Xp22. Phenotypic heterogeneity of MRX87 patients represents a new observation relevant to the functional consequences of polyAlanine expansions enriching the puzzling complexity of ARXdup24-linked diseases.</p
Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care
Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42% 60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management
Polipharmacy and Multimorbity in Oncological Patients: An Open Challenge
Kirkham and colleagues presented an original study about cancer survivors in Canadian population and reported that the odds of several cardiovascular disease risk factors are higher among middle-aged. Several risk factors are connected to a toxic lifestyle and are associated with cardiovascular diseases and general health status. The paper is very relevant in managing oncological patients. A particular attention should be given to some anamnestic data about the presence of other pathologies (as self-reported diabetes and hypertension) and drug therapy with particular consideration of angiotensin-converting enzyme inhibitors that present a protective action against cardiovascular events and reduce the incidence of type II diabetes. In order to identify and intervene on risk factors, clinicians should depict the pharmacological therapy taken by the study population, assuming that in the elderly this may be potentially protective on cardiovascular risk profile compared to younger cancer survivors
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