Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology) survey

<p>Abstract</p> <p>Background</p> <p>The PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). The aims of this paper are: (i) to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii) to assess the clinical management, subjective wellbeing and attitudes toward medications.</p> <p>Methods</p> <p>A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period.</p> <p>Results</p> <p>Almost half of patients (46%) showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%), than in aggression toward other people (20%). A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%), followed by depression (16%) and personality disorders (14%), and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge), while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge) and depression (41 vs 32% during stay and 44 vs 25% at discharge). Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%). Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self-reported compliance increased during hospital stay.</p> <p>Conclusion</p> <p>Results confirm the widespread use of antipsychotics and the increasing trend in atypical drugs prescription, in both psychiatric in- and outpatients.</p

Effects of the new, non benzodiazepine, anxiolytic drug buspirone on the serotonergic system

The effects of the new, non benzodiazepine, anxiolytic drug buspirone and its metabolite 1-(2-pyrimidinyl)-piperazine (1-PP) were studied on the serotonergic system by in vivo voltammetry. This technique, in association with carbon fiber microelectrodes, chronically implanted in the hippocampus, caudate nucleus and nucleus accumbens of freely moving rats, continuously recorded 5-hydroxy-indoleacetic acid (5HIAA), the serotonin metabolite, in the extracellular space. The administration of buspirone (10 mg/kg i.p.) induced a decrease in 5HIAA in the hippocampus but not in the caudate nucleus and nucleus accumbens. This effect lasted about 150 min; 1-PP was found to be ineffective. The regional specificity of buspirone suggests a role for hippocampal serotonin in anxiety

Alzheimer's disease : another target for heparin therapy

Alzheimer's disease (AD) is the leading cause of dementia and cognitive decline in the elderly. Brain tissue changes indicate that the two main proteins involved in AD are amyloid-beta (A\u3b2), which is associated with the formation of senile amyloid plaques, and tau, which is associated with the formation of neurofibrillary tangles. Although a central role for A\u3b2 in the pathogenesis of AD is indisputable, considerable evidence indicates that A\u3b2 production is not the sole culprit in AD pathology. AD is also accompanied by an inflammatory response that contributes to irreversible changes in neuronal viability and brain function, and accumulating evidence supports the pivotal role of complement and contact systems in its pathogenesis and progression. The complexity of AD pathology provides numerous potential targets for therapeutic interventions. Compounds that interact directly with A\u3b2 protein or interfere with its production and/or aggregation can reduce the inflammatory and neurotoxic effects of A\u3b2, and heparin, a glycosaminoglycan mixture currently used in the prophylaxis and treatment of thrombosis, might be a candidate, as recent research has been extended to consider its nonanticoagulant properties, including its modulation of various proteases and anti-inflammatory activity

Mannose binding lectin deficiency reduces functional deficits and histological damage after experimental traumatic brain injury

Background: Mannose binding lectin (MBL) is the activator of the lectin complement pathway. After brain ischemia MBL could be a mediator of secondary brain damage, while after brain trauma (TBI) data suggest that it could be linked to neuroprotection. In order to clarify the role of MBL after TBI we characterized its temporal activation and the effects of its inhibition in a model of cerebral contusion. Methods: 1) Male C57/Bl6 (WT) mice received intraperitoneal anesthesia (Pentobarbital, 65 mg/kg) followed by the controlled cortical impact to model TBI (injury parameters: velocity of 5 meter/s and 1 mm depth of deformation). MBL immunostaining was evaluated at 30 min, 6, 12, 24, 48, 96 h and 1 week after TBI using anti MBL-A and MBL-C antibodies. 2) The effects of MBL inhibition were evaluated in WT and MBL double knockout (-/-) mice. Functional outcome was tested using the Neuroscore and Beam Walk test weekly for 4 weeks postinjury. Histologic outcome was evaluated by neuronal cell count in the cortex adjacent to the contusion. Results: We observed MBL-C positive immunostaining in the injured cortex starting at 30 minutes postinjury and up to 1 week, suggestive of an activation of this pathway. MBL-C was observed both at endothelial and tissue level. MBL-A was detected in the injured brain but its staining was much lower compared to that of MBL-C. Injured WT and MBL (-/-) mice showed motor deficits up to 4 weeks postinjury when compared to their controls. Motor deficits were reduced in MBL (-/-) compared to WT mice at 2-4 weeks postinjury (p<0.01 for Neuroscore and Beam Walk). Moreover we observed a reduced cortical cell loss at 4 weeks postinjury in MBL (-/-) mice compared to WT (p < 0.05). Conclusions: We observed that 1) TBI induced MBL deposition/synthesis on injured vessels and in the brain tissue; 2) MBL deficiency was associated with functional neuroprotection, suggesting that MBL modulation might be a potential therapeutic target after TBI

Easily available, low cost 19F MRI agents: Poly(ethylene-glycol)-functionalized fluorinated ethers

A simple derivatisation of commercially available poly(ethylene-glycols) of different molecular weight followed by the reaction with the selected fluorinated organic molecule, perfluoro-tertbutanol, allowed an easy synthesis of several novel polymers of different fluorine content. The properties of the new materials as MRI agents were preliminarily investigated. In all cases a single 19F signal at NMR in deuterated chloroform and D2O was registered; for a few fluorinated polymeric candidates a good solubility in water was observed and MR imaging of the fluorinated polymer successfully provided images. Most interesting results were obtained with the sample of 1436 MW (24% fluorine content) that not only gave a spectrum with a single resonance line, but, most importantly, was tolerated in low doses when in vivo experiments on animals (mice) were conducted

Poly(ethylene-glycol)-based Fluorinated Esters: a Readily Available Entry for Novel 19F-MRI agents

Readily available, low cost, hydrosoluble poly(ethylene-glycol) derivatives of 2-(trifluoromethyl)-3,3,3-trifluoro-propanoic acid were easily synthesized and their properties as MRI agents are preliminarily investigated. Two novel polymers, of 2356 Da and 756 Da, respectively, both showing a single 19F signal at NMR in deuterated chloroform and D2O were fully characterized; both compounds were shown to be soluble in water. However when experiments of in vitro MR imaging were conducted a clear imaging was obtained only with the sample of 756 MW, pointing at the importance of the fluorine content of the carrier