Neuroinflammatory processes, A1 astrocyte activation and protein aggregation in the retina of Alzheimer’s disease patients, possible biomarkers for early diagnosis

Alzheimer's disease (AD), a primary cause of dementia in the aging population, is characterized by extracellular amyloid-beta peptides aggregation, intracellular deposits of hyperphosphorylated tau, neurodegeneration and glial activation in the brain. It is commonly thought that the lack of early diagnostic criteria is among the main causes of pharmacological therapy and clinical trials failure; therefore, the actual challenge is to define new biomarkers and non-invasive technologies to measure neuropathological changes in vivo at pre-symptomatic stages. Recent evidences obtained from human samples and mouse models indicate the possibility to detect protein aggregates and other pathological features in the retina, paving the road for non-invasive rapid detection of AD biomarkers. Here, we report the presence of amyloid beta plaques, tau tangles, neurodegeneration and detrimental astrocyte and microglia activation according to a disease associated microglia phenotype (DAM). Thus, we propose the human retina as a useful site for the detection of cellular and molecular changes associated with Alzheimer's disease

A burning test on Cistus chaparral in Sicily

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Post Surgical Pyoderma Gangrenosum in flap surgery: Diagnostic clues and treatment recommendations

Background: Post Surgical Pyoderma Gangrenosum (PSPG) is a neutrophilic dermatosis causing aseptic necrotic ulcerations within surgical sites. It is often misdiagnosed as infection or ischemia and worsened by the inappropriate treatment. Therefore diagnostic clues must be identified and awareness for PSPG raised.Methods: We present two cases of PSPG after flap surgery and a review of the literature.Results: Seventeen cases of PSPG after flap surgery were found. Fever, pain and redness are the most common initial symptoms. In 63%, lesions were on the flap and the adjacent skin. In 63%, the donor site is also involved. Time to diagnosis was nine days to four years. Frequent debridement (89%) and administration of antibiotics (74%) illustrate the misdiagnosis of infection or ischemia. PSPG in flap surgery seems to be less associated with underlying diseases, than other forms of Pyoderma Gangrenosum. Corticoids are the most commonly used treatment. Of the 19 cases, 10 experienced partial or total flap loss.Conclusion: PSPG must be included in the differential diagnosis of postoperative wound problems. Recognizing the diagnostic clues can lead to early diagnosis and treatment with systemic immunotherapy. Associated diseases should be investigated and additional surgery can only be successful when associated with immunotherapy

Urethral Reconstruction in Anterolateral Thigh Flap Phalloplasty: A 93-Case Experience

BACKGROUND: Urethral reconstruction in anterolateral thigh flap phalloplasty cannot always be accomplished with one flap, and the ideal technique has not been established yet. In this article, the authors' experience with urethral reconstruction in 93 anterolateral thigh flap phalloplasties is reported. METHODS: Ninety-three anterolateral thigh phalloplasties performed over 13 years at a single center were retrospectively reviewed to evaluate outcomes of the different urethral reconstruction techniques used: anterolateral thigh alone without urethral reconstruction (n = 7), tube-in-tube anterolateral thigh flap (n = 5), prelaminated anterolateral thigh flap with a skin graft (n = 8), anterolateral thigh flap combined with a free radial forearm flap (n = 29), anterolateral thigh flap combined with a pedicled superficial circumflex iliac artery perforator flap (n = 38), and anterolateral thigh flap combined with a skin flap from a previous phalloplasty (n = 6). Seventy-nine phalloplasties were performed for female-to-male sex reassignment surgery. The others were performed in male patients with severe penile insufficiency. RESULTS: Urethral complication rates (fistulas and strictures) were as follows: tube-in-tube anterolateral thigh flap, 20 percent; prelaminated anterolateral thigh flap, 87.5 percent; free radial forearm flap urethra, 37.9 percent; superficial circumflex iliac artery perforator urethral reconstruction, 26.3 percent; and skin flap from previous phalloplasty, 16.7 percent. CONCLUSIONS: When tube-in-tube urethra reconstruction is not possible (94.2 percent of cases), a skin flap such as the superficial circumflex iliac artery perforator flap or the radial forearm flap is used for urethral reconstruction in anterolateral thigh phalloplasties. Flap prelamination is a second choice that gives high stricture rates. If a penis is present, its skin should be used for urethral reconstruction and covered with an anterolateral thigh flap. With these techniques, 91.86 percent of patients are eventually able to void while standing. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV

The Relationship Between Attachment Dimensions and Perceptions of Group Relationships Over Time: An Actor–Partner Interdependence Analysis

A group member’s attachment, anxiety, and avoidance is related to how the group member and the other group members (OGMs) perceive group relationships. In addition, the collective attachment strategies of the OGMs may also be related to how the individual group member and the others perceive the relationships in the group. We extend previous research, using the actor partner interdependence model (APIM), to examine how group members’ and aggregated OGMs’ attachment anxiety and avoid- ance were related to group members’ and OGMs perceptions of positive bonding, positive working, and negative relationships measured early and late in interpersonal growth groups. Three hundred twenty-five Italian graduate students were randomly assigned to 1 of 16 interpersonal growth groups that met for 9 weeks with experienced psychologists. Attachment anxiety and avoidance was assessed with the Attachment Style Questionnaire (ASQ) and the third and eighth session ratings of group relationships were assessed with the Group Questionnaire (GQ). For group members, the relationships between attachment and group relationships were stable across time; for OGMs the relation- ship between attachment and group relationships only emerged late in the group. Group member’s and OGMs attachment anxiety was positively related to positive bonding or working relationships and attachment avoidance was negatively related to positive bonding or working relationships for both group member’s and OGMs’ perceptions of group relationships. The implication of these findings for group composition is discussed

All bonds are not the same: A response surface analysis of the perceptions of positive bonding relationships in therapy groups

Intrapersonal split alliances were defined as discrepancies in how group members perceived their positive bonding relationships with the group leader, the other group members, and the group-as-a-whole, and were related to group members' outcome. Participants were 168 patients (116 women and 52 men) diagnosed as overweight or obese who participated in 1 of 20, 12-session, therapy groups for weight management. Group members completed the Outcome Questionnaire-45 (OQ-45, Lambert et al., 2004) pre- and posttreatment and the Group Questionnaire (GQ, Krogel et al., 2013) at early, middle and late group sessions. Early, middle, and late ratings were aggregated because bond scores were consistent across time. Two-level (members within groups), polynomial regressions and response surface analyses were used to examine congruency and discrepancy in ratings of Positive Bonding Relationships to the leader, group members, and group-as-a-whole. When the discrepancy between positive bonding relationships with the leader and positive bonding relationships with the group members increased, and when the discrepancy between positive bonding relationships with the group members and positive bonding relationships with the group-as-a-whole increased, there was less symptom improvement. The findings show that, like interpersonal split alliances, intrapersonal split alliances are harmful for treatment progress and need to be recognized and addressed by the group leader

Dimensioni di personalit\ue0 in soggetti obesi BED e NON-BED.

Introduzione Pochi studi hanno esaminato la presenza di differenti dimensioni di personalit\ue0 in soggetti obesi BED e non-BED (Peterson et al., 2010) e i risultati appaiono ancora poco chiari. Lo studio si propone di: a) confrontare le dimensioni di personalit\ue0 in soggetti obesi BED e non-BED; b) approfondire l\u2019associazione tra stili di personalit\ue0 e comportamenti binge in relazione ad altre variabili sintomatiche. Metodo 143 soggetti adulti obesi non-BED e 60 soggetti obesi BED che hanno richiesto un trattamento presso un sevizio pubblico sui disturbi alimentari, hanno compilato i seguenti strumenti di assessment: MCMI-III (Millon, 1997), BES (Gormally et al, 1982), OQ-45 (Lambert et al., 2004), EDI-2 (Garner, 1984), RSES (Rosenberg, 1965) e IIP-32 (Horowitz et al., 2000). Risultati In entrambi i gruppi non si riscontrano punteggi clinicamente elevati nelle scale di personalit\ue0. Soggetti obesi BED ottengono punteggi significativamente pi\uf9 elevati rispetto al disturbo di personalit\ue0 borderline (p<.05) e su diverse scale sintomatiche. Verranno presentate analisi correlazionali tra le dimensioni di personalit\ue0 e alcune variabili sintomatologiche (e.g. autostima, inadeguatezza, consapevolezza enterocettiva) condotte separatamente nei due gruppi. Conclusioni Lo studio conferma la presenza di differenze significative tra soggetti obesi BED e non-BED