Nerve growth factor, brain-derived neurotrophic factor, and the chronobiology of mood: a new insight into the "neurotrophic hypothesis"

The light information pathways and their relationship with the body rhythms have generated a new insight into the neurobiology and the neurobehavioral sciences, as well as into the clinical approaches to human diseases associated with disruption of circadian cycles. Light-based strategies and/or drugs acting on the circadian rhythms have widely been used in psychiatric patients characterized by mood-related disorders, but the timing and dosage use of the various treatments, although based on international guidelines, are mainly dependent on the psychiatric experiences. Further, many efforts have been made to identify biomarkers able to disclose the circadian-related aspect of diseases, and therefore serve as diagnostic, prognostic, and therapeutic tools in clinic to assess the different mood-related symptoms, including pain, fatigue, sleep disturbance, loss of interest or pleasure, appetite, psychomotor changes, and cognitive impairments. Among the endogenous factors suggested to be involved in mood regulation, the neurotrophins, nerve growth factor, and brain-derived neurotrophic factor show anatomical and functional link with the circadian system and mediate some of light-induced effects in brain. In addition, in humans, both nerve growth factor and brain-derived neurotrophic factor have showed a daily rhythm, which correlate with the morningness–eveningness dimensions, and are influenced by light, suggesting their potential role as biomarkers for chronotypes and/or chronotherapy. The evidences of the relationship between the diverse mood-related disorders, with a specific focus on depression, and neurotrophins are reviewed and discussed herein in terms of their circadian significance, and potential translation into clinical practice

Lithium from mood stabilizer to putative cognitive enhancer

This study is the first to have demonstrated, by means of a highly sensitive test of visual memory, a potential hippocampus neuroprotective effect of lithium in patients with BD. Undoubtedly, other studies are needed to finally recognize lithium as a potential cognitive enhancer. Future studies should include, apart from highly sensitive cognitive tests, specific neurotrophic biomarkers, such as BDNF, NGF, etc. Finally, it will be of outmost importance to evaluate the minimal length of treatment and the optimum serum level in order to combine potential clinical benefit and, particularly for older patients, clinical safety

Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder

INTRODUCTION: Although adjustment disorder (AD) is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing) often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD. METHODS: A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry "A. Fiorini" Hospital, Terracina (Latina, Italy), was performed. RESULTS: The sample consisted of 93 patients (46 males and 47 females), aged between 26 and 85, with medium-high educational level who were mainly employed. In most cases (54.80%), a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%), was reported. The main stressors linked to the development of AD were represented by working problems (32.30%), family problems (23.70%), and/or somatic disease (22.60%) with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records. CONCLUSION: Confirming previous data from previous reports, our results suggest that AD may have a distinct profile in demographic and clinical terms. Increased scientific attention is hoped, particularly focused on addressing a better definition of diagnostic criteria, whose correctness and accuracy are critical, especially in situations with medicolegal implications

Condotte compulsive in paziente con sindrome di Aicardi. agenesia del corpo calloso

The corpus callosum, which is the largest white matter structure in the brain of all placental mammals, connects the left and right cerebral hemispheres. An alteration in its morphology, hypoconnectivity or hyperconnectivity is a common marker of various neuropsychiatric pathologies. One of these is Aicardi syndrome, which is characterized by a triad of callosal agenesis, infantile spasms and chorioretinal lacunae. Patients affected by Aicardi syndrome frequently display other malformations together with congenital defects of the eyes, ribs and vertebrae. Based on the current clinical knowledge, this syndrome is now recognized as a complex neurodevelopmental disorder that includes neurological and constitutional symptoms. However, literature data have not yet defined the presence of a particular set of symptoms in psychiatric patients with this condition. The present case is the first report in which an on-going compulsive behaviour focused on the insistence to order objects has been observed in Aicardi syndrom

Trends in peptic ulcer mortality in Italy, 1955-1985

Study objective-The aim was to analyse trends in mortality from peptic ulcer in Italy between 1955 and 1985, disentangling the role of age, cohort of birth, and period of death. Design-This was a descriptive epidemiological survey. Death certification numbers from peptic ulcer and estimates of the resident population were obtained from official sources. From these data, age specific and age standardised mortality rates from peptic ulcer were computed. A log-linear age, period, and cohort model with arbitrary constraints on the parameters was applied to the matrices of age specific rates between 25 and 74 years of age. Setting-This was a national survey. Main results-For males, overall peptic ulcer mortality was constant or moderately upwards (from 9.0 to 9.4/100 000, on the basis of World Standard Population) from 1955 to the mid-1970s, but declined considerably afterwards to 3.7/100 000 in 1985. Truncated (35-64 years) rates were slightly more favourable, even in earlier calendar periods, but a substantial drop was observed only from the late 1970s onwards. In 1985 the standardised rate was 3.3/100 000 compared to 18.3 in 1955-1959. For females, the time pattern was similar, although the extent of the decline was smaller in absolute terms (from 1.6 to 1.2/100 000, all ages; from 2.3 to 0.7, truncated). Age specific rates showed an earlier decline in the young, while the fall started only after the mid-1970s in older age groups. On the basis of a log-linear age, period, and cohort model, the Italian generations born in the first decade of this century had the highest risk of dying from peptic ulcer, with a substantial decline for each subsequent cohort. Period trends were stable between 1955 and the mid-1970s, but declined appreciably afterwards. Conclusions-In Italy the peak rate of peptic ulcer mortality was observed in the early 1970s, with a delay of around two decades in comparison with northern Europe and the USA. This can be related to the later process of industrialisation in Italy, with the consequent changes in lifestyle habits, and to a later pattern of rise and decline of cigarette smoking. A likely explanation of the falls in mortality on a period of death basis over the last decade is the introduction of new drugs (histamine-2 receptor antagonists) for the treatment of peptic ulcer, with a reduction of complications of the disease and related mortality. This decline in mortality from peptic ulcer corresponds to the avoidance of over 1500 deaths per year in the whole of Italy

New Magnetic Anomaly Map of the Antarctic

The second generation Antarctic magnetic anomaly compilation for the region south of 60 degrees S includes some 3.5 million line-km of aeromagnetic and marine magnetic data that more than doubles the initial map's near-surface database. For the new compilation, the magnetic data sets were corrected for the International Geomagnetic Reference Field, diurnal effects, and high-frequency errors and leveled, gridded, and stitched together. The new magnetic data further constrain the crustal architecture and geological evolution of the Antarctic Peninsula and the West Antarctic Rift System in West Antarctica, as well as Dronning Maud Land, the Gamburtsev Subglacial Mountains, the Prince Charles Mountains, Princess Elizabeth Land, and Wilkes Land in East Antarctica and the circumjacent oceanic margins. Overall, the magnetic anomaly compilation helps unify disparate regional geologic and geophysical studies by providing new constraints on major tectonic and magmatic processes that affected the Antarctic from Precambrian to Cenozoic times.Korea Polar Research Institute (KOPRI) programs, PM15040 and PE17050Germany's AWI/Helmholtz Center for Polar and Marine ResearchFederal Institute for Geosciences and Natural ResourcesBritish Antarctic Survey/Natural Environmental Research CouncilItalian Antarctic Research ProgrammeRussian Ministry of Natural ResourcesU.S. National Science Foundation and National Space and Aeronautics AdministrationAustralian Antarctic Division and Antarctic Climate & Ecosystem Cooperative Research CentreFrench Polar InstituteGlobal geomagnetic observatories network (INTERMAGNET

High resolution boundary conditions of an old ice target near Dome C, Antarctica

A high resolution (1 km line spacing) aerogeophysical survey was conducted over a region near the East Antarctic Ice Sheet's Dome C that may hold a 1.5 million year old climate record. New ice thickness data derived from an airborne coherent radar sounder was combined with unpublished data that was unavailable for earlier compilations. We find under the primary candidate region elevated rough topography, near a number of subglacial lakes, but also regions of smoother bed. The high resolution of this ice thickness dataset also allows us to explore the nature of ice thickness uncertainties in the context of radar geometry and processing

Chronic constipation diagnosis and treatment evaluation: The "CHRO.CO.DI.T.E." study

Background: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. Methods: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires. In addition, gastroenterologists were also asked to record whether the patients were clinically assessed for CC for the first time or were in follow up. Diagnostic tests and prescribed therapies were also recorded. Results: Eight hundred seventy-eight consecutive CC patients (706 F) were enrolled (FC 62.5%, IBS-C 31.3%, NRC 6.2%). PAC-SYM and PAC-QoL scores were higher in IBS-C than in FC and NRC. 49.5% were at their first gastroenterological evaluation for CC. In 48.5% CC duration was longer than 10 years. A specialist consultation was requested in 31.6%, more frequently in IBS-C than in NRC. Digital rectal examination was performed in only 56.4%. Diagnostic tests were prescribed to 80.0%. Faecal calprotectin, thyroid tests, celiac serology, breath tests were more frequently suggested in IBS-C and anorectal manometry in FC. More than 90% had at least one treatment suggested on chronic constipation, most frequently dietary changes, macrogol and fibers. Antispasmodics and psychotherapy were more frequently prescribed in IBS-C, prucalopride and pelvic floor rehabilitation in FC. Conclusions: Patients with IBS-C reported more severe symptoms and worse quality of life than FC and NRC. Digital rectal examination was often not performed but at least one diagnostic test was prescribed to most patients. Colonoscopy and blood tests were the "first line" diagnostic tools. Macrogol was the most prescribed laxative, and prucalopride and pelvic floor rehabilitation represented a "second line" approach. Diagnostic tests and prescribed therapies increased by increasing CC severity

Heterogeneous melting near the Thwaites Glacier grounding line

Thwaites Glacier represents 15% of the ice discharge from the West Antarctic Ice Sheet and influences a wider catchment. Because it is grounded below sea level, Thwaites Glacier is thought to be susceptible to runaway retreat triggered at the grounding line (GL) at which the glacier reaches the ocean. Recent ice-flow acceleration2,8 and retreat of the ice front and GL indicate that ice loss will continue. The relative impacts of mechanisms underlying recent retreat are however uncertain. Here we show sustained GL retreat from at least 2011 to 2020 and resolve mechanisms of ice-shelf melt at the submetre scale. Our conclusions are based on observations of the Thwaites Eastern Ice Shelf (TEIS) from an underwater vehicle, extending from the GL to 3 km oceanward and from the ice–ocean interface to the sea floor. These observations show a rough ice base above a sea floor sloping upward towards the GL and an ocean cavity in which the warmest water exceeds 2 °C above freezing. Data closest to the ice base show that enhanced melting occurs along sloped surfaces that initiate near the GL and evolve into steep-sided terraces. This pronounced melting along steep ice faces, including in crevasses, produces stratification that suppresses melt along flat interfaces. These data imply that slope-dependent melting sculpts the ice base and acts as an important response to ocean warming