The patient-physician relationship in the face of oncological disease: A review of literature on the emotional and psychological reactions of patients and physician

The physician-patient relationship is daily destabilized by emotional reactions and psychic defenses that cancer arises in the two partners. Continued scientific and technological progresses which were reached by medicine in recent years, and particularly oncologic clinical discoveries, increased the chance of not only survival but also healing. Nevertheless, cancer diagnosis is still a hard existential text that destabilizes everyday life, all the psychic and relational balance, inevitably causing a psychological and social change not only in the patient who is affected but also into the wide social network around him (family, friends, doctors, healthcare team). The aim of this review is to understand how problems, feelings, emotions, distresses or defense mechanisms could garble the relation and the communication dynamics between physician and patients and then prejudicing the efficacy of oncologic therapeutic compliance. Pubmed and Scopus were searched, using strings related to "cancer", "physician-patient relations", burn-out", "compliance", and "communication", identifying literature published from 2000 to January 2015. Extracted papers were assessed for their relevance (10 of 412 papers initially reviewed). Results indicate that a good and empathetic relationship between physician and patient were related to good therapeutic adherence. In particular, a good physician-patient relation maximizes the impact of clinical therapies and reduces psychophysical implications

The impact of Facebook use on self-reported eating disorders during the COVID-19 lockdown

Background: The social isolation due to the COVID-19-related lockdown has had an impact on social media consumption around the world. This study examines the relationship between fear of COVID-19, Facebook use and disordered eating. Methods: Structural Equation Modeling was used to analyse two-wave survey data (T0: Italian first lockdown; T1: after two months) during the pandemic. Young adults with self-reported dysfunctional eating behaviors (N = 115; 91.3% females; mean age = 28.60 ± 7.31) were recruited to complete an online survey at T0; 66 participants (92.4% females; mean age = 28.85 ± 7.85) completed the survey at T1. They were assessed on Facebook use, dysfunctional eating cognitions, and fear of COVID-19. Results: Participants’ disordered eating cognitions increased during the pandemic. At T0, higher fear of COVID-19 was positively associated to time spent on Facebook, which in turn predicted disordered eating cognitions at T1. Moreover, maladaptive Facebook use mediated the relationship between daily time on Facebook and Shape concerns. Conclusions: The findings of this study suggest an influence of dysfunctional Facebook use in increasing disordered eating cognitions during the pandemic

The psychological impact of COVID-19 on people suffering from dysfunctional eating behaviours: A linguistic analysis of the contents shared in an online community during the lockdown

The coronavirus disease 2019 (COVID-19) spread several months ago from China and it is now a global pandemic. The experience of lockdown has been an undesirable condition for people with mental health problems, including eating disorders. The present study has the aim of understanding the impact of the first wave of the COVID-19 pandemic on people with selfreported disordered eating behaviours. A linguistic analysis was carried out with regard to the online posts and comments published by 1971 individuals (86% women) in a Facebook online community focusing on EDs during the lockdown. A total of 244 posts and 3603 comments were collected during the 56 days of lockdown (from the 10th of March until the 4th of May 2020) in Italy and were analysed by Linguistic Inquiry and Word Count (LIWC) software. The results showed that words related to peer support decreased in posts over time, and that anxiety and anger increased in the published comments. Moreover, greater feelings of negativity and anxiety were found in posts and comments throughout the COVID-19 pandemic, as well as lesser use of words related to positive emotions. Thematic qualitative analysis revealed eight themes that described the main subjective components of ED symptomatology and distress during the first COVID-19 lockdown. The current findings can help in delivering tailored treatments to people with eating disorders during the COVID-19 pandemic

Gender and the systemic hypertension-snoring association: a questionnaire-based case-control study.

Since the role of gender in the association between hypertension and snoring is unknown, we studied it while accounting for age and body mass index (BMI) as confounding variables. A questionnaire on snoring was administered to 90 hypertensive (HT) subjects (45 men and 45 women) and to 90 normotensive (NT) subjects matched for gender, age and BMI. As expected, snoring was more commonly reported by men than by women, but no significant difference was found between HT and NT men, irrespective of age. Conversely, heavy snoring was more frequently reported by HT than NT women; habitual snoring was more common among young (age50 years) HT than NT women; and heavy snoring was more common among older (age50 years) HT than NT women. These data suggest an effect of gender on the hypertension-snoring association: in men, snoring may be accounted for by age and BMI whether or not hypertension is present, whereas in women the natural history of snoring appears different and more severe in HT than in NT. Although the mechanism(s) responsible for the differences between men and women are obscure at present, gender may be an important variable in the systemic hypertension-snoring association

The Cupuacu (Theobroma Grandiflorum) fruit. High performance liquid chromatographic determination of antioxidant phenolic substances in cupuacu seed powder

A method for the qualitative analysis of antioxidant phenolic substances in cupuacu seed powder by high performance liquid chromatography is described. We have used n-exhane to degrease the cupuacu seed powder and a methanol-water (80:20) solution for the extraction of the analytes. HPLC separation was carried out by using a binary gradient elution utilizing methanol-acetonitrile 1:1 (v/v) and 0.5% (w/v) phosphoric acid. Spectral scans were continuously collected in the range 210-370 nm and the spectrophotometric chromatogram was plotted at 280 nm. Spectrofluorimetric detection was carried out with excitation at 280 nm and emission at 330 nm. Epicatechin and quercetin were identified by comparing the chromatographic behaviour and the UV spectrum of the extracted components with those of pure standards, while the spectrofluorimetric detection, by stopped flow technique, has allowed the identification of catechin and has confirmed the spectrophotometric identification of epicatechin

Serum Anti-Thyroglobulin Autoantibodies Are Specific in Predicting the Presence of Papillary-like Nuclear Features and Lymphocytic Infiltrate in the Thyroid Gland

(1) Background: Previous studies have reported a correlation between serum anti-Thyroglobulin-antibodies (TgAb) and papillary thyroid carcinoma. The aim of our study was to evaluate whether serum TgAb and anti-thyroid-peroxidase antibody (TPO) positivity was also related to pre-neoplastic histological changes such as papillary-like nuclear features (PLNF) and with the presence of lymphocytic infiltrate (LI) in thyroid surgical specimens. (2) Methods: The study was retrospectively carried out on 70 consecutively recruited patients who underwent thyroidectomy for benign process and whose TgAb and TPOAb values were retrieved from clinical records. Histological sections of thyroid surgical samples were revised, looking for PLNF and lymphocytic infiltrate. HBME1 expression was assessed by immunohistochemistry. (3) Results: Our results showed a significant association between TgAb, PLNF, and lymphocytic infiltrate. The presence of TgAb was highly specific, but less sensitive, in predicting the presence of PLNF (sensitivity = 0.6, specificity = 0.9; positive predictive value (PPV) = 0.88; negative predictive value (NPV) = 0.63). TgAb positivity showed a good association with the presence of lymphocytic infiltrate (sensitivity = 0.62, specificity = 0.9; PPV = 0.88 and NPV = 0.68). HBME1 immunoreactivity was observed in the colloid of follicles showing PLNF and/or closely associated with LI. (4) Conclusions: The presence of PLNF and LI is associated with serum TgAb positivity. The presence of TgAb and of LI could be triggered by an altered thyroglobulin contained in the HBME1-positive colloid, and could be a first defense mechanism against PLNF that probably represent early dysplastic changes in thyrocytes

Vitamin K deficiency bleeding leading to a diagnosis of Crohn’s Disease

We report the case of a 45 year old man who came to Emergency Room of Polyclinic for sudden onset of localized ecchymosis and widespread hematomas. He was subjected to blood count and first level investigations to assess coagulation. Based on the results, second level investigations were performed. Endoscopy of the gastrointestinal tract with histological examination revealed a diagnosis of Crohn's disease. Vitamin K deficiency causes the formation of vitamin K-dependent clotting factors that cannot perform their pro-coagulant action. Consequently, patients present with hemorrhagic manifestations. Clinical and laboratory features observed in this patient show that the deficiency of vitamin K-dependent coagulation factors may reveal a complex clinical condition such as an inflammatory bowel disease

Can we increase children’s rights endorsement and knowledge?: A pilot study based on the reference framework of competences for democratic culture

This pilot study is the first to examine whether a novel curriculum based on the Reference Framework of Competences for Democratic Culture (RFCDC) could increase children’s endorsement and knowledge of children’s rights. We conducted a pre-test-post-test design with an intervention and a comparison school. Pupils (n = 172) from Bulgaria, Italy, Norway, Romania, and Spain attended schools in which the curriculum was taught, whereas pupils in the comparison group (n = 120) attended schools in the same city where the curriculum was not taught. Both groups were tested on their endorsement and knowledge of rights before and at the end of the intervention. Children in the intervention group increased in endorsing children’s rights at post-test more than did children in the intervention group. Most children believed that children had rights. Children in the intervention group showed modest increases in their knowledge of rights. Future ways of implementing the RFCDC are suggested.publishedVersio

Improved Bone Regeneration Using Biodegradable Polybutylene Succinate Artificial Scaffold in a Rabbit Model

The treatment of extensive bone loss represents a great challenge for orthopaedic and reconstructive surgery. Most of the time, those treatments consist of multiple-stage surgeries over a prolonged period, pose significant infectious risks and carry the possibility of rejection. In this study, we investigated if the use of a polybutylene succinate (PBS) micro-fibrillar scaffold may improve bone regeneration in these procedures. In an in vivo rabbit model, the healing of two calvarial bone defects was studied. One defect was left to heal spontaneously while the other was treated with a PBS scaffold. Computed tomography (CT) scans, histological and immunohistochemical analyses were performed at 4, 12 and 24 weeks. CT examination showed a significantly larger area of mineralised tissue in the treated defect. Histological examination confirmed a greater presence of active osteoblasts and mineralised tissue in the scaffold-treated defect, with no evidence of inflammatory infiltrates around it. Immunohistochemical analysis was positive for CD56 at the transition point between healthy bone and the fracture zone. This study demonstrates that the use of a PBS microfibrillar scaffold in critical bone defects on a rabbit model is a potentially effective technique to improve bone regeneration