Mindful Parenting per madri di bambini con disturbi del comportamento: studio pilota

l Mindful Parenting costituisce una delle applicazioni più recenti della mindfulness, con questo approccio si intende favorire il benessere nella relazione genitore-figlio e aumentare le competenze genitoriali. I percorsi di mindfulness sono noti per potenziare le capacità attentive e di autoregolazione dell’individuo, grazie all’incremento di una maggior consapevolezza che emerge dal prestare attenzione in modo intenzionale e non giudicante al momento presente; ciò potrebbe aiutare i genitori anche a prestare attenzione, in modo consapevole e non giudicante all’interazione con il bambino. Lo scopo di questo studio pilota è di analizzare gli effetti dell’applicazione di un intervento basato sui principi del Mindful Parenting ad un campione di 16 madri di bambini con disordini del comportamento. I risultati mostrano cambiamenti statisticamente significativi nella abilità mindfulness definita di non-reazione ed una diminuzione significativa nella frequenza delle pratiche genitoriali negative. I risultati ottenuti sono incoraggianti e dimostrano che l’approccio bastato sulla mindfulness può essere un valido aiuto anche per madri di bambini con disordini del comportamento

A rapid molecular detection protocol for Chikungunya virus directly performed on Aedes albopictus (tiger mosquito)

In the last few years tiger mosquitoes (Aedes albopictus), quickly and widely spread in Italy, represent ideal vectors for different Arboviruses, particularly Dengue virus (DenV) and Chikungunya virus (ChikV), who are causing millions of patients in the world per year. For ChikV, appeared for the first time in Italy in 2007, a Surveillance Plan was defined in the Marche Region, a neighbour county of the Italian outbreak site. As a support for this surveillance, we decided to create a new multiplex RT-PCR protocol to detect ChikV directly in tiger mosquitoes. All the mosquitoes were collected with BG-Sentinel® traps (Biogents AG, Regensburg, Germany).Total RNA extraction was carried with Helix RNA plus kit (Diatech srl, Jesi, Italy). For retro-transcription and amplification a Mastercycler® ep gradient S thermal cycler (Eppendorf AG, Hamburg, Germany) was used. From the whole RNA extracted from captured mosquitoes, we developed a new end-point multiplex retro transcriptase polymerase chain reaction (RT-PCR), for both the detection and identification of Aedes spp. and ChikV. This RT-PCR protocol is able to detect ChikV directly from adult insects, during alerts or emergencies.The entomological trapping associated with bio-molecular methods represents an effective strategy to detect ChikV directly from vectors. Moreover, after a specific evaluation, this RT-PCR protocol could be applied also for human blood samples in regions with the certain presence of this virus

Prognostic Impact of Sarcopenia’s Occurrence during Radiotherapy in Oropharyngeal Cancer Patients

The current study aims to profile sarcopenic condition (both at baseline and developed during treatment) in oropharyngeal carcinoma (OPC) patients treated with curative radiotherapy (RT) +/− chemotherapy and to evaluate its impact on oncological outcomes and toxicity. A total of 116 patients were included in this retrospective single-center study. Sarcopenia assessment at baseline and at 50 Gy re-evaluation CT was obtained from two different methodologies: (i) the L3-skeletal muscle index (SMI) derived from the contouring of the cross-sectional area (CSA) of the masticatory muscles (CSA-MM); and (ii) the paravertebral and sternocleidomastoid muscles at the level of the third cervical vertebra (CSA-C3). Based on L3-SMI from CSA-MM, developing sarcopenic condition during RT (on-RT sarcopenia) was associated with worse progression-free survival (PFS) (p = 0.03) on multivariable analysis and a trend of correlation with overall survival (OS) was also evident (p = 0.05). According to L3-SMI derived from CSA-C3, on-RT sarcopenia was associated with worse PFS (p = 0.0096) and OS (p = 0.013) on univariate analysis; these associations were not confirmed on multivariable analysis. A significant association was reported between becoming on-RT sarcopenia and low baseline haemoglobin (p = 0.03) and the activation of nutritional counselling (p = 0.02). No significant associations were found between sarcopenia and worse RT toxicity. Our data suggest that the implementation of prompt nutritional support to prevent the onset of sarcopenia during RT could improve oncological outcomes in OPC setting

Prognostic Impact of Sarcopenia’s Occurrence during Radiotherapy in Oropharyngeal Cancer Patients

The current study aims to profile sarcopenic condition (both at baseline and developed during treatment) in oropharyngeal carcinoma (OPC) patients treated with curative radiotherapy (RT) +/− chemotherapy and to evaluate its impact on oncological outcomes and toxicity. A total of 116 patients were included in this retrospective single-center study. Sarcopenia assessment at baseline and at 50 Gy re-evaluation CT was obtained from two different methodologies: (i) the L3-skeletal muscle index (SMI) derived from the contouring of the cross-sectional area (CSA) of the masticatory muscles (CSA-MM); and (ii) the paravertebral and sternocleidomastoid muscles at the level of the third cervical vertebra (CSA-C3). Based on L3-SMI from CSA-MM, developing sarcopenic condition during RT (on-RT sarcopenia) was associated with worse progression-free survival (PFS) (p = 0.03) on multivariable analysis and a trend of correlation with overall survival (OS) was also evident (p = 0.05). According to L3-SMI derived from CSA-C3, on-RT sarcopenia was associated with worse PFS (p = 0.0096) and OS (p = 0.013) on univariate analysis; these associations were not confirmed on multivariable analysis. A significant association was reported between becoming on-RT sarcopenia and low baseline haemoglobin (p = 0.03) and the activation of nutritional counselling (p = 0.02). No significant associations were found between sarcopenia and worse RT toxicity. Our data suggest that the implementation of prompt nutritional support to prevent the onset of sarcopenia during RT could improve oncological outcomes in OPC setting

Life style and interaction with microbiota in prostate cancer patients undergoing radiotherapy: study protocol for a randomized controlled trial

Abstract Background Prostate cancer (PCa) is the second most common cancer in men worldwide. The standard non-surgical approach for localized PCa is radiotherapy (RT), but one of the limitations of high-dose RT is the potential increase in gastrointestinal and genitourinary toxicities. We present the protocol of the Microstyle study, a multicentre randomized two-arm crossover clinical trial. The primary outcome will be assessed at the end of 6-month intervention, by measuring the change in adherence to a healthy lifestyle score. The hypothesis is that modifying lifestyle we change microbiome and improve quality of life and decrease side effects of RT. Methods Study participants will be recruited among men undergoing RT in two Italian centers (Milan and Naples). We foresee to randomize 300 patients in two intervention arms: Intervention Group (IG) and Control Group (CG). Participants allocated to the IG will meet a dietitian and a physiotherapist before RT to receive personalized diet and exercise recommendations, according to their health status, to improve overall lifestyle and reduce side effects (bowel and/or urinary problems). Dietitian and physiotherapist will work together to set individualized goals to reduce or eliminate side effects and pain according to their health status. All participants (IG) will be given a pedometer device (steps counter) in order to monitor and to spur participants to increase physical activity and reduce sedentary behavior. Participants included in the CG will receive baseline general advice and materials available for patients undergoing RT. According to the cross-over design, the CG will cross to the intervention approach after 6-month, to actively enhance compliance towards suggested lifestyle recommendations for all patients. Discussion This trial is innovative in its design because we propose a lifestyle intervention during RT, that includes both dietary and physical activity counselling, as well as monitoring changes in microbiome and serum biomarkers. The promotion of healthy behaviour will be initiated before initiation of standard care, to achieve long lasting effects, controlling side effects, coping with feelings of anxiety and depression and improve efficacy of RT. Trial registration ClincalTrial.gov registration number: NCT05155618 . Retrospectively registered on December 13, 2021. The first patient was enrolled on October 22, 2021

Comparison of diagnostic accuracy between three different rules of interpreting high sensitivity troponin T results

With the introduction of high sensitivity troponin-T (hs-TnT) assay, clinicians face more patients with 'positive' results but without myocardial infarction. Repeated hs-TnT determinations are warranted to improve specificity. The aim of this study was to compare diagnostic accuracy of three different interpretation rules for two hs-TnT results taken 6 h apart. After adjusting for clinical differences, hs-TnT results were recoded according to the three rules. Rule1: hs-TnT >13 ng/L in at least one determination. Rule2: change of >20 % between the two measures. Rule3: change >50 % if baseline hs-TnT 14-53 ng/L and >20 % if baseline >54 ng/L. The sensitivity, specificity and ROC curves were compared. The sensitivity analysis was used to generate post-test probability for any test result. Primary outcome was the evidence of coronary critical stenosis (CCS) on coronary angiography in patients with high-risk chest pain. 183 patients were analyzed (38.3 %) among all patients presenting with chest pain during the study period. CCS was found in 80 (43.7 %) cases. The specificity was 0.62 (0.52-0.71), 0.76 (0.66-0.84) and 0.83 (0.74-0.89) for rules 1, 2 and 3, respectively (P < 0.01). Sensitivity decreased with increasing specificity (P < 0.01). Overall diagnostic accuracy did not differ among the three rules (AUC curves difference P = 0.12). Sensitivity analysis showed a 25 % relative gain in predicting CCS using rule 3 compared to rule 1. Changes between two determinations of hs-TnT 6 h apart effectively improved specificity for CCS presence in high-risk chest pain patients. There was a parallel loss in sensitivity that discouraged any use of such changes as a unique way to interpret the new hs-TnT result