Multisensory mental representation in covid-19 patients and the possibility of long-lasting gustatory and olfactory dysfunction in the CNS

Gustatory (GD) and olfactory (OD) dysfunctions are the most frequent neurological manifestations of COVID-19. We used mental imagery as an experimental psychological paradigm to access olfactory and gustatory brain representations in 80 Italian COVID-19 adult patients (68.75% reported both OD and GD). COVID-19 patients with OD + GD have a significantly and selectively decreased vividness of odor and taste imagery, indicating that COVID-19 has an effect on their chemosensory mental representations. OD + GD length and type influenced the status of mental chemosensory representations. OD + GD were become all COVID-19 negative at the time of testing. Data suggest that patients are not explicitly aware of long-term altered chemosensory processing. However, differences emerge when their chemosensory function is implicitly assessed using self-ratings. Among patients developing OD + GD, self-ratings of chemosensory function (taste, flavor) were significantly lower as compared to those who did not. At the level of mental representation, such differences can be further detected, in terms of a reduced ability to mentally activate an odor or taste mental image. Our study shows that COVID-19 infection not only frequently causes hyposmia and dysgeusia, but that may also alter the mental representations responsible for olfactory and gustatory perception

Stress Hyperglycemia Does Not Affect Clinical Outcome of Diabetic Patients Receiving Intravenous Thrombolysis for Acute Ischemic Stroke

Although stress hyperglycemia represents a main risk factor for poor outcome among patients with acute ischemic stroke (AIS) undergoing recanalization therapy, we have limited information regarding a possible influence of the premorbid diabetic status on this association. We recruited consecutive patients admitted to the Udine University Hospital with AIS who were treated with intravenous thrombolysis (IVT) from January 2015 to September 2020. On the basis of the premorbid diabetic status, our sample was composed of 130 patients with and 371 patients without diabetes. The glucose-to-glycated hemoglobin ratio (GAR) was used to measure stress hyperglycemia. Patients were stratified into 3 groups by tertiles of GAR (Q1–Q3). The higher GAR index was, the more severe stress hyperglycemia was considered. Among diabetic patients we did not observe any significant association between severe stress hyperglycemia and outcome measures (three-month poor outcome: Q1, 53.7%; Q2, 53.5%; Q3, 58.7%; p = 0.854; three-month mortality: Q1, 14.6%; Q2, 9.3%; Q3, 23.9%; p = 0.165; symptomatic intracranial hemorrhage: Q1, 7.3%; Q2, 14%; Q3, 19.6%; p = 0.256). Differently, non-diabetic subjects with more severe stress hyperglycemia showed a higher prevalence of three-month poor outcome (Q1, 32.2%; Q2, 27.7%; Q3, 60.3%; p = 0.001), three-month mortality (Q1, 9.1%; Q2, 8.4%; Q3, 18.3%; p = 0.026), and symptomatic intracranial hemorrhage (Q1, 0.8%; Q2, 0.8%; Q3, 9.9; p = 0.001). After controlling for several confounders, severe stress hyperglycemia remained a significant predictor of three-month poor outcome (OR 2.1, 95% CI 1.03–4.28, p = 0.041), three-month mortality (OR 2.39, 95% CI 1.09–5.26, p = 0.029) and symptomatic intracranial hemorrhage (OR 12.62, 95% CI 1.5–106, p = 0.02) among non-diabetics. In conclusion, premorbid diabetic status seems to influence outcome in AIS patients receiving IVT. Indeed, odds of functional dependency, mortality and hemorrhagic complications were significantly increased in patients with more severe stress hyperglycemia only when they were not affected by diabetes

Recanalisation theraphy for acute ischemic stroke in cancer patients

To date, very few studies focused their attention on efficacy and safety of recanalisation therapy in acute ischemic stroke (AIS) patients with cancer, reporting conflicting results. We retrospectively analysed data from our database of consecutive patients admitted to the Udine University Hospital with AIS that were treated with recanalisation therapy, i.e. intravenous thrombolysis (IVT), mechanical thrombectomy (MT), and bridging therapy, from January 2015 to December 2019. We compared 3-month dependency, 3-month mortality, and symptomatic intracranial haemorrhage (SICH) occurrence of patients with active cancer (AC) and remote cancer (RC) with that of patients without cancer (WC) undergoing recanalisation therapy for AIS. Patients were followed up for 3\ua0months. Among the 613 AIS patients included in the study, 79 patients (12.9%) had either AC (n = 46; 7.5%) or RC (n = 33; 5.4%). Although AC patients, when treated with IVT, had a significantly increased risk of 3-month mortality [odds ratio (OR) 6.97, 95% confidence interval (CI) 2.42\u201320.07, p = 0.001] than WC patients, stroke-related deaths did not differ between AC and WC patients (30% vs. 28.8%, p = 0.939). There were no significant differences between AC and WC patients, when treated with MT \ub1 IVT, regarding 3-month dependency, 3-month mortality and SICH. Functional independence, mortality, and SICH were similar between RC and WC patients. In conclusion, recanalisation therapy might be used in AIS patients with nonmetastatic AC and with RC. Further studies are needed to explore the outcome of AIS patients with metastatic cancer undergoing recanalisation therapy

To Fear is to Gain? The Role of Fear Recognition in Risky Decision Making in TBI Patients and Healthy Controls

Fear is an important emotional reaction that guides decision making in situations of ambiguity or uncertainty. Both recognition of facial expressions of fear and decision making ability can be impaired after traumatic brain injury (TBI), in particular when the frontal lobe is damaged. So far, it has not been investigated how recognition of fear influences risk behavior in healthy subjects and TBI patients. The ability to recognize fear is thought to be related to the ability to experience fear and to use it as a warning signal to guide decision making. We hypothesized that a better ability to recognize fear would be related to a better regulation of risk behavior, with healthy controls outperforming TBI patients. To investigate this, 59 healthy subjects and 49 TBI patients were assessed with a test for emotion recognition (Facial Expression of Emotion: Stimuli and Tests) and a gambling task (Iowa Gambling Task (IGT)). The results showed that, regardless of post traumatic amnesia duration or the presence of frontal lesions, patients were more impaired than healthy controls on both fear recognition and decision making. In both groups, a significant relationship was found between better fear recognition, the development of an advantageous strategy across the IGT and less risk behavior in the last blocks of the IGT. Educational level moderated this relationship in the final block of the IGT. This study has important clinical implications, indicating that impaired decision making and risk behavior after TBI can be preceded by deficits in the processing of fear

Stress Hyperglycemia in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion Undergoing Mechanical Thrombectomy

Stress hyperglycemia may impair outcomes in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). The glucose-to-glycated hemoglobin ratio (GAR) was used to measure stress hyperglycemia. Data from our database of consecutive patients admitted to the Udine University Hospital with AIS who were treated with MT between January 2015 and December 2020 were retrospectively analyzed. We included 204 patients in the study and stratified them into four groups according to the quartiles of GAR (Q1–Q4). The higher the GAR index, the more severe the stress hyperglycemia was considered. Patients with more severe stress hyperglycemia showed a higher prevalence of 3-month poor outcome (Q1, 53.1%; Q2, 40.4%; Q3, 63.5%; Q4, 82.4%; p = 0.001), 3-month mortality (Q1, 14.3%; Q2, 11.5%; Q3, 15.4%; Q4, 31.4%; p = 0.001), and symptomatic intracranial hemorrhage (Q1, 2%; Q2, 7.7%; Q3, 7.7%; Q4, 25.4%; p = 0.001). After controlling for several confounders, severe stress hyperglycemia remained a significant predictor of 3-month poor outcome (OR 4.52, 95% CI 1.4–14.62, p = 0.012), 3-month mortality (OR 3.55, 95% CI 1.02–12.29, p = 0.046), and symptomatic intracranial hemorrhage (OR 6.89, 95% CI 1.87–25.36, p = 0.004). In summary, stress hyperglycemia, as measured by the GAR index, is associated with a detrimental effect in patients with AIS undergoing MT

Environmental factors associated with stress in mothers of preterm newborns

Aim: In this study the effects of environmental and structural features of two different neonatal intensive care unit (NICU) settings on the time course of psychological distress in mothers of preterm infants were investigated. Methods: Levels of psychological distress in 21 mothers of premature infants hospitalized in the NICU of the Salesi Hospital were compared with levels of psychological distress in 21 mothers of premature infants from the NICU of the Sant\u2019Orsola Hospital at three different times during hospitalization. Results: Data showed that mothers from the NICU of the Salesi Hospital, where there is no presence of any specialized figure and the access for parents to the unit is ruled by time schedules, reported higher levels of psychological distress than mothers from the NICU of the Sant\u2019Orsola Hospital, characterized by the continuous presence and contact with the medical staff, which included physiotherapists and clinical psychologists, and free access to the unit for parents. Moreover, levels of psychological distress increased over time in mothers from the Salesi Hospital while levels of distress decreased or were simply maintained over time in mothers from the Sant\u2019Orsola Hospital

Emotion recognition and expression in young obese partecipants: preliminary study

This study investigated the presence of alexithymic characteristics in obese adolescents and preadolescents, testing the hypothesis of whether they had an impaired ability in emotion recognition and expression. The sample included 30 obese young participants compared to a control group composed of 30 participants with normal weight for their ages. Stimuli were 42 faces representing 7 emotional expressions. Stimuli were shown to participants who were asked to identify the emotion expressed by the face. The Level of Emotional Awareness Scale (LEAS) was adapted for children and administered to participants to evaluate their ability to describe their emotions. Young obese participants had significantly lower scores in the LEAS compared to control participants, but no differences were found in the emotion recognition task. The lack of words to describe emotions could suggest a greater prevalence of alexithymic characteristics in obese participants, but the hypothesis of a general deficit in the processing of emotional experiences was not supported

Transmission of attachment in a DMM perspective

Aim of this research is to investigate the relation between the pattern of mothers attachment and the one of their children at 12 months of age, using the Dynamic-Maturational Method (DMM) criteria for the first time in an Italian sample. It was hypothesized that mothers with secure (or balanced) pattern (B) - more sensitive and protective towards their offspring - should foster a B pattern in their children. On the contrary, insecure mothers - less sensitive, more anxious and more controlling - should promote the development of an insecure pattern in their children. A sample of 40 Italian mothers-child dyads was initially considered and 30 mothers (aged from 19 to 40 years) and their children met criteria for inclusion in the research. A final sample of 26 dyads completed the procedures. All mothers, at the 6th month of delivery, were subjected to the Adult Attachment Interview (AAI), and afterwards to the Strange Situation (SS) when their children were 12 months old. Both procedures were administered and codified in double blind by 2 reliable codifiers following DMM criteria. Results: 23.1% of mothers resulted balanced (B), 15.4% dismissing (A), 42.3% preoccupied (C), 11.5% dismissing/preoccupied (A/C) and 7.7% in course of reorganization (R). 34.6% of children resulted secure (B), 23.1% avoiding (A), 38.5% ambivalent (C) and 3.8% avoiding/ambivalent (A/C). This study confirmed the attachment transmission hypothesis revealing a modest correlation between mother\u2019s and child\u2019s secure attachment (B) (p < .05). However, a reversal pattern is evinced in a significant part of the insecure sample: children of insecure mother show an opposite pattern in respect to their mother (A versus C or C versus A). This \u201creversal trasmission of attachment\u201d is in line with others studies (Hautam\ue4ki el al., 2010a, 2010b; Shah, Fonagy, Strathearn, 2010) and is coherent with DMM theory

Investigation into factors that promote adherence to mammography screening program

The aim of the present research was to investigate the importance of different factors in promoting women's adherence to mammography screening programmes. The research was conducted during a mammography screening programme of the Emilia-Romagna region addressed to all women aged 50-69 years. The programme was designed to maximize women's participation by increasing their knowledge of the benefits of breast screening (invitation letter and information campaign) and by reducing barriers (e.g. free test). The research was conducted on a sample of 200 women who adhered to the programme, 65 of whom never had a mammogram in the past, and on a sample of 95 women who did not adhere to the programme, 42 of whom never had a mammogram and 53 of whom had mammograms privately. A semi-structured interview on demographic variables (e.g. age and marital status), an evaluation of mastery and self-esteem and an evaluation of the influence of the different information channels used during the information campaign were asked to participants. Significant differences among groups were found as regards to age, marital status and education and as regards to objective and subjective vulnerability to breast cancer. Among the information channels, the invitation letter undersigned by the family physician had the most influence