Anxiety and depression in adolescents with asthma and in their parents: A study in clinical practice

Emotional disorders, namely anxiety and depression, frequently affect adolescents with asthma. In addition, their parents also may present emotional problems. The objective of this study was to investigate anxiety and depression in asthmatic adolescents and in their parents in a real-life setting. A series of adolescents with allergic asthma were consecutively enrolled. Asthma was diagnosed according to the GINA document and consistently the symptom control grade was assessed. We used the HADS questionnaire for the adolescents, and HADS, STAY, and BDI questionnaires for their parents. Globally, 121 adolescents (71 males, 50 females, mean age 13.4±0.8 years, age ranging between 12 and 15 years) with allergic asthma and their parents were evaluated. Only 29% of adolescents had controlled asthma. Adolescents with controlled asthma had lower HADS-A and HADS-D scores than other patients, whereas there was no difference among parents. Severe maternal anxiety was more frequent in poorly controlled subjects than in partially controlled ones; absence of maternal anxiety was more common in controlled subjects. The preliminary results of the current study suggest that anxiety and depression are common in adolescents suffering from asthma as well as in their parents, mainly in mothers. Emotional disorders might affect also the asthma control. Thus, in clinical practice, the psychological assessment could be included in the asthma work-up

As perspectivas da pequena produção familiar na agricultura.

As perspectivas da pequena produção familiar na agricultura constitui um tema controvertido na sociologia e na economia rural. A modernização da agricultura alterou suas relações com o restante da economia. As mudanças na base técnica e as políticas agrícolas determinaram a necessidade de crescimento das escalas mínimas viáveis do ponto de vista técnico e econômico, promovendo um processo de seleção e exclusão entre os pequenos produtores rurais, sem no entanto implicar na eliminação da pequena produção familiar

Storia naturale dell’infiammazione allergica

Allergic pathologies are the most common immunologic diseases and their prevalence and severity show a constantly increasing trend in industrialized countries. The present article presents some recent epidemiological data, the natural development of the allergic inflammation and its pathophysiology, focusing on the recent concept of a “minimal persistent inflammation”, with particular regard to its long term treatment with antiallergic drugs. In fact, according to the most recent interpretations, allergy has to be considered as a complex phenomenon, characterized by a inflammatory response to allergenic stimuli. The complicated interrelation between cells, cytokines and affected structures is described. Very often allergic diseases of the upper airways are associated with and complicate asthma, and data that support the benefits of treating these diseases as a whole are presented. Long-term treatment of allergies with antiflogistic/antiallergic molecules is capable of reducing tissutal damage, besides improving the quality of life of the patient and lowering the frequency of acute episodes. The chronic treatment with antiallergic drugs appears to be favorable also from a pharmacoeconomical point of view, as it is associated with a reduction of overall pharmaceutical expenses and of lost working/school days, as well as determining an improved quality of life for the patient and its relatives, particularly in pediatric age. The management of the allergic patient has always to be approached with an integrated multidisciplinary attitude, in which the efforts tend to the identification of all concurrent diseases, because the optimal treatment may be achieved only with the recognition and the resolution of all underlying diseases

The Clinical Relevance of Gastroesophageal Reflux Disease and Laryngopharyngeal Reflux in Clinical Practice

Gastric reflux may be considered a para-physiological event that may occur up to 50 times a day. It usually happens when gas (less commonly liquids) flow back from stomach into esophagus. However, when defense mechanisms leave, disease may progress. If the esophagus is the trigger, gastroesophageal reflux disease (GERD) emerges. The prevalence of GERD in the primary care setting seems to be even more evident when one considers that, in the United States, 4.6 million office encounters annually are primarily for GERD, whereas 9.1 million encounters include GERD in the top 3 diagnoses for the encounter. GERD constitutes also the most frequently first-listed gastrointestinal diagnosis in ambulatory care visits. In addition, the extraesophageal manifestations of reflux, including LPR, asthma, and chronic cough, have been estimated to cost $5438 per patient in direct medical expenses in the first year after presentation and$13,700 for 5 years. Presently, the newest alginate compounds renowned the interest in this attracting and stimulating area. In this regard, a new medical device (Marial®), unique still now possessing the indication for both GERD and LPR, has been recently launched in the Italian market, two large surveys were conducted in Italy: RELIEF, involving 86 otolaryngologists, and EMERGE, involving 56 gastroenterologists. The aims of these surveys were: (1) to define clinical characteristics, including previous treatment, of the patients referred to consultation; (2) to evaluate the reliability of RFS, GIS, and RSI questionnaires in real-world settings, such as specialist office; and (3) to investigate the patients’ perception of efficacy of the prescribed therapy, based on the best practice and considering also the new medical device Comparing the patients’ perception of treatment efficacy, reduction in RSI values for each single symptom before and after a 4 week-treatment with Marial® alone or with PPI in add-on in EMERGE and RELIEF patients are reported. Marial® alone treatment induced a statistically significant higher reduction in each single symptom in RELIEF patients than in EMERGE patients, with the exception of heartburn, chest pain, indigestion, or stomach acid coming up. Similar results were obtained evaluating the reduction in RSI values in patients treated with PPI in add-on that was able to determine a higher statistically significant decrease in RELIEF than in EMERGE patients in each single symptom, with the exception of heartburn, chest pain, indigestion, or stomach acid coming up

Tra drammaturgia e linguistica: analisi di "…tra la Carne e il Cielo" e intervista alla librettista Maddalena Mazzocut-Mis

...tra la Carne e il Cielo is an opera by Azio Corghi set to a libretto by Maddalena Mazzocut-Mis. The inspiration of the opera is the essay Studi sullo stile di Bach by Pier Paolo Pasolini, a critical analysis to Bach’s violin sonatas. Mazzocut-Mis re-uses Pasolini’s words in the libretto, while the music is a variation on Bach’s sonatas by Corghi. The aim of this paper is the analysis of the language of Pasolini and the dramaturgical use of his words in the opera focusing on the passage from essay to libretto....tra la Carne e il Cielo is an opera by Azio Corghi set to a libretto by Maddalena Mazzocut-Mis. The inspiration of the opera is the essay Studi sullo stile di Bach by Pier Paolo Pasolini, a critical analysis to Bach’s violin sonatas. Mazzocut-Mis re-uses Pasolini’s words in the libretto, while the music is a variation on Bach’s sonatas by Corghi. The aim of this paper is the analysis of the language of Pasolini and the dramaturgical use of his words in the opera focusing on the passage from essay to libretto

Relationship between rhinitis duration and worsening of nasal function

While it is well known that asthma is characterized by airway remodeling, few studies instead have investigated this issue in patients with allergic rhinitis (AR)

The relevance of obesity on asthma control in identical twins.

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