bluuebunny/crossref_metadata_2025 huggingface dataset:
Venous Insufficiency and Foot Dysmorphism: Effectiveness of Visco-Elastic Rehabilitation Systems on Veno-Muscle System of the Foot and of the Calf
Authors: Saggini R. , Bellomo R.G. , Iodice P. , Lessiani G.
Published: January 2017

Chronic venous disease is very common and widespread. Chronic Venous Insufficiency (CVI) is a condition characterized by hypertension of the venous system of the lower limbs which manifests itself through a large range of symptoms. The main cause of (CVI) is hypertension of the venous system of lower limbs, which in most cases is due to reflux for the incontinence of the valvar system of veins. Other causes are related to obstruction of the venous outflow, or at a reduced venous emptying due to inefficiency of the system of the veno-muscular pumps of the calf and of the foot. The purpose of this study was to evaluate if the use of a non-invasive rehabilitative model, which is characterized by two different visco-elastic insoles, is effective both to reduce postural imbalances and to improve the efficiency of the veno-muscular pumps of the foot and of the calf using photoplethysmography in reflected light.

Fifty (50) patients suffering from flatfoot and ped cavus, were studied doing a stabilometric and baropodometric test to evaluate the angle of the foot and the podalic angle. Patients were evaluated by examining vascular examination and venous reography in basal condition, using corrective visco-elastic insoles for the correction of dysmorphisms that we were studying.

An improvement of the angle of the Right and Left axis (p<0.05) and the podalic angle (p<0.001), using the right insole both in the flatfoot and cavus foot, was shown by the podobarographic examination. A not important tendency to improvement was also shown by the use of non-specific insole in both pathologies. The vascular examination showed an improvement of 38% in venous emptying capacity of the foot/calf veno-muscular pump in cavus foot with the specific “B” insole (p<0.002). An important improvement of 24%, using the specific “A” insole (p<0.05), was documented in flatfoot.

The photoplethysmography examination documented a significant improvement of the venous emptying capacity of foot-calf veno-muscular system due to the use of specific insoles for the studied dysmorphism, with an improving tendency even with the use of non-specific insoles. The hemodynamic improvement is correlated with the improvement of the analyzed biomechanical parameters: contact time, lenght of the halfstep, podalic angle and angle of the foot. The partial normalization of biomechanical parameters allows a reorganization of relationships of forces between ground and foot, as well as the improvement of the function of the subtalar joint, causing a partial recovery of the complex physiological mechanism of activation of the veno-muscular pumps of the foot and of the calf.
Spinal Infection Multidisciplinary Management Project (SIMP): From Diagnosis to Treatment Guideline
Authors: Gasbarrini A. , Boriani L. , Nanni C. , Zamparini E. , Rorato G. , Ghermandi R. , Salvadori C. , Allegri V. , Bandiera S. , Barbanti-Brodano G. , Colangeli S. , Corghi A. , Terzi S. , Babbi L. , Amendola L. , Cristini F. , Marinacci G. , Tumietto F. , Ciminari R. , Malaguti M.C. , Rimondi E. , Difiore M. , Bacchin R. , Facchini F. , Frugiuele J. , Morigi A. , Albisinni U , Bonarelli S , Fanti S. , Viale P , Boriani S.
Published: January 2017

Spine infections require a multidisciplinary approach to be treated and solved. A guide line to drive physicians in the deep complexity of such a disease is extremely helpful. SIMP suggests a flow-chart built up on clear concepts such as right and well managed antibiotic therapy, sound stability of the spine, correct and smart use of the standard and functional imaging techniques, such as f18 FDG PET/CT. In 16 months a total of 41 patients have been treated for spondylodiscitis, discitis and vertebral osteomyelitis by our team of physicians and 25 patients have been enrolled in a prospective study whose target is the assessment of the SIMP flow-chart and of every single aspect that characterize it.
An Original Method for the Evaluation of in Vivo Controlled Release of the Ceramic Materials
Authors: Graci C. , Spinelli M.S. , Del Bravo V. , Muratori F. , Piconi C. , Perisano C. , Maccauro G.
Published: January 2017

In recent years, the use of ceramic materials in orthopaedics and dentistry is becoming increasingly popular. However, it is important to know their biological and mechanical properties to optimize their use. The aim of this study is to describe a specific method to assess in vivo the effects of chronic release of ceramic materials implanted, in relation also to the type of material, pellets or powders. This was achieved by implanting ceramic powders and pellets, formed by low cohesion grains, in the patellar tendon of 48 New Zealand adult rabbits (24 with powders and 24 with pellets). The motion of the joint allowed easily and progressively the release of grains, detached from surface of the pellets and released to the joint space. Animals were sacrificed at different intervals (1, 3, 6, 12 months). Retrieved knee joints underwent X-Ray, histological and ultrastructural analysis.
The Manangement of Knee Cartilage Defects with Modified Amic Technique: Preliminary Results
Authors: Panni A. Schiavone , Cerciello S. , Vasso M.
Published: January 2017

Cartilage defects represent a common problem in orthopaedic practice. The knee is frequently involved and the medial femoral condyle is the most common localization. Predisposing factors are: traumas, inflammatory conditions and biomechanics alterations. Several surgical options are available once correct diagnosis is given and accurate patient evaluation has been performed. The aim of our study was to prospectively evaluate functional results of modified autologous matrix induced chondrogenesis (AMIC) technique in a population of patients affected by focal cartilage defects A population of 17 patients was enrolled in this study. 10 patients were male, mean age at the time of surgery was 39 years, right side was involved in 11 cases. All patients were evaluated with accurate physical exam and complete imaging study. At an average FU of 36 months, mean IKDC score and Lysholm score improved from 32 to 82 and from 38 to 74. 13 patients out of 17 (76.5%) were satisfied or extremely satisfied with their functional result. MRI control showed reduction of the defect area and subchondral oedema in 10 cases (58.8%). AMIC technique is a relatively new option in the treatment of full thickness cartilage lesions. It enhances the advantages of microfractures since the Chondrogide membrane protects and stabilizes the blood plug acting as a matrix for new cartilage formation. First reports on AMIC technique, show comparable results to autologous chondrocyte implantation (ACI) with the advantage of a single stage technique and no donor site morbidity. AMIC technique represents a new option in the treatment of full thickness cartilage defect. It is safe and reliable. Our data are in accordance with previously reported series in literature and confirm the good objective and subjective results of this procedure.
Statins and Cardiovascular Risk in Rheumatic Diseases
Authors: Marasini B. , Massarotti M.
Published: January 2017

Chronic inflammatory rheumatic diseases are associated with an increased risk of cardiovascular (CV) atherosclerotic events. The inflammatory state, which is the hallmark of chronic rheumatic diseases, is the important driving force for accelerated atherogenesis. Since the control of traditional risk factors alone is insufficient in reducing the risk, much attention has been directed towards the potential use of statins. Statins, a family of drugs that suppress cholesterol biosynthesis by inhibiting the hydroxymethyl glutaryl coenzyme A reductase, have been shown to significantly reduce CV-related morbidity and mortality. In addition to lower lipid levels, several non-lipid lowering pleiotropic effects, including anti-inflammatory and immunomodulatory activities, make statins potential therapeutic agents in chronic rheumatic diseases. However, lipid metabolism in chronic rheumatic diseases is complex, since inflammatory states can induce alterations in lipid levels and function, so that cholesterol target levels from general guidelines may not be adequate in chronic inflammatory rheumatic diseases. Larger trials are needed to refine the precise benefits and health-utility associated with this therapy.
Altered Immune Responses during Septicaemia in Patients Suffering from Haematological Malignancies
Authors: Kurz K. , Garimorth K. , Joannidis M. , Fuchs D. , Petzer A. , Weiss G.
Published: January 2017

Septicaemia is a frequent complication in patients with haematological malignancies. In this study we analysed markers of inflammation/immune activation (C- reactive protein, interleukin-6, neopterin), tryptophan metabolites and mannose binding lectin (MBL) levels consecutively in 36 septic patients with haematological malignancies (HM) and “non-haematological” diseases [intensive care unit (ICU) patients]. During septicaemia different chronological sequences for inflammation markers CRP, IL-6 and neopterin were seen in HM and ICU patients. Septic ICU-patients presented with significantly increased tryptophan degradation and higher neopterin and CRP levels at baseline, while MBL levels were lower in this group compared to subjects with HM. Concentrations of inflammation markers Were linked to each other and associated with enhanced tryptophan degradation. Patients who died during follow-up of 28 days tended to have lower baseline MBL concentrations than survivors. Septic patients with HM showed an impaired pro-inflammatory immune response compared to patients with non-haematological diseases.
Immunohistochemical Profile of Neurotrophins and MIB-1 in Jugulotympanic Paragangliomas: Prognostic Value and Review of the Literature
Authors: Artico M. , De Vincentiis M. , Ionta B. , Bianchi E. , Bosco S. , Monteleone M. , Fumagalli L. , Magliulo G.
Published: January 2017

Jugulo-tympanic paragangliomas are the most common primary neoplasm of the middle ear, but little is still known about the histological features differentiating the benign and malignant forms. We investigated, with an immunohistochemical procedure, the expression of neurotrophins with their receptors, in fifteen samples of paragangliomas, and MIB-1 in order to consider them as prognostic factors of malignancy. We observed a general positivity for NGF – TrKA – NT4 – TrKC in the cytoplasm, and a strong expression for BDNF in the extracellular space. MIB-1 was moderate in the nucleus of neoplastic cells, weak in the cytoplasm and totally absent in the extracellular space. The comparison between the clinical recurrences and the rate of cytoplasmatic neurotrophins showed strong immunoreactivity in recurrent patients. It should be emphasized that 2 of the 3 recurrences had a wider distribution of the neutrophins, leading to hypothesize the involvement of these substances in the cell proliferation of glomus tumors. Malignant forms of these rare glomus tumors cannot be clearly identified using MIB-1 as a prognostic marker, although we can affirm that neurotrophins and their receptors can be considered as a panel of potential diagnostic markers to monitor the development of such malignancies. Although the small number of patients does not allow definitive conclusions to be made, our findings showed a possible trend towards significance which requires a more powerful study to evaluate this further.
Satisfaction with Allergy Treatments Depends on Symptom Severity but Not on Allergen Specificity in Patients with Allergic Rhinitis
Authors: Ciprandi G. , Incorvaia C. , Scurati S. , Puccinelli P. , Rossi O. , Frati F.
Published: January 2017

Allergic rhinitis is characterized by troublesome symptoms that may be particularly severe. Most of rhinitics are dissatisfied with drug treatments. The dissatisfaction level depends on symptoms severity, but not on the type of causal allergen.
Microrna 143–145 Deficiency Impairs Vascular Function
Authors: Norata G.D. , Pinna C. , Zappella F. , Elia L. , Sala A. , Condorelli G. , Catapano A.L.
Published: January 2017

MicroRNAs are required for vascular smooth muscle growth, differentiation and function. MiR143-145 modulates cytoskeletal dynamics and acquisition of the contractile phenotype by smooth muscle cells. Lack of this miRNA cluster results in decreased blood pressure and reduced vasocontraction. As all these observations point to a key role for miR143-145 in the vasculature, we investigated whether miR143-14S deficiency is associated with impaired vascular tone. Vasocontraction was assessed in isolated aortic rings from miR143-145 KO and wild type animals incubated with increasing concentrations of phenylephrine (10−9M to 10−5M) or KCl 0.3M. In both cases, aortic vessel contraction was dramatically reduced in miR143-145 KO animals compared to controls. Next, aortic rings were pre-contracted with phenylephrine (EC60: 10−7M) and concentration responses for acetylcholine were obtained. A significantly reduced vasodilation was observed in miR143-145 KO animals compared to controls and similar results were obtained when an exogenous donor of nitric oxide (sodium nitroprusside) was used. Endothelial nitric oxide synthase or guanylate cyclase mRNA expression were not different between the animal groups thus suggesting to investigate the effect of other vasodilators. Isoprenaline mediated vasodilation was significantly reduced in miR143-145 KO animals compared to controls in the absence or in the presence of the guanylate cyclase inhibitor ODQ (10−4M), suggesting that also beta adrenergic vasodilation is impaired following miR143-145 deficiency. Finally, the effect of a stable mimetic prostacyclin, namely iloprost, was investigated and again a reduced vasodilation was observed in miR143-145 KO animals. MiR143-145 deficiency is associated not only with altered vasocontraction but also with impaired vasodilation, which probably reflects the impaired VSMC differentiation phenotype reported in miR143-145 KO animals.
Yes-Associated Protein 1 Promotes Adenocarcinoma Growth and Metastasis through Activation of the Receptor Tyrosine Kinase Axl
Authors: Cui Z-L. , Han F-F. , Peng X-H. , Chen X. , Luan C-Y. , Han R-C. , Xu W-G. , Guo X-J.
Published: January 2017

Yes-associated protein 1 (YAP1), a nuclear effector of the Hippo pathway, plays an important role in tumorigenesis and progression of multiple cancers. The present study aimed to investigate the clinical significance of YAP1 and receptor tyrosine kinase Axl expression in human lung adenocarcinomas (LAC). We further explored possible molecular mechanisms mediated by YAP1 in LAC and gastric adenocarcinoma (GAC) cells. Forty-nine cases of human LAC and normal lung tissue (NLT) were collected. The expression of YAP1 and Axl was assessed by immunohistochemical assay through tissue microarray procedure and the clinicopathologic characteristics of all patients were analyzed. Using a loss of function approach, we investigated the effects of small hairpin RNA (shRNA)-mediated knockdown of YAP1 on the expression of Axl, proliferating cell nuclear antigen (PCNA) and matrix metalloproteinase-9 (MMP-9), and the proliferative activities and invasive potential in LAC A549 and GAC SGC-7901 cell lines. As a result, the expression of YAP1 and Axl was found in LAC tissues with higher strong reactivity rate compared to the NLT (87.8% vs.60.8%, p=0.000;77.6% vs 0.0%, P=0.000), but they did not associate with the age, gender, tumor size, TNM staging or lymph node metastases of LAC patients (each p>0.05). Spearman rank correlation analysis showed a positive correlation between YAP1 and Axl expression. Furthermore, knockdown of YAP in vitro markedly down-regulated the expression of Axl, PCNA and MMP-9, and inhibited the proliferation and invasion of LAC and GAC cells. Taken together, YAP1 and Axl are highly expressed in LAC compared to the NLT, and knockdown of YAP1 may inhibit the proliferation and invasion of adenocarcinoma cells through downregulation of the Axl pathway, representing a potential therapeutic target for the treatment of cancer.
The Use of Cortical Heterologous Sheets for Sinus Lift Bone Grafting: A Modification of Tulasne's Technique with 7-Year Follow-up
Authors: Di Stefano D.A. , Cazzaniga A. , Bassi M. Andreasi , Ludovichetti M. , Ammirabile G. , Celletti R.
Published: January 2017

In this article, the authors describe their experience with using cortical deantigenated equine bone sheets in sinus lift grafting procedures performed on 23 patients. The technique employed resembles that described by Tulasne but avoids the need for using harvested calvaria bone and introduces some additional operating variants. The use of heterologous cortical bone sheets effectively managed even large lacerations of the Schneiderian membrane and allowed for immediate stabilization of the heterologous bone granules. Average histomorphometric values for bone cores collected six months after grafting, at the time of implant placement, were: newly formed bone tissue 43.9±4.2%, residual bone substitute 7.4±1.4%, medullary spaces 48.7±4.0%. At seven year follow-up, clinical and radiographic examination indicated that the use of the bone sheets preserved the regenerated bone volume. In conclusion, the use of heterologous cortical bone sheets in association with granular bone graft material enabled long-term stabilization of the graft material and effective management of intra-surgical complications.
Habitual Snoring in Children with Previous Allergic Sensitization
Authors: Zicari A.M. , Occasi F. , Marcelli A. Cesoni , Lollobrigida V. , Celani C. , Indinnimeo L. , Tancredi G. , De Castro G. , Duse M.
Published: January 2017

Previous studies have reported a high prevalence of allergy in children with Habitual Snoring (HS), but the relationship between allergy in the early years of life and the subsequent development of this Sleep Disordered Breathing (SDB) is yet to be elucidated. The purpose of the present study was to determine the role of early, under 36 months of age, allergic sensitization to food (with or without sensitization to airborne allergens) in determining the development of HS 8–10 years after. One hundred and fortyeight children (10–14 years, mean age 12 years) with a history of food allergy were selected. Under the age of 36 months, atopic status was assessed by skin prick test for a panel of airborne and food allergens. Questionnaires filled in by parents were used to collect information on children's snoring and associated symptoms. HS was defined as snoring three or more times per week. At 1–3 years of age 54 (36.5%) children were positive to food allergens alone, and 94 (63.5%) were positive also to airborne allergens. After 8–10 years of life, when patients were aged between 10 and 14 years, habitual snoring was reported in 37 (25%) children. Furthermore, among the 54 children under three years of age sensitized only to food, 8 (14.8%) became HS while of the 94 children sensitized to both food and inhalants allergens 29 (30.9%) developed HS. The difference between those two groups was statistically significant (p=0.04). We reported a significant risk of developing HS in children with early allergic sensitization. Specifically this risk was higher when food allergy was associated with inhalant allergy. The onset of upper airway inflammation due to allergic triggers in subjects under three years of age may be related to the subsequent development of SDB after 8–10 years.
Anti-Hemorrhagic Agents in Oral and Dental Practice: An Update
Authors: Scarano A. , Murmura G. , Di Cerbo A. , Palmieri B. , Pinchi V. , Mavriqi L. , Varvara G.
Published: January 2017

Many oral surgeons in their daily practice have the problem of controlling postoperative bleeding. In surgical, oral and maxillofacial practice, standard anti-hemorrhagic protocols, especially in high risk patients, are obviously required and need to be continuously updated. The purpose of this review is to give a rational insight into the management of bleeding in oral and dental practice through modern drugs and medical devices such as lysine analogues and serine protease inhibitors, desmopressin, fibrin sealants, cyanoacrylates, gelatins, collagen and foams, protein concentrates, recombinant factors, complementary and alternative medicine and other compounds.
Salso-Sulphide Thermal Water in the Prevention of Recurrent Respiratory Infections in Children
Authors: Varricchio A. , Giuliano M. , Capasso M. , Del Gaizo D. , Ascione E. , De Lucia A. , Avvisati F. , Capuano F. , De Rosa G. , Di Mauro F. , Ciprandi G.
Published: January 2017

Recurrent respiratory infections (RRI) represent a social problem for both the pharmaco-economic impact and the burden on the family. Thermal water is popularly well accepted. However, there is no scientific evidence of its preventive activity on recurrent respiratory tract infections (RRI). Therefore, the purpose of this study was to evaluate the effects of Agnano thermal water nasal irrigation on RRI prevention in children. A total of 107 children (70 males, mean age 4.5±1.2 years) with RRI were enrolled in the study. At baseline, children were randomly assigned to the treatment with: A) inhaled crenotherapy with salso-sulphide water or B) isotonic saline (NaCl 0.9%). Inhaled therapy was performed using nasal washing by Rino-jet (ASEMA srl, Milan, Italy) b.i.d. for 12 days. Nasal washing lasted 2 minutes per nostril. Immediately before washing, children inhaled 1 l of water by stream inhalation per 2 minutes. Crenotherapy was capable of significantly reducing: the number of respiratory infections, nasal symptoms, neutrophil and bacteria count, turbinate and adenoidal hypertrophy, presence of biofilm, and blockage of ostiomeatal complex (OCM). In conclusion, this study provides the first evidence that Agnano crenotherapy may be capable of preventing RRI in children as it exerts some positive effects, such as reduction of nasal obstruction, OCM blockage, biofilm, and inflammatory events.
Ink Spot Lentigo: Singular Clinical Features in a Case Series of Patients
Authors: Bottoni U. , Nisticò S. , Amoruso G.F. , Schipani G. , Arcidiacono V. , Scali E. , Tassone P. , Greco M. , Amorosi A.
Published: January 2017

Ink spot lentigo, also known as “reticulated black solar lentigo”, is a melanotic macula commonly described in fair-skinned individuals on sun-exposed areas of the body. Clinically it is a darkly pigmented type of solar lentigo; herein the term “ink spot” lentigo. In contrast to common solar lentigines, ink spot lentigo is reported as a unique lesion. However usually ink spot lentigo appears among several common solar lentigines. We report a series of 5 patients who presented ink spot lentigo with typical dermoscopic pattern but singular clinical features.
Management of Immunosuppression and Antiviral Treatment before and after Heart Transplant for HIV-Associated Dilated Cardiomyopathy
Authors: Durante-Mangoni E. , Maiello C. , Limongelli G. , Sbreglia C. , Pinto D. , Amarelli C. , Pacileo G. , Perrella A. , Agrusta F. , Romano G. , Marra C. , Di Giambenedetto S. , Nappi G. , Utili R.
Published: January 2017

Infection with HIV may lead to the development of cardiomyopathy as improved antiretroviral regimens continue to prolong patient life. However, advanced therapeutic options, such as heart transplant, have until recently been precluded to HIV-positive persons. A favorable long-term outcome has been obtained after kidney or liver transplant in HIV-positive recipients fulfilling strict virological and clinical criteria. We recently reported the first heart transplant in a HIV-infected patient carried out in our center. In this article, we detail the major challenges we faced with the management of antiretroviral and immunosuppressive treatments over the first 3 years post-transplant. The patient had developed dilated cardiomyopathy while on antiretroviral treatment with zidovudine, lamivudine and efavirenz. He was in WHO Stage 1 of HIV infection and had normal CD4+ count and persistently undetectable HIV-RNA. In spite of cardiac resynchronization therapy and maximal drug therapy, the patient progressed to end stage heart failure, requiring heart transplant. He was placed on a standard immune suppressive protocol including cyclosporine A and everolimus. Despite its potential pharmacokinetic interaction with efavirenz, everolimus was chosen to reduce the long-term risk of opportunistic neoplasia. Plasma levels of both drugs were monitored and remained within the target range, although high doses of everolimus were needed. There were no infectious, neoplastic or metabolic complications during a 3-year follow-up. In summary, our experience supports previous data showing that cardiac transplantation should not be denied to carefully selected HIV patients. Careful management of drug interactions and adverse events is mandatory.
Immunomodulatory Effect and Acetylcholine Receptor Binding of a Thymopeptide (Tp4) on Human Peripheral Blood Lymphocytes
Authors: Szelényi Judith , Páldi-Haris Piroska , Hóllan Susan
Published: January 2017

The effect of a synthetic thymopeptide, Tp4 (RGH 0206) on nAChR binding capacity and stimulatory responses of normal human peripheral lymphocytes were studied. The present study is the first to demostrate that Tp4 binds to the nAChR on PBLs and this binding is resulted in rapid modulatory effect on the activation signal and affects also the proliferative response. The inhibitory effect of Tp4 on 125Iα-Btx or 3H-nicotine binding was in correlation with a rapid increase of cGMP-level. Another activation parameter; AChE activity, showing the same concentration dependency, was declined reaching the maximal effect in the same, 6–60 nM, range. After a 72h incubation with suboptimal dose of PHA, both proliferation rate and AChE activity were inhibited. The results are in good agreement with earlier observations on the suppressive nature of nAChR on PBLs and on binding of thymopeptides to nAChR from electric tissue, as well as with the reported inhibiting effect of thymus hormones on IL-2 production. The present data might have relevance to the pathogenesis and diagnostics of myasthenia gravis, because the binding of overproduced thymopeptides to nAChRs in various organs could lead to different effects, i.e. to altered cholinergic transmission at the neuromuscular junctions and to the alteration of lymphocyte functions on PBLs and on thymocytes too.
Murine Inter-Sex Difference in Methylcholanthrene Induced Tumor and its Correlation with NK Activity
Authors: Ghoneum M. , Jackson K. , Salem F. , Gill G.
Published: January 2017

Susceptibility to 3-methylcholanthrene (MC) induced tumor development between adult male and female C3H mice at 3–4 mo. old was examined. Animals that were injected (s.c.) with a tumorigenic dose (150 μg/mouse) of MC demonstrated a significant difference in the latent period of tumor development between both sexes. Female mice were more responsive and developed tumors at 3 wks after treatment, whereas, male mice were less responsive as indicated by the longer latent period (10 wks). In order to correlate these data with activity of natural killer (NK) cells, splenic NK activity was measured by 4 hr 51Cr-release assay. The results showed male mice having higher activity: 27 lytic units (LU) in comparison to female ones (3 LU). This was attributed to a decrease in the lytic effect of female NK cells (11%) compared to male mice (20%), since the binding capacity of effector cells to their targets was similar in both sexes (15%), as indicated by single cell assay. The possible role of an immunosuppressive factor (IF) in the sera of female mice was investigated. NK cells from young females demonstrated 33% suppression in activity post culture with sera from 3–4 mo. old female mice.

In conclusion, this study demonstrates a sex-linked tumor development by MC treatment, and correlates this phenomenon with differences of NK activity between young male and female mice as well as in the age-dependent decline of reactivity. A possible immunosuppressive mechanism may be operative in explaining as to why MC is more effective in tumorigenesis in female mice as opposed to males.
Effect of Indomethacin and Thymostimulin on Natural Killer Activity of Thalassemic Patients and Normal Subjects
Authors: Goicoa Maria Aranzazu , Ballart I.J. , Palacios M. Fernanda , De Miani Susana A. , Estevez Maria E. , Diez R.A. , Sen Luisa
Published: January 2017

To evaluate whether indomethacin (IM) and thymostimulin (TP-1) could revert the alterations of natural killer cytotoxicity (NKC) observed in patients and carriers of Thalassemia Major (TM), 14 TM patients, 10 TM carriers, 16 normal controls, and 4 polytransfused patients were studied. In vitro, IM induced an increase in NKC of normal controls and TM carriers (Δ CI: + 5.98±2.49 and + 9.77±6.82 respectively), but not in TM patients (-0.32±1.45) or other polytransfused recipients. The addition of IM to Concanavalin A (Con A) also resulted in an increase of NKC in normal controls and TM carriers, similar to that induced by each substance separately in normal controls, or by IM alone in TM carriers. Similarly, TP-1 (50 μg/ml) induced increases of NKC in normal subjects (+ 4.66±3.62), but not in TM patients (-1.1±2.43). The impairment in NKC observed in TM and polytransfused patients, and the absence of response to Con A in both, TM patients and carriers, do not seem to be mediated by an excessive production of prostaglandins. The lack of response not only to Con A, but also to TP-1 could indicate a quantitative or qualitative defect in T cells, that affects NKC regulation, or a deficient response of NK cells to modulators produced by T lymphocytes.
Specific Antibodies to Om-89 Can Account for its Clinical Anti-Inflammatory Properties
Authors: Phipps P.A. , Moore A.R. , Gowland G. , Willoughby D.A.
Published: January 2017

The glycoprotein rich extract of E.coli, OM-89, has immunomodulatory properties and is used in the treatment of rheumatoid arthritis. One property ascribed to OM-89 is polyclonal B cell activation, however, less clear is whether administration of the drug results in the appearance of specific B-cell responses. Immunoprecipitation was used to demonstrate that OM-89 reactive antibody compexes could be formed in serum following oral (40mg/kg) or parenteral administration of OM-89. ELISAs were developed to measure OM-89 specific antibody isotypes (IgM, IgG1, IgG2a, IgG2b and IgG2c) in serum from orally dosed rats (4, 40 and 400mg/kg, 3 times a week for 6 weeks). A significant (p<0.05) increase in OM-89 specific IgG2a was observed at a dose of 40mg/kg, a dose shown previously to be efficacious in animal models of inflammation. These animals had significant elevations in IgG2a anti-GroEL (p<0.05) and anti-DnaK (p<0.05), major immunogenic epitopes in the drug. The possibility that these antibodies could be protective against chronic inflammation was investigated by examining the effect of serum transfer from OM-89 sensitised rabbits on granuloma weight in the cotton pellet model of chronic inflammation in rats. Serum from immune animals reduced granuloma weight by 22% (p<0.05) compared to untreated controls and by 33% (p<0.001) compared to controls dosed with the pre-immune serum. These results suggest that the induction of protective/blocking antibodies represents one mechanism in the therapeutic action of OM-89.
Oxatomide in Food Allergies. Comparative Study versus Disodium Chromoglycate
Authors: Gasbarrini G. , Addolorato G. , Castelli E. , Foschi F. G. , Marsigli L. , Capristo E. , Gentiloni N. , Cammarota G. , Gasbarrini A. , Nicora M. , Quercia O. , Stefanini G. F.
Published: January 2017

A randomized, controlled, single blind study was carried out to compare the efficacy and safety of oxatomide and disodium chromoglycate in the treatment of adverse reactions to food.

Twenty-three patients (16F and 7M) with urticaria (16 patients), respiratory (5 patients), intestinal (15 patients) and/or neurological symptoms (3 patients) were treated for 60 days: 14 (9F and 5M; mean ± SD age 36.3 ± 13.8 years) with oxatomide, 60 mg every evening and 9 (7F and 2M; 31.5 ± 15.1 years) with disodium chromoglycate, 500 mg three times a day. Both therapies lasted two months. On admission and after 15,30 and 60 days skin (wheals, itching, vesicular blisters, scratching lesions), respiratory (rhinorrhea, sneezing, coughing, wheezing), intestinal (constipation, diarrhea, bloating, abdominal pain and/or cramps) and neurological (headache, irritability) symptoms were assessed.

Wheals decreased in number and size in both groups (p<0.005). Itching became less severe in the two groups (p<0.05), although the improvement in the oxatomide group was faster. Vesicular blisters, present in one patient in the oxatomide group at baseline, disappeared by days 15 and 30, reappearing in a mild form at the end of the study. The frequency of scratching lesions decreased. Sneezing and wheezing disappeared in both groups. Digestive system symptoms also improved.

Both treatments were effective as regards cutaneous, intestinal and respiratory symptoms, with a significant reduction of itching, wheals and vesicular blisters and the complete relies of intestinal disorders. The drugs were well tolerated.
Female Sexual Disorders: Psychiatric Aspects
Authors: Segraves Robert Taylor
Published: January 2017

Objective:

This manuscript reviews the current information concerning female sexual dysfunction that is relevant to general psychiatric practice.

Method:

Research identified by the key words sexual dysfunction and prevalence, comorbidity, psychiatric drugs, or pharmacotherapy is reviewed.

Results:

Epidemiologic studies indicate that approximately 30% of female subjects between ages 18 and 59 years have sexual complaints of at least 3 months' duration in the past year. A high comorbidity with other psychiatric syndromes exists. Many psychiatric drugs are associated with sexual dysfunction. Drug treatments for female sexual dysfunction are being investigated.

Conclusion:

Knowledge concerning the treatment of female sexual dysfunction is important to the general psychiatric clinician.
Stigma Impact on Moroccan Families of Patients with Schizophrenia
Authors: Kadri Nadia , Manoudi Fatiha , Berrada Soumia , Moussaoui Driss
Published: January 2017

Objectives:

First, to explore whether in Morocco, a non-Western country, family members of patients with schizophrenia suffer from stigma and, if they do, which areas of their lives are most affected; and second, to explore family members' knowledge about the illness and their attitudes toward the patients.

Methods:

The study was conducted among 100 family members accompanying patients with schizophrenia. We used a heteroquestionnaire that inquired about family members' and patients' sociodemographic data, family members' knowledge of the patients' illness, their attitudes and behaviours toward the patient, and their perception of stigma.

Results:

Family members' mean age was 47.44 years, SD 12.83; 69% were women; 38% had no education; and 77% had no professional activity. Most families (76%) reported having no knowledge about the illness. However, the illness was considered to be incurable (39%), severe (37%), chronic (80%), and handicapping (48%) and was believed to be caused by drug use (25%), stressing life events (such as conflict or bereavement; 46%), sorcery (25%), organic disturbance (30%), or heredity (23%). We found that most of the families suffer from stigma and discrimination. A total of 86.7% reported they have hard lives because of the illness, and 72% reported psychological suffering caused by sleep and relationship disturbances and a poor quality of life.

Conclusions:

In this study, we found that Moroccan families of patients with schizophrenia suffer from stigma. We found the same results in European, In North American, and in some Arab and Islam countries. Despite the belief that traditional societies are more supportive of the weak and the sick, stigma is a major burden in addition to that of the illness.
Child Abuse, Psychiatric Disorder, and Running Away in a Community Sample of Women
Authors: Andres-Lemay V Joy , Jamieson Ellen , MacMillan Harriet L
Published: January 2017

Objective:

Studies involving clinical samples of adolescents indicate that running away is a common problem associated with substantial emotional impairment, yet little information is available from community-based samples. This study aimed to investigate runaway behaviour in female adolescents with and without a history of maltreatment in childhood.

Method:

We analyzed data from a province-wide community survey conducted in Ontario ( n = 3760 girls and women, aged 15 to 64 years). Respondents returned a self-completed questionnaire regarding their history of maltreatment as children. Psychiatric disorder was assessed with a revised version of the Composite International Diagnostic Interview.

Results:

Respondents who reported physical abuse only, sexual abuse only, and physical abuse with sexual abuse were 2 to 4 times more likely to report running away from home before age 16 years. Parental psychiatric disorder, respondent psychiatric disorder, respondent age, and income were also significant correlates of running away.

Conclusions:

Understanding the relation between exposure to maltreatment as a child, psychiatric disorder, and running away in women is important for determining ways to prevent a behaviour that puts youth at high risk for a wide range of difficulties.
Neuroactive Steroids in Schizophrenia
Authors: Shulman Yanina , Tibbo Philip G
Published: January 2017

Schizophrenia is a psychiatric disorder with a complicated pathophysiology, involving many biochemical abnormalities in the brain. Because neuroactive steroids (NASs) modulate neurotransmitter systems that are implicated in the pathology of schizophrenia, recent research has focused on examining the role that NASs play in the illness. Although research in this area is relatively new, it appears that NASs may potentially be implicated in the pathophysiology of the illness. This paper reviews the current understanding of NASs, the research literature on NASs in schizophrenia and in animal models of the illness (including the effects of antipsychotic medication on NASs) and on the potential antipsychotic role of NASs themselves and, finally, discusses future directions for this area of schizophrenia research.
Tardive Dyskinesia in the Era of Typical and Atypical Antipsychotics. Part 2: Incidence and Management Strategies in Patients with Schizophrenia
Authors: Margolese Howard C , Chouinard Guy , Kolivakis Theodore T , Beauclair Linda , Miller Robert , Annable Lawrence
Published: January 2017

Objective:

Tardive dyskinesia (TD), the principal adverse effect of long-term conventional antipsychotic treatment, can be debilitating and, in many cases, persistent. We sought to explore the incidence and management of TD in the era of atypical antipsychotics because it remains an important iatrogenic adverse effect.

Methods:

We conducted a review of TD incidence and management literature from January 1, 1965, to January 31, 2004, using the terms tardive dyskinesia, management, therapy, neuroleptics, antipsychotics, clozapine, olanzapine, risperidone, quetiapine, ziprasidone, and aripiprazole. Additional articles were obtained by searching the bibliographies of relevant references. We considered articles that contributed to the current understanding of both the incidence of TD with atypical antipsychotics and management strategies for TD.

Results:

The incidence of TD is significantly lower with atypical, compared with typical, antipsychotics, but cases of de novo TD have been identified. Evidence suggests that atypical antipsychotic therapy ameliorates long-standing TD. This paper outlines management strategies for TD in patients with schizophrenia.

Conclusion:

The literature supports the recommendation that atypical antipsychotics should be the first antipsychotics used in patients who have experienced TD as a result of treatment with conventional antipsychotic agents. The other management strategies discussed may prove useful in certain patients.
Neurobiological Factors Linking Personality Traits and Major Depression
Authors: Foster Jane A , MacQueen Glenda
Published: January 2017

Objective:

To examine the neurobiological basis of personality and depression.

Method:

We examined preclinical and clinical studies related to neuroanatomy, neuroendocrine, molecular, and genetic alterations in depressed patients. We considered whether common neurobiological factors might be shared between personality and depression.

Results:

Preclinical studies provide insights into the neurobiological mechanisms underlying the pathophysiology of depression including neuroendocrine alterations in hypothalamic–pituitary–adrenal (HPA) function, neuroanatomical alterations in key brain regions, and alterations in neurotrophin and serotonergic signalling systems. Clinical studies show similar alterations in depressed patients. Evidence suggests that neuroendocrine alterations in HPA function may contribute to personality traits. Brain regions implicated in depression, including the hippocampus and the anterior cingulate cortex, might play a role in personality. Key molecules implicated in depression have been extensively studied with reference to personality traits, particularly neuroticism. To date, physiological measures (serum and positron emission tomography) provide the strongest evidence implicating brain-derived neurotrophic factor and serotonin in personality, while genetic evidence is less convincing.

Conclusions:

A neurobiological link exists between personality and depression; however, more work is needed to provide an understanding of the nature of this relation and to link this work with clinical studies examining the influence of personality factors on depression.
Stability and Progression of Disordered Gambling: Lessons from Longitudinal Studies
Authors: LaPlante Debi A , Nelson Sarah E , LaBrie Richard A , Shaffer Howard J
Published: January 2017

Objective:

Few studies have explicitly examined the stability (that is, the tendency for individuals to stay at one diagnostic level as opposed to moving to another improved or worsened level) or progression of disordered gambling; however, conventional wisdom holds that disordered gambling is intractable and escalating. The objective of this study was to examine these assumptions.

Method:

We reviewed 5 recent prospective studies of gambling behaviour among nontreatment samples for evidence related to the stability and progression of disordered gambling.

Results:

Our review found no evidence to support the assumption that individuals cannot recover from disordered gambling (that is, the persistence assumption), no evidence to support the assumption that individuals who have more severe gambling problems are less likely to improve than individuals who have less severe gambling problems (that is, the selective-stability assumption), and no evidence to support the assumption that individuals who have some gambling problems are more likely to worsen than individuals who do not have gambling problems (that is, the progression assumption).

Conclusion:

Contrary to professional and conventional wisdom suggesting that gambling problems are always progressive and enduring, this review demonstrates instability and multidirectional courses in disordered gambling.
Residents' Perceived Physician-Manager Educational Needs: A National Survey of Psychiatry Residents
Authors: Sockalingam Sanjeev , Stergiopoulos Vicky , Maggi Julie
Published: January 2017

Objective:

To determine Canadian psychiatry residents' perceived gaps in physician-manager competencies during their residency training.

Methods:

Residents at 16 Canadian psychiatry residency programs were mailed an 11-item questionnaire (a copy is available from the authors) assessing their perceived deficiencies in selected managerial knowledge (GSk) and skill (GSs) areas as determined by gap scores (GS). GSs are defined as the difference between residents' perceived current and desired level of knowledge or skill in selected physician-manager domains. Residents' educational preferences were also elicited in the questionnaire.

Results:

Among the 494 psychiatry residents who were sent the survey, 237 residents (48%) responded. Residents reported the greatest GSk in Program Planning and the greatest GSs in Personal and Professional Self-Care. Predictors of greater total GSks included a lack of previous administrative education during medical school, higher training level, and female sex. Only sex was a significant predictor of total GSss. More than 50% of residents preferred workshops, small groups, mentoring, and didactic learning methods for furthering their knowledge and skills.

Conclusion:

Residents report significant gaps in specific physician-manager training areas, specifically Program Planning, and Personal and Professional Self-Care. The results of this national survey can inform the development of formal physician-manager curricula. To appeal to residents, such curricula should incorporate more interactive pedagogical methods combined with mentoring opportunities.
The Beck Cognitive Insight Scale in Outpatients with Psychotic Disorders: Further Evidence from a French-Speaking Sample
Authors: Favrod Jérôme , Zimmermann Grégoire , Raffard Stéphane , Pomini Valentino , Khazaal Yasser
Published: January 2017

Objective:

The Beck Cognitive Insight Scale (BCIS) evaluates patients' self-report of their ability to detect and correct misinterpretation. Our study aims to confirm the factor structure and the convergent validity of the original scale in a French-speaking environment.

Method:

Outpatients ( n = 158) suffering from schizophrenia or schizoaffective disorders fulfilled the BCIS. The 51 patients in Montpellier were equally assessed with the Positive and Negative Syndrome Scale (PANSS) by a psychiatrist who was blind of the BCIS scores.

Results:

The fit indices of the confirmatory factor analysis validated the 2-factor solution reported by the developers of the scale with inpatients, and in another study with middle-aged and older outpatients. The BCIS composite index was significantly negatively correlated with the clinical insight item of the PANSS.

Conclusions:

The French translation of the BCIS appears to have acceptable psychometric proprieties and gives additional support to the scale, as well as cross-cultural validity for its use with outpatients suffering from schizophrenia or schizoaffective disorders. The correlation between clinical and composite index of cognitive insight underlines the multidimensional nature of clinical insight. Cognitive insight does not recover clinical insight but is a potential target for developing psychological treatments that will improve clinical insight.
Basal Thyrotropin and Major Depression: Relation to Clinical Variables and Treatment Outcome
Authors: Joffe Russell T , Levitt Anthony J
Published: January 2017

Objective:

There is a current argument in thyroidology about whether the normal range for basal thyrotropin (TSH) is too broad. Some groups suggest that a TSH of less than 2.5 mIU/L is a better cut-off for euthyroidism. Because major depression is associated with changes in thyroid hormone status and thyroid hormones may be an effective treatment for major depression, we examined whether TSH levels above or below 2.5 mIU/L were related to clinical variables or treatment outcome in euthyroid patients with major depression.

Methods:

Outpatients with major depression ( n =166) were assigned to high–normal and low–normal TSH groups based on their basal TSH levels. The 2 groups were compared along clinical variables and treatment outcome.

Results:

The low–normal TSH group was significantly more depressed, as measured by Hamilton Depression Rating Scale scores, and had more anxiety symptoms and suicidal tendencies than the high–normal group. There was no difference in treatment response between the groups.

Conclusions:

A comparison of low–normal and high–normal basal TSH groups with major depression revealed significant differences in severity and symptoms of depression but no difference in treatment outcome. These data are preliminary and require replication in a larger sample.