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Background: Psychotic-like anomalous self-experiences (ASEs) are core and early features of schizophrenia spectrum disorders, which have been recently also postulated to underlie embodiment disturbance in feeding and eating disorders (FEDs). The present study was aimed at investigating the interplay between ASEs and specific psychopathology in FED., Methods: Ninety persons with Anorexia Nervosa and 41 with Bulimia Nervosa were evaluated with the inventory of psychotic-like anomalous self-experiences (IPASE), identity and eating disorders (IDEA), body uneasiness test (BUT), and eating disorder examination questionnaire (EDE-Q). The same assessment was performed for 92 subjects recruited from the general population. Structural equation modelling was employed to test the role of embodiment/identity disorders in mediating the relationship between ASEs and ED psychopathology., Results: Patients with FED displayed high scores on IPASE, comparable with people with schizophrenia spectrum disorders. A significant correlation was also demonstrated between IPASE, BUT and EDE-Q. All IPASE domains were strongly related to feeling extraneous from one's own body by IDEA. All IPASE domains demonstrated a high relationship with BUT Depersonalization scale. A strong correlation was also reported between total scores of IPASE and IDEA. The mediation model confirmed that ASEs impact on FED symptomatology through the mediation of both embodiment/identity disorders and body image., Discussion: Anomalous interoceptive processes may represent the first step of a maladaptive process-impairing embodiment, selfhood, and identity in FED. Assessment of ASEs might be a valid tool to identify an early-shared vulnerability of severe disorders characterized by embodiment alterations., (© 2024 John Wiley & Sons Australia, Ltd.)

Purpose: There is increasing evidence that photobiomodulation (PBM) therapy is both an effective and safe approach in hematopoietic stem cell transplantation (HSCT) for both prevention and management of oral mucositis (OM), but its use in clinical practice is still limited and the timing of application is under discussion. The aim of this retrospective study was to evaluate possible differences between patients treated either with preventive or curative PBM therapy., Methods: The retrospective case series included 24 patients suffering from multiple myeloma who underwent the same conditioning and transplantation protocol. Patients were treated either with preventive PBM starting from the first day of conditioning up to two days post-HSCT or with curative PBM (starting at OM onset for four consecutive days). OM score, pain, and functional parameters were recorded., Results: All patients developed OM. Preventive PBM was significantly more effective in reducing OM severity (p < 0.0001) and pain (p < 0.0001) post-HSCT than curative PBM. Furthermore, we found a lower number of patients reporting discomfort in all subjective parameters (pain during swallowing, chewing, and speaking) in the preventive PBM group. No adverse events related to PBM therapy were recorded in both groups., Conclusion: The timing for PBM therapy in patients undergoing HSCT is crucial: when started on the first day of conditioning, it significantly reduces both pain and OM severity, providing an important benefit also in subjective oral functions such as speaking, swallowing, and chewing, thus increasing the overall adherence to the oncological therapies., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Dis-sociality (DS) reflects the impairment of social experience in people with schizophrenia; it encompasses both negative features (disorder of attunement, inability to grasp the meaning of social contexts, the vanishing of social shared knowledge) and positive features (a peculiar set of values, ruminations not oriented to reality), reflecting the existential arrangement of people with schizophrenia. DS is grounded on the notion of schizophrenic autism as depicted by continental psychopathology. A rating scale has been developed, providing an experiential phenotype. Here we present the Autism Rating Scale for Schizophrenia - Revised English version (ARSS-Rev), developed on the Italian version of the scale. The scale is provided by a structured interview to facilitate the assessment of the phenomena investigated here. ARSS-Rev is composed of 16 distinctive items grouped into 6 categories: hypo-attunement, invasiveness, emotional flooding, algorithmic conception of sociality, antithetical attitude toward sociality, and idionomia. For each item and category, an accurate description is provided. Different intensities of phenomena are assessed through a Likert scale by rating each item according to its quantitative features (frequency, intensity, impairment, and need for coping). The ARSS-Rev has been able to discriminate patients with remitted schizophrenia from euthymic patients with psychotic bipolar disorder. This instrument may be useful in clinical/research settings to demarcate the boundaries of schizophrenia spectrum disorders from affective psychoses., (© 2023 S. Karger AG, Basel.)

Background: Several studies report the useful therapeutic results of regional hyperthermia in association with chemotherapy (CHT) and radiotherapy for the treatment of pancreatic cancer. Modulated electro-hyperthermia (mEHT) is a new hyperthermia technique that induces immunogenic death or apoptosis of pancreatic cancer cells in laboratory experiments and increases tumor response rate and survival in pancreatic cancer patients, offering beneficial therapeutic effects against this severe type of cancer., Aim: To assess survival, tumor response and toxicity of mEHT alone or combined with CHT compared with CHT for the treatment of locally advanced or metastatic pancreatic cancer., Methods: This was a retrospective data collection on patients affected by locally advanced or metastatic pancreatic cancer (stage III and IV) performed in 9 Italian centers, members of International Clinical Hyperthermia Society-Italian Network. This study included 217 patients, 128 (59%) of them were treated with CHT (no-mEHT) and 89 (41%) patients received mEHT alone or in association with CHT. mEHT treatments were performed applying a power of 60-150 watts for 40-90 min, simultaneously or within 72 h of administration of CHT., Results: Median patients' age was 67 years (range 31-92 years). mEHT group had a median overall survival greater than non-mEHT group (20 mo, range 1.6-24, vs 9 mo, range 0.4-56.25, P < 0.001). mEHT group showed a higher number of partial responses (45% vs 24%, P = 0.0018) and a lower number of progressions (4% vs 31%, P < 0.001) than the no-mEHT group, at the three months follow-up. Adverse events were observed as mild skin burns in 2.6% of mEHT sessions., Conclusion: mEHT seems safe and has beneficial effects on survival and tumor response of stage III-IV pancreatic tumor treatment. Further randomized studies are warranted to confirm or not these results., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

The epidermal growth factor receptor (EGFR) signaling pathway is one of the main pathways responsible for propagating the luteinizing hormone (LH) signal throughout the cumulus cells and the oocyte. Recently, we have proposed the C-C motif chemokine receptor 2 (CCR2) and its main ligand (monocyte chemoattractant protein-1, MCP1) as novel mediators of the ovulatory cascade. Our previous results demonstrate that the gonadotropins (GNT), amphiregulin (AREG), and prostaglandin E2 (PGE2) stimulation of periovulatory gene mRNA levels occurs, at least in part, through the CCR2/MCP1 pathway, proposing the CCR2 receptor as a novel mediator of the ovulatory cascade in a feline model. For that purpose, feline cumulus-oocyte complexes (COCs) were cultured in the presence or absence of an EGFR inhibitor, recombinant chemokine MCP1, and gonadotropins [as an inducer of cumulus-oocyte expansion (C-OE), and oocyte maturation] to further assess the mRNA expression of periovulatory key genes, C-OE, oocyte nuclear maturation, and steroid hormone production. We observed that MCP1 was able to revert the inhibition of AREG mRNA expression by an EGFR inhibitor within the feline COC. In accordance, the confocal analysis showed that the GNT-stimulated hyaluronic acid (HA) synthesis, blocked by the EGFR inhibitor, was recovered by the addition of recombinant MCP1 in the C-OE culture media. Also, MCP1 was able to revert the inhibition of progesterone (P4) production by EGFR inhibitor in the C-OE culture media. Regarding oocyte nuclear maturation, recombinant MCP1 could also revert the inhibition triggered by the EGFR inhibitor, leading to a recovery in the percentage of metaphase II (MII)-stage oocytes. In conclusion, our results confirm the chemokine receptor CCR2 as a novel intermediate in the ovulatory cascade and demonstrate that the EGFR/AREG and the CCR2/MCP1 signaling pathways play critical roles in regulating feline C-OE and oocyte nuclear maturation, with CCR2/MCP1 signaling pathway being downstream EGFR/AREG pathway within the ovulatory cascade., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Conte, Tellechea, Park, Ballerini, Jaita and Peluffo.)

messenger RNA (mRNA)-Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccines such as BNT162b2 became available in late 2020, but hematological malignancy patients (HM pts) were not evaluated in initial registration trials. We hereby report the results of a prospective, unicentric, observational study Response to COVID-19 Vaccination in hEmatological malignancies (CERVAX) developed to assess the postvaccine serological and T-cell-mediated response in a cohort of SARS-CoV2-negative HM pts vaccinated with BNT162b2. Patients with lymphomas [non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL)], chronic lymphocytic leukemia (CLL), and multiple myeloma (MM); off-therapy for at least 3 months; in a watch-and-wait program; or in treatment with ibrutinib, venetoclax, and lenalidomide were included. Different time points were considered to assess the serological response to the vaccine: before the second dose (T1), at 3-6-12 months after the first dose (T2-3-4, respectively). Since March 2021, 39 pts have been enrolled: 15 (38%) NHL, 12 (31%) CLL, and 12 (31%) MM. There were 13 of the 39 pts (33%) seroconverted at T1; an increase of the serological response was registered after the second dose (T2) (22/39 pts, 56%) and maintained after 6 months (22/39 pts, 56%) and 12 months (24/39 pts, 61%) from the first dose (T3-T4, respectively). Non-serological responders at T4 were 7/39 (18%): 0/15 NHL, 1/12 MM (8%), and 6/12 CLL (50%). All of them were on therapy (one lenalidomide, three ibrutinib, and three venetoclax). SARS-CoV2-reactive T-cell analysis (interferon gamma release assays) was available since June 2022 and was evaluated at 12 months (T4) from the first dose of vaccine in 31/39 pts (79%). T-cell-mediated-responders were 17/31 (55%): most of them were NHL and MM (47%, 41% and 12% for NHL, MM, and CLL, respectively). Both serological and T-cell non-responders were represented by pts on active therapy (venetoclax/ibrutinib). During the period of observation, eight (20.5%) pts developed mild SARS-CoV2 infection; no coronavirus disease 19 (COVID-19)-related deaths or hospitalizations were registered. In conclusion, in our cohort of lymphoproliferative pts receiving BNT162b2, CLL diagnosis and venetoclax/ibrutinib seem to be related with a lower humoral or T-mediated response. Nevertheless, the efficacy of mRNA vaccine in HM pts and the importance to continue the vaccine program even in non-responders after the first dose are supported in our study by demonstrating that a humoral and T-cell-mediated seroconversion should be observed even in the subsets of heavily immunocompromised pts., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mohamed, Lucchini, Sirianni, Porrazzo, Ballotta, Ballerini, De Sabbata, De Bellis, Cappuccio, Granzotto, Toffoletto, Fortunati, Russignan, Florea, Torelli and Zaja.)

CD8 + T cells are a major prognostic determinant in solid tumors, including colorectal cancer (CRC). However, understanding how the interplay between different immune cells impacts on clinical outcome is still in its infancy. Here, we describe that the interaction of tumor infiltrating neutrophils expressing high levels of CD15 with CD8 + T effector memory cells (T EM ) correlates with tumor progression. Mechanistically, stromal cell-derived factor-1 (CXCL12/SDF-1) promotes the retention of neutrophils within tumors, increasing the crosstalk with CD8 + T cells. As a consequence of the contact-mediated interaction with neutrophils, CD8 + T cells are skewed to produce high levels of GZMK, which in turn decreases E-cadherin on the intestinal epithelium and favors tumor progression. Overall, our results highlight the emergence of GZMK high CD8 + T EM in non-metastatic CRC tumors as a hallmark driven by the interaction with neutrophils, which could implement current patient stratification and be targeted by novel therapeutics., (© 2022. The Author(s).)

Background: 25-hydroxyvitamin D (VD) effects on lung function and immune-modulation might affect respiratory syncytial virus (RSV) infection outcomes. We aimed to assess VD levels on admission and their association with life-threatening RSV disease (LTD)., Methods: A prospective cohort study was conducted during 2017-2019. Previously healthy infants aged <12 months, hospitalized with a first episode of RSV infection, were enrolled. LTD was defined by need for intensive care and ventilatory support. Serum VD levels <20 ng/mL were categorized as deficient, and 20-29.9 ng/mL as insufficient., Results: Of 125 patients studied, 73 (58%) were male. Median age was 4 months. Twenty-two patients developed LTD. No differences in viral load were seen between cases with LTD and controls (P = .94). Patients who developed LTD had significantly lower VD levels: median 18.4 ng/mL (IQR, 15.1-26.9 ng/mL) versus 31.7 ng/mL (IQR, 23.6-42.0 ng/mL), P < .001; 59% of infants with LTD had VD deficiency compared with 12% in those with better outcome. Multivariable regression analysis confirmed VD deficiency as a risk factor (odds ratio, 11.83; 95% confidence interval, 3.89-35.9; P < .001)., Conclusions: These findings provide additional evidence for the development of strategies to prevent severe RSV infections., Competing Interests: Potential conflicts of interest . All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Objectives: Long COVID is a major public health issue. Whether long COVID is comorbid with psychiatric disorders remains unclear. Here, we investigate the association between long COVID, psychiatric symptoms and psychiatric disorders., Design: Cross-sectional., Settings: Bicêtre Hospital, France, secondary care., Participants: One hundred seventy-seven patients admitted in intensive care unit during acute phase and/or reporting long COVID complaints were assessed 4 months after hospitalisation for an acute COVID., Main Outcome Measures: Eight long COVID complaints were investigated: fatigue, respiratory and cognitive complaints, muscle weakness, pain, headache, paraesthesia and anosmia. The number of complaints, the presence/absence of each COVID-19 complaint as well as lung CT scan abnormalities and objective cognitive impairment) were considered. Self-reported psychiatric symptoms were assessed with questionnaires. Experienced psychiatrists assessed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-based diagnoses of psychiatric disorders., Results: One hundred and fifteen (65%) patients had at least one long COVID complaint. The number of long COVID complaints was associated with psychiatric symptoms. The number of long COVID complaints was higher in patients with psychiatric disorders (mean (m) (SD)=2.47 (1.30), p<0.05), new-onset psychiatric disorders (m (SD)=2.41 (1.32), p<0.05) and significant suicide risk (m (SD)=2.67 (1.32), p<0.05) than in patients without any psychiatric disorder (m (SD)=1.43 (1.48)). Respiratory complaints were associated with a higher risk of psychiatric disorder and new-onset psychiatric disorder, and cognitive complaints were associated with a higher risk of psychiatric disorder., Conclusions: Long COVID is associated with psychiatric disorders, new-onset psychiatric disorders and suicide risk. Psychiatric disorders and suicide risk should be systematically assessed in patients with long COVID., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/disclosure-of-interest/ and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work. NN reported personal fees from MSD and Biogen outside the submitted work. DM reported personal fees from Actelion, GSK, Pfizer, MSD, Chiesi, Boehringer and Incyte Biosciences France, grants from Bayer and MSD and non-financial support from Acceleron outside the submitted work. XM reported personal fees from Getinge Pulsion Medical and Baxter outside the submitted work. No other disclosures were reported. LB reported grants from Sanofi Genzyme for a presentation concerning Gaucher disease, and pharmacogenetics and drug interactions with Eliglustat outside the submitted work., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Denial of pregnancy is a public health problem due to maternal, fetal, and neonatal morbidity, affecting both physical and mental health. It generally involves an absence of the physical signals associated with pregnancy such as abdominal swelling, amenorrhea, weight gain, or even perception of fetal movements. Despite the potential consequences for mother and child, there is still little data on its clinical features and the neurocognitive mechanisms involved. In this paper, we provide an update on the clinical, socio-demographic, and psychopathological characteristics of pregnancy denial based on contemporary scientific literature. We first define denial of pregnancy by referring to the history of the concept, previous definitions, and nosographic classifications. We then detail the clinic of denial by distinguishing the physical and psychological symptoms of this disorder, then the socio-demographic, gynecological, and psychiatric characteristics. We describe the consequences of denial on the mother, infant, and the dyad, referring to situations of cryptic neonaticide. Finally, we show the importance of perinatal neuroscience research on maternal interoception to understand the mechanisms involved in denial of pregnancy, and improve their medical management in clinical practice., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Aim To describe the technique of the four-corner fusion with two retrograde crossed headless screws in cases of carpal collapse. Methods This technique is a consolidated procedure performed in cases of scaphoid non- union advanced collapse (SNAC) type II and III, scapholunate advanced collapse (SLAC) type II and III and in other cases of carpal collapse. Between 2017 and 2019 we treated six male patients (a mean age of 55.0 years) with radiocarpal osteoarthritis. Our technique involves the use of two retrograde crossed headless screws; the first screw was placed distally proximally from the uncinate to the lunate and the second screw from the pyramidal to the capitate, crossed at approximately 90 degrees. Clinical and radiographic two-year follow-up was performed. Before the treatment and during the follow-ups VAS, PRWE and DASH Quick score scales, measured wrist range of motion (WROM) were administered and evaluated. Results In all cases the X-ray consolidation of arthrodesis within five months was noticed; in 50% patients already under 3-month control. No observed signs of mobilization of screws and inflammatory or infectious processes were found. All patients were satisfied (reduction/disappearance of pain). All surgically treated patients resumed normal daily activities. These improvements were confirmed by the results of the evaluation scale and clinical examination. Conclusion This technique, in our opinion, represents a gold standard. Its low costs of the material used (especially comparing to other technique), a low prevalence of complications of materials and fusion in 100% of cases should be also considered., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)

A relevant number of organ-on-chips is aimed at modeling epithelial/endothelial interfaces between tissue compartments. These barriers help tissue function either by protecting (e.g., endothelial blood-brain barrier) or by orchestrating relevant molecular exchanges (e.g., lung alveolar interface) in human organs. Models of these biological systems are aimed at characterizing the transport of molecules, drugs or drug carriers through these specific barriers. Multilayer microdevices are particularly appealing to this goal and techniques for embedding porous membranes within organ-on-chips are therefore at the basis of the development and use of such systems. Here, we discuss and provide procedures for embedding porous membranes within multilayer organ-on-chips. We present standard techniques involving both custom-made polydimethylsiloxane (PDMS) membranes and commercially available plastic membranes. In addition, we present a novel method for fabricating and bonding PDMS porous membranes by using a cost-effective epoxy resin in place of microfabricated silicon wafers as master molds., (© 2022. Springer Science+Business Media, LLC, part of Springer Nature.)

Apparent comorbidity between Bipolar Disorder (BD) and Obsessive-Compulsive Disorder (OCD) is a common condition, but its meaning has not been clarified yet. The present study aimed to evaluate the pattern of occurrence of obsessive-compulsive symptoms (OCS) in the different phases of BD. One hundred and sixty-five BD patients, 62 (37.5%) euthymic, 34 (20.6%) in hypomanic/manic phase, 43 (26%) in depressive phase and 26 (15.7%) in mixed state, were assessed with the Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Hamilton Depression Rating Scale (HAM-D), the Young Mania Rating Scale (YMRS) and the Ruminative Response Scale (RRS). In the whole sample, the severity of OCS was associated to the severity of depressive symptoms. The highest severity of OCS (YBOCS total score) was observed in the mixed group and the lowest scores in the hypomanic/manic group. Our findings suggest that OCS in BD patients appear as a state-dependent phenomenon cycling with the mood phases, particularly exacerbating in the context of depressive and mixed states., (Copyright © 2021. Published by Elsevier B.V.)

Aim To illustrate the surgical treatment of bilateral post-traumatic scaphoid fracture. Methods We came across a young student, who sustained bilateral, undisplaced scaphoid waist fractures following a fall during a football match. Despite careful clinical and radiographic evaluation by four views at the Accident and Emergency (A&E) Department, we initially performed only the diagnosis of the left scaphoid fracture treating it with a percutaneous Acutrack headless screw. Eight months later this patient returned to the A&E department due to a new trauma to his right wrist with the onset of painful symptoms: cystic scaphoid non-union. No pain had been reported on the wrist in those months. Results We performed osteosynthesis with Herbert headless screw through an extended volar approach placing a non-vascularized cortico-spongious bone grafts taken from radius. Periodic follow up by clinical examination, X-ray and CT scan with evidence of bone healing was performed. Conclusion Bilateral scaphoid fractures are rarely encountered, mostly as stress fractures in athletes and manual workers. If left untreated, arthritis, deformity, and instability can lead to significant disability. Comprehensive imaging should be done in case of suspected scaphoid fractures, especially after a trauma, even in the presence of modest symptoms, as failure to do so may lead to missed fracture. Considering what was exposed, the radiographic check on the right wrist repeated about two weeks after the trauma would have avoided a missed diagnosis, even in the absence of reported clinical symptoms. We therefore recommend to repeat the radiographic examination in all situations like these., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)

Social dysfunctions (SD) are frequently observed in subjects with schizophrenia. Some of these dysfunctions are also observed in other neuropsychiatric disorders such as autism spectrum disorders (ASD), major depression, bipolar disorder, or Alzheimer disease. Recently, a characterization of a specific type of SD in schizophrenia has been proposed, with the concept of dis-sociality, which form the core aspect of "Schizophrenic Autism" (SA). The present study aimed to explore the presence in people with schizophrenia of SA, independent of other autistic traits, which can be often found in schizophrenia and other neurodevelopmental disorders. We used a structured interview-the Autism Rating Scale (ARS), an instrument devised to detect and measure SA. Fifty-one outpatients affected by schizophrenia (26 remitted, SCZ-r) and 28 affected by bipolar disorder type 1, with psychotic features, in the euthymic phase (BD-e) were recruited. Before assessing the specificity for schizophrenia of SA, we tested the internal consistency, the convergent and divergent validity of the ARS in the schizophrenia sample. Specificity was assessed by examining potential differences in ARS scores between SCZ-r and BD-e subjects. ARS showed good internal consistency, as well as convergent and divergent validity. ARS items were more frequently of moderate severity in SCZ-r than in BD-e subjects. This scale can contribute to establish more precise phenomenal boundaries between schizophrenia and bipolar disorder, and opens up the possibility of identifying a different type of SD in schizophrenia, independent of autistic traits and negative symptoms, which might benefit from different treatments., Competing Interests: AM has been a consultant and/or advisor to or has received honoraria from Gedeon Richter Bulgaria, Janssen Pharmaceuticals, Lundbeck, Otsuka, Pfizer and Pierre Fabre; she has a patent applied in the field of treatment of schizophrenia. SG has been a consultant and/or advisor to or has received honoraria from Millennium Pharmaceutical, Innova Pharma - Recordati Group, Janssen Pharmaceutica NV, Gedeon Richter-Recordati, Angelini, Lundbeck Italia and Sunovion Pharmarmaceuticals. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Palumbo, Stanghellini, Mucci, Ballerini, Giordano, Lysaker and Galderisi.)

Background: Depressive disorders, despite being classified as mood or affective disorders, are known to include disturbances in the experience of body, space, time, and intersubjectivity. However, current diagnostic manuals largely ignore these aspects of depressive experience. In this article, we use phenomenological accounts of embodiment as a theoretical foundation for a qualitative study of abnormal body phenomena (ABP) in depressive disorders., Methods: 550 patients affected by schizophrenic and affective disorders were interviewed in a clinical setting. Interviews sought to uncover the qualitative features of experiences through self-descriptions. Clinical files were subsequently digitized and re-examined using consensual qualitative research., Results: Ninety-nine out of 100 patients with MDD reported at least one ABP. From cross-analysis of the MDD sample, we obtained 4 general categories of ABP, 3 of which had additional subcategories. The 4 categories include slowed embodied temporality (N = 90), anomalous vital rhythms (N = 82), worries about one's body (N = 22), and body deformation (N = 47)., Conclusions: The results provide empirical evidence in support of theoretical discussions of embodiment in MDD found in the work of classical and contemporary phenomenologists. The findings also provide nuanced insight into the experience of persons living with MDD. Some categories of ABP, like slowed embodied temporality, can help to finely characterize psychomotor retardation or the so-called "medically unexplained symptoms" (MUS). This fine-tuned characterization can help to connect MUS to neuropsychological and neurobiological (e.g., alterations of interoceptive processes linked to anomalies of the brain resting-state hypothesis) and inflammatory (e.g., studies linking environmental stressors, inflammation mediators, and neurovegetative and affective symptoms) models of MDD. Our results can also support a pathogenic model of MDD, which posits, on the phenomenal level, ABP as the point of departure for the development of secondary symptoms including cognitive elaborations of these, namely, delusions about the body. Moreover, some of the categories, when contrasted with phenomenological qualitative studies of other disorders, provide conceptual resources of differential diagnosis and of identifying a "depressive core syndrome." For example, findings within category 4, deformation of the body, provide resources for using ABP to distinguish between MDD and schizophrenia., (© 2021 S. Karger AG, Basel.)

Background: Patients with schizophrenia display experiential anomalies in their feelings and cognitions arising in the domain of their lived body. These abnormal bodily phenomena (ABP) are not part of diagnostic criteria for schizophrenia. One of the reasons is the difficulty to assess specific ABP for schizophrenia spectrum disorders. The present study aimed to explore the presence in patients with schizophrenia of specific ABP., Methods: We used a semistructured interview-the Abnormal Bodily Phenomena questionnaire (ABPq), an instrument devised to detect and measure ABP specific to patients with schizophrenia. Fifty-one outpatients affected by schizophrenia and 28 euthymic outpatients affected by bipolar disorder type I with psychotic features (BD-pf-e) were recruited. Before assessing the specificity for schizophrenia of the observed ABP, we tested the internal consistency and the convergent validity of the ABPq in patients with schizophrenia. Specificity was assessed by examining potential differences in ABPq among the patients with schizophrenia in remission (SCZ-r) and BD-pf-e., Results: The ABPq shows strong internal consistency and convergent validity. As to the specificity, ABP measured by ABPq were more frequent and severe in SCZ-r than in BD-pf-e. In particular, all ABPq dimensions, except "Coherence," had at least mild severity in over 50% of SCZ-r, while dimensions with at least mild severity were observed in 5-10% of the BD-pf-e., Conclusions: These findings can contribute to establish more precise phenomenal boundaries between schizophrenia and bipolar disorder, to explore the borders between nonpsychotic and psychotic forms of ABP, between ABP and negative and disorganized symptoms, and to enlighten core aspects of schizophrenia.

Abnormal space experience (ASE) is a common feature of schizophrenia, despite its absence from current diagnostic manuals. Phenomenological psychopathologists have investigated this experiential disturbance, but these studies were typically based on anecdotal evidence from limited clinical interactions. To better understand the nature of ASE in schizophrenia and attempt to validate previous phenomenological accounts, we conducted a qualitative study of 301 people with schizophrenia. Clinical files were analyzed by means of Consensual Qualitative Research, an inductive method for analyzing descriptions of lived experience. Our main findings can be summed up as follows: (1) ASEs are a relevant feature in schizophrenia (70.1% of patients reported at least 1 ASE). (2) ASE in schizophrenia are characterized by 5 main categories of phenomena (listed from more represented to less represented): (a) experiences of strangeness and unfamiliarity (eg "Everything appeared weird. Face distorted, world looks terrible, nasty"); (b) experiences of centrality/invasion of peripersonal space (eg "Handkerchief on scaffolding: message telling him something"); (c) alteration of the quality of things (eg "Buildings leaning down"); (d) alteration of the quality of the environment (eg "Person sitting six feet away seemed to be at an infinite distance"); and (e) itemization and perceptive salience (eg "All patients [in ward] have bright eyes"). (3) ASEs are much more frequent in acute (91.9%) than in chronic (28.15%) schizophrenia patients. Moreover, our findings further empirical support for phenomenological accounts of schizophrenia, including those developed by Jaspers, Binswanger, Minkowski, and Conrad, among others and provide the background for translational research., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The role of hyperthermia (HT) in cancer therapy and palliative care has been discussed for years in the literature. There are plenty of articles that show good feasibility of HT and its efficacy in terms of tumor response and survival improvements. Nevertheless, HT has never gained enough interest among oncologists to become a standard therapy in clinical practice. The main advantage of HT is the enhancement of chemotherapy (CHT), radiotherapy (RT), chemoradiotherapy (CRT), and immunotherapy benefits. This effect has been confirmed in several types of tumors: esophageal, gastrointestinal, pancreas, breast, cervix, head and neck, and bladder cancers, and soft tissue sarcoma. HT effects include oxygenation and perfusion changes, DNA repair inhibition and immune system activation as a consequence of new antigen exposure. The literature shows a wide variety of randomized, nonrandomized, and observational studies and both prospective and retrospective data to confirm the advantage of HT association to CHT and RT. There are still many ongoing trials on this subject. This article summarizes the available literature on HT in order to update the current knowledge on HT use in association with RT and/or CHT from 2010 up to 2019.

Schizophrenia patients frequently display an array of abnormal bodily phenomena (ABPs). There is literature to suggest that the presence of ABPs may be representative of a fundamental disruption of the embodied and prereflexive state of selfhood and hence be relevant for the development of schizophrenia spectrum disorders. ABPs have been considered as trait features of vulnerability to psychosis and may have value as potential markers for early detection, target symptoms for prevention and predictors of clinical outcomes. This longitudinal cohort study aimed to explore: (1) the prevalence of ABPs in first episode psychosis, (2) their longitudinal stability, (3) how ABPs compare with data from patients with enduring psychosis, and (4) how aspects of disorders of self-experience (DSEs) and ABPs and the corresponding instruments relate to each other. Sixteen patients were recruited from an early intervention in psychosis service. They were assessed with a series of structured and semi-structured interviews at point of entry, after 6 months and 12 months of follow-up. A variety of ABPs and DSEs were displayed in all study subjects, associated with high levels of core psychotic symptoms and reduced with treatment over time. Compared with findings of both acute and chronic schizophrenia patients, the prevalence of ABPs seems to be representative of severity and acuteness of the illness. Two factors were identified with stable trait characteristics and might be of predictive value for the course of the illness. Further studies with bigger samples are needed to further test the value of ABPs as early markers of detection and predictors of clinical course. The association between DSEs and ABPs warrants further investigation., (© 2020 S. Karger AG, Basel.)

This article builds on and extends the 'optical-coenaesthetic disproportion' (OCDisp) hypothesis of feeding and eating disorders (FEDs) matching data obtained through clinical research with laboratory evidence from neuroscience and neuropsychological studies. The OCDisp hypothesis, developed through the assessment in clinical setting of bodily experience using the IDentity and EAting (IDEA) disorder questionnaire, argues that in persons with FED the internal perception of one's embodied self (i.e., coenaesthesia) is deeply affected (their possibility to feel themselves is weakened or threatened by coenaesthopathic and emotional paroxysms; their bodily feelings are discontinuous over time), and as a compensation to it, these persons experience their own body as an object that is looked at by others. To FED persons, their body is principally given to them as an object 'to be seen.' The other's look serves as an optical prosthesis to cope with hypo- and dis-coenaesthesia and as a device through which persons with FED can define themselves and attenuate the anxiety produced by the conflicts between being-oneself and being-for-others. After describing the OCDisp hypothesis, we will gather evidence supporting it with neuroscience studies on FED. Our focus will be on data pointing to dampened multisensory integration of interoceptive and esteroceptive signals, demonstrating a predominance of the visual afferents toward signals arising within the body. In the final part of the article, we will show consistencies but also draw distinctions between our clinical hypothesis and neuroscience-based data and hypotheses and draft a potential agenda for translational research inspired by these., (Copyright © 2019 Stanghellini, Ballerini and Mancini.)

Objective: Verify whether Percutaneous Transluminal Angioplasty (PTA) may affect neural conduction properties in Multiple Sclerosis (MS) patients, thereby modifying patients' disability, with prospective neurophysiological, urodynamic, clinical and subjective well-being evaluations., Methods: In 55 out of 72 consecutively screened MS patients, the following procedures were carried out before (T0), at 2-6 months (T1) and at 6-15 months (T2) after a diagnostic phlebography, eventually followed by the PTA intervention if chronic cerebrospinal venous insufficiency (CCSVI) was diagnosed: clinical/objective evaluation (Expanded Disability Status Scale, EDSS), ratings of subjective well-being, evaluation of urodynamic functions and multimodal EPs (visual, acoustic, upper and lower limbs somatosensory and motor evoked potentials)., Results: The number of dropouts was relatively high, and a complete set of neurophysiological and clinical data remained available for 37 patients (19 for urological investigations). The subjective well-being score significantly increased at T1 and returned close to basal values at T2, but their degree of objective disability did not change. Nevertheless, global EP-scores (indexing the impairment in conductivity of central pathways in multiple functional domains) significantly increased from T0 (7.9 ± 6.0) to T1 (9.2 ± 6.3) and from T0 to T2 (9.8 ± 6.3), but not from T1 and T2 (p > 0.05). Neurogenic urological lower tract dysfunctions slightly increased throughout the study., Conclusions: The PTA intervention did not induce significant changes in disability in the present cohort of MS patients, in line with recent evidence of clinical inefficacy of this procedure., Significance: Absence of multimodal neurophysiological and functional testing changes in the first 15 months following PTA suggests that conduction properties of neural pathways are unaffected by PTA. Current findings suggest that the short-lived (2-6 months), post-PTA, beneficial effect on subjective well-being measures experienced by MS patients is likely related to a placebo effect., (Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)

Metacognition refers to the activities which allow for the availability of a sense of oneself and others in the moment. Research mostly in North America with English-speaking samples has suggested that metacognitive deficits are present in schizophrenia and are closely tied to negative symptoms. Thus, replication is needed in other cultures and groups. The present study accordingly sought to replicate these findings in a Spanish speaking sample from Chile. Metacognition and symptoms were assessed among 26 patients with schizophrenia, 26 with bipolar disorder and 36 community members without serious mental illness. ANCOVA controlling for age and education revealed that the schizophrenia group had greater levels of metacognitive deficits than the bipolar disorder and community control groups. Differences in metacognition between the clinical groups persisted after controlling for symptom levels. Spearman correlations revealed a unique pattern of associations of metacognition with negative and cognitive symptoms. Results largely support previous findings and provide added evidence of the metacognitive deficits present in schizophrenia and the link to outcome cross culturally. Implications for developing metacognitively oriented interventions are discussed., (Published by Elsevier B.V.)

Background: Phenomenological psychopathology, through theoretical and idiographic studies, conceptualizes major depressive disorder (MDD) as a disorder of time experience. Investigations on abnormal time experience (ATE) in MDD adopting methodologies requested by the standards of empirical sciences are still lacking. Our study aimed to provide a qualitative analysis, on an empirical ground and on a large scale, of narratives of temporal experiences of persons affected by MDD., Methods: We interviewed 550 consecutive patients affected by affective and schizophrenic disorders. Clinical files were analysed by means of consensual qualitative research., Results: Out of 100 MDD patients, 96 reported at least 1 ATE. The principal categories of ATE are vital retardation - the experience of a stagnation of endogenous vital processes (37 patients), the experience of present and future dominated by the past (29 patients), and the experience of the slackening of the flow oftime (25 patients). A comparison with ATE in schizophrenia patients showed that in MDD, unlike in schizophrenia, there is no disarticulation of time experience (disorder of temporal synthesis) but rather a disorder of conation or inhibition of becoming., Limitations: The interview style was not meant to make a quantitative assessment ("false negatives" cannot be excluded)., Conclusions: Our findings confirm the relevance of distinctive features of ATE in MDD, support the hypothesis of an intrinsic disordered temporal structure in depressive symptoms, and may have direct implications in clinical practice, especially in relation to differential diagnosis, setting the boundaries between "true" and milder forms of depression, and neurobiological research., (© 2016 S. Karger AG, Basel.)

In this paper, we discuss the philosophical and psychopathological background of Domain 3, Other persons, of the Examination of Anomalous World Experiences (EAWE). The EAWE interview aims to describe the manifold phenomena of the schizophrenic lifeworld in all of their concrete and distinctive features, thus complementing a more abstract, symptom-focused approach. Domain 3, Other persons, focuses specifically on subjectively experienced interpersonal disturbances that may be especially common in schizophrenia. The aim of this domain, as with the rest of the EAWE, is to provide clinicians and researchers with a systematic orientation toward, or knowledge of, patients' experiences, so that the experiential universe of schizophrenia can be clarified in terms of the particular feel, meaning, and value it has for the patient. To help provide a context for EAWE Domain 3, Other persons, we propose a definition of "intersubjectivity" (IS) and "dissociality." The former is the ability to understand other persons, that is, the basis of our capacity to experience people and social situations as meaningful. IS relies both on perceptive- intuitive as well as cognitive-computational resources. Dissociality addresses the core psychopathological nucleus characterizing the quality of abnormal IS in persons with schizophrenia and covers several dimensions, including disturbances of both perceptive-intuitive and cognitive-computational capacities. The most typical perceptive-intuitive abnormality is hypoattunement, that is, the lack of interpersonal resonance and difficulties in grasping or immediately understanding others' mental states. The most characteristic cognitive-computational anomaly is social hyperreflexivity, especially an algorithmic conception of sociality (an observational/ethological attitude aimed to develop an explicit, often rule-based personal method for participating in social transactions). Other anomalous interpersonal experiences, such as emotional and behavioral responses to others, are also discussed in relation to this core of dissociality., (© 2017 S. Karger AG, Basel.)

Background: Contemporary phenomenological research has considered abnormal bodily phenomena (ABP) to be a phenotypic trait of subjects with schizophrenia in their first psychotic episode. Yet the prevalence of ABP and their clinical significance in subjects at Ultra High Risk (UHR) of psychosis remain unidentified. This study is an exploratory investigation of ABP in UHR subjects and matched healthy controls (HCs) examining their relation to clinical features and basic self-disturbances., Methods: A sample of 26 UHR and 14 HC subjects from three prodromal and early intervention clinics in South London, West London and Cambridge was assessed with the Abnormal Bodily Phenomena questionnaire (ABPq), Comprehensive Assessment of At-Risk Mental States (CAARMS), the Positive and Negative Syndrome Scale (PANSS), the Social and Occupational Functioning Assessment Scale (SOFAS) and the Examination of Anomalous Self Experiences (EASE) checklist., Results: In our sample ABP occurred in 73.1% of UHR subjects and prominent ABP (proABP) were referred in 53.8% of them. No HC subject reported ABP. The UHR group with proABP had lower CAARMS total score (t=-9.265, p=0.006). There were no differences in PANSS total score (t=-1.235, p=0.277), SOFAS score (H(2) 22.27, p=0.666) and EASE total scores (z=8.565, adjusted p=0.185) in the UHR subjects with prominent ABP versus those that did not., Discussion: This initial investigation suggests that ABP could be a prevalent phenotypic feature of UHR subjects., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Abnormal time experience (ATE) in schizophrenia is a long-standing theme of phenomenological psychopathology. This is because temporality constitutes the bedrock of any experience and its integrity is fundamental for the sense of coherence and continuity of selfhood and personal identity. To characterize ATE in schizophrenia patients as compared to major depressives we interviewed, in a clinical setting over a period of 15 years, 550 consecutive patients affected by schizophrenic and affective disorders. Clinical files were analyzed by means of Consensual Qualitative Research (CQR), an inductive method suited to research that requires rich descriptions of inner experiences. Of the whole sample, 109 persons affected by schizophrenic (n = 95 acute, n = 14 chronic) and 37 by major depression reported at least 1 ATE. ATE are more represented in acute (N = 109 out of 198; 55%) than in chronic schizophrenic patients (N = 14 out of 103; 13%). The main feature of ATE in people with schizophrenia is the fragmentation of time experience (71 out of 109 patients), an impairment of the automatic and prereflexive synthesis of primal impression-retention-protention. This includes 4 subcategories: disruption of time flowing, déjà vu/vecu, premonitions about oneself and the external world. We contrasted ATE in schizophrenia and in major depression, finding relevant differences: in major depressives there is no disarticulation of time experience, rather timelessness because time lacks duration, not articulation. These core features of the schizophrenic pheno-phenotype may be related to self-disorders and to the manifold of characteristic schizophrenic symptoms, including so called bizarre delusions and verbal-acoustic hallucinations., (© The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: In girls with Idiopathic Central Precocious Puberty (ICPP) concern has been raised by the potential impact of GnRH-analogues (GnRHa) treatment on body weight. We evaluated the effect of GnRHa on Body Mass Index (BMI) in girls with ICPP according to weight status at diagnosis., Methods: One hundred seventeen ICPP girls were divided according to pretreatment weight status in: normal weight (NW), overweight (OW) and obese (OB). BMI at one and two years of treatment was assessed. BMI-SDS of 60 patients who reached adult height (AH) was compared to that of 33 ICPP untreated girls., Results: NW girls significantly increased their baseline BMI-SDS at 1 and 2 years of treatment. OW girls only had a significant increment at one year of treatment while OB girls showed no BMI-SDS change. Patients evaluated at AH (at least four years after GnRHa withdrawal) showed a significant decrease on BMI compared to baseline and a significantly lower BMI than the untreated group., Conclusion: In ICPP girls the BMI increase under GnRHa was inversely related to the pretreatment weight status. In the long term follow-up, no detrimental effect of GnRHa on body weight was observed. BMI-SDS was lower in treated than in untreated girls.

Subtle anomalies of bodily experience have for long been described as relevant features of schizophrenia spectrum disorders, however such disturbing and alienating experiences are usually neglected in routine clinical examination. The overarching aim of this qualitative study is to offer an experience-close mapping of abnormal bodily phenomena (ABP) in patients with schizophrenia that might assist clinical examination and inform the development of dedicated assessment tools. We followed a stepwise methodology: first, data from n=550 clinical interviews were analyzed adopting consensual qualitative research (CQR) inductive method in order to identify relevant clusters of ABP. Then, ABP profiled in schizophrenia patients (n=301) were contrasted with ABP identified in patients affected by major depression (n=56). 70% of the interviewees in the schizophrenia sample reported anomalies of lived corporeality, that could be condensed in the following categories: Dynamization, Morbid objectivation, Dysmorphic-like phenomena and Pain-like phenomena. Those appeared to be reducible to two core features that were not paralleled in the affective disorder sample: dynamization (e.g. ongoing bodily feelings of disintegration/violation) and thingness/mechanization (e.g. one's body experienced as a object-like mechanism). We suggest that dynamization and thingness/mechanization might be considered schizophrenia-specific experiential phenotypes that can contribute to early differential diagnosis of somatic complaints in mental health help-seekers., (Copyright © 2014 Elsevier Inc. All rights reserved.)

There are no studies regarding the course leading to carpal tunnel syndrome (CTS) diagnosis and factors influencing the diagnostic process. The study aim is to analyse CTS diagnostic path assessing whether the type of physician (general practitioners or specialist) may influence the manner and timing of diagnosis, and whether CTS severity at diagnosis may be predicted by factors related to Public Health Service and/or to patient. A medical history form was filled in by 375 consecutive patients with idiopathic CTS enrolled at an electromyography service. The patient answered a self-administered questionnaire on symptom severity and the neurophysiologist quantified clinical and electrophysiological CTS severity. The patients going directly to general practitioner were older and more blue collars, had minor education level, more symptom duration, more clinical and electrophysiological severity, more medical examination numbers, more time elapsing between first visit to a doctor and referral for EMG than those going to a specialist. But all variables are interrelated and when multivariate logistic regression analyses were performed, only patient age and some other few independent variables related to patient or health care but not to referring doctor could predict CTS severity at the diagnosis. Typology of the first doctor did not influence diagnostic path. The patients should reduce the time elapsing between CTS symptom onset and consulting doctor thus, permitting early treatments. Some corrective actions on diagnostic path may concern the public health service by reducing waiting lists to perform electrodiagnostic testing and giving greater information to population at risk.

This overview provides an analysis of some of the immunotherapies currently in use and under investigation, with a special focus on the tumor microenvironment, which we believe is a major factor responsible for the general failure of immunotherapy to date. It is our expectation that combining immunotherapy with methods of altering the tumor microenvironment and targeting regulatory T cells and myeloid cells will yield favorable results.

The purpose of this study is to answer the following question: What are the typical features of abnormal bodily experiences (ABEs) in persons affected by acute first-episode schizophrenia? Our overall objective is to contribute to enhance early diagnosis of schizophrenia, and providing supplementary diagnostic criteria especially for ultra-high risk patients. In a group of 39 patients with first-episode schizophrenia selected from a sample of 393 psychotic patients, 30 (76.9 %) reported ABEs. By means of a phenomenologically-based qualitative method of inquiry, we recognized four subtypes of ABEs whose main characteristics are dynamization of bodily boundaries and construction, morbid objectivization/devitalization, dysmorphic experiences and pain-like experiences. These four typologies of ABEs are documented through the patients' first-person self-descriptions, and then operationally defined. Two main properties emerge as tentative eidetic (defining) cores of ABEs in early schizophrenia: dynamization of bodily boundaries and construction, and morbid objectivization/devitalization. Sharpening the diagnostic sensibility for typically schizophrenic ABEs can help improve differential diagnosis between schizophrenia and other disorders entailing other types of anomalies of lived corporeality. Also, studying possible transitions from schizophrenic cenesthopathies to bodily delusions in persons with schizophrenia may refine the concept of bizarre delusions by improving its validity. Furthermore, our knowledge about the pathogenesis of schizophrenia may profit from an in-depth assessment of ABEs and their relationship with an abnormal sense of selfhood, especially in early schizophrenia.

The aim is to verify whether glabella electrical stimulation evokes sympathetic skin responses (SSR) without inter-side differences in latency and area of the responses and is more useful in mononeuropathies than peripheral nerve stimulation. SSRs were recorded in 25 healthy subjects from right palm, third (M3SSR) and fifth fingers and contralateral third finger. The inter-side differences of grand mean area and mean of largest area of M3SSR were significant only by ulnar nerve and not by glabella stimulation. Therefore glabella stimulation may be used in mononeuropathies comparing SSR area recorded from affected side with respect to contralateral healthy side., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Male patients with an extra sex chromosome or autosome are expected to present primary hypogonadism at puberty owing to meiotic germ-cell failure. Scarce information is available on trisomy 21, a frequent autosomal aneuploidy. Our objective was to assess whether trisomy 21 presents with pubertal-onset, germ-cell specific, primary hypogonadism in males, or whether the hypogonadism is established earlier and affects other testicular cell populations. We assessed the functional status of the pituitary-testicular axis, especially Sertoli cell function, in 117 boys with trisomy 21 (ages: 2months-20year). To compare with an adequate control population, we established reference levels for serum anti-Müllerian hormone (AMH) in 421 normal males, from birth to adulthood, using a recently developed ultrasensitive assay. In trisomy 21, AMH was lower than normal, indicating Sertoli cell dysfunction, from early infancy, independently of the existence of cryptorchidism. The overall prevalence rate of AMH below the 3rd percentile was 64.3% in infants with trisomy 21. Follicle-stimulating hormone was elevated in patients <6months and after pubertal onset. Testosterone was within the normal range, but luteinizing hormone was elevated in most patients <6months and after pubertal onset, indicating a mild Leydig cell dysfunction. We conclude that in trisomy 21, primary hypogonadism involves a combined dysfunction of Sertoli and Leydig cells, which can be observed independently of cryptorchidism soon after birth, thus prompting the search for new hypotheses to explain the pathophysiology of gonadal dysfunction in autosomal trisomy., (© 2011 The Authors. International Journal of Andrology © 2011 European Academy of Andrology.)

Cerebrotendinous xanthomatosis (CTX) is a rare neurometabolic disease due to defective activity of sterol 27-hydroxylase, with plasma and tissue cholestanol storage. Clinical phenotype is characterized by both systemic manifestations and neurological signs. Therapy with chenodeoxycholic acid (CDCA) suppresses abnormal bile acid synthesis. The purpose of the study was to assess the frequency and clinical relevance of spasticity in the CTX phenotype and to study the usefulness of transcranial magnetic stimulation (TMS) in detecting corticospinal tract damage and monitoring the effects of replacement therapy. Twenty-four CTX patients underwent clinical evaluation including general disability scores, pyramidal and cerebellar function scales, assessment of serum cholestanol and TMS. Nine patients who started CDCA therapy at baseline received clinical and neurophysiological follow up. All patients showed signs of pyramidal damage which were relevant for clinical disability in 18 out of 24 cases (75%), resulting in spastic paraparesis. TMS revealed corticospinal alterations even in subjects with mild clinical signs of corticospinal tract involvement. After CDCA treatment, serum cholestanol decreased to normal concentrations in all patients. Clinical picture was unchanged in seven out of nine cases; in two others pyramidal signs disappeared. A reduction in abnormal neurophysiological parameters was found. Spastic paraparesis is the most frequent and relevant neurological feature in CTX patients. Replacement treatment with CDCA can prevent the progression of pyramidal damage, especially if started early in the course of the disease. TMS represents a sensitive indicator of corticospinal tract dysfunction and subclinical improvements in pyramidal function after CDCA therapy.

This is a critical review of research on the subjective experience of social dysfunction in persons with schizophrenia. Studies from the phenomenological and cognitive paradigms are examined, and significant outcomes and shortcomings are pointed out. Clinical phenomenologists have mainly interpreted schizophrenic dissociality as an anomaly of prereflexive attunement. The main shortcoming of phenomenological research is that it lacks adequate methodology to collect reliable data since most studies are based on the analysis of a few typical cases. Cognitivism has reliably documented disorders of social functioning in large-scale experimental studies. The main shortcoming of most cognitive paradigms is that they do not properly investigate the personal level of experience in real-world functioning. We conclude that there is a need to reliably collect data through quantitative as well as qualitative methodology as established and accepted by the scientific community in the area of schizophrenic dissociality, reflecting the subjective experiences of people with schizophrenia in the real world., (Copyright © 2011 S. Karger AG, Basel.)

Objective: This is an empirical study exploring the personal level of experience of social dysfunction in persons with schizophrenia., Method: We adopted a qualitative method of inquiry based on a review of transcripts of individual therapy sessions conducted for 52 persons with chart diagnoses of schizophrenia or schizotypal disorder., Results: In our interviews, the experience of the social world in persons with schizophrenia emerged as an overall crisis of immediate, prepredicative, prereflexive attunement, typically accompanied by feelings of invasiveness and abnormalities in bodily and emotional sensations; a hyperreflexive mode for understanding the intentions of other persons, and a sceptical, aversive and sometimes utopian attitude towards sociality., Conclusion: Social dysfunction in persons with schizophrenia may reflect a disorder of the process of corporeal identification/differentiation that allows both for the intersubjective understanding through body-to-body attunement and for the demarcation between self and other., (Copyright © 2011 S. Karger AG, Basel.)

Numerical models indicate that collective animal behavior may emerge from simple local rules of interaction among the individuals. However, very little is known about the nature of such interaction, so that models and theories mostly rely on aprioristic assumptions. By reconstructing the three-dimensional positions of individual birds in airborne flocks of a few thousand members, we show that the interaction does not depend on the metric distance, as most current models and theories assume, but rather on the topological distance. In fact, we discovered that each bird interacts on average with a fixed number of neighbors (six to seven), rather than with all neighbors within a fixed metric distance. We argue that a topological interaction is indispensable to maintain a flock's cohesion against the large density changes caused by external perturbations, typically predation. We support this hypothesis by numerical simulations, showing that a topological interaction grants significantly higher cohesion of the aggregation compared with a standard metric one.

Purpose of Review: This review focuses on social dysfunction in persons with schizophrenia and addresses three main questions. What is the core ability that is disordered in social dysfunction according to mainstream paradigms? How is social dysfunction primarily assessed in current research? Which levels of personal experience, and which trans-personal and sub-personal factors, are assessed by mainstream empirical research?, Recent Findings: Empirical studies on social dysfunction include research on trans-personal factors (stigma, availability of social and psychiatric facilities, and family resources), sub-personal factors (neurocognition) and personal factors (social cognition, coping and noncognitive factors). The main recent findings of these approaches are described and commented upon. Inconsistencies between studies are identified., Summary: What is it like to be a person with schizophrenia in the social world? Building upon empirical research, we can finally address this question. We argue that more qualitative research is needed into the reasons that persons with schizophrenia have for adopting or embracing their given type of relatedness to the others.

This is an explorative study on the values of persons with schizophrenia based on transcripts of individual therapy sessions conducted for 40 persons with chart diagnoses of schizophrenia or schizotypal disorder. Values are action-guiding attitudes that subject human activities to be worthy of praise or blame. The schizophrenic value system conveys an overall crisis of common sense. The outcome of this has been designated as antagonomia and idionomia. Antagonomia reflects the choice to take an eccentric stand in the face of commonly shared assumptions and the here and now "other." Idionomia reflects the feeling of the radical uniqueness and exceptionality of one's being with respect to common sense and the other human beings. This sentiment of radical exceptionality is felt as a "gift," often in view of an eschatological mission or a vocation to a superior, novel, metaphysical understanding of the world. The aim of this study is neither establishing new diagnostic criteria nor suggesting that values play an etio-pathogenetical role in the development of schizophrenia but improving our understanding of the "meaning" of schizophrenic experiences and beliefs, and by doing so reducing stigmatization, and enhancing the specificity and validity of "psychotic symptoms" (especially bizarre delusions) and of "social and occupational dysfunction" through a detailed description of the anthropological and existential matrix they arise from.

Objective: To determine the occurrence of carpal tunnel syndrome (CTS) and ulnar neuropathy at the elbow (UNE) in a cohort of floor cleaners and to check differences between workers with and without CTS., Methods: All female floor cleaners of three major hospitals in Tuscany (Italy) were contacted. Clinical and electrophysiological severity of CTS and UNE were evaluated with standardized scales and symptoms were assessed with the self-administered Boston Questionnaire (BQ); demographic and non-occupational factors and durations of current and previous occupations were recorded. Univariate analysis of risk factors was performed in workers with and without CTS. Logistic regression was used to evaluate the capacity of independent variables to predict CTS., Results: Out of a total of 179 cleaners, 145 (81%)-mean age 39.6 years (20-64 years)-were enrolled in the study; 70 (48%) had CTS (diagnosis based on clinical and electrophysiological findings). BQ symptom and hand function scores were anomalous in 108 (74%) and 84 (58%) subjects, respectively. UNE was detected in 7/103 women. Univariate analysis showed that cleaners with CTS were older, had greater BMI and longer exposure to cleaning with previous employers than those without CTS. In the logistic regression, the only predictor of CTS was cleaning with previous employers (O.R. 12.1, 95% CI 3-49.9)., Conclusions: These results indicate a high occurrence of CTS in floor cleaners; UNE is less frequent than CTS, presumably due to repetitive movements that stress wrists more than elbows. The only predictive factor of CTS was cleaning as an occupation with previous employers. Therefore, the actual risk factor for CTS could not be cleaning per se, but how this job is performed.

Carpal tunnel syndrome (CTS) patients are known to show gender-related differences in severity. The main aim of this cross-sectional study was to determine whether these differences between women and men may be related to age, education or body mass index (BMI) in two populations, one with idiopathic CTS not treated surgically and the other with idiopathic CTS treated by surgical decompression. A secondary aim was to check differences in surgical results between the genders in the surgical population. The non-surgical population consisted of 172 subjects (126 women and 46 men, mean age 55.1 years) whose data were obtained at electrophysiological examination. The surgical population consisted of 219 patients (177 women and 42 men, mean age 55.1 years) whose data were obtained before surgery. Age, education, BMI, duration of symptoms, electrophysiological and clinical severity of CTS (with ordinal scales), and the self-administered Boston Questionnaire (BQ) of symptoms and functional status of hands were considered. There were no differences in age or clinical and electrophysiological severity between women and men in either group, except for distal motor latency of the median nerve that was more delayed and duration of symptoms that was shorter in men than women in non-surgical sample. Men had a higher BMI than women. Women had higher BQ scores in the surgical and non-surgical samples. These differences remained when the results were analysed matching the men with an identical number of women of the same age, education and BMI. In the surgical population, the results of surgical decompression did not modify the gender-related differences in severity. As in many other syndromes and diseases, for a given clinical severity, women with CTS were more sensitive than men in reporting their symptoms. Risk factors of CTS, such as age, education and BMI, were not responsible for these differences. The results of surgical decompression were similar in men and women.

Retrospective features of 91 consecutive cases (68 men, 23 women; mean age 44.4 years) of radial mononeuropathy diagnosed over the last 8 years in two electromyography (EMG) services are reported to define the clinical and electrophysiological findings of radial neuropathies in relation to traumatic and non-traumatic causes and site of injury. The occurrence of radial neuropathy was 0.65 x 100 first electromyographic examinations. The most frequent site of damage was the main trunk at the spiral groove of the humerus (36%); the most frequent cause was nerve trauma (70%) due to fracture (36%). In neuropathies of the main trunk and posterior interosseous (PI) nerve, "complete nerve injury" was observed in 36% of cases, conduction motor block in 33% and motor conduction velocity slowing in 46%. At least one of these findings was present in 51%, whereas motor neurography was normal in 13% of cases. Sensory action potential (SAP) anomalies were observed in 51% of cases. In neuropathy of the superficial radial nerve, no SAP was detected in 30% of cases; in all others except one, SAP was reduced in amplitude. Non-traumatic neuropathies showed severer conduction block and less severe anomalies of SAP than traumatic neuropathies. No differences were found between men and women. EMG is essential for confirming the site of injury and neurographic study may be helpful for diagnosis, providing information about lesion type and severity.

Background: Although ulnar neuropathy at the elbow (UNE) is the second most frequent focal peripheral neuropathy of the upper limb after carpal tunnel syndrome (CTS), no figures on its prevalence or incidence in the general population have been reported., Objective: To determine the incidence of UNE in a general population., Methods: Retrospective study to identify newly diagnosed cases on the basis of clinical symptoms or signs and slowing of motor conduction velocity of the ulnar nerve across the elbow or surgical evidence of nerve compression in the elbow region. In the 5-year period from 1995 to 1999, cases among residents in Siena Province (Italy) were identified from medical records of electromyographic services of Local Health District no. 7 and from hospital medical records coded ICD 354.2, 04.49 and 04.6. Siena province has a population of 251,930., Results: In the 5-year period, 311 cases (112 women and 199 men, mean age 56 years, range 15-86) were identified. The mean annual crude incidence was 24.7 cases per 100,000 person-years, and the standardized incidence was 20.9. The sex-specific incidences were 32.7 for men and 17.2 for women. The mean annual crude and sex-specific incidences remained constant during the study period. The age-specific incidences of whole population and both genders showed an increasing trend with decade of age. The incidence of "possible", "probable" and "definite" UNE cases, classified according to level of motor conduction velocity anomalies and evidence of surgical compression of the ulnar nerve at the elbow, was 4.3, 10.6, and 9.8, respectively. The residents of a health subdistrict where manual work is dominant had a higher male-specific incidence (57.1) than other areas., Conclusions: This is the first published study on the incidence of UNE. The incidence was higher in males than females and about one-thirteenth that reported for CTS in part of the present geographic area.