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Baricitinib is a Janus-kinase (JAK) 1/2 inhibitor, approved for the treatment of moderate-to-severe rheumatoid arthritis (RA) patients with inadequate response to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). We report the first real-life experience with baricitinib in a monocentric cohort of unselected RA patients.We enrolled consecutive RA patients starting baricitinib. At baseline and after 4, 12, 24 and 48 weeks we assessed the disease activity by composite indices (SDAI, CDAI and DAS28CRP) and ultrasonography, and we recorded any adverse events. The primary endpoint was the percentage of patients achieving SDAI remission at week 4.We enrolled 59 patients [(F:M = 50:9, median age 58.1 years (IQR 12.8), median disease duration 144 (IQR 150) months] treated with baricitinib in combination with a csDMARD (52.5%) or monotherapy (47.5%) for a median follow-up of 24 weeks (IQR 36). The 12-month drug retention rate was 74%. At weeks 4, 12, 24 and 48 we observed a significant reduction of DAS28, CDAI and SDAI, global health and pain (p0.001 for all). After 4 weeks of treatment, 12% of patients achieved SDAI remission. Concomitant csDMARDs, previous biological DMARDs, gender, seropositivity and BMI did not affect the efficacy of baricitinib. Baricitinib allowed a significant reduction in prednisone dose after 12 and 24 weeks and a rapid and sustained ultrasound improvement. No serious adverse events, serious infections or cardiovascular events were recorded.Our study confirms the efficacy and safety profile and rapid onset of the effect of baricitinib in RA patients in a real-life setting.

Applicazione del metodo dell'EQUILIBRIO FONATORIO nel danno ricorrenziale da trauma laringeo

Background: Adolescence has been recognized as a critical period for mental health during which it is fundamental to the well-being of adolescents to provide early and appropriate mental health interventions. Self-image perceptions play a particularly relevant role during adolescence since individuals are extensively involved in reorganizing their identity and relationships. Although the self-image development implies adaptive outcomes for most adolescents, some age-related tasks can be difficult to deal with and lead to psychological suffering for a minority of them. Method: This study examined how domain-specific self-image was associated with psychological distress in 128 treatment-seeking adolescents aged 13–18 (60.9% female). The adolescents completed the Offer Self-Image Questionnaire to measure their global and domain-specific self-image and the Youth-Outcome Questionnaire to assess their psychological distress. Results: Regression analyses indicated that impulse control, emotional tone, family, and social functioning significantly predict worse psychological functioning in the entire group. Moreover, significant gender differences emerged showing a more complex set of risk factors among adolescent females, thus suggesting the need for gender-targeted preventive and treatment strategies. Conclusions: The findings highlight that adolescents’ feelings and concerns about their self-image may be key factors to consider in planning, developing, and delivering effective public mental health services for adolescents.

In the Italian market, voluntary certifications implying higher levels of animal welfare generally fall into wider production schemes. Despite of the results of EU surveys indicating that about 50% of Italian consumers can easily identify and find animal-friendly products, they still are distributed scarcely or discontinuously in the main retail chains. To assess the apparent contradiction between the intricate information consumers receive from labels and their declared awareness about animal welfare, a survey was conducted in Emilia Romagna region on 355 Italian consumers (face-to-face interviews based on a structured, semi-close-ended questionnaire). Overall, consumers showed a low degree of knowledge about animal welfare attributes, animal farming conditions and animal protection policies (about 30% of correct answers), and a low level of awareness of the effects of their purchasing choices on the welfare of farmed animals (22%). The respondents also showed difficulties in identifying animal-friendly products and often confused them with other certified foods, having sometimes a weak connection (or none at all) to animal welfare (e.g., Protected Designation of Origin products). However, most consumers declared to be ready to pay a premium price in name of animal welfare. In conclusion, a labelling system for the welfare content of animal-derived foods is confirmed to be an effective strategy to compensate the efforts of farmers in improving animal welfare, provided that the information given is clear and able to fill the substantial lack of consumer knowledge.