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From March 2020 to May 2021, several lockdown periods caused by the COVID-19 pandemic have limited people’s usual activities and mobility in Italy, as well as around the world. These unprecedented confinement measures dramatically modified citizens’ daily lifestyles and behaviours. However, with the advent of summer 2021 and thanks to the vaccination campaign that significantly prevents serious illness and death, and reduces the risk of contagion, all the Italian regions finally returned to regular behaviours and routines. Anyhow, it is unclear if there is a long-tail effect on people’s quality of life, sleep- and physical activity-related behaviours. Thanks to the dataset described in this paper, it will be possible to obtain accurate insights of the changes induced by the lockdown period in the Italians’ health that will permit to provide practical suggestions at local, regional, and state institutions and companies to improve infrastructures and services that could be beneficial to Italians’ well being.

The aim of the present study was to investigate the effect of a short-term (4 weeks) non-soccer-specific training programme based on speed, agility and quickness (SAQ) and a soccer-specific training programme based on small-sided games (SSG) on cognitive and physical performance in preadolescent soccer players. Twenty-one participants were randomly assigned to SAQ group (n = 11) or SSG group (n = 10). They were tested pre and post interventions on physical (5 m sprint, 20 m sprint and sprint with turns of 90°) and cognitive (inhibitory control by means of the Flanker task and perceptual speed by means of the visual search task) performances. Although no significant time x group interactions were observed, the main effect of time was significant for cognitive performance and 5 m and 20 m sprint, showing improvements after both SAQ and SSG. These findings highlight that 4 weeks of SAQ training programme induced comparable improvements in cognitive and physical performance with respect to a soccer-specific training programme based on SSG in preadolescent soccer players. Non-sport-specific activities targeting speed, agility and quickness combined with cognitive engagement (i.e., SAQ) should be useful strategies as soccer-specific activities to be included within a soccer training programme for promoting both physical and cognitive domain in preadolescent individuals.

The forced isolation due to the COVID-19 pandemic interrupted the lifestyle intervention programs for people with obesity. This study aimed to assess: (1) the behaviors of subjects with obesity towards medical care during the pandemic and (2) their interest in following a remotely delivered multidisciplinary program for weight loss. An online self-made survey addressed to subjects with obesity was linked to the official website of our institute. Four hundred and six subjects completed the questionnaire (90% females, 50.2 ± 11.6 years). Forty-six percent of the subjects cancelled any scheduled clinical assessments during the pandemic, 53% of whom had chronic disease. Half of the subjects were prone to following a remotely delivered lifestyle intervention, especially with a well-known health professional. About 45% of the respondents were favorable towards participating in remote psychological support and nutritional intervention, while 60% would practice physical activity with online tools. Male subjects and the elderly were more reluctant than those female and younger, especially for online psychological support. Our survey showed an interest on the part of the subjects with obesity to join a multidisciplinary weight loss intervention remotely delivered. Male subjects and the elderly seem less attracted to this intervention, and this result highlights that, even with telemedicine, the approach to weight management should be tailored.

This study aimed to compare the effects of non-sport-specific and sport-specific training methods on physical performance and perceptual response in young football players. Seventy-nine under 11 participants were selected and assigned to non-sport-specific (NSSG), sport-specific (SSG), and control (CNTG) groups. The NSSG training protocol consisted of combined stimuli based on balance, agility, and jump rope drills. The SSG training protocol included technical exercises, defensive and offensive game-based drills, and a small-sided game. The CNTG included the participants not taking part in any sport training. All participants were tested for general motor coordination (Harre test), dynamic balance (Lower Quarter Y-balance test), and dribbling before and after 10 weeks of training (NSSG and SSG) or habitual activity (CNTG). At post-intervention, perceived enjoyment was requested by the Physical Activity Enjoyment Scale (PACES). A two-way repeated measure analysis of covariance was used to detect interactions and main effects of time and groups controlling for baseline values. Whereas, a one-way analysis of variance was used to evaluate PACES-related differences between groups. NSSG gained greater improvements (p &lt, 0.05) compared with SSG in the Harre and Lower Quarter Y-balance tests, while dribbling skills improved similarly in both groups. Regarding PACES, NSSG and SSG presented a comparable perceived enjoyment. These findings suggest that a 10-week non-sport-specific training is an enjoyable practice capable to promote greater improvements in general motor coordination and dynamic balance compared with sport-specific training in youth football players. This can occur without impairment of football-specific skills.

The aim of this study was to assess the efficacy of using real-time visual feedback (VF) during a one-week balance training intervention on postural sway parameters in young karatekas. Twenty-six young male karatekas (age = 14.0 ± 2.3 years) were randomly divided into two groups: real-time VF training (VFT, n = 14) and control (CTRL, n = 12). Their center of pressure (COP) displacement (path length, COPpl, distance from origin, COPod) was assessed pre- and post-training on a Wii Balance Board platform in two positions (Flex: knee of the supporting leg slightly bent, maximum hip and leg flexion of the other leg, Kick: knee of the supporting leg slightly bent, mawashi-geri posture for the kicking leg). Both groups trained twice a day for seven days, performing a one-legged stance on the non-dominant limb in the Kick position. During the training, VFT received real-time VF of COP displacement, while CTRL looked at a fixed point. No interaction effect was found (p &gt, 0.05). VFT exhibited greater changes pre- and post-training in Flex COPpl (−25.2%, g = 1.5), Kick COPpl (−24.1%, g = 1.3), and Kick COPod (−44.1%, g = 1.0) compared to CTRL (−0.9–−13.0%, g-range: 0.1–0.7). It is possible that superimposing real-time VF to a week-long balance training intervention could induce a greater sport-specific balance-training effect in young karatekas.

The aim of the present study was to investigate the differences between types of sport (i.e., closed vs. open skills sport) on inhibitory control and motor fitness in children. Forty-nine children were allocated into three groups based on their sports participation, which comprised an open skill sport group, a closed skill sport group, and a sedentary group. Participants were tested on cognitive performance (inhibitory control by the Flanker task) and motor fitness (reaction time, speed, agility, power, balance). Open skill sport group appeared to display higher inhibitory control (response time and accuracy of incongruent condition of the Flanker task) and motor fitness performance (reaction time, speed, agility, power) than sedentary group, whereas its superiority over closed skill sport group was found only in speed and agility. Moreover, closed skill sport group had only a better reaction time than sedentary group. Our data supports the framework according to which cognitive demands in complex motor actions may contribute to explain the beneficial effects of exercise on inhibitory control. This might suggest that the complexity of the environment (typical in open skill sports) in which sport training is performed plays a key role for both cognitive and motor development in children.

BACKGROUND Respiratory muscle training has been shown to provide positive effects for both health and performance purposes. The aim of this study was to evaluate the effects of a six-week period of nasal breathing on pulmonary function and cardio-respiratory fitness in young basketball players. METHODS Thirty-four, male, basketball players were enrolled and assigned either to experimental group (EG) or to control group (CG). All participants were tested for Yo-Yo Intermittent Recovery level 1 (Yo-Yo IR1), Shuttle Sprint Test (SST), Forced Vitality Capacity (FVC), Forced Expiratory Volume in one second (FEV1) and Peak Expiratory Flow (PEF). EG group followed reduced breathing frequency training program focused on intermittent running exercises while performing nasal breathing. RESULTS The main findings were significant interactions in Yo-Yo IR1 test, FVC, FEV1 and PEF (p

The present study aimed to determine the contribution of soccer players' anthropometric features to predict their physical performance. Sixteen players, from a professional youth soccer academy, were recruited. Several anthropometric features such as corrected arm muscle area (AMA

The purpose of this study was to monitor the changes in breathing pattern, trunk muscle stabilization, and upper-body muscular power in Paralympic swimmers throughout a competitive season over three time points: October (T1), March (T2), and August (T3). Six top-level Paralympic swimmers voluntarily participated in this study. The Friedman test, the Bonferroni–Dunn multiple comparison post hoc analysis, and Kendall’s W concordance coefficient for the measure of effect were used. A significant difference was found in the breathing pattern, trunk stability, and upper-body power variables from the T1 to T3 season (p

The aim of this study was to evaluate the effects of 12-week balance and slackline training programs on physical performance and perceived enjoyment scale in young soccer players. Forty-one preadolescent soccer players were assigned to two experimental groups performing traditional balance (BLT) or slackline training (SLT), and a control group. Pre-post assessment encompassed Balance Error Scoring System (BESS), Star Excursion Balance test (SEBT), sprint with 90° turns (S90), and countermovement jump (CMJ). The rate of perceived enjoyment scale (PACES) was applied at the end of the experimental period. SLT and BLT improved similarly in BESS, SEBT and S90. No changes were detected in the CMJ. Regarding PACES score, SLT presented significantly higher values than BLT. Young athletes may benefit from a motivating training approach, thus, a designed program based on slackline drills should be preferable to improve physical performance in terms of balance and change of direction ability in preadolescent soccer players.

Facial asymmetry is considered a marker of psychological, emotional and physiological distress, while anxiety is a behavioural, psychological and physiological response to a threat to well-being. Since individuals respond to anxiety with specific patterns (e.g., muscular tension), it is reasonable to hypothesize that anxiety could contribute to facial tension and therefore facial asymmetry. Instead, since facial asymmetry is perceived as "unpleasant" from peers, its presence may be a hindrance to social adaptation contributing to generate anxiety. In this study, we investigated whether resting facial asymmetry and anxiety are associated in young population. Full frontal facial photographs of 56 Caucasian males were taken in resting state to obtain indices of asymmetry in six facial landmarks. Anxiety status was assessed using the State-Trait Anxiety Inventory (STAI-Y). Analysis of the face showed that asymmetry and laterality of specific facial landmarks were associated with anxiety. State anxiety was associated with eyebrow and lateral angle of the eye, while trait anxiety was associated with eyebrow and lateral angle of the mouth. Moreover, as compared with contralateral landmarks, the left landmarks were lifted/expanded in subjects with elevated trait/state anxiety, whereas the right landmarks were lifted/expanded in subjects with low-trait/state anxiety.

Studies have suggested a relationship between low circulating levels of Vitamin D and depression. Vitamin D deficiency may be a consequence of depression-related factors, such as reduced sun exposure, decreased outdoor activity, and dietary changes, but it can also play a role in the pathophysiology of depressive conditions through a range of molecular mechanisms. In the present manuscript, findings related to prospective longitudinal studies on the relationship between Vitamin D levels and depressive symptoms and to randomized controlled trials on Vitamin D supplementation for depressive disorders are reviewed.

The aim of this retrospective case study is the longitudinal description of the physical and functional parameters of a top-level Paralympic swimmer class S9-SB8-SM9 during four swimming seasons of training, from the Paralympic games in London 2012 to the Paralympic games in Rio 2016. A 22-year-old male swimmer underwent a specific preventive dry-land training based on diaphragmatic breathing, postural alignment, and slow-velocity resistance training aimed to improve his muscle strength. He was tested by using the Functional Movement Screen™, photographic postural assessment and vertical jump. The swimmer improved his functional, postural and strength parameters indicating a better functional movement and muscular power. These results show that a four-year specific dry-land intervention could be capable of enhancing the functional and physical requirements of a top-level Paralympic swimmer. This approach might be a suitable novel alternative for coaches and athletic trainers to integrate their training protocols for athletes with similar impairments.

Psychopathological symptoms and reduced health related quality of life (HRQoL) are frequent in cirrhotics, but no data on their association with cirrhosis prognosis assessed by the MELDNa score are available. Prospective data on the long-term effect of deceased donor liver transplantation (LT) on psychopathological symptoms are needed. Before entering the LT waiting list, 44 consecutive LT cirrhotic candidates without a major psychiatric disorder underwent a psychopathological assessment, including Symptom Checklist-90-revised (SCL-90-R) and Defense Style Questionnaire (DSQ). HRQoL was measured by Short Form 36 Health Survey (SF-36). Abnormal performance at each questionnaire was defined by using 44 age, gender, BMI and education-matched healthy subjects. Separate binary logistic regression models were used to test the association of the Child-Pugh, MELD and MELDNa scores with abnormal performance at each questionnaire. Fourteen patients repeated the battery tests 3 years after LT. Before LT, increasing MELDNa was the only prognostic score independently associated with an abnormal SCL-90-R global psychopathological score index (OR: 1.207; 95% CI: 1.026–1.420; P = 0.02) and the best independent predictor of reduced HRQoL. After LT, compared to status prior to LT, performance at SF-36 general health perception scale ameliorated (P = 0.02), performance at SCL-90-R somatization scale (P = 0.001) and global psychopathological score index (P

Klinefelter’s syndrome (KS) is associated with specific neurobehavioral features and personality traits. The aim of our study was to investigate fluid intelligence, personality traits and personality disorders (PD) and possible correlations with testosterone in a cohort of adult KS patients. We analyzed 58 adult KS patients with the classic 47, XXY karyotype. The Structured Clinical Interview for axis II disorders was used to assess DSM IV personality disorders. Personality traits were assessed using MMPI-2. Fluid intelligence was tested by using Raven’s Standard Progressive Matrices (SPM) Test. Testosterone blood concentration was measured by CMIA. PD prevalence was 31%. Four altered MMPI scales (Social Responsibility, Dominance, Ego Strength and Repression) were found in more than 40% of patients. Overcontrolled hostility and MacAndrew Alcoholism Scale-Revised scales were altered in the PD− group only. Biz-Odd Thinking and Post-Traumatic Stress Disorder scale were associated with the presence of personality disorder. The raw SPM score was 44 ± 10.8 without any significant correlation with testosterone. No significant difference in mean age, SPM raw score and MMPI score was observed between eugonadal, hypogonadal and treated patients. Most KS patients had average fluid intelligence. PD prevalence was higher than in the general population. Testosterone was not correlated with fluid intelligence, personality traits or PD, but a reduction in marital distress was observed in treated patients. This could suggest that testosterone therapy can improve physical symptoms and this effect could also improve relationship abilities and wellness awareness.

Psychiatric disorders are common in obese patients and they are often considered contraindications for bariatric surgery. In this patients Axis I profile has been widely investigated, while only few studies on Axis II profile are reported. Aim of the study was to examine the prevalence of Axis II psychopathology, to describe the typical body image and to evaluate the prevalence of childhood abuse in bariatric surgery candidates.A total of 102 consecutive obese patients (77 females) were evaluated by the Structured Clinical Interview for DSM IV which assessed Axis I Disorders. After the exclusion of Axis I Disorders, 50 patients (36 females, BMI: 44.68 ± 9.48 Kg/m2, age: 44.5 ± 11.7 years) were enrolled. All 50 patients received a psychiatric assessment including the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II); the Body Uneasiness Test, part a (BUT-A), which assesses body image disorders; the Childhood Trauma Questionnaire (CTQ) as a screening test of childhood maltreatment histories.Nineteen patients (38%) were affected by Axis II disorders. Cluster C disorders, including avoidant, dependent and obsessive-compulsive personality disorders, represented the most common diagnosis (24%). Moreover, 34 patients (68%) showed body image disorders (BID), with a GSI score ≥1.2 and 24 (48%) referred an abuse during childhood. Patients with Axis II disorder or a body image uneasiness or a history of maltreatment during childhood, showed higher BMI in adulthood.Psychiatric comorbidities in obese patients were not only represented by depression or anxiety (Axis I disorders), but also by personality disorders (Axis II), body image disorders and childhood abuse. The identification of these conditions could improve outcomes of bariatric surgery and represent an indication for a most important psychiatric support before, during and after surgery.

Background: The aim of this study was to determine whether the serotonin transporter gene (5-HTT), a key component in the control of the serotonergic system, is associated with endometriosis in an Italian population. Findings: A case–control study, comprising 137 Italian patients with surgically confirmed endometriosis and 120 healthy controls, was carried out. 5-HTT genotypes (LL, SL and SS) were obtained by polymerase chain reaction and gel electrophoresis analysis. We found no overall difference in genotypic and allelic distributions of the 5-HTT gene between cases and controls. Conclusions: Our results suggest that the 5-HTT L/S promoter polymorphism is not associated with susceptibility to endometriosis in the studied Italian patients.

Objective.The aim of this preliminary study was to determine whether psychiatric disorders, psychopathological symptoms, and alexithymia are associated with endometriosis in an Italian population.Study Design.A preliminary study comprising 37 Italian patients with surgically confirmed endometriosis and 43 controls, without clinical and ultrasound signs of endometriosis, was carried out. Both patients and controls were evaluated for the presence/absence of psychiatric disorders, psychopathological symptoms, alexithymia, and pain symptoms (nonmenstrual pelvic pain, dysmenorrhea, and dyspareunia).Results.Statistically significant differences were found between cases and controls for prevalence of mood and anxiety disorders, malfunctioning on obsessive-compulsive subscale (P<0.01) and depression subscale (P<0.05) of the Symptom Checklist-90-Revisited (SCL-90-R), and higher alexithymia levels (P<0.01). Patients with endometriosis-associated pain showed greater prevalence of psychiatric disorders compared to pain-free patients but that difference was not significant. Significant correlation was found between malfunctioning in some SCL-90-R dimensions and pelvic pain, dysmenorrhea, and dyspareunia scores at the visual analog score (VAS).Conclusion.Some psychopathological aspects, such as psychoemotional distress and alexithymia, are more frequent in women with endometriosis and might amplify pain symptoms in these patients.

During the last years, in Italy as well abroad, psychological counseling has been spreading through university environment, offering a range of opportunities, from individual settings to post-counseling group psychotherapies. Medical students, on the basis of data from several works within international literature, would represent a population particularly exposed to stressors.In our study we have recruited a sample of 44 medical students at Sapienza University of Rome. As evaluation tools we have used: a gathering card of socio-demographic variables, the Structured Clinical Interview for DSM-IV Axis I Disorders Clinical Version (SCID-I CV) and a satisfaction card of the service. RESULTS; Fourteen students showed one or more diagnosis in Axis 1 of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Frequency analysis through χ2 test has underlined statistically significant differences relative to geographic origin variable. The service has been evaluated as alright.Although the data presented need deeper and more extensive verifications, our study supports the need of a service of psychological counseling devoted to university population and, even more, to medical students.

In almost all the universities worldwide, the admission to the Faculty of Medicine is subject to a specific selection process. In most cases tests are used to assess the cognitive abilities of the candidates. However, a growing number of universities (particularly American and Canadian) is using a set of instruments to evaluate non-cognitive skills in addition to these tests. Among the most commonly used tools are included personal interviews, Multiple Mini Interview (MMI), Personal Quality Assessment (PQA). In Italy in the last decade increasing emphasis was placed on assessing students' attitudes through the use of orientation tests (given in classrooms or online fillable), as part of several projects that involve collaboration between secondary school and university. Nevertheless, the admission to the Faculty of Medicine does not yet provide a psychological and aptitude assessment, but relies exclusively on cognitive features. In a similar way to what is already the case with the selection of personnel in law enforcement agency, we propose a selection model that includes an assessment of psychological features and aptitudes of the candidates, as well as cognitive skills.

In the last decades there was an increasing interest in early detection of prodromal symptoms in schizophrenia and, more specifically, in detecting subjects at high risk for psychosis. However, especially in case of childhood-onset schizophrenia (COS), sometimes it is possible to don't recognize its early symptoms and to ascribe the observed clinical picture to other diseases, with consequent delay in diagnosis and treatment of these patients. In this case report we want to underline the importance of an early detection of schizophrenia, with a focus on differential diagnosis between Attention Deficit/Hyperactivity Disorder and schizophrenia.

The aims of the study are to evaluate, in the Italian context, the presence and clinical features of early prodromal symptoms before the psychotic onset and, most of all, the duration of the period between the first onset of any psychiatric symptom and the psychotic onset (Duration of Untreated Illness).The study was carried out on a sample of 296 inpatients with a diagnosis of "non-affective psychosis" enrolled in "Villa dei Fiori" inpatients Clinic in Rome. The retrospective analysis was developed using clinical records and clinical interview with patients and their parents. The evaluation of the psychotic onset and of DUI was assessed with the PANSS (Positive and Negative Symptoms Scale).The mean DUI is 4.7 ± 4.4 years. We found a connection between DUI and early symptoms of psycosis: depressive symptoms (4.9; DS=5.0) were most frequently observed, followed by anxiety symptoms (5.1; DS=4.8), eating disorders (5.7; DS=3.0); obsessive symptoms (4.5; DS=3.6); social withdrawal (5.9; DS=4.9); psychotic like symptoms (2.6; DS=1.3). DUI resulted lower in psychotic like symptoms than in the depressive ones.In Italy DUI turn out to be much longer than in other Country where do exists specialized services for early intervention. For this reason seem to be necessary to explore the opportunity to develop also in Italy specialized services for adolescents and young adults at risk and at their psychotic onset.

To evaluate (i) the incidence of psychiatric disorders and (ii) the frequency of Mood Disorders diagnoses in a sample of 115 university students afferent to Sportello Counseling-Accoglienza Studenti "Fatti vivo!" of "Sapienza" University of Rome, between November 2008 and December 2010; to point out correlations with socio-demographic variables.The prevalence of Mood Disorders was evaluated with the Structured Clinical Interview for DSM IV Axis I Disorders Clinical Version (SCID-I cv), drawn up by the counselor at first meeting. Each student completed a data collection from which investigates socio-demographic characteristics. A descriptive analysis was conducted and the associations between variables and Axis I diagnoses were investigated.The overall mean age is 24.7 years. A DSM IV-TR Axis I Disorder was diagnosed in 26.9%, of which 45.2% is constituted by Mood Disorders (mean age of 25.7 years). Male students, the highest family members' mean age and the lowest regular studies (64% pursue a course of regular studies) seem to be characteristics of the subgroup of students with Mood Disorders diagnoses compared to the subgroups with other Axis I Disorders diagnoses. Moreover, the same subgroup most frequently recognizes as pathological its condition (78.6%) compared to the subgroup with other Axis I Disorders diagnoses (53.3%). Those differences, however, aren't statistically significant.The discovered percentage of Axis I diagnoses in general and Mood Disorders in particular could be considered representative of perceived unease degree in a population of university students. At the same time, the difficulty in identifying the early signs of uneasiness and in recognizing as pathological own condition interferes with and delays the awareness of the need of a psychological/psychiatric support and the expression of the help-seek.

To evaluate: (i) self-perceived stress, depressive and anxiety symptoms in a community sample of young adults; (ii) which elements have most impact on the development of mental disease; (iii) if high levels of mental disease are related to help-seeking behavior.The study was carried out on a sample of 1660 university students. The evaluation of the perceived stress was conducted using the Stress-Related Vulnerability Scale (SVS), the evaluation of depressive and anxiety symptoms with Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI). A descriptive analysis of all the data collected was carried out and the principal links between variables and level of mental disease were detected. Finally the reasons for the failure to seek help were investigated.Mean scores of BDI-II and BAI were respectively 10.9 (sigma = 8.3) and 11.4 (sigma = 9.4) and about 4% of the sample showed a pathological level of stress with the SVS. Female sex, non resident status and conflictual family climate were found to be more related with more severe anxious and depressive symptoms. Moreover, the latter ones were found to be strongly related with help-seeking behavior.In this sample mental disease associated with distress show a significant percentage. Higher level of anxiety and depressive symptoms are more related to perceived need for help and help-seeking behavior. Nevertheless the level of unexpressed help-seeking turn out to be high for multiple reason.

The principal aim of this study is: (i) to assess the rate of depressive disorders in a sample of patient in a psychotherapy service of the Department of Psychiatric Sciences and Psychological Medicine at the Sapienza University, Roma; (ii) to focus the psychopathological features of depressive patient through the SCL-90R scale; (iii) to evaluate the correlation between SCL-90R score and categorical diagnosis.The sample of this study includes 178 patients, who came to our service for a psychotherapy. The anamnestic and clinical information were collected for each patient. Each patient is submitted to the multidimensional scale SCL-90R in the curse of the first interview. A descriptive analysis of all the data collected was made and the principal links between SCL-90 R score and categorical diagnosis were detected.About 46% of the patients were depressive disorders following the DSM-IVTR diagnostic criteria. About 70% of depressive patients have psychoticism pathological scores, 60% have paranoic pathological scores, 70% anxiety pathological scores and 60% interpersonal sensibility pathological scores. The depressive dimension was pathological in about 77% of anxious patient and in 87% of patient with personality disorders.The DSM.IVTR categorical psychiatric diagnosis might underestimate important psychopathological dimensions which are underline through a dimensional scale as the SCL-90R and through a psychodynamic diagnostic instrument.

The association between pharmacological treatment and psychotherapy is frequent. However doesn't exist any agreement or guide-line about the management of this combined therapy. Therefore we considered useful to evaluate which were the most frequent way of management of the combined therapy in a sample of 120 psychiatrists.A 10-items questionnaire finalized to explore the management way of the combined therapy was administered to a sample of 120 psychiatrists. A descriptive analysis of the data was made and the association between different variables was explored. The statistical analysis was performed using SPSS 13.0.35% of the sample work as a private practitioner, 19.17% is involved in public health (CMHT'S). More than 50% of the sample consider the combined therapy as a effective. In the public field the combined treatment turn out to be the most utilized, opposite than in private practice. 75% of the sample manage alone the combined therapy, while 25% work in team with a colleague. 85% of the pharmacotherapy is utilized in psychosis with positive symptoms, followed by the mood disorder with psychotic symptoms. Neuroleptics are the most frequently prescribed drug.The combined therapy seems to be useful when coherently with the psychotherapy theory model. The pharmacological treatment should be utilized when strictly necessary and, if is possible, the combined therapy should be managed by one psychiatrist.

The depersonalization is a clinical condition of frequent observation that occurs often in the late adolescence and among the young adults. This condition most of the time causes anguish justified from the gravity of the symptomatic perception, involving consequently a series of clinical problems, not last the answer that such condition generates in the observer: answer not only aware, that influences strongly the diagnostic interpretation and the therapeutic approach.We tried to investigate this clinical condition within a sample of 267 subjects, 120 of them examinated in our outpatients ambulatory of psychotherapy and 147 examinated in E.R. and in inpatients unit.The percentage of patients with depersonalization, similarly to other studies, is quantitatively different in the two samples. However, what seems obvious is that if the differences for what concerns the frequency and the symptomatic intensity are rather marked, otherwise for what concerns the psychodinamic aspect the differences appears less sharp.This observation puts in evidence, on the model of many international studies about the latent psychosis, that in psychiatry at the seriousness of the psychodynamic and prognostic aspects not always corresponds the seriousness of the symptomatic aspects.

Differential diagnosis of brain tumor types is mainly based on cell morphology and could benefit from additional markers. The cAMP second-messenger system is involved in regulating cell proliferation and differentiation and is conceivably modulated during cancer transformation. The cAMP second-messenger system mainly activates protein kinases, which are in part docked to cytoskeleton, membranes, or organelles by anchoring proteins, forming protein aggregates that are detergent insoluble and not freely diffusible and that are characteristic for each cell type. The intracellular distribution of the detergent-insoluble regulatory subunits (R) of the cAMP-dependent protein kinase has been examined in mouse and rat glioma cells both in vitro and in vivo by immunohistochemistry. In normal rodent brains, the RIIalpha regulatory subunit is detergent insoluble only in ependymal cells, while in the rest of the brain it is present in soluble form. Immunohistochemistry shows that in both mouse and rat glioma cell lines, RIIalpha is mainly detergent insoluble. RIIalpha is localized close to the nucleus, associated with smooth vesicles in the trans-Golgi network area. Both paclitaxel and vinblastine cause a redistribution of RIIalpha within the cell. Under conditions that increased intracellular cAMP, apoptosis of glioma cells was observed, and it was accompanied by RIIalpha redistribution. Also in vivo, detergent-insoluble RIIalpha can be observed in mouse and rat gliomas, where it delineates the border between normal brain tissue and glioma. Therefore, intracellular distribution of detergent-insoluble RIIalpha can assist in detecting tumor cells within the brain, thus making the histologic diagnosis of brain tumors more accurate, and may represent an additional target for therapy.

The authors offer three interpretations of onychophagia, a widespread but largely unstudied phenomenon. The first is phenomenological, and characterises onychophagia as a non-pathological behavioural symptom present in many pathologies and a distinct syndrome that is sometimes quite severe. The second is clinical, and indicates the convergent and divergent connections between onychophagia and the most frequent eating disorders. The third is psychodynamic, and suggests an interpretative hypothesis of onychophagia itself and the frequent sensation of trouble and refusal that it often provokes even in doctors and psychotherapists.

To compare the predictive value of thallium-201 single photon emission computed tomography (SPECT) scintigraphy (Sci) and low-dose dobutamine echocardiography (Dob) in predicting late recovery of dysfunctioning myocardium in patients with recent, uncomplicated myocardial infarction (MI).19 patients (18 male, aged 58+/-8 years) with recent MI and ejection fraction50% (35.5+/-8.3%) underwent 5-15 microg/kg per min Dob, rest-redistribution Sci and coronary angiography, respectively, 14+/-6, 16+/-7 and 17+/-5 days after MI. On an eleven-segment ventricular model devised to compare Dob and Sci segment by segment, each dysfunctioning ventricular segment was considered viable if it showed recovery of mechanical function at the echocardiographic follow-up, performed 6.3+/-1.5 months after revascularization (five PTCA, five GABG) or medical therapy. Among the 104 dysfunctioning segments, of which 26 (25%) showed recovery at follow-up, Dob and Sci gave a concordant response in 50 (48%, k = 0.13), correctly predicting the recovery (or not) of function in 42. Forty-two of 54 discordant responses were due to segments judged viable only by Sci and which had no recovery at follow-up (of these 37 were akinetic or severely hypokinetic at baseline). At the segment-by-segment analysis, the sensitivity, specificity, and accuracy in predicting recovery of function at follow-up were, respectively, 69, 88 and 84% for Dob as against 88, 36 and 49% for Sci (P0.001 for both specificity and accuracy, P=NS for sensitivity).In patients with recent MI, the specificity of Dob in the detection of myocardium capable of late mechanical recovery is significantly higher with respect to Sci, whereas sensitivity is slightly, not significantly higher for the latter. It is conceivable that Sci detects viable myocardium even if it is transmurally limited to epicardial layers in segments with severely impaired mechanical function in which viability will not affect late recovery of function.

The Night Eating Syndrome (NES) is usually interpreted in organicistic and physiological terms. This paper looks at it dynamically in terms of the psychic dimension of the patient through an examination of the contrasting tensions (emptiness and fullness; saving and destroying the object, etc.) that are the unconscious cause of his NES. A relationship is suggested between nocturnal reawakenings as a form of eating behaviour and the undreamt or avoided dreams used by the patient as a defence against "perception" of the unconscious.

The major urinary proteins (MUPs) are proteins secreted by the liver and filtered by the kidneys into the urine of adult male mice and rats, the MUPs of rats being also referred to as alpha(2U)-globulins. The MUP family also comprises closely related proteins excreted by exocrine glands of rodents, independently of their sex. The MUP family is an expression of a multi-gene family. There is complex hormonal and tissue-specific regulation of MUP gene expression. The multi-gene family and its outflow are characterized by a polymorphism which extends over species, strains, sexes, and individuals. There is evidence of evolutionary conservation of the genes and their outflow within the species and evidence of change between species. MUPs share the eight-stranded beta-barrel structure lining a hydrophobic pocket, common to lipocalins. There is also a high degree of structural conservation between mouse and rat MUPs. MUPs bind small natural odorant molecules in the hydrophobic pocket with medium affinity in the 10(4)-10(5) M(-1) range, and are excreted in the field, with bound odorants. The odorants are then released slowly in air giving a long lasting olfactory trace to the spot. MUPs seem to play complex roles in chemosensory signalling among rodents, functioning as odorant carriers as well as proteins that prime endocrine reactions in female conspecifics. Aphrodisin is a lipocalin, found in hamster vaginal discharge, which stimulates male copulatory behaviour. Aphrodisin does not seem to bind odorants and no polymorphism has been shown. Both MUPs and aphrodisin stimulate the vomeronasal organ of conspecifics.

Retrovirus-mediated gene therapy is a particularly attractive approach for glioblastoma multiforme (GBM), given the poor prognosis of this tumour and its localized proliferation in post-mitotic tissue. In this study we assessed, for the first time in humans, the therapeutic potential of a newly designed bicistronic Moloney vector (pLIL-2-TK), combining the expression of a suicide gene (thymidine kinase, tk) with an immunomodulatory gene (human interleukin 2, IL-2). Evidence of transgene activity in the treated tumours is presented.

Four patients affected by glioblastoma recurrence were treated with a gene therapy-immunotherapy protocol consisting of intratumoral injections of culture cells producing a retroviral vector which expresses human interleukin-2 and the herpes simplex virus thymidine kinase genes. Seven to 14 days after implantation, the patients were treated with ganciclovir at standard doses. Anatomopathological and immunohistochemical data confirm the efficacy of transduction. From the clinical point of view, gene therapy combined with immunotherapy demonstrated safety and a short-range but clearcut oncolytic effect.

The systemic haemodynamic pattern and its changes after at least 6 months of successful percutaneous transluminal angioplasty (PTRA) was evaluated in a group of patients with renovascular hypertension (RVH). Fourteen patients, nine males and five females, aged 21 to 58 years, were studied; 12 had fibrodysplastic and two had atherosclerotic stenosing renal vascular lesions. Seven were cured and seven improved. Hypertension was characterized by increased plasma volume (PV) and total peripheral vascular resistance (TPR). Mean peripheral plasma renin activity (PRA) and 24-h urine aldosterone (UA) were elevated. However, the vasoconstriction did not appear to be related to the increased activity of the renin-angiotensin system. After at least 6 months of a successful PTRA, the fall in blood pressure (BP) was associated with a decrease in TPR; PV appeared normal, and PRA and UA became normal.

It has been shown that renal hemodynamic changes following the decrease in cardiac output (CO) after therapy with beta-blockers may affect glomerular filtration rate (GFR), therefore limiting the effectiveness of these drugs; obviously more serious effects might be expected in nephropathic patients with previously reduced renal function. Recent clinical studies have demonstrated that nadolol, a non-cardioselective beta-blocker, preserves the renal blood flow (RBF) and the GFR. In this study, the drug was administered alone (80 mg once daily) for 2 months to 9 male renal parenchymal hypertensive patients with normal or moderately reduced renal function. Systemic and renal hemodynamics, plasma volume (PV), plasma renin activity (PRA) and urinary aldosterone excretion (UA) were evaluated before and after treatment. As blood pressure (BP) fell so did the cardiac index (4.27 +/- 1.05 l/min/m2 to 3.14 +/- 0.48 p less than 0.01), while the peripheral resistance index (TPRI) rose slightly (2257 +/- 658 to 2459 +/- 498 p = NS). No change in PV, RBF, GFR and renal vascular resistance was observed. An increasing trend in PRA (0.81 +/- 0.56 to 1.27 +/- 0.95 ng/ml/h) and no change in UA were observed. Our data show that nadolol was both well tolerated and effective in lowering BP, that it caused systemic hemodynamic alterations similar to those described for other beta-blockers, and preserved RBF and GFR also in renal hypertensive patients with reduced non-azotemic renal function.

The Authors' aim was to assess the effectiveness of Sequential Scintiphotography of the Liver with 99mTc-HIDA (SSFH) in the evaluation of post operative jaundice, in operations of biliary derivation (43 observations in 28 patients). SSFH proved to be highly reliable even in comparison with more laborious procedures (such as Transhepatic Cholangiography), and superior to equally simple procedures such as Echo Tomography and Computerised Tomography, evidencing itself as the investigation of choice for the study of this pathology, especially in long-term follow-ups.

Here we report that aloe-emodin (AE), a hydroxyanthraquinone present in Aloe vera leaves, has a specific in vitro and in vivo antineuroectodermal tumor activity. The growth of human neuroectodermal tumors is inhibited in mice with severe combined immunodeficiency without any appreciable toxic effects on the animals. The compound does not inhibit the proliferation of normal fibroblasts nor that of hemopoietic progenitor cells. The cytotoxicity mechanism consists of the induction of apoptosis, whereas the selectivity against neuroectodermal tumor cells is founded on a specific energy-dependent pathway of drug incorporation. Taking into account its unique cytotoxicity profile and mode of action, AE might represent a conceptually new lead antitumor drug.