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Le malattie del trofoblasto di origine gestazionale (GTD) rappresentano una complicanza rara della gravidanza. Esse si dividono in forme benigne (mola idatiforme parziale e completa) e maligne (tumori del trofoblasto, GTN). Nonostante la prognosi favorevole che attualmente accompagna tale diagnosi, la natura stessa di queste malattie costituisce una considerevole fonte di stress per le pazienti che ne sono affette. Metodi. Trentuno pazienti affette da GTD hanno completato una batteria di questionari autosomministrati volti a valutare il ruolo dei meccanismi di difesa nell’influenzare l’adattamento psicologico alla malattia, in particolare la presenza di sintomi ansiosi e depressivi e lo stress legato all’infertilità. Risultati. Le pazienti affette da tumori del trofoblasto riportano un maggiore utilizzo di meccanismi di difesa maturi rispetto alle pazienti con mola idatiforme. Le analisi di regressione evidenziano che, al netto di variabili demografiche e mediche correlate alla patologia, i meccanismi di difesa immaturi mantengono una relazione specifica con l’ansia di stato e con lo stress legato all’infertilità riportato dalle pazienti. Conclusioni. I risultati suggeriscono l’importanza di considerare, nella progettazione di interventi clinici, gli specifici meccanismi di difesa messi in atto dalle pazienti, in quanto significativamente coinvolti nel modulare l’adattamento psicologico alle GTD Gestational Trophoblastic Disease (GTD) is a group of disorders that derive from the placenta and arise after a rare gestational event. They can be divided into pre-malignant forms (partial and complete hydatidiform mole) and malignant forms called Gestational Trophoblastic Neoplasia (GTN). Despite a favourable prognosis, the nature of this group of disorders can be a source of stress for patients who are affected by this disease. Methods. Thirty-one patients diagnosed with GTD completed a battery of self-administered questionnaires aimed at analysing the psychological adaptation of the patients to the disease. The variables analysed were the following: defense mechanisms, anxiety, depression and infertility-related stress. Results. Patients with GTN use mature defense mechanisms significantly more than patients with hydatidiform mole. Regression analyses highlight that, considering demographic and clinical variables, immature defense mechanisms are significantly related to state anxiety. Immature defence mechanisms also significantly predict infertility-related global stress. Conclusions. The results show the importance of taking into consideration defense mechanisms used by patients, as they are involved in the modulation of psychological adaptation to GTD.

The present research aims to obtain information on cancer deaths in the five Latium provinces in the years 2006-2010 and to highlight similarities and differences between them.The survey was carried through statistical elaboration of cancer mortality data for the years 2006-2010 obtained from the National Institute of Statistics.The mortality due to oncological diseases in Rieti province showed a decreasing temporal trend for the years investigated. Among all the Latium provinces, Rieti presented the lowest standardized mortality rates. This phenomenon could be related to specific environmental conditions and low levels of air, water and soil pollution affecting the Rieti province.The results of the present study show that the "healthy" environment of Rieti province could be considered as a benchmark for studies in oncological diseases.

The aim of the study was to perform a preliminary analysis of the mortality data for cancer as widely as possible, in order to obtain useful information for planning specific public health interventions. For this purpose, data on cancer mortality in the province of Rieti (Latium, central Italy) have been collected and analysed. To date, in the Rieti province a Cancer Registry record is not available.The study was conducted through statistical analysis of cancer mortality data related to the years 2008 and 2009, obtained from the National Institute of Statistics. Data were cumulative for the province of Rieti and specific for the five districts in which the province is divided.The standardized mortality rates obtained for Rieti province resulted lower than those reported for the other provinces of the Latium region, for Italy and for the European Community, both for 2008 and 2009. In these years, the anatomical areas more affected in terms of mortality were "trachea, bronchus and lung", "colorectal" and "stomach", but gender differences were evidenced.The present study, also considering the limitation of two years studied only, leads to some basic insights about the importance of updating mortality data to trace an epidemiological profile, to evaluate the presence of risk and protective factors, to program strategically health interventions, and to assess the effectiveness of these interventions.

Prosaposin is a neurotrophic factor that has been demonstrated to mediate trophic signalling events in different cell types; it distributes to surface membranes of neural cells and also exists as a secreted protein in different body fluids. Prosaposin was demonstrated to form tightly bound complexes with a variety of gangliosides, and a functional role has been suggested for ganglioside-prosaposin complexes. In this work, we provide evidence that exogenous prosaposin triggers a signal cascade after binding to its target molecules on lipid rafts of pheochromocytoma PC12 cell plasma membranes, as revealed by scanning confocal microscopy and linear sucrose gradient analysis. In these cells, prosaposin is able to induce extracellular signal-regulated kinase phosphorylation, sphingosine kinase activation, and consequent cell death prevention, acting through lipid rafts. These findings point to the role of lipid rafts in the prosaposin-triggered signalling pathway, thus supporting a role for this factor as a new component of the multimolecular signalling complex involved in the neurotrophic response.

Exposure to single and multiple carcinogenic metals and/or semimetals represents a major environmental risk factor for public health. In particular, children are more susceptible to environmental pollutants than adults, but specific studies are still limited. The aims of the present study were: 1) to trace the exposure and co-exposure profiles to eight known or suspected carcinogenic metals and semimetals (As, Be, Cd, Co, Cr, Ni, Pb, and Sb); and: 2) to evaluate the influence of some possible interfering/confounding factors on the exposure to these elements during childhood.Cross-sectional study.We recruited 159 healthy Italian children attending a primary school of the urban area of Rome, Italy. Selected metals were determined by inductively coupled plasma mass spectrometry on urinary samples collected at the end of a "typical" day (one sample for each child), while information about possible confounding/interfering factors were collected via questionnaires.The great part of the studied children resulted co-exposed to the monitored metals: 83.2%, 69.2%, 51.0% and 29.3% of the participants were concurrently exposed to at least two, three, four and five trace elements, respectively. Gender was the only one among the investigated variable that significantly influenced the co-exposure, with females resulting at lower risk (OR = 0.392; 95 IC = 0.156 - 0.989; p0.047).Given the importance of protecting child's health and the risks related to the exposure to carcinogenic metals, especially when they occur simultaneously, other researches in this field are strongly recommended.

Purpose: Chemotherapy-induced nausea (CIN) is a relevant problem for gynaecological cancer patients. The evaluation of CIN is a key aspect in its management, along with the identification of associated risk factors. The objective of the study was to compare different measurements of nausea and to investigate personal risk factors in CIN development. Method: Eighty-one women treated for gynaecological cancers took part. The presence of CIN was evaluated using the MASCC Antiemesis Tool (MAT) and a patient’s report to clinicians at the subsequent chemotherapy cycle. Personal risk factors were assessed using the State-Trait Anxiety Inventory and a self-report questionnaire. Results: The study shows that the agreement between patients’ assessment of CIN with MAT and what they referred to clinicians was only moderate for acute nausea (Cohen’s Kappa = 0.55; p < 0.001), while good for delayed nausea (Cohen’s Kappa = 0.68; p < 0.001). At multiple logistic regression analysis, younger age, anticipatory nausea, patient medium-high expectations of CIN, and parity emerged as risk factors for the development of acute nausea (p = 0.0087, 0.0080, 0.0122 and 0.0021, respectively). Patient medium-high expectations of CIN and being single resulted to be risk factors for delayed nausea (p = 0.0397 and 0.0024, respectively). Conclusions: Our findings confirm that personal factors contribute to individual differences in the development of CIN; moreover, we highlight the importance of CIN evaluation by clinicians, underlining the need to usereliable instruments.

Purpose This research aimed to investigate the socio-demographic, clinical, and psychological variables predictive of a greater functioning and quality of life in patients with gynecological cancer after their first cycle of carboplatin and taxol-based chemotherapy. Methods The sample of the present research consisted of 104 patients. The European Organization on Research and Treatment of Cancer QLQ-C30, the State-Trait Anxiety Inventory-Form Y, and the Multidimensional Scale of Perceived Social Support were administered to each participant. Results The analyses showed that higher state anxiety levels predicted a lower role, emotional, and social functioning and a lower general quality of life. Higher trait anxiety levels and social support perceived from one’s friends predicted a greater role functioning. Similarly, having a relationship predicted a greater physical, cognitive, and social functioning. On the contrary, the presence of relapsed cancer was negatively associated with these patients’ quality of life. Conclusions The present study highlighted the importance of identifying patients at higher risk of experiencing lower levels of functioning and worse general quality of life to implement tailored interventions from the beginning of treatment, thus improving the quality of life of these patients throughout the chemotherapy treatment.

Gestational trophoblastic disease (GTD) represents a spectrum of rare pregnancy-related disorders, including both premalignant and malignant entities. Although GTD's medical outcomes have been widely explored, limited data are available regarding the related psychological, sexual, and fertility issues. The present chapter aims to enhance comprehension of the psychosocial impact of GTD by discussing the main quantitative and qualitative evidence available in this field. Although patients globally report a good quality of life, clinically significant levels of anxiety and depression have been consistently found across studies. Similarly, despite the quality of couple relationships being generally satisfactory, they often complain of a lack of sexual desire. Moreover, pregnancy loss may raise significant and long-term fertility-related concerns. Specific socio-demographic and clinical factors have been identified as predictors of psychosocial outcomes. At the clinical level, research suggests that there is a need to provide multidisciplinary care to patients.

COVID-19 pandemic involved several psychosocial consequences. We aimed at monitoring the mental health of Italian adults during the lockdown imposed by the government. We present here results from the baseline assessment of the "EmotionalThermometer [TermometroEmotivo] project on a sample of 1548 Italian adults. We assessed the socio-demographic conditions of participants, individuals' perception of the COVID-19-situation, psychological distress, emotion regulation strategies, and perceived social support. Having a worse representation of COVID-19 and consulting news more frequently, with higher anxiety and less credibility of different sources of information, were positively associated with psychological distress and post-traumatic responses. Being female, younger age, living in high-risk regions, having symptoms of COVID-19, and having relatives/friends with such symptoms represented risk factors for a worse perception of COVID-19 and distress. Social support and cognitive reappraisal represented protective factors for mental health.

Purpose of Review We aim to provide quantitative evidence on the psychological impact of epidemic/pandemic outbreaks (i.e., SARS, MERS, COVID-19, ebola, and influenza A) on healthcare workers (HCWs). Recent Findings Forty-four studies are included in this review. Between 11 and 73.4% of HCWs, mainly including physicians, nurses, and auxiliary staff, reported post-traumatic stress symptoms during outbreaks, with symptoms lasting after 1–3 years in 10–40%. Depressive symptoms are reported in 27.5–50.7%, insomnia symptoms in 34–36.1%, and severe anxiety symptoms in 45%. General psychiatric symptoms during outbreaks have a range comprised between 17.3 and 75.3%; high levels of stress related to working are reported in 18.1 to 80.1%. Several individual and work-related features can be considered risk or protective factors, such as personality characteristics, the level of exposure to affected patients, and organizational support. Summary Empirical evidence underlines the need to address the detrimental effects of epidemic/pandemic outbreaks on HCWs’ mental health. Recommendations should include the assessment and promotion of coping strategies and resilience, special attention to frontline HCWs, provision of adequate protective supplies, and organization of online support services. Electronic supplementary material The online version of this article (10.1007/s11920-020-01166-z) contains supplementary material, which is available to authorized users.

Breast cancer and its pharmacological treatment often induce an impairment in women's sexual functioning and couple relationships, as a consequence of physiological changes and psychosocial issues that may arise and persist long after treatment. This study aims to evaluate the sexual functioning, the quality of the couple relationship, and the overall health status of breast cancer survivors. A further objective is to determine the predictive role of specific clinical and sociodemographic variables for sexual functioning and the couple relationship. Sixty-four breast cancer survivors completed the following questionnaires: the Female Sexual Function Index (FSFI), the Dyadic Adjustment Scale (DAS), the Short Form Health Survey-12 (SF-12), and a self-report questionnaire to collect sociodemographic characteristics. Clinical information was retrieved from medical records. Compared to normative data, our sample reported significantly (p .01) lower mean scores in the FSFI, DAS, and Physical Component (PCS) and Mental Component Summary (MCS) of the SF-12. Multiple regression analyses show a significant effect of age, hormonal therapy, and psychological well-being on sexual functioning and a significant effect of physical and mental well-being on the quality of the couple relationship. Additionally, 75% of patients qualified for sexual dysfunction as measured by the FSFI global scale, and 71.9% declared they were not adequately informed about the side effects of treatments on sexuality. The high prevalence of sexual dysfunction in breast cancer survivors underlines the need for specific attention to this problem, starting from a complete and targeted communication between patients and health providers regarding these side effects.El cáncer de mama y su tratamiento farmacológico frecuentemente producen un deterioro del funcionamiento sexual de las mujeres y de las relaciones de pareja como consecuencia de los cambios fisiológicos y los problemas psicosociales que pueden surgir y continuar mucho después del tratamiento. Este estudio tiene como finalidad evaluar el funcionamiento sexual, la calidad de la relación de pareja y el estado de salud general de las sobrevivientes de cáncer de mama. Otro objetivo es determinar el papel predictivo que desempeñan las variables clínicas y sociodemográficas específicas para el funcionamiento sexual y la relación de pareja. Sesenta y cuatro sobrevivientes de cáncer de mama contestaron los siguientes cuestionarios: el Índice de la Función Sexual Femenina (Female Sexual Function Index, FSFI), la Escala de Ajuste Diádico (Dyadic Adjustment Scale, DAS), la Encuesta Breve sobre la Salud-12 (Short Form Health Survey-12, SF-12) y un cuestionario de autoinforme para recopilar características sociodemográficas. Se obtuvo información clínica de expedientes médicos. En comparación con los datos normativos, nuestra muestra informó puntajes de la media significativamente más bajos (p0.01) en el FSFI, en la DAS y en el Resumen del Componente Físico (PCS) y del Componente Mental (MCS) de la SF-12. Los análisis de regresión múltiple indican un efecto significativo de la edad, la terapia hormonal y el bienestar psicológico en el funcionamiento sexual, y un efecto significativo del bienestar físico y mental en la calidad de la relación de pareja. Además, el 75 % de las pacientes reunió los requisitos de disfunción sexual según la medición de la escala global del FSFI, y el 71.9 % declaró que no estaba adecuadamente informado acerca de los efectos secundarios de los tratamientos en la sexualidad. La alta prevalencia de disfunción sexual en las sobrevivientes de cáncer de mama subraya la necesidad de atender este problema de manera específica, partiendo de una comunicación completa y dirigida entre pacientes y profesionales de la salud con respecto a estos efectos secundarios.乳腺癌及其药物治疗往往会对妇女的性功能和夫妻关系造成损害，这是由生理变化和社会心理问题引起的，并在治疗后长期存在。本研究旨在评估乳腺癌幸存者的性功能、夫妻关系的质量和整体健康状况。另一个目标是确定特定临床和社会人口学变量对性功能和夫妻关系的预测作用。 对64名乳腺癌幸存者进行调查。他们完成了以下问卷：女性性功能指数(FSFI)、二元调整量表(DAS)、健康调查简表-12(SF-12)，以及一份收集社会人口特征的自我报告问卷。临床资料则从病历中提取。 与常模数据相比，我们的样本报告的FSFI、DAS、SF-12的生理成分（PCS）和心理成分总结（MCS）的平均得分显著降低（P0.01）。多元回归分析显示，年龄、激素治疗和心理健康对性功能有显著影响，身心健康对夫妻关系质量有显著影响。此外，75%的患者符合FSFI全局量表测量的性功能障碍，71.9%的患者宣称没有充分了解乳腺癌治疗对性欲方面的副作用。性功能障碍的发病率高。乳腺癌幸存者中性功能障碍的高发率凸显了对这一问题给予特别关注的必要性，从患者和医疗服务提供者之间就这些副作用进行全面和有针对性的沟通开始。.

Introduction Prevalence of suicidal ideation (SI) and behaviours are higher among patients with cancer than general population. No systematic review/meta-analysis investigated this topic; therefore, our aim will be to assess the relationship between cancer and SI and behaviours. Methods We will search PubMed/MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO and Cochrane Library databases from their inception until 30 June 2018. Case– control and cohort studies focused on the association between cancer (any type) and suicidal outcomes (suicide, suicide attempt and SI) will be included. Two team members will independently: (A) perform the selection of the included studies and data extraction, with the supervision of a third member in case of discrepancies and (B) assess each study with: (1) Newcastle-Ottawa Scale (NOS); (2) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement; (3) Grading of Recommendations Assessment, Development and Evaluation (GRADE). We will conduct a random-effects meta-analysis. Individual and pooled ORs and associated 95% CIs will be calculated as well as between-study heterogeneity. We will examine the potential for publication bias. If possible, we will explore reasons for potential between-study heterogeneity. Ethics and dissemination This study does not require ethical approval. The study will be submitted to a peer reviewed journal, will be publicly disseminated and will be the topic of research presentations, This work is partly supported by the Swedish Cancer Society (grant no: CAN 2014/417), Swedish Research Council for Health, Working Life, and Welfare (grant no: 2017-00531), Karolinska Institutet (Senior Researcher Award and Strategic Research Area in Epidemiology Award)

The cancer genetic counseling (CGC) identifies genetic mutations for hereditary neoplastic diseases, but little is known on its psychological effects on subjects. Methods. The present study involved women who underwent genetic counseling for breast or ovarian cancer: 19 unaffected, 43 current patients, and 28 past patients. The aim of the study was to examine the relation between coping strategies and the quality of life during genetic counseling before testing, considering the effects of psychopathological symptoms and the health status. Results. Results showed that the use of avoidance strategies led to a decrease in quality of life, and that this relationship was entirely mediated by the intensity of psychopathological symptoms, while the health status did not show any effect on it. Conclusions. The study, which is the first in Italy, suggests the importance of assessing coping strategies in subjects who undergo the CGO to identify individuals who are at risk of decrease of psychological well-being. Indeed, psychological counselling improving coping strategies could preserve the psychological well-being of individuals.

Background Gestational Trophoblastic Disease comprises a group of benign and malignant disorders that derive from the placenta. Using Leventhal’s Common-Sense Model as a theoretical framework, this paper examines illness perception in women who have been diagnosed with this disease. Methods Thirty-one women diagnosed with Gestational Trophoblastic Disease in a hospital in Italy were asked to complete the Illness Perception Questionnaire-Revised to measure the following: illness Identity, illness opinions and causes of Gestational Trophoblastic Disease. Results High mean scores were observed in the Emotional representations and Treatment control subscales. A significant difference emerged between hydatidiform mole patients and those with gestational trophoblastic neoplasia on the Identity subscale. A significant correlation emerged between “time since diagnosis” and the Treatment control subscale. Discussion This study is the first to investigate illness perception in Gestational Trophoblastic Disease. From a clinical perspective the results highlight the need for multidisciplinary support programs to promote a more realistic illness perception.

Objectification theory was tested as a suitable framework for explaining sexual orientation differences in disordered eating behaviors in college-aged Italian men. The theory's applicability to 125 homosexual and 130 heterosexual men was investigated using self-report questionnaires. Gay men scored significantly higher on exposure to sexually objectifying media, body surveillance, body shame, disordered eating behaviors, and depression than heterosexual men. Although path analyses support the theory's applicability to both groups, for gay men the path model demonstrated a better fit to the objectification theory for disordered eating and depression. Practical implications are discussed.

Objective: Previous studies have shown that taking care of elderly, demented patients carries a high cost to caregivers' health, and is associated with negative consequences for physical and mental health. The aim of this study is to investigate which socio-demographic and clinical variables are significantly associated with higher levels of distress in caregivers, and the relationship between caregivers' levels of distress and the coping strategies they adopt. Patients and participants: The study samples 112 caregivers of demented patients, consecutively admitted to the Department of Neurology of San Raffaele-Turro Hospital (Milan, Italy). Measurements and results: Caregivers were asked to complete the CBI and the COPE. Caregivers with the highest levels of distress are characterised by an impaired physical health status. Avoidance coping may represent a risk factor associated with higher levels of distress; conversely, an active and problem-focused approach to stressful situations may act as a protective factor. © Springer-Verlag 2008.