Search

Aim: The aim of the present study was to identify clinical and socio-demographic factors associated with duration of untreated illness (DUI) in patients affected by panic disorder (PD). Methods: Data were collected from patients' medical records (N = 157) of two mental health services respectively located in Milan and in Monza (Italy). Correlation analyses and analysis of variance (ANOVAs) were run to analyse the relation between DUI and quantitative/qualitative variables respectively. Statistically significant variables in uni- variate analyses were then inserted in a linear multivariable regression model (backward procedure). Results: Mean DUI was 27.33 (±50.56) months. Patients with an earlier age at onset (r = −0.270; p <.01), a longer duration of illness (r = 0.483; p <.01) and who received a lifetime psychotherapy (F = 6.86; p =.01) had a longer DUI. The final global model showed that a longer DUI was associated with pre-onset poly-substance misuse (p =.05) and a longer duration of illness (p <.01). Conclusion: The results of our study showed that a longer DUI was predicted by clinical factors such as the presence of a pre-onset poly-substance use disorder and that delayed proper treatment can lead to a chronicization of PD, as indicated by a longer duration of illness. Further studies are needed to in-depth investigate the role of DUI in influencing the course and outcome of anxiety disorders, including PD.

Introduction. Intimate partner violence (IPV) is a relevant public health issue due to its consequences on physical and mental health (mainly depression and post traumatic stress disorder) and then on the healthcare system. Aims. The main goal of this study is to evaluate the prevalence and consequences of IPV in a sample of women admitted to an outpatient clinic for anxiety and depression (VADEMECUM). Materials and methods. We conducted a cross-sectional study with 150 patients who entered the aforementioned outpatient clinic of the ASST San Gerardo Hospital in Monza (Italy) during the period October 2016-May 2017. All participants completed a screening questionnaire investigating IPV and the K6 questionnaire as index of psychological distress. Results. Among 150 women, 36 (24%) were victims of IPV: 35 with emotional abuse, 23 with physical abuse, and 7 with sexual abuse. In the "abused" group, 80% of women had psychic and physical health consequences, whilst 53% requested help from relatives/friends and/or healthcare staff. Conjugal status (p=0.024), voluntary pregnancy interruptions (p=0.015), anxiety episodes history (p=0.028), previous or current psychological treatment (p=0.001 and p=0.036, respectively), (K6) levels of psychological distress (p=0.0004) and child abuse (p=0.012) were significantly associated with IPV. Conclusions. "Abused" women have positive psychiatric history of anxiety, greater demand for psychological care, child abuse and worst psychological distress status compared to "not abused". This evidence as well as the high IPV prevalence found in our study suggest the need for appropriate screening and specific treatment pathways in psychiatric services.

The study of the microbiome in broiler chickens holds great promise for the development of strategies for health maintenance and performance improvement. Nutritional strategies aimed at modulating the microbiota-host relationship can improve chickens' immunological status and metabolic fitness. Here, we present the results of a pilot trial aimed at analyzing the effects of a nutritional strategy involving vitamin B2 supplementation on the ileum, caeca and litter microbiota of Ross 308 broilers, as well as on the metabolic profile of the caecal content. Three groups of chickens were administered control diets and diets supplemented with two different dosages of vitamin B2. Ileum, caeca, and litter samples were obtained from subgroups of birds at three time points along the productive cycle. Sequencing of the 16S rRNA V3-V4 region and NMR metabolomics were used to explore microbiota composition and the concentration of metabolites of interest, including short-chain fatty acids. Vitamin B2 supplementation significantly modulated caeca microbiota, with the highest dosage being more effective in increasing the abundance of health-promoting bacterial groups, including Bifidobacterium, resulting in boosted production of butyrate, a well-known health-promoting metabolite, in the caeca environment.

L’11 marzo 2020 l’Organizzazione Mondiale della Sanità (OMS) dichiara la malattia da nuovo coronavirus 2019 (COVID-19) una pandemia globale e la Lombardia risulta fin da subito la regione italiana più drammaticamente colpita. L’impatto della pandemia e del lockdown, in termini di conseguenze sulla salute mentale di pazienti, cittadini e operatori sanitari è ormai noto, ampiamente discusso e universalmente descritto, anche in luoghi e Paesi culturalmente e socialmente molto diversi tra di loro. Tutto ciò ha condotto a profondi cambiamenti nell’organizzazione dei Servizi ad opera dei Dipartimenti di Salute Mentale e Dipendenze (DSMD) e si è globalmente assistito, soprattutto in una fase iniziale, ad una contrazione delle prestazioni erogate (sia ospedaliere che territoriali) e ad un incremento degli interventi erogati in modalità telematica, con la definizione di procedure, linee guida e modalità operative alternative nei diversi Servizi afferenti ai DSMD. In questo lavoro vengono descritti alcuni esempi dei cambiamenti avvenuti all’interno del DSMD dell’ASST di Monza nel periodo marzo-maggio 2020. La ricaduta sul lungo periodo in termini psicopatologici e psicosociali di un evento di tale portata rimane complessa e, ad ora, solo in parte prevedibile in relazione alla sua evoluzione nel prossimo futuro: tale esperienza porrà nuove e fondamentali sfide ai Dipartimenti di Salute Mentale e, più in generale, ai Servizi sanitari, che si troveranno a ridefinire priorità e a rimodulare piani di intervento che consentano una rapida riorganizzazione in caso di nuove circostanze emergenziali ed il reperimento di risorse in grado di garantire interventi più rapidi, appropriati ed efficaci.

BACKGROUND. Chimeric antigen receptor (CAR) T cell immunotherapy has resulted in complete remission (CR) and durable response in highly refractory patients. However, logistical complexity and high costs of manufacturing autologous viral products limit CAR T cell availability. METHODS. We report the early results of a phase I/II trial in B cell acute lymphoblastic leukemia (B-ALL) patients relapsed after allogeneic hematopoietic stem cell transplantation (HSCT) using donor-derived CD19 CAR T cells generated with the Sleeping Beauty (SB) transposon and differentiated into cytokine-induced killer (CIK) cells. RESULTS. The cellular product was produced successfully for all patients from the donor peripheral blood (PB) and consisted mostly of CD3+ lymphocytes with 43% CAR expression. Four pediatric and 9 adult patients were infused with a single dose of CAR T cells. Toxicities reported were 2 grade I and 1 grade II cytokine-release syndrome (CRS) cases at the highest dose in the absence of graft-versus-host disease (GVHD), neurotoxicity, or dose-limiting toxicities. Six out of 7 patients receiving the highest doses achieved CR and CR with incomplete blood count recovery (CRi) at day 28. Five out of 6 patients in CR were also minimal residual disease negative (MRD–). Robust expansion was achieved in the majority of the patients. CAR T cells were measurable by transgene copy PCR up to 10 months. Integration site analysis showed a positive safety profile and highly polyclonal repertoire in vitro and at early time points after infusion. CONCLUSION. SB-engineered CAR T cells expand and persist in pediatric and adult B-ALL patients relapsed after HSCT. Antileukemic activity was achieved without severe toxicities.

The successful implementation of chimeric antigen receptor (CAR)-T cell therapy in the clinical context of B cell malignancies has paved the way for further development in the more critical setting of acute myeloid leukemia (AML). Among the potentially targetable AML antigens, CD33 is insofar one of the main validated molecules. Here, we describe the feasibility of engineering cytokine-induced killer (CIK) cells with a CD33.CAR by using the latest optimized version of the non-viral Sleeping Beauty (SB) transposon system "SB100X-pT4." This offers the advantage of improving CAR expression on CIK cells, while reducing the amount of DNA transposase as compared to the previously employed "SB11-pT" version. SB-modified CD33.CAR-CIK cells exhibited significant antileukemic activity in vitro and in vivo in patient-derived AML xenograft models, reducing AML development when administered as an "early treatment" and delaying AML progression in mice with established disease. Notably, by exploiting an already optimized xenograft chemotherapy model that mimics human induction therapy in mice, we demonstrated for the first time that CD33.CAR-CIK cells are also effective toward chemotherapy resistant/residual AML cells, further supporting its future clinical development and implementation within the current standard regimens.