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Recent years have seen a growing interest in psychoanalytic and psychodynamic psychotherapy regarding clinical work with young adults. What has been particularly useful in defining the specific nature of clinical work with young adults is the construct of emerging adulthood. This work puts forward a psychoanalytic psychotherapeutic approach aimed at emerging adults, illustrating it through clinical cases. The objective of this approach is to help young adults acquire greater awareness of their resources, inclinations, and relational models, promoting consolidation of the process of subjectification. Therefore, therapy intends to foster the capacity of the patient to process the feelings of instability and indecision typical of emerging adulthood, serving as a secure basis for the exploration and mentalization of identity aspects which are in the shadows or have been colonized by alienating parental introjections. From the perspective of developmental psychoanalysis, the therapist performs an action aimed to promote interrupted or suspended developmental processes in young adults. This action pays attention to the definition of their life choices relating to the present and the capacity to design their future, creating a safe space suitable for fostering the emergence of the potential of the Self and the consequent process of becoming a subject.

Fasting before procedural sedation is a hot topic in everyday medical life with the main concern regarding pulmonary aspiration. Fasting guidelines before procedural sedation have always been the same as those used for general anaesthesia. However, procedural sedation and general anaesthesia differ in terms of invasiveness, drugs, duration and patient characteristics. This results in lower risk of pulmonary aspiration during procedural sedation, when compared to general anaesthesia. Moreover, a large case series of sedations performed in the emergency department with no respect for the proper fasting times showed no association between fasting duration and any type of adverse event with the latter occurring also in patients that properly fasted. The type of procedure (with the need of airway management) and characteristics of the patient seem to matter more. Furthermore, prolonged fasting is uncomfortable and has been associated with hypoglycaemia and dehydration. For this reason, fasting guidelines before procedural sedation should be adapted on the presence of risk factors, such as ASA score, need for airway management, comorbidities, type of procedure and drug used.

Witnessing domestic violence may have serious negative consequences for the health, development and well-being of children. Only recently, witnessing domestic violence has been evaluated as a form of child maltreatment, considering the effects it may have within the family. Domestic violence is a complex and lasting experience that often results in interruptions, losses and challenges for the meaningful relationships of children. Children have very often feelings of fear, worry, guilt, helplessness and sadness and adopt strategies to deal with such traumatic situations. Moreover, children exposed to domestic violence have a high risk of having delays in cognitive, psychic, emotional and physical development with school and social interaction difficulties, internalising and externalising problems, learning disorders, aggressive behaviour and post-traumatic symptoms. Therefore, it is critical to early identify the signals that children show to help them and their family get out of the violent and abusive environment.

The study examined the effectiveness of a brief psychodynamic counseling intervention on psychological distress and general life satisfaction in a sample of 124 students by comparing pre- and posttreatment data. The authors also tested the moderating role of pretreatment attachment styles. Results showed that most participants (57%) can be classified as a nonclinical population, whereas only a minority of participants belong to a clinical population (17%) and a subclinical population (26%) according to the Symptom Checklist 90 Revised (SCL-90-R). Psychodynamic counseling intervention was shown to be associated with a decrease in the Global Severity Index and the anxiety and depression subscales of the SCL-90-R. Clinical effectiveness was greater for participants belonging to the clinical group. General life satisfaction increased significantly for all students. The authors found no moderation effect of attachment styles. Brief psychodynamic counseling intervention was associated with a reduction of psychological distress and an increase in life satisfaction.

Background - Motherhood in adolescence is associated with numerous risk factors that could have a negative effect on the well-being of the mother, on her parenting skills and on the relationship with her child. Aims - To assess the psychopathological profile and psychosocial risk factors of 104 adolescent and young mothers (age range 13-21) who were recruited at the Child Neuropsychiatric Unit of ASST “Santi Paolo and Carlo” Hospital (Milan, Italy). Materials and method - 3 months after giving birth, mothers filled in a personal data sheet; maternal attachment models and reflective functioning were evaluated with Adult Attachment Interview and the presence of maternal adverse childhood experiences were analysed with CECA. Depressive risk with EPDS, anxiety risk with STAI-Y and parenting stress with PSI-SF were also assessed. Results - 75% of mothers have a low socio-economic level and 80% have low levels of education. In 79% of the cases, the mothers do not work and 50% of them interrupted their studies. Pregnancy is mostly not desired (76%) and the majority of them have a family history of parenthood in adolescence. On a psychopathological level, depressive and anxious risks are high. Most adolescent and young mothers have an insecure attachment model with low reflective functioning; moreover, 51% of the mothers have experienced at least one adverse childhood experience and adverse experiences are often cumulative. Conclusion - The study shows a high-risk psychopathological and psychosocial profile of motherhood in adolescence, which can have an effect on the mother's health, affecting her ability to interact and build an adequate relationship with her child. It is therefore important to implement early interventions to support the child-adolescent mother relationship from the earliest phases, promoting maternal mentalization and sensitivity.

Transition to parenthood is considered a critical process for mothers of twins. There are, however, few studies on the subject. This study aims to evaluate the differences between mother-twin infant dyads and mother-singleton infant dyads with regard to maternal depression, anxiety, parenting stress, and the quality of mother-infant interaction. Mothers of twin infants (N = 40) were compared to mothers of singletons (N = 72). At infant 3months, maternal depression, anxiety, and parenting stress were assessed via a questionnaire and styles of interaction with the Care-Index. The results indicated that mothers of twins (vs mothers of singletons) had significantly higher state anxiety and higher scores on the Difficult Child Scale of the Parenting Stress Index at infant 3months. No significant differences between the two groups were found with regard to maternal depression. Mothers of twins had significantly lower sensitivity and were more unresponsive than mothers of singletons. Twin infants had significantly more difficult and compliant behaviours than singleton infants. Assisted reproductive treatment (ART) and prematurity had no effect on any of the examined variables. State anxiety was shown to partially mediate the relationship between twin parenthood and maternal sensitivity and to completely mediate the relationship between twin parenthood and infant difficult style. Maternal unresponsiveness was shown to be exclusively linked to being the parent of twins. The study shows that twin parenthood has a significant effect on maternal mental health and on the quality of mother-infant interaction and highlights the importance of early prevention programmes for twin parents.

Adolescent motherhood is a turning point in the life of the young mother, entailing potentially positive reorganization of her developmental trajectories. Very often, however, it is weighed down by cumulative risk factors which make her relationship with the infant difficult, with short- and long-term effects on the development of the infant and on the wellbeing of the mother. In fact, early motherhood is frequently associated with several risk factors both during pregnancy and post-partum, as socio-economic disadvantage, low levels of education, lack of social support, unstable relationships with the partner, being a single parent, and living with a multi-problematic family. Adolescent mothers are also more likely than adult mothers to have insecure attachment models and to have experienced physical, sexual, and emotional abuse. Moreover, in the perinatal period, adolescent mothers often suffer from mental health issues such as depression, anxiety, and parenting stress. With regard to the relationship with their infants, adolescent mothers have difficulty understanding the needs of their infants, often adopting intrusive and neglecting behavior with harsh parenting. In turn children of adolescent mothers are at risk for insecure and disorganized attachment, for suffering maltreatment by mothers, and for having psychopathological problems. We present an attachment-based intervention program (PRERAYMI, Promoting Responsiveness, Emotion Regulation, and Attachment in Young Mothers and Infants) to support adolescent mothers from pregnancy up to 2 years of the children, involving, when present, the father. It is based on the video feedback technique, psychological counselling, and developmental guidance with the aim to improve maternal sensitivity and mentalization and child secure attachment to the mother and to prevent psychopathological problems of the mother and the child.

BACKGROUNDMaternal-fetal attachment (MFA) is the emotional bond between a mother and her fetus and is influenced by numerous risk and protective factors during pregnancy. However, according to the literature, the results relating to the influence of these factors are mixed.METHODThe aim of the study is to identify the relationship between MFA and maternal distress, evaluated as maternal depression and anxiety, alexithymia, and perceived social support during the prenatal period in an Italian community sample. Ninety-four pregnant women completed self-report questionnaires.RESULTSResults showed that total MFA was negatively associated with maternal anxiety and alexithymia and was positively associated with social support. Moreover, maternal depression was negatively associated with the quality subscale of MFA The quality subscale of MFA was negatively associated with maternal state and trait anxiety and alexithymia and was positively associated with social support. The intensity subscale of MFA was positively associated with social support. Multiple regression showed that alexithymia and social support predicted MFA with a higher effect than maternal depression and anxiety.CONCLUSIONSThe results are useful for planning interventions aimed at supporting the mother-infant bond starting from pregnancy.

Placental implantation anomalies in first-trimester abortions may determine severe bleeding leading to hysterectomy. There are very few cases of urgent hysterectomy post-abortion reported in the literature, related to placenta accreta spectrum, but in any of them is considered association with benign trophoblastic lesions. We report the case of a woman, who underwent surgical voluntary abortion by vacuum aspiration during first trimester, without any apparent surgical complications. Immediately, after this procedure, the patient had massive vaginal bleeding; an emergency hysterectomy was performed. Histological examination showed an exaggerated placental site (EPS). Morphological findings describe a trophoblastic tumor-like lesion, which differs from placenta accreta and often considered an asymptomatic occasional feature. Proliferative index, evaluated by double immunostain for CK8-18 and Ki-67, was unremarkable (

The study examined the effectiveness of PRERAYMI (Promoting Responsiveness Emotion Regulation and Attachment in Young Mothers and Infants) attachment-based intervention programme aimed at adolescent mother-infant dyads. The intervention used video-feedback and developmental guidance to promote maternal mind-mindedness and sensitivity. 32 adolescent mother-infant dyads in the intervention group were compared to 12 adolescent mother-infant dyads in the control group. Maternal mind-mindedness and maternal/infant styles of interaction were evaluated, at the pre-treatment (infant 3 months) and at the post-treatment (infant 9 months). The results indicated the effectiveness of the intervention in enhancing mind-mindedness, with more mind-related comments and fewer non-attuned mind-related comments, maternal sensitivity and infant cooperative behaviour, and in reducing maternal controlling behaviour, in the intervention group. Changes in mother/infant interaction styles or in mind-mindedness in the control group were not detected. The attachment based medium term intervention helped to improve adolescent mother-infant relationship, which is otherwise potentially at risk.

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.

Background: Intimal sarcomas are rare malignant mesenchymal tumors arising from the heart and large blood vessels. Their intraluminal growth leads to vascular obstructive symptoms and peripheral neoplastic embolization. Direct infiltration of the lungs or metastases to the pulmonary system, occur in 40% of cases and extrathoracic spread is frequent, also in presentation. Intussusception is an unusual event in adults, accounting for Case Presentation: We describe a rare case of a 50-year-old man suffering of bowel obstruction due to intussusception sustained by a small bowel metastasis of a primary cardiac intimal sarcoma. One year and a half before the onset of abdominal symptoms, a grade II intimal sarcoma was removed from his left atrium and consequently he followed a chemotherapy protocol. Four months later a CT scan revealed local recurrence. Eighteen months after heart surgery he referred to the ER with abdominal pain. CT scan showed an ileal intussusception and the patient was scheduled for surgery. A tract of 10 cm ileus was removed containing an intramural polypoid solid mass. Histological analyses revealed a grade II intimal sarcoma consistent with his first diagnosis.Conclusion: Primary heart tumors are late found and often partially resected, therefore metastatic pathways are to be expected. Adult small bowel intussusception is a rare event and caused by a malignancy in one third of cases. Therefore, our recommendation is to always resect the tract involved in order to perform a proper diagnosis.

Skin manifestations of COVID-19 infections are diverse and are new to the dermatology community. We had the opportunity to examine the clinical and histopathological features of several patients who were divided into 3 groups. The first group included 8 COVID-19–positive patients who were hospitalized and quarantined at home. The second group included children and young adults who presented with chilblain erythema, erythema multiforme, and urticaria-like lesions. This group of patients was negative for the COVID-19 gene sequences by polymerase chain reaction but had a high risk of COVID-19 infection. The third group included clinically heterogeneous and challenging lesions. These patients were not subject to either polymerase chain reaction tests or serological analyses because they sought dermatological attention only for a dermatosis. The histopathological analysis of these cases showed a wide spectrum of histopathological patterns. What appears to be constant in all skin biopsies was the presence of prominent dilated blood vessels with a swollen endothelial layer, vessels engulfed with red blood cells, and perivascular infiltrates, consisting mainly of cytotoxic CD8+ lymphocytes and eosinophils. In 2 cases, there was diffuse coagulopathy in the cutaneous vascular plexus. In the early phases of the disease, there were numerous collections of Langerhans cells in the epidermis after being activated by the virus. The presence of urticarial lesions, chilblains, targetoid lesions (erythema multiforme–like lesions), exanthema, maculohemorrhagic rash, or chickenpox-like lesions associated with the histopathological features mentioned previously should cause clinical dermatologists to suspect the possibility of COVID-19 infection, especially in patients with fever and cough.

Summary About one-third of endometrial carcinomas (ECs), mainly of endometrioid histology, harbor the mismatch repair (MMR) defects and microsatellite instability (MSI). Among these, ECs arising in women with Lynch syndrome (LS) account for a large proportion. To date, no somatic genetic analyses have been published comparing LS-ECs with sporadic ECs. In this work, we examined the mutational profiles of a well-characterized series of sporadic and LS-related ECs, performing exonic targeted sequencing of 16 genes mainly involved in MSI ECs. Next-generation sequencing analysis was performed in 35 ECs on the MiSeq platform (Illumina, San Diego, CA), and the mutational profile was analyzed integrating molecular and immunohistochemical data. PTEN, ARID1A, and ARID2 were the most frequently mutated genes regardless of MSI status or family history. MSI ECs showed a higher mutational load than MMR-proficient cases, exhibiting an MMR-deficient mutational signature. Among MSI tumors, LS-related and sporadic ECs exhibited similar mutational profiles, with MSH2 as the most commonly mutated gene. KRAS mutations seemed to be more common in sporadic MSI ECs than in LS-related ECs even if further studies are needed to confirm this finding. MMR-deficient ECs carried a higher mutational load and an excess of C>T transitions compared with MMR-proficient ECs, suggesting that the use of a small gene panel may be adequate to highlight significant differences between these 2 groups. An integrated analysis of genetic and epigenetic features of LS-related and sporadic ECs provides useful insights into disease biology and diagnostic classification of these tumors.

The study evaluated reflective functioning (RF), maternal attachment, mind-mindedness, and emotional availability among 44 adolescent mother–infant dyads and 41 adult mother–infant dyads. At infant age 3Âmonths, mother–infant interaction was coded with the mind-mindedness coding system and Emotional Availability Scales; mother attachment and RF were evaluated with the Adult Attachment Interview (AAI). Adolescent mothers (vs. adult mothers) were more insecure and had lower RF; they were also less sensitive, more intrusive and hostile, and less structuring of their infant’s activity; they used fewer attuned mind-related comments and fewer mind-related comments appropriate to infant development. In adult mothers, the Mother Idealizing and Lack of Memory AAI scales were correlated to non-attuned mind-related comments and the Father Anger scale to negative mind-related comments. In adult mothers, RF was associated with sensitivity. This was not the case with adolescent mothers. In both groups of mothers, there were no associations between sensitivity and mind-mindedness

Microsatellite instability (MSI) testing is tricky in gynaecological cancers (GC). Thus, we aimed to describe the instability patterns to improve MSI test interpretation in sporadic and hereditary GCs. Ninety-five cases, including uterine and ovarian cancers, with known genetic and immunohistochemical (IHC) features, were analysed for MSI by a mononucleotide repeats pentaplex (MRP). We identified 13 ambiguous cases that did not fully meet MSI criteria (‘borderline’ cases, B-MSI), which were mainly represented by MSH2/MSH6-deficient and Lynch syndrome cases. Also, we evaluated nine additional loci of candidate MSI markers that did not improve the detection of MSI cases, but might be useful for discordant or borderline samples. In conclusion, although MSI and IHC test are highly concordant, a subset of ambiguous MSI cases deserves a careful interpretation in particular when MSH2/MSH6 are involved.RPL22andSRPRtesting may be useful to integrate MRP panel for the analysis of critical cases.

RNASET2 is an extracellular ribonuclease endowed with a marked antitumorigenic role in several carcinomas, independent from its catalytic activity. Besides its antitumorigenic role by the recruitment to the tumor mass of immune cells from the monocyte/macrophage lineage, RNASET2 is induced by cellular stress and involved in actin cytoskeleton remodeling affecting cell interactions with the extracellular matrix (ECM). Here, we aimed to investigate the effects of RNASET2 expression modulation on cell phenotype and behavior in epithelial ovarian cancer (EOC) cellular models. In silico analysis on two publicly available datasets of gene expression from EOC patients (n = 392) indicated that increased RNASET2 transcript levels are associated with longer overall survival. In EOC biopsies (n = 101), analyzed by immunohistochemistry, RNASET2 was found heterogeneously expressed among tumors with different clinical&ndash, pathological characteristics and, in some cases, its expression localized to tumor-associated ECM. By characterizing in vitro two models of EOC cells in which RNASET2 was silenced or overexpressed, we report that RNASET2 expression negatively affects growth capability by conferring a peculiar cell phenotype upon the interaction of EOC cells with the ECM, resulting in decreased src activation. Altogether, these data suggest that drugs targeting activated src might represent a therapeutic approach for RNASET2-expressing EOCs.

Objective: In the 1st year of the post-partum period, parenting stress, mental health, and dyadic adjustment are important for the wellbeing of both parents and the child. However, there are few studies that analyze the relationship among these three dimensions. The aim of this study is to investigate the relationships between parenting stress, mental health (depressive and anxiety symptoms), and dyadic adjustment among first-time parents. Method: We studied 268 parents (134 couples) of healthy babies. At 12 months post-partum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Post-natal Depression Scale, the State-Trait Anxiety Inventory, and the Dyadic Adjustment Scale. Structural equation modeling was used to analyze the potential mediating effects of mental health on the relationship between parenting stress and dyadic adjustment. Results: Results showed the full mediation effect of mental health between parenting stress and dyadic adjustment. A multi-group analysis further found that the paths did not differ across mothers and fathers. Discussion: The results suggest that mental health is an important dimension that mediates the relationship between parenting stress and dyadic adjustment in the transition to parenthood.

Primary marginal zone B-cell MALT-type lymphomas of the uterine corpus are exceedingly rare entities, with only 6 cases reported in the literature to date. We present the additional case of a 70-yr-old white woman who underwent a laparoscopic total hysterectomy with bilateral salpingo-oophorectomy for an asymptomatic ovarian cyst. At microscopic examination, endometrial samples showed a dense, nodular lymphocytic infiltrate, suggestive of a lymphoproliferative disorder. Morphology, immunohistochemistry, and molecular analysis supported the diagnosis of MALT-type lymphoma of the endometrium. Benign reactive conditions, such as endometritis and other small B-cell lymphomas were ruled out. Moreover, we investigated the pathogenesis of our case, focusing on Chlamydia trachomatis infection, chromosomal translocations affecting the NF-kB pathway, and discussing the role of autoimmunity in the development of MALT-type lymphomas.

Background: Maternal childhood experiences of maltreatment affect parenting and have consequences for a child's social-emotional development. Adolescent mothers have a higher frequency of a history of maltreatment than adult mothers. However few studies have analyzed the interactions between adolescent mothers with a history of childhood maltreatment and their infants. Objective: The aim of the study was to examine the effect of maternal childhood experiences of maltreatment on mother-infant emotion regulation at infant 3 months, considering both infant and mother individual emotion regulation and their mutual regulation. Participants: Participants were 63 adolescent and young adult mother-infant dyads recruited at a hospital. Methods: The mothers were administered the Adult Attachment Interview to evaluate reflective functioning and attachment and the Childhood Experiences of Care and Abuse was used to evaluate maternal childhood experiences of maltreatment. Mother-infant interactions were coded with a modified version of the Infant Caregiver Engagement Phases. Results: Dyads with mothers with childhood maltreatment (vs dyads with mothers with no maltreatment) spent more time in negative emotional mutual regulation (p = .009) and less time in positive and neutral mutual emotion regulation (p = .019). Cumulative maternal childhood experiences of maltreatment were associated positively with mother and infant negative states at individual and dyadic level and with the AAI scales of Passivity and Unresolved Trauma (p < .05). The effect of cumulative maternal childhood experiences of maltreatment on mother-infant emotion regulation was direct and not mediated by maternal attachment and reflective function. Conclusions: Maternal childhood experiences of maltreatment increase the risk connected to early motherhood, affecting mother-infant emotion regulation.

Background: While the association between anxiety and postpartum depression is well known, few studies have investigated the relationship between these two states and parenting stress. Furthermore, a number of studies have found that postpartum depression affects mother-infant emotion regulation, but there has been only one study on anxiety and emotion regulation and no studies at all on parenting stress and emotion regulation. Therefore, the primary aim of our study is to identify, in a community sample of 71 mothers, the relationship between maternal depression, anxiety, and parenting stress. The second aim is to examine the relationship between anxiety, postpartum depression, and parenting stress and mother-infant emotion regulation assessed at 3 months. Methods: Mother-infant interaction was coded with a modified version of the Infant Caregiver and Engagement Phases (ICEP) using a microanalytic approach. The Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), and Parenting Stress Index-Short Form (PSI-SF) were administered to the mothers to assess depression, anxiety, and parenting stress, respectively. Results: Analysis revealed correlations between anxiety and depression, showing that parenting stress is associated with both states. In a laboratory observation, depression was correlated with both negative maternal states and negative dyadic matches as well as infant positive/mother negative mismatches; anxiety was correlated with both negative maternal states and infant negative states as well as mismatches involving one of the partners having a negative state. Multiple regression analysis showed that anxiety is a greater predictor than depression of less adequate styles of mother-infant emotion regulation. Parenting stress was not shown to predict such regulation.

Introduction: As part of the flourishing line of enquiry into children's emotion understanding, wereport the results of a conversation-based intervention study aimed at improving participants' emotioncomprehension, and exploring the intervention effect as a function of attachment security. Method: The study was conducted at school with the participation of 98 second-grade children (meanage: 7 years, 7 months; SD: 3.4 months). Participants were assigned to experimental and control groupsthat were balanced with respect to attachment security and insecurity as evaluated using the SeparationAnxiety Test (SAT). The experimental group was exposed to a conversational intervention, in whichshort story readings with emotional content were used to stimulate discussion on the nature, causes andregulation of emotion. The children in the control group listened to the same stories, but did not takepart in the conversational activity. Children from both groups were individually pre- and post-tested onmeasures of emotional lexicon (ELT) and emotion comprehension (TEC). Results: The training was found to have a significant effect on the emotion comprehension of the childrenallocated to the experimental group. In addition, non-secure children displayed higher gains in emotioncomprehension than secure participants. The implications of the findings for educational and schoolcontexts are discussed. Introduction. – Dans le domaine fertile des recherches sur la compréhension de l’émotion par les enfants,nous exposons les résultats d’une étude, basée sur le dialogue, visant l’amélioration de la compréhensionde l’émotion de la part des enfants et explorant l’effet de l’intervention en fonction de la sécurité del’attachement. Méthodologie. – L’étude a été conduite à l’école, avec la participation de 98 étudiants de deuxième année (âge moyen : 7 ans, 6 mois ; écart-type : 3,5 mois). Les étudiants ont été répartis dans des groupes expéri-mental et de contrôle, équilibrés par rapport à la sécurité ou l’insécurité de l’attachement et évalués par le Separation Anxiety Test (SAT). Le groupe expérimental a été exposé à une intervention conversationnelle, basée sur des courts contes à contenu émotionnel, visant la stimulation de la discussion sur la nature, lescauses et la régulation de l’émotion. Les enfants dans le groupe de contrôle ont écouté les même comptes,mais ils n’ont pas pris part à l’activité conversationnelle. Les enfants des deux groupes ont été individu-ellement testés a priori et a posteriori sur des mesures de lexique émotionnel (ELT) et de compréhensionde l’émotion (TEC). Résultats. – Les analyses ont montré un effet significatif de l’entraînement à la compréhension de l’émotionparmi les enfants du groupe expérimental. Également, les enfants insécurisés ont fait preuve de gains plusimportants dans la compréhension de l’émotion par rapport aux enfants sécurisés. Les implications deces résultats sont ensuite discutées

ObjectiveRecent data from the literature indicate gynecological cancers (GCs) as sentinel cancers for a diagnosis of Lynch syndrome (LS). Clinical approaches to identifying LS have low sensitivity, whereas somatic tests on GCs may be a more sensitive and cost-effective strategy.MethodsA series of 78 GCs belonging to 74 patients sent to the Genetic Counselling Service were investigated using microsatellite instability, immunohistochemical expression of mismatch repair (MMR) genes, and MLH1 promoter methylation.ResultsThe presence of microsatellite instability was observed in 67.5% of GCs, and the absence of immunohistochemical expression of at least 1 of the 4 MMR proteins was observed in 71.4% of GCs, showing 96.1% concordance between the methods. Methylation analysis using methylation specific multiplex ligation-dependent probe amplification performed on 35 samples revealed MLH1 promoter hypermethylation in 18 cases (54%). Molecular analysis identified 36 LS carriers of MMR variants (27 pathogenetic and 9 variants of uncertain significance), and, interestingly, 3 LS patients had MLH1 methylated GC.With regard to histological features, LS-related GCs included endocervical cancers and also histological types different from the endometrioid cancers. The presence of peritumoral lymphocytes in GCs was statistically associated with LS tumors.ConclusionsSomatic analysis is a useful strategy to distinguish sporadic from LS GC. Our data allow the identification of a subset of LS patients otherwise unrecognized on the basis of clinical or family history alone. In addition, our results indicate that some clinicopathological features including age of GC diagnosis; presence of peritumoral lymphocytes; isthmic, endocervical sites, and body mass index value could be useful criteria to select patients for genetic counseling.

In recent years, the role played by the stromal microenvironment has been given growing attention in order to achieve a full understanding of cancer initiation and progression. Because cancer is a tissue-based disease, the integrity of tissue architecture is a major constraint toward cancer growth. Indeed, a large contribution of the natural resistance to cancer stems from stromal microenvironment components, the dysregulation of which can facilitate cancer occurrence. For instance, recent experimental evidence has highlighted the involvement of stromal cells in ovarian carcinogenesis, as epitomized by ovarian xenografts obtained by a double KO of the murine Dicer and Pten genes. Likewise, we reported the role of an ancient extracellular RNase, called Ribonuclease T2 (RNASET2), within the ovarian stromal microenvironment. Indeed, hyperexpression of RNASET2 is able to control tumorigenesis by recruiting macrophages (mostly of the anticancer M1 subtype) at the tumor sites. We present biological data obtained by RNASET2 silencing in the poorly tumorigenetic and highly RNASET2-expressing human OVCAR3 cell line. RNASET2 knockdown was shown to stimulate in vivo tumor growth early after microinjection of OVCAR3 cells in nude mice. Moreover, we have investigated by molecular profiling the in vivo expression signature of human and mouse cell xenografts and disclosed the activation of pathways related to activation of the innate immune response and modulation of ECM components. Finally, we provide evidence for a role of RNASET2 in triggering an in vitro chemotactic response in macrophages. These results further highlight the critical role played by the microenvironment in RNASET2-mediated ovarian tumor suppression, which could eventually contribute to better clarify the pathogenesis of this disease., JRC.I.1-Chemical Assessment and Testing

The perinatal period is recognized as a sensitive time for a mother’s psychological state. While depressive symptoms have been widely studied in mothers, only recently literature is increasing on man’s psychological adjustment during the perinatal period, but still there is a lack of studies considering both woman and man’s perinatal mood. The aim of the study was to compare different contexts of transition to parenthood, characterized by the presence of specific risk factors (adolescent pregnancy, twin pregnancy, preterm birth) with conditions with low psychosocial risk, assessing the prevalence of maternal and paternal depressive symptoms and the relationship between woman and man’s symptomatology. Parental couples were recruited in different contexts, according to the aims of the study. For each field to investigate, 30 couples (30 mothers and fathers) were recruited (during the woman’s pregnancy or after childbirth), for a total of 180 couples. Consent form, socio-demographic form and Parental Cumulative Psychosocial Risk Questionnaire (PCPSRQ; PRIN, 2013) were completed by participants. The Edinburgh Postnatal Depression Scale (EPDS) was completed by women and men at 3 months postpartum in the Italian version, using validated cut-off values. Based on the literature, we expect to find a higher prevalence of depressive symptoms, in both mothers and fathers, where more relevant risk factors related to parenthood are present. We also expect to find a significant relationship between maternal and paternal mood. This study underlines the relevance of promoting prevention and intervention for both mothers and fathers, during a sensitive period as the perinatal one, considering the possible presence of specific risk factors. This research is supported by grants from PRIN 2013/2016 20107JZAF4, Italian Ministry for Education, University and Research (MIUR).

Parenting should be conceived as a dynamic process effected by multiple and multi-level historical and current influences (Belsky & Vondra, 1989). The cumulative effects of multiple “distal” risk factors such as education and income, and “proximal” risk factors such as parental stress, supports, and depressive symptoms, are more influential than the effect of any risk factor alone (Sameroff, 2000). The present study is part of a PRIN research funding aimed to a) identify how post-partum depression throughout the first year of the child’s life might affect the mother-infant interaction and affect regulation, b) analyze the relationship between these variables and the quality of attachment and possible indicators of risk in children with respect to psychopathological problems in the second year of life; c) identify mediating factors with respect to these variables. The current work focuses on the last objective and aims to verify the factorial structure of the Parental Cumulative Psychosocial Risk Questionnaire (PCPSRQ; PRIN, 2013), created to collect information on first time fathers and mothers by means of a self-report. 650 first time parents, 268 mother-father dyads and 114 mothers (mothers’ mean age= 32.9 yrs; SD 6.16; fathers’ mean age= 36.8, SD= 6.12) completed the PCPSRQ during the 6th month of pregnancy. Dichotomous individual, historical, social, and circumstantial variables were included. The Factorial analysis with Mplus confirmed the PCPSRQ hypothesized factorial structure (e.g., medical pregnancy, paternal mental disorders, maternal mental disorders). The PCPSRQ appears as a valid instrument in order to evaluate cumulative risks that need to be considered in supporting the child’s health and her/his relationship with the caregiver. This research is supported by grants from PRIN 2013/2016 20107JZAF4, Italian Ministry for Education, University and Research (MIUR).

Background: A compromised base excision repair (BER) promotes carcinogenesis by accumulating oxidative DNA-damaged products as observed in MUTYH-associated polyposis, a hereditary colorectal cancer syndrome marked by adenomas and cancers with an accumulation of 8-oxoguanine. Remarkably, DNA global demethylation has been shown to be mediated by BER, suggesting a relevant interplay with early colorectal tumourigenesis. To check this hypothesis, we investigated a cohort of 49 adenomas and 10 carcinomas, derived from 17 MUTYH-associated polyposis patients; as adenoma controls, we used a set of 36 familial adenomatous polyposis and 24 sporadic polyps. Methods: Samples were analysed for their mutational and epigenetic status, measured as global LINE-1 (long interspersed nuclear element) and gene-specific LINE-1 MET methylation by mass spectrometry and pyrosequencing. Results: MUTYH-associated polyposis adenomas were strikingly more hypomethylated than familial adenomatous and sporadic polyps for both DNA demethylation markers (P=0.032 and P=0.007 for LINE-1; P=0.004 and P

Ovarian carcinosarcomas (OCS), also known as malignant mixed mesodermal/Mullerian tumors, are rare neoplasms (1%-4% of all malignant ovarian tumors) composed of high-grade malignant epithelial and mesenchymal elements. OCS occurs in older women. It is associated with a poor outcome and is usually not involved in inherited cancer syndromes. We present 2 cases of OCS; one arising in a patient with a pathogenetic BRCA1 mutation and the other in a woman affected by Lynch Syndrome (LS) carrying a MSH6 germline mutation. To the best of our knowledge, this is the first time that this second type of case has been reported. In this study, we investigated somatic impairment of the wild-type BRCA1 and MSH6 alleles in the OCS of these 2 patients. We also explored in both OCS, the occurrence of TP53 loss of function, which is a genetic alteration known to occur in BRCA-linked ovarian tumorigenesis but not in LS tumors. Moreover, we also provide further data about the histogenesis of OCS.

Objective To evaluate the risk factors potentially involved in the development of cervical intraepithelial neoplasia (CIN) recurrence after cervical conization in a long-term follow-up period. Study design Consecutive patients with histologically proven CIN who had undergone either cold knife conization or a loop electrosurgical excision procedure were enrolled and scheduled for serial follow-up examinations over a 10-year period. Data were stored in a digital database. Multivariate analysis was performed to identify factors for recurrence. Results Between January 1999 and December 2009, 282 patients fulfilled the inclusion criteria and were included in the final statistical analysis. After a median follow-up of 26.7 months (range 6–100), 64 (22.7%) women developed histologically confirmed recurrence. The 2-year recurrence-free survival was 83.7% and 66.7% for women with negative and positive margins, respectively ( p = 0.008). The 5-year recurrence-free survival was 75.4% and 50.3% for patients with negative and positive margins, respectively ( p = 0.0004). Positive surgical margin was the most important independent predictor of recurrence [HR 2.5 (95%CI 1.5–4.5), p = 0.0007; Wald 11.338]. After multinomial logistic regression the indication for conization based on persistent CIN1 was the only independent predictor for negative margin [OR 0.3 (95%CI 0.1–0.7), p = 0.008]. Conclusions Our study demonstrated that the surgical margin status represents the most important predictor for CIN recurrence after conization. After excisional therapy, close follow-up is mandatory for the early detection of recurrent disease. The identification of risk factors for recurrence may guide clinical decision-making on expectant management versus re-intervention.

A recent body of evidence indicates an active role for stromal (mis)-regulation in the progression of neoplasias. Within this conceptual framework, genes belonging to the growing but still poorly characterized class of tumor antagonizing/malignancy suppressor genes (TAG/MSG) seem to play a crucial role in the regulation of the cross-talk between stromal and epithelial cells by controlling malignant growth in vivo without affecting any cancer-related phenotype in vitro. Here, we have functionally characterized the human RNASET2 gene, which encodes the first human member of the widespread Rh/T2/S family of extracellular RNases and was recently found to be down-regulated at the transcript level in several primary ovarian tumors or cell lines and in melanoma cell lines. Although we could not detect any activity for RNASET2 in several functional in vitro assays, a remarkable control of ovarian tumorigenesis could be detected in vivo. Moreover, the control of ovarian tumorigenesis mediated by this unique tumor suppressor gene occurs through modification of the cellular microenvironment and the induction of immunocompetent cells of the monocyte/macrophage lineage. Taken together, the data presented in this work strongly indicate RNASET2 as a previously unexplored member of the growing family of tumor-antagonizing genes.