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Antonia Pierobon,1 Elisa Sini Bottelli,1 Laura Ranzini,1 Claudio Bruschi,2 Roberto Maestri,3 Giorgio Bertolotti,4 Marinella Sommaruga,5 Valeria Torlaschi,1 Simona Callegari,1 Anna Giardini1 1Psychology Unit, 2Department of Pulmonary Rehabilitation, 3Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano, 4Psychology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tratate, 5Clinical Psychology and Social Support Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Camaldoli, Italy Abstract: In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in COPD and may affect pulmonary rehabilitation delivery and outcome. The aims of the study were to describe a COPD population in a rehabilitative setting as regards the patients depressive symptoms, anxiety, mild cognitive impairment (MCI) and self-reported adherence and to analyze their relationships; to compare the COPD sample MCI scores with normative data; and to investigate which factors might predict adherence to prescribed physical exercise. This was a multicenter observational cross-sectional study. Of the 117 eligible stable COPD inpatients, 84 were enrolled according to Global initiative for chronic Obstructive Lung Disease (GOLD) criteria (mainly in Stage III–IV). The assessment included Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), anxiety, depression and self-reported pharmacological and nonpharmacological adherence. From the MMSE, 3.6% of patients were found to be impaired, whereas from the MoCA 9.5% had a likely MCI. Patients referred had mild-severe depression (46.7%), anxiety (40.5%), good pharmacological adherence (80.3%) and difficulties in following prescribed diet (24.1%) and exercise (51.8%); they struggled with disease acceptance (30.9%) and disease limitations acceptance (28.6%). Most of them received good family (89%) or social (53%) support. Nonpharmacological adherence, depression, anxiety and MCI showed significant relations with 6-minute walking test, body mass index (BMI) and GOLD. Depression was related to autonomous long-term oxygen therapy modifications, disease perception, family support and MCI. In the multivariate logistic regression analysis, higher BMI, higher depression and lower anxiety predicted lower adherence to exercise prescriptions (P=0.0004, odds ratio =0.796, 95% CI =0.701, 0.903; P=0.009, odds ratio =0.356, 95% CI =0.165, 0.770; and P=0.05, odds ratio =2.361, 95% CI =0.995, 5.627 respectively). In COPD patients, focusing on pharmacological and nonpharmacological adherence enhance the possibility of tailored pulmonary rehabilitation programs. Keywords: depression, anxiety, mild cognitive impairment, adherence, COPD, pulmonary rehabilitation

Introduction: In recent decades, there has been extensive research on the association between Autism Spectrum Disorders (ASD) and Eating Disorders (ED), as well as the existence of sensory sensitivity alterations in both diagnostic groups. Objectives: The present study aimed to examine the presence of autistic traits in a sample of adult women diagnosed with different ED, and the concurrent role of autistic traits and sensory sensitivity in both their eating disorder symptomatology and their autism-related eating behaviours. Methods: Seventy-five women with different ED completed the Eating Attitude Test (EAT-26), the Autism Quotient (AQ), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), the Sensory Perception Quotient - Short Form 35 item (SPQ-SF35) and the Swedish Eating Assessment for Autism Spectrum Disorders (SWEAA), which investigates specific eating behaviour related to autism. Results: 12% of the sample scored above the cut-off at both the AQ and the RAADS-R, while 68% scored above the cut-off at the RAADS-R only. We found an association between: i) hypersensitivity in the taste domain and ED severity and autistic-like eating behaviours; ii) hypersensitivity in the vision domain and autistic-like eating behaviours; iii) higher autistic traits and ED severity and autistic-like eating behaviours. Conclusions: This study confirms the presence of autistic traits in patients with ED and underscores the significance of conducting additional systematical investigations on this topic across all diagnostic categories of ED. It is becoming progressively evident that identifying and measuring the levels of autistic traits in patients with ASD is crucial not only for a better understanding of the causes of these disorders, but also because it would help to tailor specific therapeutic interventions, especially considering the cognitive flexibility issues presented by these patients and the socio-emotional challenges they face. Additionally, this study has laid the foundation for further insights into the relationship between sensory sensitivity and dysfunctional eating behaviours typical of ED and ASD. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

This study examined the presence of autistic traits in a sample of adult women diagnosed with different Eating Disorders (ED), and explored the concurrent role of autistic traits and sensory sensitivity in influencing both their eating disorder symptomatology and their autism-related eating behaviours. Seventy-five women with different ED (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, Other Specified Feeding or Eating Disorder) completed the Eating Attitude Test (EAT-26), the Autism Quotient (AQ), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), the Sensory Perception Quotient - Short Form 35 item (SPQ-SF35) and the Swedish Eating Assessment for Autism Spectrum Disorders (SWEAA). Twelve percent of participants scored above the cut-off on both the AQ and the RAADS-R, while 68% scored above the cut-off on the RAADS-R only. A mediation analysis revealed that the association between sensory sensitivity (SPQ-SFR35) and scores on both the EAT-26 and the SWEAA was significantly mediated by the presence of autistic traits (RAADS-R). These findings, first, confirm the presence of autistic traits in individuals with ED; second, they show that a lower sensory threshold (i.e., a higher sensory sensitivity) is associated with a higher presence of autistic traits which were, in turn, positively associated with dysfunctional eating behaviours typical of ED and ASD. This study ultimately highlights the importance of further research on autistic traits across all diagnostic categories of ED., (© 2024. The Author(s).)

Summary: Spontaneous intraparenchymal hemorrhage (IPH) is relatively common and has a very important impact on clinical outcomes, motor and functional abilities and it may affect different cognitive domains. A 60-year-old male was admitted in post-acute phase, at Istituti Clinici Scientifici Maugeri IRCCS, to undertake neuro-motor treatment for a period of 4 months. The patient was affected by IPH. The clinical presentation revealed left hemiparesis, mild dysphagia, cognitive deficits (attention, visuospatial abilities and executive functions), psychiatric symptoms, emotional dysregulation and previous difficulties in medication management. The patient received an intensive cognitive, motor, speech and occupational rehabilitative intervention. Neuropsychological, motor, speech and occupational assessment and computerized tomography were performed before and after rehabilitative training to evaluate changes after the interdisciplinary intervention. The patient showed an improvement in cognitive, motor, speech and functional performances as well as in emotional aspects. After 1 year at home, the patient performed an outpatient visit that shown the substantial maintenance of the performances reached after the rehabilitative intervention. Rehabilitative interventions after IPH should always be provided by interdisciplinary teams in order to reach the best possible clinical outcomes and to maintain them over time., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by GIMLE.)

Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease characterized by partially irreversible chronic airflow limitation. Current literature highlights that COPD patients also have an increased risk to develop Mild Cognitive Impairment (MCI) and dementia. Chronic patients with cognitive impairment experience a worsening of health-related quality of life, mainly because it could affect treatment self-management, medication adherence and personal independence. Moreover, they also report high levels of anxiety and depression, which are associated with disease severity, poor quality of life, poor adherence to rehabilitation programs and difficulties in self-management. In current literature, there is a lack of studies describing simultaneously the associations between cognitive impairment, dysfunctional psychosocial factors, self-management abilities and their impact on pharmacological/non-pharmacological adherence. Therefore, the aim of the present short review is to describe the implications of cognitive impairment and psychosocial factors for clinical practice and disease management in COPD patients. Due to the interaction of these factors on adherence to rehabilitation programs, self-management and rehabilitation completion, future research should investigate simultaneously the role of all these different aspects to individuate a specific clinical approach that might include specific screening tools to evaluate cognitive impairment and psychosocial difficulties. A timely specific evaluation, within an interdisciplinary approach, could help to implement a more individualized and personalized treatment., (Copyright © 2020 Ranzini, Schiavi, Pierobon, Granata and Giardini.)

Introduction: Chronic obstructive pulmonary disease (COPD) is a complex multi-component disorder characterized by progressive irreversible respiratory symptoms and extrapulmonary comorbidities, including anxiety-depression and mild cognitive impairment (MCI). However, the prevalence of these impairments is still uncertain, due to non-optimal screening methods. This observational cross-sectional multicentre study aimed to evaluate the prevalence of anxiety-depressive symptoms and MCI in COPD patients, identify the most appropriate cognitive tests to screen MCI, and investigate specific cognitive deficits in these patients and possible predictive factors., Materials and Methods: Sixty-five stable COPD inpatients (n = 65, aged 69.9±7.6 years, mainly stage III-IV GOLD) underwent the following assessments: Hospital Anxiety and Depression Scale (HADS), Geriatric Depression Scale (GDS) or Beck Depression Inventory-II (BDI-II), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and a complete neuropsychological battery (ENB-2) including different cognitive domains (attention, memory, executive functions, and perceptive and praxis abilities)., Results: Moderate-severe anxiety was present in 18.5% of patients and depressive symptoms in 30.7%. The prevalence of MCI varied according to the test: 6.2% (MMSE), 18.5% (MoCA) and 50.8% (ENB-2). In ENB-2, patients performed significantly worse compared to Italian normative data on digit span (5.11±0.9 vs. 5.52±1.0, p = 0.0004), trail making test-B (TMT-B) (176.31±99.5 vs. 135.93±58.0, p = 0.004), overlapping pictures (26.03±8.9 vs. 28.75±8.2, p = 0.018) and copy drawing (1.370.6 vs. 1.61±0.5, p = 0.002). At logistic regression analysis, only COPD severity (p = 0.012, odds ratio, OR, 4.4 [95% CI: 1.4-14.0]) and anxiety symptoms (p = 0.026, OR 4.6 [1.2-17.7]) were significant and independent predictors of the deficit in copy drawing, which assesses visuospatial and praxis skills., Conclusion: Given the prevalence of neuropsychological impairments in COPD patients, the routine adoption in rehabilitation of screening tools for mood and cognitive function, including digit span, TMT-B and copy drawing, may be useful to detect psychosocial comorbidities and personalize the rehabilitative program., Competing Interests: The authors have declared that no competing interests exist.

A retrospective study was performed to evaluate the incidence of seizure and anticonvulsant prophylaxis in 138 patients operated from september 1987 to august 1989 for extra-axial supratentorial tumors. 15 patients (10.9%) developed seizures in the early post-operative period. We have considered the importance of histological type and side of lesions, a previous history of epilepsy and the pre and intraoperative prophylaxis. We can say that there is a statistical significance between sellar and middle cranial fossa tumors and the frequency of post-operative epilepsy and that anticonvulsant prophylaxis can reduce post-operative seizure. There is no statistical significance between the previous history of epilepsy the type of anesthesia and post-operative seizure.

Forty-nine patients operated during an early clipping phase of cerebral aneurysm were reviewed; none had an associated ventricular flooding and/or intraparenchymal hematoma. Starting from the day of operation 37 patients were treated with anticonvulsant drugs using methods and dosages where were unlikely to guarantee efficacious cover. Forty-two patients made a satisfactory recovery, 5 patients died and 2 had severe neurological sequelae; 2 patients (4.4%) had early seizures during the first week after operation. In view of the inadequate cover of the anticonvulsant drugs and the homogeneous clinical characteristics of patients included in the study, the low number of attacks suggests an overall re-evaluation of anticonvulsant treatment and the need to select patients with a higher risk of an epileptic attack.