[Obesity psychological treatment: beyond cognitive and behavioral therapy]

The psychological assessment of the patient with obesity aims to identify the factors of maintenance of excess weight, such as eating disorders or anxio-depressive disorders. Psychotherapy helps a better weight management. Cognitive-behavioral therapy has shown its effectiveness in the treatment of obesity. New psychotherapeutic approaches are explored. The hypnosis and mindfulness are proposed for the management of emotions and stress. A targeted approach on the body image disorder decreases body dissatisfaction. When post-traumatic stress syndrome is involved, EMDR (Eye Movement Desensitization & Reprocessing) is better than other types of therapies. Family therapy is indicated when the entourage is impacted. Psychological difficulties should be the subject of specific care.

Circulating plasma antioxidants, inflammatory markers and asymptomatic carotid atherosclerosis in end-stage renal disease patients: a case control study

Few studies have been conducted on the relationship between antioxidant plasma vitamin concentrations, inflammatory markers and carotid atherosclerosis with inconclusive results in endstage renal disease (ESRD) patients. A case-control study was performed to investigate the relationship between plasma antioxidant concentrations, inflammatory markers, and carotid intima-media thickness (CIMT) in healthy subjects and in patients undergoing hemodialysis (HD). We enrolled 40 subjects (20 healthy, 20 with ESRD) asymptomatic for carotid atherosclerosis. After carotid ultrasound investigation (CUI), medical history data, physical examination, venous blood samples were collected. These were analyzed for concentrations of antioxidant vitamins (A, E), carotenoids (lycopene, beta-carotene), inflammatory markers (C-reactive protein, fibrinogen), and lipid profile. Low concentrations of vitamin A, vitamin E, lycopene, and beta-carotene were significantly associated with carotid atherosclerosis in patients with ESRD (p less than 0.001). In addition, high concentration of low density lipoprotein cholesterol and total cholesterol (p less than 0.01), C-reactive protein and fibrinogen (p less than 0.001) were also associated with carotid atherosclerosis, while other laboratory parameters considered (high density lipoprotein cholesterol and triglycerides) were not significantly associated with carotid atherosclerosis. A regular intake of foods rich in antioxidant vitamins with low fat concentrations may slow the progression of atherosclerotic process in this group of patients.

[Respiratory function involvement in intestinal chronic inflammatory disease: description of a case]

In the process of chronic intestinal inflammatory diseases the involvement of other organs and apparatuses is frequent. The respiratory apparatus, however, is not so frequently concerned as other organs, especially with regard to the paediatric age. The rarity of clinical evidences concerning the respiratory apparatus contrasts with the anomalies of the lung functionality tests described in literature. A fifteen year old boy is taken into consideration. He was first examined at the age of nine, when his symptomatology (slight fever and abdominal pain) was regarded as a chronic intestine inflammatory disease and it was treated with salazopyrina and cortisone. Compilations supervened later on, such as ilium arthritis, psoriasis-like dermatitis, perineal abscess. Five years after the beginning of the intestine disease the lungs were also involved and there was evidence of dyspnoea, especially when the patient was under stress. The clinical picture was confirmed by the reduction of the parameters of the respiratory functionality in the sense of an insufficiency of obstructive and restrictive kind. The pulmonary compilation was treated with disodium cromoglycate; such treatment was stopped, after the appearance of headache. After more than a year since the supervening of the lung complication the patient is being kept under periodic control to evaluate his pulmonary functionality. The indexes are constantly altered in the sense of a reduction of FEV 1, of FVC, of FEF 25-75 and of PEF, while the ventilatory and perfusional pulmonary scintigraphy has not shown relevant anomalies.

Perinatal mortality in southern Italy

Perinatal deaths occurring in the Campania region of southern Italy in 1982 were analysed. The perinatal mortality rate was 17.6 per thousand (stillbirth rate 8.3, early neonatal mortality rate 9.3). Compared with Swedish data, our deaths excess does not seem attributable to an unfavourable birthweight distribution, but to high birthweight mortality rates in every birthweight category and particularly in the normal birthweight group (greater than 2500 g). This group of newborns, representing about 94% of the births, contributes 45.4% of perinatal deaths; this situation is not common in developed countries, where the normal birthweight newborns form a much smaller proportion of perinatal deaths. The analysis of the causes of perinatal mortality, even though autopsies are rarely executed in Campania, shows a high prevalence of events which should be prevented by good antenatal and perinatal care.