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Panzeri A, DeVita M, Di Rosa E, Bottesi G, Brundisini V, Guarrera C, Ravelli A, Ponza I, Cattelan A, Volpe B, Iannizzi P, Ghisi M, Schiavo R, Mapelli D. Trauma Shaping the Psychopathological Correlates of Patients with Long-COVID: A 6-Months Longitudinal Study with Repeated Measures Mixed Models. Psychiatry Res 2023; 330:115609. [PMID: 38006716 DOI: 10.1016/j.psychres.2023.115609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 11/27/2023]
Abstract
This research aimed at investigating how the experience of trauma can influence the psychological correlates of long-COVID over time in a clinical sample of patients hospitalized because of COVID-19. Through a longitudinal research design, 70 post-acute patients with COVID-19 were followed-up after hospital discharge in 3-time points up to 6 months and completed the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Symptoms Checklist-90-Revised (SCL-90 R). Repeated measures mixed models with random intercept were used to evaluate the effect of trauma (yes/no) over time (T1, T2, T3) on the SCL-90-R scales. Results showed that patients with trauma display significantly worse psychological outcomes in all the SCL-90-R dimensions [all padj < .05 for the principal effects of trauma(y)], especially in symptoms of depression [time 2 vs time 1*trauma(y): b = -3.86, 95%CI (-7.18, -0.53), padj = .035; time 3 vs time 1*trauma(y): b = -4.77, 95%CI (-8.10, -1.45), padj = .011], anxiety [time 3 vs time 1*trauma(y): b = -4.54, 95%CI (-7.72, -1.37), padj = .011], and obsessive-compulsive difficulties [time 3 vs time 1*trauma(y): b = -4.03, 95%CI (-7.20, -0.86), padj = .027]. These findings shed light on the long-term psychological consequences of COVID-19 among hospitalized patients and highlight the key role of trauma, suggesting its assessment to tailor psychological interventions.
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Affiliation(s)
- Anna Panzeri
- Department of General Psychology, University of Padua, Italy.
| | - Maria DeVita
- Department of General Psychology, University of Padua, Italy; Geriatrics Division, Department of Medicine, University of Padua, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padua, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padua, Italy
| | - Virginia Brundisini
- Unità Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Claudia Guarrera
- Unità Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Adele Ravelli
- Geriatrics Division, Department of Medicine, University of Padua, Italy
| | - Isabella Ponza
- Unità Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Annamaria Cattelan
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy
| | - Biancarosa Volpe
- Unità Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | | | - Marta Ghisi
- Department of General Psychology, University of Padua, Italy; Unità Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Rossana Schiavo
- Unità Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Daniela Mapelli
- Department of General Psychology, University of Padua, Italy
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Devita M, Di Rosa E, Iannizzi P, Bianconi S, Contin SA, Tiriolo S, Ghisi M, Schiavo R, Bernardinello N, Cocconcelli E, Balestro E, Cattelan AM, Leoni D, Volpe B, Mapelli D. Risk and Protective Factors of Psychological Distress in Patients Who Recovered From COVID-19: The Role of Cognitive Reserve. Front Psychol 2022; 13:852218. [PMID: 35719579 PMCID: PMC9204198 DOI: 10.3389/fpsyg.2022.852218] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/05/2022] [Indexed: 01/06/2023] Open
Abstract
Recent studies reported the development of psychological distress symptoms in patients who recovered from COVID-19. However, evidence is still scarce and new data are needed to define the exact risk and protective factors that can explain the variability in symptoms manifestation. In this study, we enrolled 257 patients who recovered from COVID-19 and we evaluated the levels of psychological distress through the Symptoms Checklist-90-R scale. Data concerning illness-related variables were collected from medical records, while the presence of subjective cognitive difficulties, both before and after the illness, as well as the level of the cognitive reserve (CR), were assessed over a clinical interview. Results revealed that being female and reporting the presence of subjective cognitive difficulties after COVID-19 were associated with higher levels of psychological distress. At the same time, being admitted to the hospital and having a high CR were protective factors. Adding new information to this emerging research field, our results highlight the importance of a complete psychological and cognitive assessment in patients with COVID-19.
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Affiliation(s)
- Maria Devita
- Department of General Psychology, University of Padua, Padua, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padua, Padua, Italy
| | - Pamela Iannizzi
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Sara Bianconi
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Sara Anastasia Contin
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Simona Tiriolo
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padua, Padua, Italy.,Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Rossana Schiavo
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Nicol Bernardinello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Elisabetta Cocconcelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Elisabetta Balestro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | | | - Davide Leoni
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Biancarosa Volpe
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Daniela Mapelli
- Department of General Psychology, University of Padua, Padua, Italy
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Tarzia V, Tessari C, Fabozzo A, Cavalli C, Pagnin C, Volpe B, Bottio T, Gerosa G. Antiphospholipid antibody syndrome and LVAD: What are the chances? A case report and literature review. Int J Artif Organs 2021; 45:235-238. [PMID: 33734820 DOI: 10.1177/0391398821996726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Left-ventricular-assist-device (LVAD) implantation in patients with antiphospholipid-syndrome (APS) is considered a high-risk procedure and its indication still represents an open challenge. Herein, we report a 63-year-old man with APS and end-stage heart failure, for whom a HeartMate3-LVAD and a continuous rheologic profile monitoring with a multiparametric assessment resulted the optimal therapeutic strategy.
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Affiliation(s)
| | | | | | | | - Chiara Pagnin
- Cardiac-Surgery-Unit, University of Padua, Padua, Italy
| | | | - Tomaso Bottio
- Cardiac-Surgery-Unit, University of Padua, Padua, Italy
| | - Gino Gerosa
- Cardiac-Surgery-Unit, University of Padua, Padua, Italy
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Devita M, Di Rosa E, Iannizzi P, Bianconi S, Contin SA, Tiriolo S, Bernardinello N, Cocconcelli E, Balestro E, Cattelan A, Leoni D, Mapelli D, Volpe B. Cognitive and Psychological Sequelae of COVID-19: Age Differences in Facing the Pandemic. Front Psychiatry 2021; 12:711461. [PMID: 34603102 PMCID: PMC8481580 DOI: 10.3389/fpsyt.2021.711461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/16/2021] [Indexed: 11/24/2022] Open
Abstract
Literature about the novel Coronavirus (COVID-19) is currently focusing on the potential cognitive and neuropsychiatric sequelae observed in individuals receiving intensive care unit (ICU) treatments. The aim of the present study is to evaluate the differences in cognitive and psychological sequelae of COVID-19 between younger and older adults, regardless of being admitted to the ICU or not. The study involved 299 recovered individuals (from 18 to 90 years old), who underwent a comprehensive cognitive and psychological assessment. Linear regression models were conducted separately for Montreal Cognitive Assessment (MoCA) test and Post-traumatic Stress Disorder Checklist (PCL) scores to investigate the effect of socio-demographic and clinical characteristics on them. Separate linear regression models were then applied sorting participants by age: younger adults (<65 years) and older adults (≥65 years). In the whole sample, PCL scores were predicted by the intensity of care received, by being intubated, and by the persistence of cough after 1 month after hospitalization. Only age had instead an effect on cognition. In younger adults, PCL scores were predicted by the presence of neurological symptoms, by the intensity of care received, and by being intubated; MoCA scores were only predicted by the intensity of care received. No significant associations were found in older adults. Psychological negative effects of the COVID-19 pandemic particularly affect individuals under 65 years old, who also subjectively report cognitive sequelae associated with the infection. Individuals over 65 years old, instead, seem to be free from psychological and cognitive difficulties due to COVID-19.
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Affiliation(s)
- Maria Devita
- Department of General Psychology (DPG), University of Padua, Padua, Italy
| | - Elisa Di Rosa
- Department of General Psychology (DPG), University of Padua, Padua, Italy
| | | | - Sara Bianconi
- U.O.C. Clinical Psychology, Hospital of Padua, Padua, Italy
| | - Sara A Contin
- U.O.C. Clinical Psychology, Hospital of Padua, Padua, Italy
| | - Simona Tiriolo
- U.O.C. Clinical Psychology, Hospital of Padua, Padua, Italy
| | - Nicol Bernardinello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Elisabetta Cocconcelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Elisabetta Balestro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | | | - Davide Leoni
- Infectious Disease Unit, Hospital of Padua, Padua, Italy
| | - Daniela Mapelli
- Department of General Psychology (DPG), University of Padua, Padua, Italy
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Burra P, Bizzaro D, Forza G, Feltrin A, Volpe B, Ronzan A, Feltrin G, Carretta G, D'Amico F, Cillo U, Germani G. Severe acute alcoholic hepatitis: can we offer early liver transplantation? Minerva Gastroenterol (Torino) 2020. [PMID: 33140622 DOI: 10.23736/s1121-421x.20.02778-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Alcohol-related liver disease is one of the most prevalent liver diseases worldwide and is the second most common indication for liver transplantation. Most transplant programs require 6 months of abstinence prior to transplantation; commonly referred to as the "six-month rule." According to this rule, the patients admitted for severe acute alcoholic hepatitis are not eligible for liver transplantation in most transplant centers. However, there is increasing evidence that if liver transplantation is performed in selected patients after the first episode of severe decompensation with no response to steroid therapy, it represents an effective treatment. In such selected patients, the post-transplant outcomes are good with survival rates that are significantly higher when compared with patients not responding to medical therapy and not transplanted. A multidisciplinary assessment, involving several stakeholders such as a transplant hepatologist, transplant surgeon, psychologist and psychiatrist is becoming mandatory to properly evaluate the candidate to liver transplantation for alcoholic liver diseases and severe acute alcoholic hepatitis. In the clinical setting of severe acute alcoholic hepatitis, further studies are needed for the identification of accepted selection clinical and psychosocial criteria that can provide the best long-term results. The early liver transplantation option should therefore be explored within strict criteria for this setting.
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Affiliation(s)
- Patrizia Burra
- Unit of Gastroenterology and Multivisceral Transplant, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy -
| | - Debora Bizzaro
- Unit of Gastroenterology and Multivisceral Transplant, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
| | - Giovanni Forza
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University Hospital of Padua, Padua, Italy
| | | | | | - Andrea Ronzan
- Unit of Psychiatry, University Hospital of Padua, Padua, Italy
| | | | - Giovanni Carretta
- Department of Directional Hospital Management, University Hospital of Padua, Padua, Italy
| | - Francesco D'Amico
- Unit of Hepatobiliary Surgery and Liver Transplantation, University Hospital of Padua, Padua, Italy
| | - Umberto Cillo
- Unit of Hepatobiliary Surgery and Liver Transplantation, University Hospital of Padua, Padua, Italy
| | - Giacomo Germani
- Unit of Gastroenterology and Multivisceral Transplant, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
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Burra P, Bizzaro D, Forza G, Feltrin A, Volpe B, Ronzan A, Feltrin G, Carretta G, D'Amico F, Cillo U, Germani G. Severe acute alcoholic hepatitis: can we offer early liver transplantation? Minerva Gastroenterol (Torino) 2020; 67:23-25. [PMID: 33140622 DOI: 10.23736/s2724-5985.20.02778-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Alcohol-related liver disease is one of the most prevalent liver diseases worldwide and is the second most common indication for liver transplantation. Most transplant programs require 6 months of abstinence prior to transplantation; commonly referred to as the "six-month rule." According to this rule, the patients admitted for severe acute alcoholic hepatitis are not eligible for liver transplantation in most transplant centers. However, there is increasing evidence that if liver transplantation is performed in selected patients after the first episode of severe decompensation with no response to steroid therapy, it represents an effective treatment. In such selected patients, the post-transplant outcomes are good with survival rates that are significantly higher when compared with patients not responding to medical therapy and not transplanted. A multidisciplinary assessment, involving several stakeholders such as a transplant hepatologist, transplant surgeon, psychologist and psychiatrist is becoming mandatory to properly evaluate the candidate to liver transplantation for alcoholic liver diseases and severe acute alcoholic hepatitis. In the clinical setting of severe acute alcoholic hepatitis, further studies are needed for the identification of accepted selection clinical and psychosocial criteria that can provide the best long-term results. The early liver transplantation option should therefore be explored within strict criteria for this setting.
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Affiliation(s)
- Patrizia Burra
- Unit of Gastroenterology and Multivisceral Transplant, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy -
| | - Debora Bizzaro
- Unit of Gastroenterology and Multivisceral Transplant, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
| | - Giovanni Forza
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University Hospital of Padua, Padua, Italy
| | | | | | - Andrea Ronzan
- Unit of Psychiatry, University Hospital of Padua, Padua, Italy
| | | | - Giovanni Carretta
- Department of Directional Hospital Management, University Hospital of Padua, Padua, Italy
| | - Francesco D'Amico
- Unit of Hepatobiliary Surgery and Liver Transplantation, University Hospital of Padua, Padua, Italy
| | - Umberto Cillo
- Unit of Hepatobiliary Surgery and Liver Transplantation, University Hospital of Padua, Padua, Italy
| | - Giacomo Germani
- Unit of Gastroenterology and Multivisceral Transplant, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
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7
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Cavalli C, Tarzia V, Marini M, Gregori D, Casella S, Bottio T, Toscano G, Fraiese AP, Gambino A, Volpe B, Gerosa G. A comparison of quality of life and psychological distress in heart transplantation patients at adult and pediatric ages. Clin Transplant 2020; 33:e13335. [PMID: 29935045 DOI: 10.1111/ctr.13335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 06/01/2018] [Accepted: 06/06/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of the current study was to evaluate and compare the quality of life (QOL) and psychological status of adult patients who underwent heart transplant (HTx) at pediatric or adult ages. METHODS The population consisted of two groups: patients who received HTx after 18 years old and pediatrics who received HTx between the age of 1 and 18 years. At the time of the study, all patients were over 18 years old. QOL data were collected from patients using 36-item Short-Form Health Survey (SF-36) and psychological distress by the Symptom checklist 90-revised questionnaire (SCL-90-R). RESULTS A total of 232 HTx patients were evaluated; 217 were transplanted at an adult age and 15 at a pediatric one. QOL improved significantly in pediatrics patients in the general health perceptions subscale and physical pain subscale than adult patients. The Global Index of the psychological distress did not differ in the two groups, but the pediatric patients registered statistically significant higher scores on the interpersonal sensitivity symptom subscale (adult group 36 ± 0.42 vs pediatric group 81 ± 0.79), the hostility subscale (adult group m 39 ± 0.44 vs pediatric group 73 ± 0.76) and the paranoid ideation subscale (adult group 46 ± 0.46 vs pediatric group 96 ± 1.02). CONCLUSION The pediatric heart recipients showed better quality of life, but they show marked sensitivity, hostility and paranoid ideation which increases the risk of mental distress and therefore their adherence to medical treatment.
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Affiliation(s)
- Chiara Cavalli
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Vincenzo Tarzia
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | | | - Dario Gregori
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | | | - Tomaso Bottio
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Giuseppe Toscano
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Angela Pompea Fraiese
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Antonio Gambino
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | | | - Gino Gerosa
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
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Bottesi G, Granziol U, Forza G, Volpe B, Feltrin A, Battermann F, Cavalli C, Cillo U, Gerosa G, Fraiese A, Rea F, Loy M, Maiorano D, Rizzi I, Leandro G, Ferraro C, Biasi C, Donato D, Vidotto G, Maldonado JR. The Psychosocial Assessment of Transplant Candidates: Inter-Rater Reliability and Predictive Value of the Italian Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT). Psychosomatics 2020; 61:127-134. [DOI: 10.1016/j.psym.2019.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/25/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
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9
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Ivanidze J, Mackay M, Hoang A, Chi JM, Cheng K, Aranow C, Volpe B, Diamond B, Sanelli PC. Reply. AJNR Am J Neuroradiol 2019; 40:E67-E68. [PMID: 31780464 DOI: 10.3174/ajnr.a6361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- J Ivanidze
- Department of Radiology Weill Cornell Medicine New York, New York
| | - M Mackay
- The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases
| | - A Hoang
- Department of Radiology, Northwell Health
| | - J M Chi
- Department of Radiology, Northwell Health
| | - K Cheng
- Department of Radiology, Northwell Health
| | - C Aranow
- The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases
| | - B Volpe
- The Center for Biomedical Science, Feinstein Institute for Medical Research
| | - B Diamond
- The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Manhasset, New York
| | - P C Sanelli
- Feinstein Institute for Medical Research, The Center for Health Innovations and Outcomes Research Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Manhasset, New York Department of Radiology, Northwell Health Imaging Clinical Effectiveness and Outcomes Research Program Manhasset, New York
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10
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Cipolletta S, Entilli L, Nucci M, Feltrin A, Germani G, Cillo U, Volpe B. Psychosocial Support in Liver Transplantation: A Dyadic Study With Patients and Their Family Caregivers. Front Psychol 2019; 10:2304. [PMID: 31649602 PMCID: PMC6795706 DOI: 10.3389/fpsyg.2019.02304] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 09/27/2019] [Indexed: 12/17/2022] Open
Abstract
Background and aims: Liver transplantation provides an opportunity of survival for patients with liver failure; however, this procedure is known to be psychologically and physically fatiguing for patients and their informal caregivers. The aim of this study was to investigate how perceived social support and the distribution of dependency were associated with the psychological wellbeing of patients waiting for liver transplantation and their caregivers, as a dyad. Methods: The present was a cross-sectional study. Ninety-five participants were recruited at a hospital in Northern Italy, during the psychological evaluation for inclusion in the transplantation list: 51 patients (19 with alcohol-related illness) and 44 family caregivers. Both patients and caregivers filled in a Symptom Checklist and Kelly’s Dependency Grids. Patients also compiled the Medical Outcome Study Social-Support Survey, and caregivers compiled the Family Strain Questionnaire Short-Form. Results: Caregivers reported important levels of strain and strongly related to a worsening of their own and patients’ symptoms. Patients with alcohol-related pathologies had a narrower social network, which corresponded to an increase in family strain. On the sample as a whole, regression analyses showed that perceived social support and dependency measures did not predict patients’ and caregivers’ symptoms. Nevertheless, cluster analysis identified a group of caregivers who distributed their dependency more and experienced lower levels of depression, anxiety, and strain. Conclusions: These results suggest the usefulness of a dyadic approach in the research, prevention, and care of liver diseases. A deeper comprehension of the functioning of dyads will help practitioners in the identification of situations at risk.
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Affiliation(s)
| | - Lorenza Entilli
- Department of General Psychology, University of Padua, Padua, Italy
| | - Massimo Nucci
- Department of General Psychology, University of Padua, Padua, Italy
| | | | - Giacomo Germani
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Umberto Cillo
- Hepatobiliary Surgery and Liver Transplantation Unit, Department of General Surgery and Organ Transplantation, Padua University Hospital, Padua, Italy
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11
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Affiliation(s)
| | - M Mackay
- Feinstein Institute for Medical Research The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead, New York
| | - A Hoang
- Department of Radiology Northwell Health New York, York
| | | | - C Aranow
- Feinstein Institute for Medical Research The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead, New York
| | - J Ivanidze
- Department of Radiology Weill Cornell Medical College New York, New York
| | - B Volpe
- Feinstein Institute for Medical Research The Center for Biomedical Science
| | - B Diamond
- Feinstein Institute for Medical Research The Center for Health Innovations and Outcomes Research
| | - P C Sanelli
- Feinstein Institute for Medical Research The Center for Health Innovations and Outcomes Research Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead, New York.,Department of Radiology Imaging Clinical Effectiveness and Outcomes Research Program Northwell Health New York, New York
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12
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Chi JM, Mackay M, Hoang A, Cheng K, Aranow C, Ivanidze J, Volpe B, Diamond B, Sanelli PC. Alterations in Blood-Brain Barrier Permeability in Patients with Systemic Lupus Erythematosus. AJNR Am J Neuroradiol 2019; 40:470-477. [PMID: 30792254 DOI: 10.3174/ajnr.a5990] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 12/30/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Neuropsychiatric systemic lupus erythematosus refers to central and peripheral nervous system involvement, which may occur secondary to antineuronal antibodies crossing the blood-brain barrier that preferentially target cells in the hippocampus leading to abnormal hypermetabolism and atrophy. Thus, we hypothesized that alterations in BBB permeability, detected on dynamic contrast-enhanced MR imaging, occur in the hippocampus in patients with systemic lupus erythematosus before development of neuropsychiatric systemic lupus erythematosus. MATERIALS AND METHODS Six patients with systemic lupus erythematosus without neuropsychiatric systemic lupus erythematosus and 5 healthy controls underwent dynamic contrast-enhanced MR imaging with postprocessing into BBB permeability parameters (K trans and Ve) and CBF. Standardized methods selected ROI sampling of the abnormal brain regions detected on FDG-PET. The mean and SD of K trans, Ve, and CBF were calculated. Linear regression and nonparametric Spearman rank correlation analyses of K trans and Ve with CBF were performed. Dynamic contrast-enhanced curves and the area under the curve were generated for each brain region. Student t test comparisons were performed. RESULTS Quantitative data revealed that patients with systemic lupus erythematosus have statistically increased K trans (P < .001) and Ve (P < .001) compared with controls. In patients with systemic lupus erythematosus, statistically significant positive correlations were seen between K trans (P < .001) and Ve (P < .001) with CBF. Furthermore, the mean area under the curve revealed statistically increased BBB permeability in the hippocampus (P = .02) compared with other brain regions in patients with systemic lupus erythematosus compared with controls. CONCLUSIONS These initial findings are proof-of-concept to support the hypothesis that patients with systemic lupus erythematosus have increased BBB permeability, specifically in the hippocampus, compared with other brain regions. These findings may advance our understanding of the underlying pathophysiology affecting the brain in autoimmune diseases.
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Affiliation(s)
- J M Chi
- From the Department of Radiology (J.M.C., K.C.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - M Mackay
- Feinstein Institute for Medical Research (M.M., C.A., B.D.), The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - A Hoang
- Department of Radiology (A.H.), Northwell Health, Manhasset, New York
| | - K Cheng
- From the Department of Radiology (J.M.C., K.C.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - C Aranow
- Feinstein Institute for Medical Research (M.M., C.A., B.D.), The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - J Ivanidze
- Department of Radiology (J.I.), Weill Cornell Medical College, New York, New York
| | - B Volpe
- Feinstein Institute for Medical Research (B.V.), The Center for Biomedical Science, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - B Diamond
- Feinstein Institute for Medical Research (M.M., C.A., B.D.), The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - P C Sanelli
- Feinstein Institute for Medical Research (P.C.S.), The Center for Health Innovations and Outcomes Research, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York.,Department of Radiology (P.C.S.), Northwell Health, Imaging Clinical Effectiveness and Outcomes Research Program, Manhasset, New York
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Ivanidze J, Mackay M, Hoang A, Chi JM, Cheng K, Aranow C, Volpe B, Diamond B, Sanelli PC. Dynamic Contrast-Enhanced MRI Reveals Unique Blood-Brain Barrier Permeability Characteristics in the Hippocampus in the Normal Brain. AJNR Am J Neuroradiol 2019; 40:408-411. [PMID: 30733256 DOI: 10.3174/ajnr.a5962] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 12/17/2018] [Indexed: 11/07/2022]
Abstract
We report a prospective dynamic contrast-enhanced MR imaging analysis of region-specific blood-brain barrier permeability in 5 healthy subjects. By means of standardized postprocessing and ROI sampling methods, the hippocampi revealed significantly elevated area under the dynamic contrast-enhanced curve and significantly increased blood-brain barrier permeability metrics (volume transfer constant and volume in the extravascular extracellular space) from model-based quantitation. These findings suggest unique blood-brain barrier permeability characteristics in the hippocampus, which are concordant with previous animal studies, potentially laying the groundwork for future studies assessing patient populations in which hippocampal pathology plays a role.
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Affiliation(s)
- J Ivanidze
- From the Department of Radiology (J.I.), Weill Cornell Medicine, New York New York
| | - M Mackay
- The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases (M.M., C.A., B.D.).,Donald and Barbara Zucker School of Medicine (M.M., A.H., J.M.C., K.C., C.A., B.V., B.D., P.C.S.), Hofstra/Northwell School of Medicine, Hempstead, New York
| | - A Hoang
- Department of Radiology (A.H., P.C.S.).,Donald and Barbara Zucker School of Medicine (M.M., A.H., J.M.C., K.C., C.A., B.V., B.D., P.C.S.), Hofstra/Northwell School of Medicine, Hempstead, New York
| | - J M Chi
- Department of Radiology (J.M.C., K.C.).,Donald and Barbara Zucker School of Medicine (M.M., A.H., J.M.C., K.C., C.A., B.V., B.D., P.C.S.), Hofstra/Northwell School of Medicine, Hempstead, New York
| | - K Cheng
- Department of Radiology (J.M.C., K.C.).,Donald and Barbara Zucker School of Medicine (M.M., A.H., J.M.C., K.C., C.A., B.V., B.D., P.C.S.), Hofstra/Northwell School of Medicine, Hempstead, New York
| | - C Aranow
- The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases (M.M., C.A., B.D.).,Donald and Barbara Zucker School of Medicine (M.M., A.H., J.M.C., K.C., C.A., B.V., B.D., P.C.S.), Hofstra/Northwell School of Medicine, Hempstead, New York
| | - B Volpe
- The Center for Biomedical Science (B.V.), Feinstein Institute for Medical Research, Manhasset, New York.,Donald and Barbara Zucker School of Medicine (M.M., A.H., J.M.C., K.C., C.A., B.V., B.D., P.C.S.), Hofstra/Northwell School of Medicine, Hempstead, New York
| | - B Diamond
- The Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases (M.M., C.A., B.D.).,Donald and Barbara Zucker School of Medicine (M.M., A.H., J.M.C., K.C., C.A., B.V., B.D., P.C.S.), Hofstra/Northwell School of Medicine, Hempstead, New York
| | - P C Sanelli
- The Center for Health Innovations and Outcomes Research (P.C.S.).,Department of Radiology (A.H., P.C.S.).,Imaging Clinical Effectiveness and Outcomes Research Program (P.C.S.), Northwell Health, New Hyde Park, New York.,Donald and Barbara Zucker School of Medicine (M.M., A.H., J.M.C., K.C., C.A., B.V., B.D., P.C.S.), Hofstra/Northwell School of Medicine, Hempstead, New York
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Tarzia V, Tessari C, Fabozzo A, Cavalli C, Bocca T, Pagnin C, Volpe B, Bottio T, Gerosa G. RF03 ANTITHROMBOTIC STRATEGIES AFTER HEARTMATE III IMPLANTATION. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550036.12636.f0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Bouchery T, Volpe B, Shah K, Lebon L, Filbey K, LeGros G, Harris N. The Study of Host Immune Responses Elicited by the Model Murine HookwormsNippostrongylus brasiliensisandHeligmosomoides polygyrus. ACTA ACUST UNITED AC 2018; 7:236-286. [DOI: 10.1002/cpmo.34] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- T. Bouchery
- Global Health Institute, École Polytechnique Fédérale de Lausanne (EPFL); Lausanne Switzerland
| | - B. Volpe
- Global Health Institute, École Polytechnique Fédérale de Lausanne (EPFL); Lausanne Switzerland
| | - K. Shah
- Global Health Institute, École Polytechnique Fédérale de Lausanne (EPFL); Lausanne Switzerland
| | - L. Lebon
- Global Health Institute, École Polytechnique Fédérale de Lausanne (EPFL); Lausanne Switzerland
| | - K. Filbey
- Malaghan Institute of Medical Research; Wellington New Zealand
| | - G. LeGros
- Malaghan Institute of Medical Research; Wellington New Zealand
| | - N. Harris
- Global Health Institute, École Polytechnique Fédérale de Lausanne (EPFL); Lausanne Switzerland
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Dal Lin C, Marinova M, Rubino G, Gola E, Brocca A, Pantano G, Brugnolo L, Sarais C, Cucchini U, Volpe B, Cavalli C, Bellio M, Fiorello E, Scali S, Plebani M, Iliceto S, Tona F. Thoughts modulate the expression of inflammatory genes and may improve the coronary blood flow in patients after a myocardial infarction. J Tradit Complement Med 2018; 8:150-163. [PMID: 29322004 PMCID: PMC5755999 DOI: 10.1016/j.jtcme.2017.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Mental stress is one of the main risk factors for cardiovascular disease. Meditation and music listening are two techniques that are able to counteract it through the activation of specific brain areas, eliciting the so-called Relaxing Response (RR). Epidemiological evidence reveals that the RR practice has a beneficial prognostic impact on patients after myocardial infarction. We aimed to study the possible molecular mechanisms of RR underlying these findings. METHODS We enrolled 30 consecutive patients after myocardial infarction and 10 healthy controls. 10 patients were taught to meditate, 10 to appreciate music and 10 did not carry out any intervention and served as controls. After training, and after 60 days of RR practice, we studied the individual variations, before and after the relaxation sessions, of the vital signs, the electrocardiographic and echocardiographic parameters along with coronary flow reserve (CFR) and the carotid's intima media thickness (IMT). Neuro-endocrine-immune (NEI) messengers and the expression of inflammatory genes (p53, Nuclear factor Kappa B (NfKB), and toll like receptor 4 (TLR4)) in circulating peripheral blood mononuclear cells were also all observed. RESULTS The RR results in a reduction of NEI molecules (p < 0.05) and oxidative stress (p < 0.001). The expression of the genes p53, NFkB and TLR4 is reduced after the RR and also at 60 days (p < 0.001). The CFR increases with the relaxation (p < 0.001) and the IMT regressed significantly (p < 0.001) after 6 months of RR practice. CONCLUSIONS The RR helps to advantageously modulate the expression of inflammatory genes through a cascade of NEI messengers improving, over time, microvascular function and the arteriosclerotic process.
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Affiliation(s)
- Carlo Dal Lin
- Department of Cardiac, Thoracic and Vascular Sciences, Padua University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Mariela Marinova
- Department of Laboratory Medicine, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Giorgio Rubino
- Department of Cardiac, Thoracic and Vascular Sciences, Padua University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Elisabetta Gola
- Department of Medicine, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Alessandra Brocca
- Department of Medicine, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Giorgia Pantano
- Department of Laboratory Medicine, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Laura Brugnolo
- Department of Laboratory Medicine, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Cristiano Sarais
- Department of Cardiac, Thoracic and Vascular Sciences, Padua University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Umberto Cucchini
- Department of Cardiac, Thoracic and Vascular Sciences, Padua University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Biancarosa Volpe
- Clinical Psychology, Department of Cardiac, Thoracic and Vascular Sciences, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Chiara Cavalli
- Clinical Psychology, Department of Cardiac, Thoracic and Vascular Sciences, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Maura Bellio
- Clinical Psychology, Department of Cardiac, Thoracic and Vascular Sciences, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Emilia Fiorello
- Clinical Psychology, Department of Cardiac, Thoracic and Vascular Sciences, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Sofia Scali
- Clinical Psychology, Department of Cardiac, Thoracic and Vascular Sciences, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Mario Plebani
- Department of Laboratory Medicine, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Sabino Iliceto
- Department of Cardiac, Thoracic and Vascular Sciences, Padua University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
| | - Francesco Tona
- Department of Cardiac, Thoracic and Vascular Sciences, Padua University-Hospital, Via Giustiniani 2, 35100 Padua, Italy
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18
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Mapelli D, Bardi L, Mojoli M, Volpe B, Gerosa G, Amodio P, Daliento L. Neuropsychological profile in a large group of heart transplant candidates. PLoS One 2011; 6:e28313. [PMID: 22180780 PMCID: PMC3236740 DOI: 10.1371/journal.pone.0028313] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Accepted: 11/05/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recent studies have reported that patients with end-stage heart disease can have cognitive deficits ranging from mild to severe. Little is known, however, about the relationship between cognitive performance, neurophysiological characteristics and relevant clinical and instrumental indexes for an extensive evaluation of patients with heart failure, such as: left ventricular ejection fraction (LVEF) and other haemodynamic measures, maximum oxygen uptake during cardiopulmonary exercise testing, comorbidities, major cardiovascular risk factors and disease duration. Our purpose was to outline the cognitive profiles of end-stage heart disease patients in order to identify the cognitive deficits that could compromise the quality of life and the therapeutic adherence in end-stage heart disease patients, and to identify the variables associated with an increased risk of cognitive deficits in these patients. METHODS 207 patients with end-stage cardiac disease, candidates for heart transplant, were assessed by complete neuropsychological evaluation and by electroencephalographic recording with EEG spectral analysis. RESULTS Pathological scores in one or more of the cognitive tests were obtained by 86% of the patients, while 36% performed within the impaired range on five or more tests, indicating poor performance across a broad range of cognitive domains. The executive functions were the cognitive domain most impaired (70%). Poor performances were not related to the aetiology of heart disease, but rather to cerebral dysfunction secondary to haemodynamic impairment and to comorbidities. CONCLUSIONS Severe heart failure induces significant neurophysiological and neuropsychological alterations, which may produce an impairment of cognitive functioning and possibly compromise the quality of life of patients and the therapeutic adherence.
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Affiliation(s)
- Daniela Mapelli
- Department of General Psychology, University of Padua, Padua, Italy.
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Proietti R, Mapelli D, Volpe B, Bartoletti S, Sagone A, Dal Bianco L, Daliento L. Mental stress and ischemic heart disease: evolving awareness of a complex association. Future Cardiol 2011; 7:425-37. [PMID: 21627481 DOI: 10.2217/fca.11.13] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The connection between cardiovascular disease and psychosocial risk factors has been the subject of an ever-growing body of literature over the last 50 years. Studies on the role of negative emotions, personality traits, chronic stress and social determinants have brought to light their possible role in triggering acute coronary syndromes, although further studies are required to clarify controversial results regarding the association between cardiovascular risk and important psychological problems such as depression and anxiety. The recognition of the role of emotional events in acute coronary syndromes paved the way for provocation experiments, aimed at inducing mental stress in a controlled setting and then documenting reversible impairment of myocardial perfusion, depolarization anomalies and arrhythmias. This ultimately led to the formalization of the concept of mental stress-induced myocardial ischemia. Accumulating evidence on the mechanistic bases of such phenomena outline a wide range of central and peripheral physiological changes associated with emotions and behaviors, whose effects are exerted on the cardiovascular system, sympathetic nervous system and the hypothalamus-hypophysis neuroendocrine axis. This article outlines the main steps in the identification of psychological aspects as cardiovascular risk factors and emphasizes the relevance of emotional stress as a trigger of acute cardiovascular events. Finally, a description is provided of the pathophysiological mechanisms behind mental stress-induced myocardial ischemia and pathways connecting the heart and brain.
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Giardini A, Pierobon A, Majani G, Biffa G, Volpe B, Sala A, Gangeri L, Aurelio MT, Ferri F, Colombo EM, Fontana L, Trabucco G, Travaglini C, Zoncheddu P, Nobili R, Bellapi S, Masolo LS, Sacchi AM. Adherence self report assessment in solid-organ pre and post transplant recipients. G Ital Med Lav Ergon 2011; 33:A69-A76. [PMID: 21488486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE There is strong evidence that many patients with chronic diseases have difficulties to adhere to the medical regimens. As to transplantation, nonadherence to the prescribed medical regimen has repeatedly been found to predict morbidity and mortality, both in adults and in children. Many instruments are available in order to assess nonadherence to immunosuppressive medication, whereas only few are available on behavioural components. Aim of the study was to present the Adherence Schedule in Transplantation (ASiT, in its three versions: ASiT-A, Adults; ASiT-PA, Proxy Adult and ASiT-PC, Proxy Child) that evaluates the Cognitive Relational Antecedents of adherence to treatment and the Self-efficacy in disease management in patients before and after transplantation. METHOD (1) Review and construct analysis of the already existing adherence Schedules, on the basis of literature review and clinical experience; (2) Construction of the ASiT in its three versions from an adaptation of the already existing adherence Schedules; (3) Administration of the ASiT to pre and post transplant recipients followed by a semi-structured interview in order to discuss with the patients pros and cons; (4) ASiT correction on the basis of patients' comments; (5) Translation in English by a bilingual English mother tongue. RESULTS On the whole 56 Schedules were administered to pre and post transplant (liver, heart, lung and kidney) recipients and their proxy and resulted to have good construct validity, were easily administered and were well accepted by patients. CONCLUSIONS As to research the ASiT could cover a wide range of nonadherence sources. Within a clinical context our Schedule could be a not time consuming tool useful in favouring the communication about adherence and able to enhance patients' personal limits and resources.
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Affiliation(s)
- Anna Giardini
- Servizio di Psicologia, Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Montescano (PV), Italy.
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Favaro A, Gerosa G, Caforio ALP, Volpe B, Rupolo G, Zarneri D, Boscolo S, Pavan C, Tenconi E, d'Agostino C, Moz M, Torregrossa G, Feltrin G, Gambino A, Santonastaso P. Posttraumatic stress disorder and depression in heart transplantation recipients: the relationship with outcome and adherence to medical treatment. Gen Hosp Psychiatry 2011; 33:1-7. [PMID: 21353121 DOI: 10.1016/j.genhosppsych.2010.10.001] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 10/03/2010] [Accepted: 10/05/2010] [Indexed: 12/18/2022]
Abstract
OBJECTIVE There is growing evidence of the importance of psychiatric risk factors for predicting the outcome of heart transplantation (HT) recipients. The aim of our study was to investigate the role of major depression and posttraumatic stress disorder (PTSD) in the prediction of the outcome of HT in a consecutive sample of 107 recipients. METHOD All subjects of the study underwent a structured diagnostic interview for assessing the presence of pretransplant and posttransplant major depression and transplantation-related PTSD 1 to 5 years after HT. The adherence to medical treatment was assessed some months after the structured interview. The medical outcome (acute rejections, cancer, mortality) was followed up for 8 years on average after the interview, using a prospective design. RESULTS Estimated frequency of psychiatric diagnoses after HT was 12% for transplantation-related PTSD and 41% for major depression. The presence of an episode of major depression prior to HT is a significant independent risk factor for posttransplant malignancies. Age, posttransplant malignancies and poor adherence are significant predictors of mortality in the survival analyses. CONCLUSIONS The present study highlights the importance of the assessment of psychosocial variables and psychiatric diagnoses before and after transplantation in HT recipients. Our findings have important clinical implications and require replication with larger samples.
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Affiliation(s)
- Angela Favaro
- Department of Neurosciences, University of Padua, Padova, Italy.
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Wang L, Lee J, Huerta P, Volpe B, Diamond B. Maternal antibodies and fetal brain development. J Reprod Immunol 2010. [DOI: 10.1016/j.jri.2010.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Favaro A, d'Agostino C, Zarnieri D, Boscolo S, Moz M, Gambino A, Volpe B, Santonastaso P, Gerosa G. 466: Posttraumatic Stress Disorder and Major Depression in Heart Transplantation Recipients: The Relationship with Outcome and Medical Compliance. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Affiliation(s)
- Luciano Daliento
- Department of Cardiology, University of Padua, Padova 35128, Italy.
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Desideri G, Necozione S, Di Gregorio N, Tarquini D, Quattrociocchi C, Volpe B, Grassi D, Croce G, Raffaele A, Mauti G, Lechiara MC, Taglieri G, Ferri C. Increased Circulating Levels of Soluble CD40L are Predictive of Alzheimer??s Disease Progression. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Scarso P, Volpe B, Melendugno A, Daliento L. [Psychological problems and cognitive impairments in the GUCH Community]. Ital Heart J Suppl 2003; 4:705-11. [PMID: 14635387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The increase of the GUCH Community requires a new definition of cardiac surgical success, which has to be considered either in terms of survival or quality of life and quality of health. Clinical and psychological problems are present in this population secondary to native cardiac disease, surgical correction, and social environment. Cognitive impairment after cardiac surgery is not rare, but an exhaustive evaluation of the psychological and neurodevelopmental outcome of patients operated on for total correction of congenital heart disease is complex and its clinical significance can be obtained by the integration of cardiological data, psychological status, and sociodemographic variables.
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Affiliation(s)
- Patrizia Scarso
- Servizio di Psicologia Clinica, Cattedra di Cardiochirurgia, Università degli Studi, Padova
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Baker H, Liu N, Chun HS, Saino S, Berlin R, Volpe B, Son JH. Phenotypic differentiation during migration of dopaminergic progenitor cells to the olfactory bulb. J Neurosci 2001; 21:8505-13. [PMID: 11606639 PMCID: PMC6762814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2001] [Revised: 07/25/2001] [Accepted: 08/27/2001] [Indexed: 02/21/2023] Open
Abstract
A possible source for transplantable neurons in Parkinson's disease are adult olfactory bulb (OB) dopamine (DA) progenitors that originate in the anterior subventricular zone and reach the OB through the rostral migratory stream. We used adult transgenic mice expressing a lacZ reporter directed by an 8.9 kb tyrosine hydroxylase (TH) promoter to investigate the course of DAergic differentiation. Parallel transgene and intrinsic TH mRNA expression occurred during migration of DA interneurons through the mitral and superficial granule cell layers before these cells reached their final periglomerular position. Differential transgene and calcium-calmodulin-dependent protein kinase IV expression distinguished two nonoverlapping populations of interneurons. Transgenic mice carrying a TH8.9kb/lacZ construct with a mutant AP-1 site demonstrated that this element confers OB DA-specific TH gene regulation. These results indicate that DA phenotypic determination is specific to a subset of mobile OB progenitors.
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Affiliation(s)
- H Baker
- Burke Medical Research Institute, Weill Medical College, Cornell University, White Plains, New York 10605, USA
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Conti B, Sugama S, Kim Y, Tinti C, Kim H, Baker H, Volpe B, Attardi B, Joh T. Modulation of IL-18 production in the adrenal cortex following acute ACTH or chronic corticosterone treatment. Neuroimmunomodulation 2000; 8:1-7. [PMID: 10859481 DOI: 10.1159/000026445] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Interleukin (IL)-18 is a proinflammatory cytokine and a stimulator of cell-mediated immune responses. We have previously reported that acute stress stimulates the production of IL-18 mRNA in the glucocorticoid (GC)-producing cells of the adrenal cortex. In order to investigate the mechanisms governing the expression of IL-18 in the adrenal cortex, the effects of acute ACTH or chronic corticosterone treatment on the levels of IL-18 mRNA and protein were examined by in situ hybridization and Northern and Western blot assays. Adult male Sprague-Dawley rats received a subcutaneous injection of ACTH or subcutaneous implantation of slow-release corticosterone pellets followed by an injection of saline or ACTH. After 4 h, ACTH induced a 4-fold increase in IL-18 mRNA levels and elevated the content of pro-IL-18 peptide. Six days of chronic corticosterone treatment did not alter the basal levels of IL-18 mRNA and reduced those of pro-IL-18. Finally, ACTH treatment of animals under the corticosterone regimen induced a 2-fold increase in IL-18 mRNA and elevated the levels of the pro-IL-18 protein. The levels of the precursor, p45, and the active subunit p10 peptides of the IL-18-processing enzyme, IL-1beta-converting enzyme (ICE), showed no substantial differences in all the conditions tested. IL-1beta was not detected under these experimental conditions. These data demonstrate that the production of IL-18 in the adrenal cortex is stimulated by ACTH treatment and is not inhibited by the direct action of corticosterone. In contrast to the anti-inflammatory action of GCs, IL-18 may have an immunostimulatory role during acute stress.
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Affiliation(s)
- B Conti
- Laboratory of Molecular Neurobiology, Weill Medical College of Cornell University at The Burke Medical Research Institute, White Plains, NY 10605, USA.
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Speare M, Volpe B, White R, McLean B. HR and the budget knife. Healthc Hum Resour 1994; 3:10-1. [PMID: 10137524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- M Speare
- University of California-Los Angeles Medical Center
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Glynn P, Higby D, Moriarty E, Ficalora M, Volpe B, Koletsky A, White C. Infusional cisplatin and etoposide in the treatment of stage III-B and IV non-small cell lung cancer: a well tolerated regimen. J Med 1994; 25:193-201. [PMID: 7996063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Twenty-eight evaluable patients were treated with an infusion of cisplatin and etoposide for advanced non-small cell lung cancer. A response was demonstrated in 43%, although only two patients had documented partial responses. The regimen was surprisingly low in toxicity, both acute and chronic, and is suitable for palliation of patients who are elderly or suffer from chronic illnesses which preclude more agressive therapy.
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Affiliation(s)
- P Glynn
- Department of Medicine, Baystate Medical Center, Springfield, MA 01109
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Antman E, Jacob G, Volpe B, Finkel S, Savona M. Camphor overdosage. Therapeutic considerations. N Y State J Med 1978; 78:896-7. [PMID: 274623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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