Interpersonal sensitivity and persistent attenuated psychotic symptoms in adolescence

Interpersonal sensitivity defines feelings of inner-fragility in the presence of others due to the expectation of criticism or rejection. Interpersonal sensitivity was found to be related to attenuated positive psychotic symptom during the prodromal phase of psychosis. The aims of this study were to examine if high level of interpersonal sensitivity at baseline are associated with the persistence of attenuated positive psychotic symptoms and general psychopathology at 18-month follow-up. A sample of 85 help-seeking individuals (mean age = 16.6, SD = 5.05) referred an Italian early detection project, completed the interpersonal sensitivity measure and the structured interview for prodromal symptoms (SIPS) at baseline and were assessed at 18-month follow-up using the SIPS. Results showed that individuals with high level of interpersonal sensitivity at baseline reported high level of attenuated positive psychotic symptoms (i.e., unusual thought content) and general symptoms (i.e., depression, irritability and low tolerance to daily stress) at follow-up. This study suggests that being "hypersensitive" to interpersonal interactions is a psychological feature associated with attenuated positive psychotic symptoms and general symptoms, such as depression and irritability, at 18-month follow-up. Assessing and treating inner-self fragilities may be an important step of early detection program to avoid the persistence of subtle but very distressing long-terms symptoms.

Efficacy of safety catheter devices in the prevention of occupational needlestick injuries: applied research in the Liguria Region (Italy)

Healthcare workers who use or may be exposed to needles are at risk of needlestick injuries, which can lead to serious infections by bloodborne pathogens. These injuries can be avoided by eliminating the unnecessary use of needles and using safety devices. The present study was aimed at evaluating the impact of a safety-engineered device, with passive fully automatic needlestick protection, on the rate of needlestick injuries among healthcare workers. The setting of the study was a network of five public healthcare institutions situated in a Northern Italian Region. Data on the type of device, the number of employees and the number of catheter devices used per year were collected through regular meetings with healthcare workers over a period of five years. The most notable result of this study was the huge risk reduction associated with safety devices. Indeed, the risk of needlestick injuries due to conventional devices was found to be 25-fold higher than that observed for safety devices. However, it is noteworthy that a considerable part of this excess can be explained by the different background number of devices used. Moreover, descriptive analysis suggested that individuals with a poor/moderate training level had a lower risk than those with good/high training, though the difference was not statistically significant. In conclusion, there is convincing evidence of a causal connection between the introduction of safety devices and the reduction in needlestick injuries. This consideration should prompt the introduction of safety devices into daily clinical practice.

Psychopathology, temperament and suicide risk in adolescence: The role of early traumatic experience

Introduction

Previous researches showed that adolescents are at high risk of suicide. Suicide is a trans-nosographic phenomenon regardless of psychiatric diagnosis. Trauma is an important risk factor for suicide and young help-seeking patients usually refer traumatic experiences, especially during childhood.

Objectives

The objective of this study is to assess the relationship between traumatic experience and suicide risk comparing adolescents with suicide risk with adolescents without suicide risk.

Aims

To investigate correlations between trauma, psychopathology and suicide risk in a sample of young help-seeking outpatients.

Methods

We recruited 99 outpatients aged between 14 and 21 years admitted to department for prevention and early intervention in adolescence of Rome. We administered psychometric instruments exploring suicide risk (SHSS, BHS), prodromal (SIPS/SOPS), affective and anxious symptoms (HAM-A, HAM-D,MRS), child abuse (CTQ) and experiences of depersonalization (CDS).

Results

Sample is composed of 31 men and 68 women. A total of 34.3% had mood disorder. A total of 28.3% reported history of emotional neglect, 20.2% emotional abuse, 9.15 sexual abuse, 5.1% physical neglect, 9,1% sexual abuse, 4% physical abuse. More than 30% of patients were at increased suicide risk. Depressive, irritable, anxious and cyclothymic temperament was associated with suicide risk. Patients with suicide risk had higher score at HAM-D (t63 = 2.65; P = 0.01), CDS (t63 = 2.77; P = 0.007), in CTQ (t63 = 3.20; P = 0.002) and BHS (t63 = 3.23; P = 0.002).

Conclusions

Adolescents with suicide risk, compared with those without, reported more frequently early traumatic experiences and psychiatric symptoms. Early traumatic experiences constitute a risk factor for both suicide risk and psychiatric symptoms during adolescence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Affective temperaments are associated with higher hopelessness and perceived disability in patients with open-angle glaucoma

AIM

The aims of the study were to study: (i) affective temperaments in open-angle glaucoma (OAG) patients with some degree of functional visual impairment; (ii) psychological well-being and perceived disability, and their associations with affective temperaments; and (iii) associations between visual impairment, affective temperaments and psychological well-being.

METHOD

Participants were 91 outpatients (39 women, and 52 men) with open-angle glaucoma (OAG) who were assessed for Visual Field Index, Mean Defect and Pattern Standard Deviation. Patients were also administered the Beck Hopelessness Scale, the TEMPS-A (Rome), the Gotland Male Depression Scale, the Emotional Well-being Scale, the Perceived Disability Questionnaire and the Suicidal History Self-Rating Screening Scale.

RESULTS

Open-angle glaucoma patients (compared with a non-clinical sample of university students) had higher scores on the TEMP-A dysthimic and hyperthimic traits and lower scores on cyclothimic, irritability and anxiety traits. Such temperament variability was not linked to differences in severity of glaucoma. We did not find strong evidence supporting the fact that measures of visual impairment were linked to emotional well-being and depression. However, logistic regression analysis revealed that patients may have different patterns related to their illness according to specific temperaments.

CONCLUSION

Patients with OAG may have different temperament profiles than non-clinical individuals. Such categorisation may be useful for predicting how they face the illness, for providing better care as well as for early recognition of mood disorders symptoms.

Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: results from a prospective multicentric study in Italy

OBJECTIVE

We conducted a cross-sectional study on the frequency and risk factors for adenomyosis in women who underwent hysterectomy for benign gynecological conditions.

STUDY DESIGN

All women who consecutively underwent hysterectomy during the study period for benign gynecological conditions at 18 gynecological departments were eligible for the study. A total of 820 women entered the study. Pathological data were collected prospectically.

RESULTS

Adenomyosis was identified in 231 women (28.2%, 95% confidence interval, CI, 24.6-32.5). The frequency of adenomyosis was similar in women with indication for surgery fibroids/menorrhagia (143 cases, 28.5%) or genital prolapse (69 cases, 28.2%). The rate ratio (RR) of adenomyosis was 1.9 (95% CI 1.2-2.8) in women reporting one or more induced abortions, in comparison with those reporting no induced abortion. Women with adenomyosis reported more frequently dysmenorrhoea and chronic pelvic pain, but not dyspareunia.

CONCLUSIONS

This study shows that adenomyosis is common in women who undergo hysterectomy and that it is more frequent among women reporting induced abortions dysmenorrhoea and chronic pelvic pain.

[Preoperative platelet count as index of the grading in endometrial carcinoma]

AIM

To investigate a possible relationship between preoperative platelet count and following clinicopathological variables of the endometrial carcinoma: age, stage, histological type, histological grading (G), myometrial invasion, lymphovascular space involvement, cervical involvement, lymph node metastasis. In particular the existence of a possible relationship between elevated preoperative platelet count (=or>300 000 microL) and negative prognostic factors.

METHODS

The authors analyzed retrospectively 120 patients with endometrial carcinoma underwent to surgery as the initial treatment. All the patients were subjected to radical surgical procedure: peritoneal cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, systematic pelvic lymphadenectomy and omentectomy. Blood platelet count was taken from the patients three days prior to the surgery.

RESULTS

The patients with platelet count<300000/microL whom they had a G1, G2, G3 they were respectively the 23.1%, 44.2% and 32.7% versus the 0%, 12.5% and 87.5%, respectively for G1, G2, G3, of the patients with platelet count>300000/microL (P=0.024). Only considering the patients to the stage I of the Federazione Internazionale dei Ginecologi ed Ostetrici (FIGO). The patients with platelet count<300000/microL whom they had a G1, G2, G3 they were respectively the 27.3%, 43.2% and 29.5% versus the 0%, 0% and 100%, respectively for G1, G2, G3, of the patients with platelet count=or>300000/microL (P=0.008). There were no differences respect to age, stage, histological type, myometrial invasion, lymphovascular space involvement and cervical involvement.

CONCLUSION

Elevated preoperative platelet count, in the patients with endometrial carcinoma, may reflect poor prognostic factor such as higher histological grade. This study allowed to observe: a significant correlation between elevated preoperative platelet count (=or>300000/microL) and tumoral grading (G3) of general population submitted to study; for the patients to the stage I FIGO a more significant correlation between elevated preoperative platelet count (=or>300000/microL) and tumoral grading: the 100% of the patients with platelet count=or>300 000/microL had a histological grading G3.

The use of a decremental dose regimen in patients treated with a chronic low-dose step-up protocol for WHO Group II anovulation: a prospective randomized multicentre study

BACKGROUND

In women with chronic anovulation, the choice of the FSH starting dose and the modality of subsequent dose adjustments are critical in controlling the risk of overstimulation. The aim of this prospective randomized study was to assess the efficacy and safety of a decremental FSH dose regimen applied once the leading follicle was 10-13 mm in diameter in women treated for WHO Group II anovulation according to a chronic low-dose (CLD; 75 IU FSH for 14 days with 37.5 IU increment) step-up protocol.

METHODS

Two hundred and nine subfertile women were treated with recombinant human FSH (r-hFSH) (Gonal-f) for ovulation induction according to a CLD step-up regimen. When the leading follicle reached a diameter of 10-13 mm, 158 participants were randomized by means of a computer-generated list to receive either the same FSH dose required to achieve the threshold for follicular development (CLD regimen) or half of this FSH dose [sequential (SQ) regimen]. HCG was administered only if not more than three follicles >or=16 mm in diameter were present and/or serum estradiol (E(2)) values were <1200 pg/ml. The primary outcome measure was the number of follicles >or=16 mm in size at the time of hCG administration.

RESULTS

Clinical characteristics and ovarian parameters at the time of randomization were similar in the two groups. Both CLD and SQ protocols achieved similar follicular growth as regards the total number of follicles and medium-sized or mature follicles (>/=16 mm: 1.5 +/- 0.9 versus 1.4 +/- 0.7, respectively). Furthermore, serum E(2) levels were equivalent in the two groups at the time of hCG administration (441 +/- 360 versus 425 +/- 480 pg/ml for CLD and SQ protocols, respectively). The rate of mono-follicular development was identical as well as the percentage of patients who ovulated and achieved pregnancy.

CONCLUSIONS

The results show that the CLD step-up regimen for FSH administration is efficacious and safe for promoting mono-follicular ovulation in women with WHO Group II anovulation. This study confirms that maintaining the same FSH starting dose for 14 days before increasing the dose in step-up regimen is critical to adequately control the risk of over-response. Strict application of CLD regimen should be recommended in women with WHO Group II anovulation.

Selective etching of metallic single-wall carbon nanotubes with hydrogen plasma

We present Raman scattering and scanning tunnelling microscopy (STM) measurements on hydrogen plasma etched single-wall carbon nanotubes (SWNTs). Interestingly, both the STM and Raman spectroscopy show that the metallic SWNTs are dramatically altered and highly defected by the plasma treatment. In addition, structural characterizations show that metal catalysts are detached from the ends of the SWNT bundles. For semiconducting SWNTs we observe no feature of defects or etching along the nanotubes. Raman spectra in the radial breathing mode region of plasma-treated SWNT material show that most of the tubes are semiconducting. These results show that hydrogen plasma treatment favours etching of metallic nanotubes over semiconducting ones and therefore could be used to tailor the electronic properties of SWNT raw materials.

Polyunsaturated fatty acids and risk of preterm delivery

Preterm delivery (PD) is characterized both by increased neonatal morbidity and mortality and by important late pathologic sequelae. From a clinical stand-point, PD may results from a medical condition where the continuation of pregnancy could bring about a marked risk for the foetus and/or for the mother, or from an adverse event where the pregnancy is going to end spontaneously before 37 weeks of gestation. In the past few years some epidemiological studies have shown that diet may interfere with complex multifactorial processes contributing to the preterm triggering of labour. The attention has been focused on polyunsaturated fatty acids (PUFA) such as alpha-linoleic acid, precursor of Omega-3 series, and linoleic acid, precursor Omega-6 series. Their importance in modulating Prostaglandin concentrations at different levels is already known. Moreover, it has been reported that in clinical situation, such as PD, the endogenous levels of PUFA are unbalanced, with a Omega-6 predominance. Experimental, observational and clinical studies suggest that dietary intake of Omega-3 fatty acids is capable of significantly prolonging the duration of gestation in the range of 4-7 days; such prolongation would possibly occur through the inhibition of prostaglandins E2 and F2 alpha. In Western population dietary intake of Omega-3 appears to be marginal, and recommended assumption could be reached only by a ten-fold increase in blue fish ingestion. The recommended intake of EPA + DHA should be 1.4 g/daily with a 1:2.5 EPA:DHA. It is therefore possible to conclude that in light of controlled clinical studies and of the actual categories of risk for preterm delivery, the dietary supplementation of Omega-3, in addition to other pharmacological measures (17alpha-hydroxyprogesterone caproate), could be implemented for the secondary and/or tertiary prophylaxis of preterm delivery.

Ultrafast MR imaging of the foetus: a study of 25 non-central nervous system anomalies

PURPOSE

The aim of this paper is to suggest Magnetic Resonance (MR) Imaging as a useful tool in prenatal diagnosis. Although ultrasonography (US) is the imaging technique of choice for prenatal screening, in cases of complex malformations US findings may be sub-optimal and give rise to diagnostic difficulties requiring further investigation. Our study is focused on non-central nervous system (CNS) abnormalities of the foetus imaged using the ultrafast sequence EXPRESS.

MATERIALS AND METHODS

38 women whose foetuses were between 21-34 gestational age were studied. Indications for the examinations included the evaluation of non-CNS abnormalities in 25 cases. Foetal MR imaging was performed on a 1.5 T system (Edge, Marconi Medical System Italia SpA, Vimercate, MI) with the half-Fourier, single-shot, fast spin-echo EXPRESS sequence. Mild maternal and foetal sedation was obtained by oral administration of benzodiazepine (1 mg).

RESULTS

In the 25 foetuses investigated for non-CNS pathologies the abnormalities were localised in the chest (9), abdomen (15) and extremities (1). The MR imaging diagnoses were: in the chest - congenital diaphragmatic hernia (CDH) (5), congenital cystic adenomatoid malformation (CCAM) (1), hydrothorax (1), cystic lymphangioma (1), Jeune syndrome (1); in the abdomen - 10 cases of urinary tract diseases - polycystic kidney (4), crossed renal ectopia (2), unilateral renal agenesis (1), solitary pelvic kidney (1), bilateral stenosis of ureteropelvic junction (1), duplex collecting system in association with controlateral hydroureteronephrosis (1)#151;5 cases of non-urinary tract pathologies#151;cystic lymphangioma of the liver (1), abdominal cystic lymphangioma (1), gastroschisis (1), gastric duplication (1), cavernous haemangioma of the liver (1); in the extremities - longitudinal hemimelia (1).

CONCLUSIONS

In our experience MR is to be considered a useful though adjunct study to prenatal US particularly in the evaluation of lung parenchyma, congenital diaphragmatic viscera herniation, thoracic masses, pleural effusion, abdominal cystic masses, and urinary tract malformations. The ultrafast EXPRESS sequence enables a complete study to be performed in a very short time; as a consequence the examination is well tolerated by the patient. Currently there is no legislation which regulates the use of magnetic fields in MR, only a series of recommendations based on studies on animal embryos and foetuses, on pregnant women exposed to magnetic fields and follow-up studies of children exposed to MR during gestation. Therefore the decision to proceed with foetal MR should be made on a case-by-case basis in close consultation with the referring obstetrician. Considering the results, in our opinion the potential of MR in the evaluation of a wide variety of non-CNS foetal diseases will increase in the near future.

Treatment of allergic diseases during pregnancy

Pregnancy may variously modify the natural history of allergic disorders through occurring endocrinologic, functional and immunological changes. A pharmacologic treatment of allergic diseases (mainly asthma) is often necessary during pregnancy. On the other hand, a drug should be not potentially teratogenic and should not have serious side effects, both for the mother and the fetus. This paper reviews current knowledge about allergic diseases during pregnancy, considering the points of view of the different specialists involved in their management. Topical mucosal agents seem to be the safest, due to their minimal or absent absorption which should reflect reduced side effects. Preferred agents should be topical antihistamines (for rhinitis and conjunctivitis), and cromones and topical steroids (for asthma), as they are both safe and effective.

Orientational and Magnetic Ordering of Buckyballs in TDAE-C 60

Spin ordering in the low-temperature magnetic phase is directly linked to the orientational ordering of C(60) molecules in organically doped fullerene derivatives. Electron spin resonance and alternating current susceptometry measurements on tetrakis(dimethylamino)ethylene-C(60) (TDAE-C(60)) (Curie temperature T(c) = 16 kelvin) show a direct coupling between spin and merohedral degrees of freedom. This coupling was experimentally demonstrated by showing that ordering the spins in the magnetic phase imprints a merohedral order on the solid or, conversely, that merohedrally ordering the C(60) molecules influences the spin order at low temperature. The merohedral disorder gives rise to a distribution of pi-lectron exchange interactions between spins on neighboring C(60) molecules, suggesting a microscopic origin for the observed spinglass behavior of the magnetic state.