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de Laurentis C, Pirillo D, Di Cristofori A, Versace A, Calloni T, Trezza A, Villa V, Alberti L, Baldo A, Nicolosi F, Carrabba G, Giussani C. Boosting teamwork between scrub nurses and neurosurgeons: exploring the value of a role-played hands-on, cadaver-free simulation and systematic review of the literature. Front Surg 2024; 11:1386887. [PMID: 38558881 PMCID: PMC10978771 DOI: 10.3389/fsurg.2024.1386887] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Background Recently, non-technical skills (NTS) and teamwork in particular have been demonstrated to be essential in many jobs, in business as well as in medical specialties, including plastic, orthopedic, and general surgery. However, NTS and teamwork in neurosurgery have not yet been fully studied. We reviewed the relevant literature and designed a mock surgery to be used as a team-building activity specifically designed for scrub nurses and neurosurgeons. Methods We conducted a systematic review by searching PubMed (Medline) and CINAHL, including relevant articles in English published until 15 July 2023. Then, we proposed a pilot study consisting of a single-session, hands-on, and cadaver-free activity, based on role play. Scrub nurses were administered the SPLINTS (Scrub Practitioners' List of Intraoperative Non-Technical Skills) rating form as a self-evaluation at baseline and 20-30 days after the simulation. During the experiment, surgeons and scrub nurses role-played as each other, doing exercises including a simulated glioma resection surgery performed on an advanced model of a cerebral tumor (Tumor Box, UpSurgeOn®) under an exoscope. At the end, every participant completed an evaluation questionnaire. Results A limited number of articles are available on the topic. This study reports one of the first neurosurgical team-building activities in the literature. All the participating scrub nurses and neurosurgeons positively evaluated the simulation developed on a roleplay. The use of a physical simulator seems an added value, as the tactile feedback given by the model further helps to understand the actual surgical job, more than only observing and assisting. The SPLINTS showed a statistically significant improvement not only in "Communication and Teamwork" (p = 0.048) but also in "Situation Awareness" (p = 0.031). Conclusion Our study suggests that team-building activities may play a role in improving interprofessional teamwork and other NTS in neurosurgery.
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Affiliation(s)
- Camilla de Laurentis
- School of Medicine and Surgery, Università Degli Studi di Milano Bicocca, Milan, Italy
- Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - David Pirillo
- Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Andrea Di Cristofori
- School of Medicine and Surgery, Università Degli Studi di Milano Bicocca, Milan, Italy
- Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | | | - Tommaso Calloni
- School of Medicine and Surgery, Università Degli Studi di Milano Bicocca, Milan, Italy
- Neurosurgery, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Trezza
- Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Valentina Villa
- Operating Room, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Lucia Alberti
- Operating Room, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Angelo Baldo
- School of Medicine and Surgery, Università Degli Studi di Milano Bicocca, Milan, Italy
- Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Federico Nicolosi
- School of Medicine and Surgery, Università Degli Studi di Milano Bicocca, Milan, Italy
| | - Giorgio Carrabba
- School of Medicine and Surgery, Università Degli Studi di Milano Bicocca, Milan, Italy
- Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Carlo Giussani
- School of Medicine and Surgery, Università Degli Studi di Milano Bicocca, Milan, Italy
- Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
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Bastoni I, Guerrini Usubini A, Gobetti M, Sanna M, Pagnoncelli G, Uboldi L, Villa V, Castelnuovo G, Sartorio A, Mendolicchio L. Let the Body Talk: Preliminary Data of an Open Trial of Dance Movement Therapy for Eating Disorders. J Clin Med 2023; 13:5. [PMID: 38202012 PMCID: PMC10779718 DOI: 10.3390/jcm13010005] [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] [Received: 09/28/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND There is growing support for considering Dance Movement Therapy (DMT) as an effective approach to improving physical and psychological symptoms in eating disorders (ED), but additional evidence is needed. The current study aims to investigate the effectiveness of a DMT intervention for inpatients with ED during an in-hospital rehabilitation program for ED in reducing emotion dysregulation and alexithymia and improving interoceptive awareness. METHODS Forty-nine consecutive inpatient young women with ED (aged between 18 and 34 years) recruited from a clinical center for the rehabilitation of obesity and ED received four group sessions of DMT intervention. All participants completed the Difficulties in Emotion Regulation Scale (DERS), the Toronto Alexithymia Scale (TAS), and the Multidimensional Assessment of Interoceptive Awareness Scale (MAIA) before (Time 0) and after the intervention (Time 1). Paired-sample t-tests were run to assess differences between Time 0 to Time 1. RESULTS From pre-to-post interventions, there was a significant reduction in the means of all of the subscales of DERS, suggesting an improvement in emotion regulation competencies, with the only exception for difficulties in awareness that increased (p = 0.016). We also found a significant reduction in alexithymia, as proved by significant differences in all of the subscales and the total score of TAS (p < 0.001), and significant improvements in interoceptive awareness as suggested by increased scores of the noticing (p = 0.043), emotional awareness (p < 0.001), body listening (p < 0.001), and trusting (p < 0.001) subscales of MAIA. CONCLUSION Overall, our results point towards the efficacy of dance/movement in reducing symptoms of eating disorders. Our findings also suggest that dancing can be considered a useful intervention to increase emotional regulation, reduce alexithymia, and enhance interoceptive awareness.
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Affiliation(s)
- Ilaria Bastoni
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy; (I.B.); (V.V.); (G.C.)
- Centro Arti Terapie, 20122 Milan, Italy; (M.S.); (G.P.); (L.U.)
| | - Anna Guerrini Usubini
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy; (I.B.); (V.V.); (G.C.)
| | - Maria Gobetti
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Mila Sanna
- Centro Arti Terapie, 20122 Milan, Italy; (M.S.); (G.P.); (L.U.)
| | - Glenda Pagnoncelli
- Centro Arti Terapie, 20122 Milan, Italy; (M.S.); (G.P.); (L.U.)
- Politecnico di Milano—METID: Metodi e Tecnologie Innovative per la Didattica, 20133 Milan, Italy
| | - Laura Uboldi
- Centro Arti Terapie, 20122 Milan, Italy; (M.S.); (G.P.); (L.U.)
| | - Valentina Villa
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy; (I.B.); (V.V.); (G.C.)
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy; (I.B.); (V.V.); (G.C.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy;
| | - Leonardo Mendolicchio
- Division of Eating and Nutrition Disorders, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 28824 Verbania, Italy;
- Experimental Laboratory for Metabolic Neurosciences, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 28824 Verbania, Italy
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Vaioli G, Bastoni I, Villa V, Mendolicchio L, Castelnuovo G, Mauro A, Scarpina F. "I cannot see your fear!" Altered recognition of fearful facial expressions in anorexia nervosa. Front Psychol 2023; 14:1280719. [PMID: 38125860 PMCID: PMC10732310 DOI: 10.3389/fpsyg.2023.1280719] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
Background The evidence about facial emotion recognition in anorexia nervosa as the role of alexithymic traits on this emotional ability is conflicting and heterogeneous. Objective We assessed the capability of recognizing facial expressions of two primary emotions, fear, and anger, in the context of anorexia nervosa. Methods Women affected by anorexia nervosa were compared with healthy weight women in a well-established implicit facial emotion recognition task. Both reaction time and level of accuracy were computed. Moreover, the individual levels of alexithymia were assessed through a standard self-report questionnaire. Results Participants with anorexia nervosa reported a significantly lower performance in terms of reaction time and accuracy when the emotion of fear-but not anger-was the target. Notably, such an alteration was linked to the levels of alexithymia reported in the self-report questionnaire. Conclusion In anorexia nervosa, difficulties in processing facial fearful (but not angry) expressions may be observed as linked to higher expressions of alexithymic traits. We suggested future research in which emotional processing will be investigated taking into account the role of the bodily dimensions of emotional awareness.
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Affiliation(s)
- Giulia Vaioli
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo, Italy
| | - Ilaria Bastoni
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo, Italy
| | - Valentina Villa
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo, Italy
| | - Leonardo Mendolicchio
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, Piancavallo, Italy
| | - Gianluca Castelnuovo
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo, Italy
- Psychology Department, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Alessandro Mauro
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo, Italy
- “Rita Levi Montalcini” Department of Neurosciences, University of Turin, Turin, Italy
| | - Federica Scarpina
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo, Italy
- “Rita Levi Montalcini” Department of Neurosciences, University of Turin, Turin, Italy
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Tagini S, Bastoni I, Villa V, Mendolicchio L, Castelnuovo G, Mauro A, Scarpina F. Corrigendum to "Affective touch in anorexia nervosa: Exploring the role of social anhedonia and lifespan experiences" [J. Affect. Disord., 324 (2023), 607-615]. J Affect Disord 2023; 328:357. [PMID: 36863909 DOI: 10.1016/j.jad.2023.02.114] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Affiliation(s)
- Sofia Tagini
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Turin, Italy.
| | - Ilaria Bastoni
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy.
| | - Valentina Villa
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy.
| | - Leonardo Mendolicchio
- Istituto Auxologico Italiano, IRCCS, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, Piancavallo (VCO), Italy.
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy; Psychology Department, Università Cattolica del Sacro Cuore, Milan, Italy.
| | - Alessandro Mauro
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Turin, Italy; Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy.
| | - Federica Scarpina
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Turin, Italy; Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy.
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Morselli L, Donzella A, Arzenton A, Asti M, Bortolussi S, Corradetti S, D’Agostino G, Di Luzio M, Ferrari M, Gandini A, Lunardon M, Villa V, Salvini A, Zangrando L, Zenoni A, Andrighetto A. Production and characterization of 111Ag radioisotope for medical use in a TRIGA Mark II nuclear research reactor. Appl Radiat Isot 2023; 197:110798. [PMID: 37028101 DOI: 10.1016/j.apradiso.2023.110798] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/17/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
Radio Pharmaceutical Therapy (RPT) comes forth as a promising technique to treat a wide range of tumors while ensuring low collateral damage to nearby healthy tissues. This kind of cancer therapy exploits the radiation following the decay of a specific radionuclide to deliver a lethal dose to tumor tissues. In the framework of the ISOLPHARM project of INFN, 111Ag was recently proposed as a promising core of a therapeutic radiopharmaceutical. In this paper, the production of 111Ag via neutron activation of 110Pd-enriched samples inside a TRIGA Mark II nuclear research reactor is studied. The radioisotope production is modeled using two different Monte Carlo codes (MCNPX and PHITS) and a stand-alone inventory calculation code FISPACT-II, with different cross section data libraries. The whole process is simulated starting from an MCNP6-based reactor model producing the neutron spectrum and flux in the selected irradiation facility. Moreover, a cost-effective, robust and easy-to-use spectroscopic system, based on a Lanthanum Bromo-Chloride (LBC) inorganic scintillator, is designed and characterized, with the aim of using it, in the future, for the quality control of the ISOLPHARM irradiated targets at the SPES facility of the Legnaro National Laboratories of INFN. natPd and 110Pd-enriched samples are irradiated in the reactor main irradiation facility and spectroscopically characterized using the LBC-based setup and a multiple-fit analysis procedure. Experimental results are compared with theoretical predictions of the developed models, showing that inaccuracies in the available cross section libraries prevent an accurate reproduction of the generated radioisotope activities. Nevertheless, models are normalized to our experimental data allowing for a reliable planning of the 111Ag production in a TRIGA Mark II reactor.
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Tagini S, Bastoni I, Villa V, Mendolicchio L, Castelnuovo G, Mauro A, Scarpina F. Affective touch in anorexia nervosa: Exploring the role of social anhedonia and lifespan experiences. J Affect Disord 2023; 324:607-615. [PMID: 36587904 DOI: 10.1016/j.jad.2022.12.137] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 12/21/2022] [Accepted: 12/25/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND The pleasantness of a gentle and slow, namely affective, touch experienced in interpersonal interactions motivates social closeness. In anorexia nervosa (AN), independent evidence suggests lower pleasantness of affective touch, as well as social withdrawal. We aim to probe both the experience of affective touch and its possible association with social anhedonia and lifespan experiences of affective bodily contacts in AN. METHODS The pleasantness of affective and non-affective touch was compared between fourteen women with AN and fourteen healthy women. Stimuli were traditionally delivered with a brush, with the experimenter's hand, as novelty, and with a stick, as control. The pleasantness of imagined and real touch was probed. Self-report questionnaires assessed social anhedonia and lifespan experiences of affective touch. RESULTS A preserved pleasantness of affective touch emerged in AN in both the imagery and real task, despite higher social anhedonia and less lifespan experience of affective touch than healthy women. LIMITATIONS Affective touch involves loved ones; thus, the experimenter's touch may not resemble real-life interactions. Future research may take advantage of imagery procedures to solve this issue. CONCLUSIONS Body-oriented therapy for AN recognizes touch as a therapeutic tool: ascertaining how touch is experienced is crucial to maximize rehabilitative outcomes. Furthermore, clarifying the possible interplay between interpersonal difficulties in AN and affective touch is especially relevant considering the possible role of the attachment style, which is intensively debated in AN, on affective touch.
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Affiliation(s)
- Sofia Tagini
- Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo, VCO, Italy; "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Turin, Italy.
| | - Ilaria Bastoni
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo, VCO, Italy.
| | - Valentina Villa
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo, VCO, Italy.
| | - Leonardo Mendolicchio
- Istituto Auxologico Italiano, IRCCS, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, Piancavallo, VCO, Italy.
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo, VCO, Italy; Psychology Department, Università Cattolica del Sacro Cuore, Milan, Italy.
| | - Alessandro Mauro
- Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo, VCO, Italy; "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Turin, Italy.
| | - Federica Scarpina
- Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo, VCO, Italy; "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Turin, Italy.
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Scarpina F, Bastoni I, Villa V, Mendolicchio L, Castelnuovo G, Mauro L, Sedda A. Self-perception in anorexia nervosa: When the body becomes an object. Neuropsychologia 2022; 166:108158. [PMID: 35033502 DOI: 10.1016/j.neuropsychologia.2022.108158] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Women with anorexia nervosa (AN) act as if they have a larger body, as evidenced in obstacle avoidance tasks, where an allocentric perspective is adopted. This alteration emerges not only when they perform, but also when they imagine movements. However, no previous study has investigated own body centered tasks. As such, in this study we aim at documenting if women with AN show an altered behaviour also when the task requires a first-person perspective. METHOD We explored the performance of eleven woman affected by AN compared to eighteen matched controls, in two motor imagery tasks based on a self-frame of reference, the Hand Laterality Task and the Mental Motor Chronometry Task. Moreover, two control tasks relative to visual imagery were administered. RESULTS In the Hand Laterality Task, affected participants did not adopt a motor strategy to judge hands laterality (i.e. no biomechanical constraints effect). Crucially, they also showed an altered behavior in the control task. Similarly, they did not show the expected isochrony in the Mental Motor Chronometry Task, when actions pertained the left (but not the right) hand, in absence of any difference in the control task. CONCLUSIONS Our findings reveal altered imagery processes in AN. Specifically, affected participants adopt a third-person, rather than a first-person perspective, even when the task requires to imagine their own body in an internal frame of reference. In other words, participants with AN objectify body stimuli. Different mechanisms (i.e., checking behaviour; mirror self-reflection; altered multisensory integration) can explain such an altered imagery in AN.
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Affiliation(s)
- Federica Scarpina
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Italy; I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy.
| | - Ilaria Bastoni
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, Piancavallo (VCO), Italy; I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Valentina Villa
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, Piancavallo (VCO), Italy; I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Leonardo Mendolicchio
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Gianluca Castelnuovo
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy; Psychology Department, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Leonardo Mauro
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Italy; I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Anna Sedda
- Psychology Department, School of Social Sciences, Heriot-Watt University, Edinburgh, UK; Centre for Applied Behavioural Sciences, School of Social Sciences, Heriot-Watt University, UK
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Guerrini Usubini A, Cattivelli R, Giusti EM, Riboni FV, Varallo G, Pietrabissa G, Manzoni GM, Consoli S, Bastoni I, Granese V, Volpi C, Villa V, Caretti A, Bottacchi M, Castelnuovo G, Molinari E. The ACTyourCHANGE study protocol: promoting a healthy lifestyle in patients with obesity with Acceptance and Commitment Therapy-a randomized controlled trial. Trials 2021; 22:290. [PMID: 33879183 PMCID: PMC8056547 DOI: 10.1186/s13063-021-05191-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/15/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND As treatment of choice in promoting psychological flexibility, Acceptance and Commitment Therapy (ACT) was found to be effective in several conditions, and among different populations, including weight management in individuals with obesity. However, the mechanism of action of psychological flexibility is less known. The aim of the present study is, within the context of a brief ACT intervention for behavioral change and behavioral maintenance of a healthy lifestyle in a sample of inpatients with obesity, to explore the effect of each subcomponent of the psychological flexibility model on treatment processes and outcomes. METHODS A randomized controlled trial will be conducted. Ninety Italian adult inpatients with obesity attending a rehabilitation program for weight loss will be randomly allocated into three experimental conditions targeting respectively each subcomponent of the psychological flexibility model: group Engage focused on values-oriented behaviors, group Openness focused on acceptance and cognitive defusion, and group Awareness focused on being present and aware of thoughts, feelings, and behaviors at every moment. Weight, BMI (kg/m2), the Psychological General Well-Being Inventory (PGWBI), the Outcome Questionnaire-45.2 (OQ-45.2), the Depression Anxiety and Stress Scale (DASS-21), the Difficulties in Emotion Regulation Scale (DERS), the Dutch Eating Behaviors Questionnaire (DEBQ), the Brief Values Inventory (BVI), the Committed Action Questionnaire (CAQ), the Italian-Cognitive Fusion Questionnaire (I-CFQ), the Five Facet Mindfulness Questionnaire (FFMQ), and the Acceptance and Action Questionnaire (AAQ-II) will be assessed at the beginning (time 0), at the end of psychological intervention (time 1), and after 3 (time 2) and 6 months (time 3) and 9 months (time 4) from discharge. During the following month after discharge, outpatients will be monitored in their adherence to a healthy lifestyle, using a wearable device. To assess the effectiveness of the intervention, mixed between-within 3 (conditions) × 4 (times) repeated measure ANOVAs will be conducted to examine changes from time 0 to time 1, 2, 3, and 4 in means of weight, BMI, and means of scores PGWBI, OQ-45.2, DASS, DERS, DEBQ, AAQ-II, BVI, CAQ, I-CFQ, and FFMQ, between three groups. DISCUSSION This study will contribute to clarify the mechanism of action of each subcomponent of the psychological flexibility model and understand its impact on the promotion of a healthy lifestyle. TRIAL REGISTRATION ClinicalTrials.gov NCT04474509 . Registered on July 4, 2020.
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Affiliation(s)
- Anna Guerrini Usubini
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy.
- Department of Psychology, Catholic University of Milan, Milan, Italy.
| | - Roberto Cattivelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Emanuele Maria Giusti
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | - Giorgia Varallo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, eCampus University, Novedrate, Italy
| | - Simone Consoli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Ilaria Bastoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Valentina Granese
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Clarissa Volpi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Valentina Villa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Annalisa Caretti
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Michela Bottacchi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
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9
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Brunani A, Sirtori A, Capodaglio P, Donini LM, Buscemi S, Carbonelli MG, Giordano F, Mazzali G, Pasqualinotto L, Zenti MG, Barbieri V, Villa V, Leonardi M, Raggi A. Disability assessment in an Italian cohort of patients with obesity using an International Classification of Functioning, Disability and Health (ICF)-derived questionnaire. Eur J Phys Rehabil Med 2020; 57:630-638. [PMID: 33165313 DOI: 10.23736/s1973-9087.20.06512-0] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Obesity is a clinical condition that contributes to the development of related disability in different areas (physical, psychological and social). Multidisciplinary treatment calls for specific instruments able to evaluate all related functional problems. We have developed a tool (an ICF-based assessment instrument, the ICF-OB schedule) to evaluate obesity-related disability, composed of an inventory of 71-items from the WHO International Classification of Functioning, Disability and Health (ICF). AIM The aim of the present study was to validate this new tool for the definition of obesity-related disability. We also sought to examine the relationship between obesity disability, an index of multimorbidity (Cumulative Illness Rating Scale [CIRS]) and a well-validated score of perceived obesity-related disability (Italian Obesity Society Test for Obesity-Related Disability [TSD-OC]). DESIGN Process validation of the ICF-OB schedule. SETTING Baseline conditions of out- and in-patients. POPULATION A large cohort of obese patients recruited from 9 multidisciplinary centers belonging to the Italian Obesity Society (SIO) network, which provide specialized obesity care. METHODS A total of 353 patients (F: 70%, age: 50.2±12.7yrs, BMI: 41.4±8.3kg/m2) were enrolled between January 2017 and June 2018. The ICF-OB was used to define patients' functioning and disability profiles in order to set and appraise rehabilitation goals. RESULTS We described the distribution of body functions (BF), body structures (BS) and activities and participations (A&P) categories and the agreement rates were significant for the majority of these. The ICF-OB was more often significantly associated, and with stronger coefficients, with patients' comorbidities as described by the CIRS rather than with Body Mass Index (BMI). The TSD-OC also presented a strong association with A&P indexes. CONCLUSIONS The complexity of clinical condition, that generates disability in obesity might be well identified with the use of this new instrument that appear significant related to the perceived disability for each patients and also with their multimorbidity. CLINICAL REHABILITATION IMPACT The ICF-OB shows great promise as a tool for goal setting in the rehabilitation of obese patients.
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Affiliation(s)
- Amelia Brunani
- IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Verbania, Verbania-Cusio-Ossola, Italy -
| | - Anna Sirtori
- IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Verbania, Verbania-Cusio-Ossola, Italy
| | - Paolo Capodaglio
- IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Verbania, Verbania-Cusio-Ossola, Italy
| | - Lorenzo M Donini
- Food Science and Human Nutrition Research Unit, Sapienza University, Rome, Italy
| | - Silvio Buscemi
- Unit of Endocrinology, Metabolic and Nutrition Diseases, University Hospital Policlinico "P. Giaccone", University of Palermo, Palermo, Italy
| | | | - Francesca Giordano
- Centro per la Cura dell'Obesità Casa di Cura Solatrix, Rovereto, Trento, Italy
| | - Gloria Mazzali
- Department of Medicine, Geriatrics Division, University of Verona, Verona, Italy
| | | | - Maria G Zenti
- Departement of Medicine, Endocrinology Division, University of Verona, Verona, Italy
| | - Valerio Barbieri
- Centro per i Disturbi Alimentari, Policlinico S. Pietro, Bergamo, Italy
| | - Valentina Villa
- IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Verbania, Verbania-Cusio-Ossola, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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10
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Villa V, Wallace S. EXPLORING THE CAREGIVING EXPERIENCE OF LATINO AND NON-HISPANIC WHITE CAREGIVERS ACROSS FOUR AGE COHORTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.574] [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: 11/14/2022] Open
Affiliation(s)
| | - S Wallace
- UCLA Fielding School of Public Health
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11
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Castelnuovo G, Giusti EM, Manzoni GM, Saviola D, Gabrielli S, Lacerenza M, Pietrabissa G, Cattivelli R, Spatola CAM, Rossi A, Varallo G, Novelli M, Villa V, Luzzati F, Cottini A, Lai C, Volpato E, Cavalera C, Pagnini F, Tesio V, Castelli L, Tavola M, Torta R, Arreghini M, Zanini L, Brunani A, Seitanidis I, Ventura G, Capodaglio P, D'Aniello GE, Scarpina F, Brioschi A, Bigoni M, Priano L, Mauro A, Riva G, Di Lernia D, Repetto C, Regalia C, Molinari E, Notaro P, Paolucci S, Sandrini G, Simpson S, Wiederhold BK, Gaudio S, Jackson JB, Tamburin S, Benedetti F. What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation. Front Neurol 2018; 9:310. [PMID: 29867723 PMCID: PMC5968866 DOI: 10.3389/fneur.2018.00310] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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: 01/15/2018] [Accepted: 04/19/2018] [Indexed: 12/12/2022] Open
Abstract
Background It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy.
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Affiliation(s)
- Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Emanuele Maria Giusti
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Donatella Saviola
- Cardinal Ferrari Rehabilitation Center, Santo Stefano Rehabilitation Istitute, Fontanellato, Italy
| | | | - Marco Lacerenza
- Pain Medicine Center, San Pio X Clinic, Humanitas, Milan, Italy
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Roberto Cattivelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Chiara Anna Maria Spatola
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Alessandro Rossi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | - Giorgia Varallo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | - Margherita Novelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | - Valentina Villa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | | | | | - Carlo Lai
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Eleonora Volpato
- Department of Psychology, Catholic University of Milan, Milan, Italy.,HD Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Cesare Cavalera
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Department of Psychology, Harvard University, Cambridge, MA, United States
| | | | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
| | - Mario Tavola
- Anesthesia and Intensive Care, ASST Lecco, Lecco, Italy
| | - Riccardo Torta
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Marco Arreghini
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Loredana Zanini
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Amelia Brunani
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Ionathan Seitanidis
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Giuseppe Ventura
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Paolo Capodaglio
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Guido Edoardo D'Aniello
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Federica Scarpina
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | - Andrea Brioschi
- Istituto Auxologico Italiano IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Verbania, Italy
| | - Matteo Bigoni
- Istituto Auxologico Italiano IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Verbania, Italy
| | - Lorenzo Priano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Istituto Auxologico Italiano IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Verbania, Italy
| | - Alessandro Mauro
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Istituto Auxologico Italiano IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Verbania, Italy
| | - Giuseppe Riva
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Daniele Di Lernia
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Claudia Repetto
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Camillo Regalia
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Paolo Notaro
- Pain Medicine, Anesthesiology Department, A.O. Ospedale Niguarda ca Granda, Milan, Italy
| | | | - Giorgio Sandrini
- C. Mondino National Neurological Institute, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Susan Simpson
- University of South Australia, Adelaide, SA, Australia.,Regional Eating Disorders Unit, NHS Lothian, Livingston, United Kingdom
| | | | - Santino Gaudio
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | | | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Fabrizio Benedetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
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12
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Thellung S, Scoti B, Corsaro A, Villa V, Nizzari M, Gagliani MC, Porcile C, Russo C, Pagano A, Tacchetti C, Cortese K, Florio T. Pharmacological activation of autophagy favors the clearing of intracellular aggregates of misfolded prion protein peptide to prevent neuronal death. Cell Death Dis 2018; 9:166. [PMID: 29416016 PMCID: PMC5833808 DOI: 10.1038/s41419-017-0252-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/13/2017] [Accepted: 12/19/2017] [Indexed: 12/22/2022]
Abstract
According to the “gain-of-toxicity mechanism”, neuronal loss during cerebral proteinopathies is caused by accumulation of aggregation-prone conformers of misfolded cellular proteins, although it is still debated which aggregation state actually corresponds to the neurotoxic entity. Autophagy, originally described as a variant of programmed cell death, is now emerging as a crucial mechanism for cell survival in response to a variety of cell stressors, including nutrient deprivation, damage of cytoplasmic organelles, or accumulation of misfolded proteins. Impairment of autophagic flux in neurons often associates with neurodegeneration during cerebral amyloidosis, suggesting a role in clearing neurons from aggregation-prone misfolded proteins. Thus, autophagy may represent a target for innovative therapies. In this work, we show that alterations of autophagy progression occur in neurons following in vitro exposure to the amyloidogenic and neurotoxic prion protein-derived peptide PrP90-231. We report that the increase of autophagic flux represents a strategy adopted by neurons to survive the intracellular accumulation of misfolded PrP90-231. In particular, PrP90-231 internalization in A1 murine mesencephalic neurons occurs in acidic structures, showing electron microscopy hallmarks of autophagosomes and autophagolysosomes. However, these structures do not undergo resolution and accumulate in cytosol, suggesting that, in the presence of PrP90-231, autophagy is activated but its progression is impaired; the inability to clear PrP90-231 via autophagy induces cytotoxicity, causing impairment of lysosomal integrity and cytosolic diffusion of hydrolytic enzymes. Conversely, the induction of autophagy by pharmacological blockade of mTOR kinase or trophic factor deprivation restored autophagy resolution, reducing intracellular PrP90-231 accumulation and neuronal death. Taken together, these data indicate that PrP90-231 internalization induces an autophagic defensive response in A1 neurons, although incomplete and insufficient to grant survival; the pharmacological enhancement of this process exerts neuroprotection favoring the clearing of the internalized peptide and could represents a promising neuroprotective tool for neurodegenerative proteinopathies.
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Affiliation(s)
- Stefano Thellung
- Section of Pharmacology, Department of Internal Medicine (DiMI), and Centre of Excellence for Biomedical Research (CEBR), University of Genova, Genova, Italy
| | - Beatrice Scoti
- Section of Pharmacology, Department of Internal Medicine (DiMI), and Centre of Excellence for Biomedical Research (CEBR), University of Genova, Genova, Italy
| | - Alessandro Corsaro
- Section of Pharmacology, Department of Internal Medicine (DiMI), and Centre of Excellence for Biomedical Research (CEBR), University of Genova, Genova, Italy
| | - Valentina Villa
- Section of Pharmacology, Department of Internal Medicine (DiMI), and Centre of Excellence for Biomedical Research (CEBR), University of Genova, Genova, Italy
| | - Mario Nizzari
- Section of Pharmacology, Department of Internal Medicine (DiMI), and Centre of Excellence for Biomedical Research (CEBR), University of Genova, Genova, Italy
| | - Maria Cristina Gagliani
- Section of Human Anatomy, Department of Experimental Medicine (DIMES), School of Medicine, University of Genova, Genova, Italy
| | - Carola Porcile
- Department of Health Sciences, University of Molise, Campobasso, Italy
| | - Claudio Russo
- Department of Health Sciences, University of Molise, Campobasso, Italy
| | - Aldo Pagano
- Section of Human Anatomy, Department of Experimental Medicine (DIMES), School of Medicine, University of Genova, Genova, Italy.,Ospedale Policlinico San Martino, IRCCS per l'Oncologia, Genova, Italy
| | - Carlo Tacchetti
- Centro Imaging Sperimentale, IRCCS Istituto Scientifico San Raffaele, Milano, Italy.,Vita-Salute San Raffaele University, Milano, Italy
| | - Katia Cortese
- Section of Human Anatomy, Department of Experimental Medicine (DIMES), School of Medicine, University of Genova, Genova, Italy
| | - Tullio Florio
- Section of Pharmacology, Department of Internal Medicine (DiMI), and Centre of Excellence for Biomedical Research (CEBR), University of Genova, Genova, Italy.
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13
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Yahyapour R, Motevaseli E, Rezaeyan A, Abdollahi H, Farhood B, Cheki M, Rezapoor S, Shabeeb D, Musa AE, Najafi M, Villa V. Reduction–oxidation (redox) system in radiation-induced normal tissue injury: molecular mechanisms and implications in radiation therapeutics. Clin Transl Oncol 2018; 20:975-988. [DOI: 10.1007/s12094-017-1828-6] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 12/27/2017] [Indexed: 02/07/2023]
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14
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Silvetti S, Ranucci M, Isgrò G, Villa V, Costa E. Preoperative colonization in pediatric cardiac surgery and its impact on postoperative infections. Paediatr Anaesth 2017; 27:849-855. [PMID: 28504326 DOI: 10.1111/pan.13169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with congenital heart defects are frequently hospitalized before surgery. This exposes them to a high risk for pathogen colonization. There are limited data on colonization prevalence in the pediatric cardiac population, and limited data concerning its potential role in the risk of developing infections after cardiac surgery. AIM This study aimed to verify the impact of preoperative colonization on postoperative infections in a population of pediatric cardiac surgery patients coming from Italy and developing countries. METHODS This was a retrospective study conducted in all the patients aged ≤18 years who underwent pediatric open-heart surgery in the year 2015. Clinical data were retrieved from the institutional database for cardiac surgery patients. Data on swab cultures were retrieved from the laboratory database. Swab colonization was tested for association with infection and other outcomes. RESULTS Among 169 children who performed the screening for pathogen colonization, 50% had at least one positive swab. Italian patients were (P=.001) less likely to be colonized with respect to foreign patients (relative risk 0.17, 95% CI 0.09-0.35). Postoperative infections in colonized patients occurred at a similar rate as in noncolonized patients (relative risk 1.24, 95% CI 0.64-2.39; P=.532). Colonized patients had a preoperative stay (P=.021) longer than noncolonized patients (mean difference 2 days, 95% CI 0.3-3.8 days). CONCLUSION The results of our study suggest that the impact of preoperative colonization on outcome and postoperative infections may be negligible; larger series are required to clearly define this issue.
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Affiliation(s)
- Simona Silvetti
- Department of CardioVascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Piazza Edmondo Malan, Milan, Italy
| | - Marco Ranucci
- Department of CardioVascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Piazza Edmondo Malan, Milan, Italy
| | - Giuseppe Isgrò
- Department of CardioVascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Piazza Edmondo Malan, Milan, Italy
| | - Valentina Villa
- Hospital Health Direction, IRCCS Policlinico San Donato, Piazza Edmondo Malan, Milan, Italy
| | - Elena Costa
- Chemistry Laboratory, IRCCS Policlinico San Donato, Piazza Edmondo Malan, Milan, Italy
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15
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Sirtori A, Brunani A, Capodaglio P, Berselli ME, Villa V, Corti S, Leonardi M, Raggi A. ICF-OB: a multidisciplinary questionnaire based on the International Classification of Functioning, Disability and Health to address disability in obesity. Eur J Phys Rehabil Med 2017; 54:119-121. [PMID: 28569456 DOI: 10.23736/s1973-9087.17.04836-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Anna Sirtori
- Department of Internal Medicine, San Giuseppe Hospital and Institute for Research and Care, Istituto Auxologico Italiano, Verbania, Italy -
| | - Amelia Brunani
- Department of Internal Medicine, San Giuseppe Hospital and Institute for Research and Care, Istituto Auxologico Italiano, Verbania, Italy
| | - Paolo Capodaglio
- Department of Internal Medicine, San Giuseppe Hospital and Institute for Research and Care, Istituto Auxologico Italiano, Verbania, Italy
| | - Maria E Berselli
- Department of Internal Medicine, San Giuseppe Hospital and Institute for Research and Care, Istituto Auxologico Italiano, Verbania, Italy
| | - Valentina Villa
- Psychological Research Laboratory, San Giuseppe Hospital and Institute for Research and Care, Istituto Auxologico Italiano, Verbania, Italy
| | | | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, C. Besta Neurological Institute for Research and Care, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, C. Besta Neurological Institute for Research and Care, Milan, Italy
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16
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Piatti PM, Cioni M, Magistro A, Villa V, Crippa VG, Galluccio E, Fontana B, Spadoni S, Bosi E, Monti LD, Alfieri O. Basal insulin therapy is associated with beneficial effects on postoperative infective complications, independently from circulating glucose levels in patients admitted for cardiac surgery. J Clin Transl Endocrinol 2017; 7:47-53. [PMID: 29067250 PMCID: PMC5651296 DOI: 10.1016/j.jcte.2017.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/23/2017] [Accepted: 01/31/2017] [Indexed: 02/07/2023]
Abstract
The effect of insulin per se on infective complications during cardiac surgery was evaluated. Eight hundred twelve patients were included. Insulin therapy decreased infections independently from glycemic levels. Basal + premeal insulin therapy is well tolerated without severe hypoglycemia cases.
Background Although hyperglycemia is a strong predictor of postoperative infective complications (PIC), little is known about the effect of basal insulin therapy (BIT) per se on PIC. Aim To evaluate if there is an association between BIT, independent of glucose levels, and a possible improvement of PIC during the perioperative cardiosurgery period (PCP). Methods In 812 patients admitted for cardiac intervention and treated with a continuous intravenous insulin infusion (CIII) for hyperglycemic levels (>130 mg/dl), a retrospective analysis was performed during the PCP (January 2009–December 2011). Upon transfer to the cardiac surgery division, if fasting glucose was ≥130 mg/dl, a basal + premeal insulin therapy was initiated (121 patients, group 1); for <130 mg/dl, a premeal insulin alone was initiated (691 patients, group 2). Findings Compared with group 2, group 1 showed reductions in PIC (2.48% vs 7.96%, p < 0.049; odds ratio: 0.294; 95% CI: 0.110–0.780), C-Reactive Protein (p < 0.05) and white blood cell (p < 0.05) levels despite glucose levels and CIII that were higher during the first two days after surgery (179.8 ± 25.3 vs 169.5 ± 10.6 mg/dl, p < 0.01; 0.046 ± 0.008 vs 0.037 ± 0.015 U/kg/h, p < 0.05, respectively). Normal glucose levels were achieved in both groups from day 3 before the discharge. The mean length of hospital duration was 18% lower in group 1 than in group 2 (7.21 ± 05.08 vs 8.76 ± 9.08 days, p < 0.007), providing a significant impact on public health costs. Conclusions Basal + preprandial insulin therapy was associated with a lower frequency of PIC than preprandial insulin therapy alone, suggesting a beneficial effect of basal insulin therapy on post-surgery outcome.
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Affiliation(s)
- P M Piatti
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - M Cioni
- Cardio-Surgery Division, IRCCS San Raffaele Institute, Milan, Italy
| | - A Magistro
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - V Villa
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - V G Crippa
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - E Galluccio
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - B Fontana
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - S Spadoni
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - E Bosi
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.,Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - L D Monti
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - O Alfieri
- Cardio-Surgery Division, IRCCS San Raffaele Institute, Milan, Italy
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Villa V, Thellung S, Bajetto A, Gatta E, Robello M, Novelli F, Tasso B, Tonelli M, Florio T. Novel celecoxib analogues inhibit glial production of prostaglandin E2, nitric oxide, and oxygen radicals reverting the neuroinflammatory responses induced by misfolded prion protein fragment 90-231 or lipopolysaccharide. Pharmacol Res 2016; 113:500-514. [PMID: 27667770 DOI: 10.1016/j.phrs.2016.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/05/2016] [Accepted: 09/12/2016] [Indexed: 12/24/2022]
Abstract
We tested the efficacy of novel cyclooxygenase 2 (COX-2) inhibitors in counteracting glia-driven neuroinflammation induced by the amyloidogenic prion protein fragment PrP90-231 or lipopolysaccharide (LPS). In search for molecules with higher efficacy than celecoxib, we focused our study on its 2,3-diaryl-1,3-thiazolidin-4-one analogues. As experimental models, we used the immortalized microglial cell line N9, rat purified microglial primary cultures, and mixed cultures of astrocytes and microglia. Microglia activation in response to PrP90-231 or LPS was characterized by growth arrest, morphology changes and the production of reactive oxygen species (ROS). Moreover, PrP90-231 treatment caused the overexpression of the inducible nitric oxide synthase (iNOS) and COX-2, with the consequent nitric oxide (NO), and prostaglandin E2 (PGE2) accumulation. These effects were challenged by different celecoxib analogues, among which Q22 (3-[4-(sulfamoyl)phenyl]-2-(4-tolyl)thiazolidin-4-one) inhibited microglia activation more efficiently than celecoxib, lowering both iNOS and COX-2 activity and reducing ROS release. During neurodegenerative diseases, neuroinflammation induced by amyloidogenic peptides causes the activation of both astrocytes and microglia with these cell populations mutually regulating each other. Thus the effects of PrP90-231 and LPS were also studied on mixed glial cultures containing astrocytes and microglia. PrP90-231 treatment elicited different responses in the co-cultures induced astrocyte proliferation and microglia growth arrest, resulting in a differential ability to release proinflammatory molecules with the production of NO and ROS mainly attributable on microglia, while COX-2 expression was induced also in astrocytes. Q22 effects on both NO and PGE2 secretion were more significant in the mixed glial cultures than in purified microglia, demonstrating Q22 ability to revert the functional interaction between astrocytes and microglia. These results demonstrate that Q22 is a powerful drug able to revert glial neuroinflammatory responses and might represent a lead to explore the chemical space around celecoxib frameworks to design even more effective agents, paving the way to novel approaches to contrast the neuroinflammation-dependent toxicity.
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Affiliation(s)
- Valentina Villa
- Laboratory of Pharmacology, Department of Internal Medicine, and Center of Excellence for Biomedical Research (CEBR), University of Genova, 16132 Genoa, Italy
| | - Stefano Thellung
- Laboratory of Pharmacology, Department of Internal Medicine, and Center of Excellence for Biomedical Research (CEBR), University of Genova, 16132 Genoa, Italy
| | - Adriana Bajetto
- Laboratory of Pharmacology, Department of Internal Medicine, and Center of Excellence for Biomedical Research (CEBR), University of Genova, 16132 Genoa, Italy
| | - Elena Gatta
- Department of Physics, University of Genova, Genoa, Italy
| | - Mauro Robello
- Department of Physics, University of Genova, Genoa, Italy
| | - Federica Novelli
- Department of Pharmacy, University of Genova, 16132 Genoa, Italy
| | - Bruno Tasso
- Department of Pharmacy, University of Genova, 16132 Genoa, Italy
| | - Michele Tonelli
- Department of Pharmacy, University of Genova, 16132 Genoa, Italy
| | - Tullio Florio
- Laboratory of Pharmacology, Department of Internal Medicine, and Center of Excellence for Biomedical Research (CEBR), University of Genova, 16132 Genoa, Italy.
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Gatti M, Wurth R, Vito G, Pattarozzi A, Campanella C, Thellung S, Maniscalco L, De Maria R, Villa V, Corsaro A, Nizzari M, Bajetto A, Ratto A, Ferrari A, Barbieri F, Florio T. Canine osteosarcoma cell lines contain stem-like cancer cells: biological and pharmacological characterization. Jpn J Vet Res 2016; 64:101-112. [PMID: 27506084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cancer stem cells (CSCs) represent a small subpopulation of cells responsible for tumor formation and progression, drug resistance, tumor recurrence and metastasization. CSCs have been identified in many human tumors including osteosarcoma (OSA). CSC distinctive properties are the expression of stem cell markers, sustained growth, self-renewal and tumorigenicity. Here we report the isolation of stem-like cells from two canine OSA cultures, characterized by self-renewal, evaluated by sphere formation ability, differential marker expression, and in vitro proliferation when cultured in a medium containing EGF and bFGF. Current therapies for OSA increased survival time, but prognosis remains poor, due to the development of drug resistance and metastases. Chemotherapy shrinks the tumor mass but CSCs remain unaffected, leading to tumor recurrence. Metformin, a drug for type 2 diabetes, has been shown to possess antitumor properties affecting CSC survival in different human and animal cancers. Here we show that metformin has a significant antiproliferative effect on canine OSA stem-like cells, validating this in vitro model for further pre-clinical drug evaluations. In conclusion, our results demonstrate the feasibility of obtaining CSC-enriched cultures from primary canine OSA cells as a promising model for biological and pharmacological studies of canine and human OSAs.
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Castelnuovo G, Giusti EM, Manzoni GM, Saviola D, Gatti A, Gabrielli S, Lacerenza M, Pietrabissa G, Cattivelli R, Spatola CAM, Corti S, Novelli M, Villa V, Cottini A, Lai C, Pagnini F, Castelli L, Tavola M, Torta R, Arreghini M, Zanini L, Brunani A, Capodaglio P, D'Aniello GE, Scarpina F, Brioschi A, Priano L, Mauro A, Riva G, Repetto C, Regalia C, Molinari E, Notaro P, Paolucci S, Sandrini G, Simpson SG, Wiederhold B, Tamburin S. Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation. Front Psychol 2016; 7:468. [PMID: 27148104 PMCID: PMC4835496 DOI: 10.3389/fpsyg.2016.00468] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/16/2016] [Indexed: 12/13/2022] Open
Abstract
Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions.
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Affiliation(s)
- Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | | | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Faculty of Psychology, eCampus UniversityNovedrate, Italy
| | - Donatella Saviola
- Cardinal Ferrari Rehabilitation Center, Santo Stefano Rehabilitation Istitute Fontanellato, Italy
| | | | | | | | - Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Roberto Cattivelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Chiara A M Spatola
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Stefania Corti
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Margherita Novelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Valentina Villa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | | | - Carlo Lai
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome Rome, Italy
| | - Francesco Pagnini
- Department of Psychology, Catholic University of MilanMilan, Italy; Department of Psychology, Harvard UniversityCambridge, MA, USA
| | - Lorys Castelli
- Department of Psychology, University of Turin Turin, Italy
| | | | - Riccardo Torta
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Marco Arreghini
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Loredana Zanini
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Amelia Brunani
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Paolo Capodaglio
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Guido E D'Aniello
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Federica Scarpina
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Neuroscience "Rita Levi Montalcini", University of TurinTurin, Italy
| | - Andrea Brioschi
- Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Lorenzo Priano
- Department of Neuroscience "Rita Levi Montalcini", University of TurinTurin, Italy; Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Alessandro Mauro
- Department of Neuroscience "Rita Levi Montalcini", University of TurinTurin, Italy; Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Giuseppe Riva
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Claudia Repetto
- Department of Psychology, Catholic University of Milan Milan, Italy
| | - Camillo Regalia
- Department of Psychology, Catholic University of Milan Milan, Italy
| | - Enrico Molinari
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Paolo Notaro
- "Pain Center II Level - Department of Surgery" - ASST Grande Ospedale Metropolitano Niguarda Milano, Italy
| | | | - Giorgio Sandrini
- Department of Brain and Behavioral Sciences, C. Mondino National Neurological Institute, University of Pavia Pavia, Italy
| | - Susan G Simpson
- School of Psychology, Social Work and Social Policy, University of South Australia Magill, SA, Australia
| | | | - Stefano Tamburin
- Department of Neurological and Movement Sciences, University of Verona Verona, Italy
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Madelaine A, Lording T, Villa V, Lustig S, Servien E, Neyret P. The effect of lateral opening wedge distal femoral osteotomy on leg length. Knee Surg Sports Traumatol Arthrosc 2016; 24:847-54. [PMID: 25326764 DOI: 10.1007/s00167-014-3387-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 07/12/2014] [Accepted: 10/10/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE Varisation distal femoral osteotomy is a well-described treatment for lateral compartment arthrosis in the young, active patient. This treatment may potentially alter the length of the lower limb . The objective of this study was to quantify the change in leg length following lateral opening wedge distal femoral osteotomy using a blade plate. METHODS Between 1998 and 2011, 29 lateral opening wedge distal femoral osteotomies were performed for symptomatic genu valgum with signs of lateral compartment arthrosis or patello-femoral symptoms. The mean age was 44.4 years (±11.3). Average follow-up was 80.2 months (±50.6). RESULTS The mean osteotomy opening was 8.3° (±2.3). The femoro-tibial mechanical axis (mFTA) was improved significantly, from 187.8° (±3.5) to 180.4° (±2.6) post-operatively (p < 0.001). The pre-operative leg length discrepancy was -0.7 cm, compared to -0.6 cm post-operatively, which was not significant (n.s.). There were five revisions to arthroplasty for disease progression at meantime of 166.6 months post-operatively. The probability of survival at 60 months was 91.4% (95% CI 74.9-100%) with end-point of revision to total knee arthroplasty and 87.6% (95% CI 74.1-100%) of revision for complications. CONCLUSIONS Lateral opening wedge distal femoral osteotomy, performed for symptomatic genu valgum, has no effect on leg length. This technique allows good correction of the axis of the lower limb; however, the complication rate is not insignificant (14%). Complications occurred mainly in post-traumatic cases and may be avoidable with attention to technique and optimum rehabilitation. The procedure should be reserved for young, active patients with significant symptoms. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- A Madelaine
- Service de chirurgie orthopédique, centre Albert Trillat, Université Claude Bernard, Lyon 1, Hôpital de la Croix-rousse, Hospices civils de Lyon, 103 grande rue de la Croix-rousse, 69004, Lyon, France.
| | - T Lording
- Service de chirurgie orthopédique, centre Albert Trillat, Université Claude Bernard, Lyon 1, Hôpital de la Croix-rousse, Hospices civils de Lyon, 103 grande rue de la Croix-rousse, 69004, Lyon, France
- Frankston Hospital, Hastings Rd, Frankston, VIC, 3199, Australia
| | - V Villa
- Service de chirurgie orthopédique, centre Albert Trillat, Université Claude Bernard, Lyon 1, Hôpital de la Croix-rousse, Hospices civils de Lyon, 103 grande rue de la Croix-rousse, 69004, Lyon, France
| | - S Lustig
- Service de chirurgie orthopédique, centre Albert Trillat, Université Claude Bernard, Lyon 1, Hôpital de la Croix-rousse, Hospices civils de Lyon, 103 grande rue de la Croix-rousse, 69004, Lyon, France
| | - E Servien
- Service de chirurgie orthopédique, centre Albert Trillat, Université Claude Bernard, Lyon 1, Hôpital de la Croix-rousse, Hospices civils de Lyon, 103 grande rue de la Croix-rousse, 69004, Lyon, France
| | - P Neyret
- Service de chirurgie orthopédique, centre Albert Trillat, Université Claude Bernard, Lyon 1, Hôpital de la Croix-rousse, Hospices civils de Lyon, 103 grande rue de la Croix-rousse, 69004, Lyon, France
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Castelnuovo G, Giusti EM, Manzoni GM, Saviola D, Gatti A, Gabrielli S, Lacerenza M, Pietrabissa G, Cattivelli R, Spatola CAM, Corti S, Novelli M, Villa V, Cottini A, Lai C, Pagnini F, Castelli L, Tavola M, Torta R, Arreghini M, Zanini L, Brunani A, Capodaglio P, D'Aniello GE, Scarpina F, Brioschi A, Priano L, Mauro A, Riva G, Repetto C, Regalia C, Molinari E, Notaro P, Paolucci S, Sandrini G, Simpson SG, Wiederhold B, Tamburin S. Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation. Front Psychol 2016; 7:115. [PMID: 26924998 PMCID: PMC4759289 DOI: 10.3389/fpsyg.2016.00115] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 01/21/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. OBJECTIVES To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. METHODS A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. RESULTS The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. CONCLUSIONS Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the paper.
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Affiliation(s)
- Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | | | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
- Faculty of Psychology, eCampus UniversityNovedrate (Como), Italy
| | - Donatella Saviola
- Cardinal Ferrari Rehabilitation Center, Santo Stefano Rehabilitation IstituteFontanellato, Italy
| | | | | | | | - Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Roberto Cattivelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Chiara A. M. Spatola
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Stefania Corti
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Margherita Novelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Valentina Villa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | | | - Carlo Lai
- Department of Dynamic and Clinical PsychologySapienza University of Rome, Italy
| | - Francesco Pagnini
- Department of Psychology, Catholic University of MilanMilan, Italy
- Department of Psychology, Harvard UniversityCambridge, MA, USA
| | - Lorys Castelli
- Department of Psychology, University of TurinTurin, Italy
| | | | - Riccardo Torta
- Department of Neuroscience “Rita Levi Montalcini”University of Turin, Italy
| | - Marco Arreghini
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Loredana Zanini
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Amelia Brunani
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Paolo Capodaglio
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Guido E. D'Aniello
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Federica Scarpina
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
- Department of Neuroscience “Rita Levi Montalcini”University of Turin, Italy
| | - Andrea Brioschi
- Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Lorenzo Priano
- Department of Neuroscience “Rita Levi Montalcini”University of Turin, Italy
- Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Alessandro Mauro
- Department of Neuroscience “Rita Levi Montalcini”University of Turin, Italy
- Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Giuseppe Riva
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Claudia Repetto
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Camillo Regalia
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Enrico Molinari
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Paolo Notaro
- “Pain Center II Level - Department of Surgery” - ASST Grande Ospedale Metropolitano NiguardaMilano, Italy
| | | | - Giorgio Sandrini
- Department of Brain and Behavioral Sciences, C. Mondino National Neurological Institute, University of PaviaPavia, Italy
| | - Susan G. Simpson
- School of Psychology, Social Work and Social PolicyUniversity of South Australia, Australia
| | | | - Stefano Tamburin
- Department of Neurological and Movement Sciences, University of VeronaVerona, Italy
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Cattivelli R, Pietrabissa G, Ceccarini M, Spatola CAM, Villa V, Caretti A, Gatti A, Manzoni GM, Castelnuovo G. ACTonFOOD: opportunities of ACT to address food addiction. Front Psychol 2015; 6:396. [PMID: 25914662 PMCID: PMC4391226 DOI: 10.3389/fpsyg.2015.00396] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/19/2015] [Indexed: 01/14/2023] Open
Affiliation(s)
- Roberto Cattivelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy
| | - Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy
| | - Martina Ceccarini
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy ; Department of Psychology, University of Bergamo Bergamo, Italy
| | - Chiara A M Spatola
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy
| | - Valentina Villa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy
| | - Annalisa Caretti
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy
| | | | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy
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Darnis A, Villa V, Debette C, Lustig S, Servien E, Neyret P. Vascular injuries during closing-wedge high tibial osteotomy: A cadaveric angiographic study. Orthop Traumatol Surg Res 2014; 100:891-4. [PMID: 25454724 DOI: 10.1016/j.otsr.2014.07.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 07/13/2014] [Accepted: 07/30/2014] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Closing-wedge high tibial osteotomy is a surgical option for patients with isolated medial compartment osteoarthritis and varus knee alignment. Vascular complications are rare, but incriminate the use of oscillating saw or osteotome. It is important to know the steps of this surgery that involve risk of vascular injury and what to do to decrease that risk. HYPOTHESIS Performing the distal osteotomy cut using an oscillating saw is a step with high risk of vascular injury. A protective device behind the tibia may decrease this risk. MATERIALS AND METHODS In this descriptive angiographic cadaver study, closing-wedge high tibial osteotomy was performed on 6 cadaveric knees in 90° knee flexion, and the distance between the surgical instrument and the popliteal artery was measured on fluoroscopy with artery opacification at the various steps of surgery. RESULTS Tibial osteotomy with oscillating saw involves high vascular risk: the mean distance between the saw-blade and the popliteal artery is 10.6mm in 90° knee flexion. Using a specific device placed behind the tibia protects the vascular structures. DISCUSSION High tibial osteotomy is indicated in medial compartment osteoarthritis of the knee and can be performed by closing or opening-wedge. Vascular injuries in closing-wedge osteotomy exist and it is recommended to perform this surgery at 90° knee flexion, although some studies report that this does not move the artery out of the way. A risk of vascular lesion should be kept in mind. The oscillation of the saw and the direction of the osteotomy should also be taken into consideration when performing a closing-wedge high tibial osteotomy in order to protect the popliteal artery. STUDY DESIGN Descriptive cadaver study. Level IV.
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Affiliation(s)
- A Darnis
- Service de chirurgie orthopédique, centre Albert-Trillat, université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France; Laboratoire d'anatomie, faculté de médecine Rockefeller, université Claude-Bernard Lyon 1, 8, avenue Rockefeller, 69003 Lyon, France.
| | - V Villa
- Service de chirurgie orthopédique, centre Albert-Trillat, université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
| | - C Debette
- Service de chirurgie orthopédique, centre Albert-Trillat, université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
| | - S Lustig
- Service de chirurgie orthopédique, centre Albert-Trillat, université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
| | - E Servien
- Service de chirurgie orthopédique, centre Albert-Trillat, université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
| | - P Neyret
- Service de chirurgie orthopédique, centre Albert-Trillat, université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
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Abstract
For the first time carbohydrate derivatives were systematically studied as doping material for a liquid crystalline phase. These compounds can exhibit a large twisting power. It may be controlled by the configurations of single chiral centers. Thus, a series of phenomena are realized in the cholesteric phase such as helix inversion, large or small temperature dependencies of the pitch, as well as broad blue phases.
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Affiliation(s)
- V. Villa
- Physikalisches Institut
- Organisch-Chemisches Institut, Westfälische Wilhelms-Universität, Münster, BR Deutschland
| | - F. Fischer
- Physikalisches Institut, Westfälische Wilhelms-Universität, Münster, BR Deutschland
| | - J. Thiem
- Organisch-Chemisches Institut, Westfälische Wilhelms-Universität, Münster, BR Deutschland
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Moscardó A, Cid A, Haya S, Latorre A, Teresa Santos M, Villa V, Bonanad S, Vallés J. C0509: Patient with Congenital Afibrinogenemia and Peripheral Arterial Thrombosis. Therapeutic Antithrombotic Management Based on Monitoring. Thromb Res 2014. [DOI: 10.1016/s0049-3848(14)50371-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Espinós JC, Turró R, Mata A, Cruz M, da Costa M, Villa V, Buchwald JN, Turró J. Early experience with the Incisionless Operating Platform™ (IOP) for the treatment of obesity : the Primary Obesity Surgery Endolumenal (POSE) procedure. Obes Surg 2014; 23:1375-83. [PMID: 23591548 DOI: 10.1007/s11695-013-0937-8] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND We report our initial experience and 6-month outcomes in a single center using the per-oral Incisionless Operating Platform™ (IOP) (USGI Medical) to place transmural plications in the gastric fundus and distal body using specialized suture anchors (the Primary Obesity Surgery Endolumenal [POSE] procedure). METHODS A prospective observational study was undertaken with institutional Ethics Board approval in a private hospital in Barcelona, Spain. Indicated patients were WHO obesity class I-II, or III, where patients refused a surgical approach. RESULTS Between February 28, 2011 and March 23, 2012, the POSE procedure was successfully performed in 45 patients: 75.6 % female; mean age 43.4 ± 9.2 SD (range 21.0-64.0). At baseline: mean absolute weight (AW, kg), 100.8 ± 12.9 (75.5-132.5); body mass index (BMI, kg/m(2)), 36.7 ± 3.8 (28.1-46.6). A mean 8.2 suture-anchor plications were placed in the fundus, 3.0 along the distal body wall. Mean operative time, 69.2 ± 26.6 min (32.0-126.0); patients were discharged in <24 h. Six-month mean AW was 87.0 ± 10.3 (68.0-111.5); BMI decreased 5.8 to 31.3 ± 3.3 (25.1-38.6) (p < 0.001); EWL was 49.4 %; TBWL, 15.5 %. No mortality or operative morbidity. Minor postoperative side effects resolved with treatment by discharge. Patients reported less hunger and earlier satiety post procedure. Liquid intake began 12 h post procedure with full solids by 6 weeks. CONCLUSIONS At 6-month follow-up of a prospective case series, the POSE procedure appeared to provide safe and effective weight loss without the scarring, pain, and recovery issues of open and laparoscopic bariatric surgery. Long-term follow-up and further study are required.
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Affiliation(s)
- J C Espinós
- Unidad de Endoscopia, Centro Médico Teknon, Vilana, 12, 08022 Barcelona, Spain.
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Espinós JC, Turró R, Mata A, Cruz M, da Costa M, Villa V, Buchwald JN, Turró J. Early experience with the Incisionless Operating Platform™ (IOP) for the treatment of obesity : the Primary Obesity Surgery Endolumenal (POSE) procedure. Obes Surg 2014. [PMID: 31309524 DOI: 10.1007/s11695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND We report our initial experience and 6-month outcomes in a single center using the per-oral Incisionless Operating Platform™ (IOP) (USGI Medical) to place transmural plications in the gastric fundus and distal body using specialized suture anchors (the Primary Obesity Surgery Endolumenal [POSE] procedure). METHODS A prospective observational study was undertaken with institutional Ethics Board approval in a private hospital in Barcelona, Spain. Indicated patients were WHO obesity class I-II, or III, where patients refused a surgical approach. RESULTS Between February 28, 2011 and March 23, 2012, the POSE procedure was successfully performed in 45 patients: 75.6 % female; mean age 43.4 ± 9.2 SD (range 21.0-64.0). At baseline: mean absolute weight (AW, kg), 100.8 ± 12.9 (75.5-132.5); body mass index (BMI, kg/m(2)), 36.7 ± 3.8 (28.1-46.6). A mean 8.2 suture-anchor plications were placed in the fundus, 3.0 along the distal body wall. Mean operative time, 69.2 ± 26.6 min (32.0-126.0); patients were discharged in <24 h. Six-month mean AW was 87.0 ± 10.3 (68.0-111.5); BMI decreased 5.8 to 31.3 ± 3.3 (25.1-38.6) (p < 0.001); EWL was 49.4 %; TBWL, 15.5 %. No mortality or operative morbidity. Minor postoperative side effects resolved with treatment by discharge. Patients reported less hunger and earlier satiety post procedure. Liquid intake began 12 h post procedure with full solids by 6 weeks. CONCLUSIONS At 6-month follow-up of a prospective case series, the POSE procedure appeared to provide safe and effective weight loss without the scarring, pain, and recovery issues of open and laparoscopic bariatric surgery. Long-term follow-up and further study are required.
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Affiliation(s)
- J C Espinós
- Unidad de Endoscopia, Centro Médico Teknon, Vilana, 12, 08022 Barcelona, Spain.
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Barbieri F, Thellung S, Würth R, Gatto F, Corsaro A, Villa V, Nizzari M, Albertelli M, Ferone D, Florio T. Emerging Targets in Pituitary Adenomas: Role of the CXCL12/CXCR4-R7 System. Int J Endocrinol 2014; 2014:753524. [PMID: 25484899 PMCID: PMC4248486 DOI: 10.1155/2014/753524] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 10/21/2014] [Indexed: 12/15/2022] Open
Abstract
Chemokines are chemotactic regulators of immune surveillance in physiological and pathological conditions such as inflammation, infection, and cancer. Several chemokines and cognate receptors are constitutively expressed in the central nervous system, not only in glial and endothelial cells but also in neurons, controlling neurogenesis, neurite outgrowth, and axonal guidance during development. In particular, the chemokine CXCL12 and its receptors, CXCR4 and CXCR7, form a functional network that controls plasticity in different brain areas, influencing neurotransmission, neuromodulation, and cell migration, and the dysregulation of this chemokinergic axis is involved in several neurodegenerative, neuroinflammatory, and malignant diseases. CXCR4 primarily mediates the transduction of proliferative signals, while CXCR7 seems to be mainly responsible for scavenging CXCL12. Importantly, the multiple intracellular signalling generated by CXCL12 interaction with its receptors influences hypothalamic modulation of neuroendocrine functions, although a direct modulation of pituitary functioning via autocrine/paracrine mechanisms was also reported. Both CXCL12 and CXCR4 are constitutively overexpressed in pituitary adenomas and their signalling induces cell survival and proliferation, as well as hormonal hypersecretion. In this review we focus on the physiological and pathological functions of immune-related cyto- and chemokines, mainly focusing on the CXCL12/CXCR4-7 axis, and their role in pituitary tumorigenesis. Accordingly, we discuss the potential targeting of CXCR4 as novel pharmacological approach for pituitary adenomas.
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Affiliation(s)
- Federica Barbieri
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
- *Federica Barbieri:
| | - Stefano Thellung
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
| | - Roberto Würth
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
| | - Federico Gatto
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
| | - Alessandro Corsaro
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
| | - Valentina Villa
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
| | - Mario Nizzari
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
| | - Manuela Albertelli
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
| | - Diego Ferone
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
| | - Tullio Florio
- Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 2-16132 Genova, Italy
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Piatti PM, Marone E, Mantero M, Setola E, Galluccio E, Lucotti P, Shehaj E, Villa V, Perticone F, Venturini M, Palini A, Airoldi F, Faglia E, Del Maschio A, Colombo A, Chiesa R, Bosi E, Monti LD. Effect of normalization of fasting glucose by intensified insulin therapy and influence of eNOS polymorphisms on the incidence of restenosis after peripheral angioplasty in patients with type 2 diabetes: a randomized, open-label clinical trial. Acta Diabetol 2013; 50:373-82. [PMID: 22907764 DOI: 10.1007/s00592-012-0426-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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] [Received: 05/03/2012] [Accepted: 08/01/2012] [Indexed: 12/25/2022]
Abstract
Primary objective was to evaluate whether an intensified insulin therapy (IIT) incorporating the target of normal fasting glucose and HbA1c levels could halve the incidence of restenosis/amputation/SCA/death at 6 months after peripheral angioplasty compared with standard care (SC) in patients with type 2 diabetes (DMT2) affected by critical limb ischemia (CLI). Forty-six consecutive patients with DMT2 and CLI were randomly assigned to a parallel, open-label study with IIT (basal-bolus glulisine + glargine administrations) or SC (glargine administration + oral antidiabetic drugs). A SNP of eNOS (rs753482-A>C) and circulating CD34(+) and CD34(+)KDR(+) progenitor cells were determined. At the end of the study, although HbA1c levels were lower in IIT than in SC (6.9 ± 1.3 % vs. 7.6 ± 1.2 %, p < 0.05), IIT did not reduce the cumulative incidence of restenosis/amputation/SCA/death (52 and 65 %, respectively, odd ratio 0.59; CI 95 %: 0.21-1.62, p = 0.59). rs753482AC+CC as compared with rs753482AA increased the cumulative incidence of restenosis/amputation/SCA/death (79 and 42 %; odd ratio 5.3; CI 95 %: 1.41-19.5, p < 0.02). Baseline CD34(+)KDR(+) were higher in rs753482AA (166.2 ± 154.0 × 10(6) events) than in rs753482AC+CC (63.1 ± 26.9 × 10(6) events, p < 0.01). At the end of the study, the highest circulating CD34(+)KDR(+) were found in IIT rs753482AA (246.9 ± 194.0 × 10(6) events) while the lowest levels were found in SC rs753482AC+CC (70.9 ± 45.0 × 10(6) events). IIT did not decrease the cumulative incidence of restenosis/amputation/SCA/death in DMT2 and CLI patients. These patients correspond to a class of fragile subjects at high risk of cardiovascular events, and new predictors of restenosis should be contemplated, such as of eNOS polymorphism, (rs753482-A>C SNP) and circulating endothelial progenitor cells.
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Affiliation(s)
- Pier Marco Piatti
- Cardio-Metabolism and Clinical Trials Unit, Department of Internal Medicine and Metabolic and Cardiovascular Science Division, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
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Thellung S, Gatta E, Pellistri F, Corsaro A, Villa V, Vassalli M, Robello M, Florio T. Excitotoxicity through NMDA receptors mediates cerebellar granule neuron apoptosis induced by prion protein 90-231 fragment. Neurotox Res 2012; 23:301-14. [PMID: 22855343 DOI: 10.1007/s12640-012-9340-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 07/13/2012] [Accepted: 07/18/2012] [Indexed: 10/28/2022]
Abstract
Prion diseases recognize, as a unique molecular trait, the misfolding of CNS-enriched prion protein (PrP(C)) into an aberrant isoform (PrP(Sc)). In this work, we characterize the in vitro toxicity of amino-terminally truncated recombinant PrP fragment (amino acids 90-231, PrP90-231), on rat cerebellar granule neurons (CGN), focusing on glutamatergic receptor activation and Ca(2+) homeostasis impairment. This recombinant fragment assumes a toxic conformation (PrP90-231(TOX)) after controlled thermal denaturation (1 h at 53 °C) acquiring structural characteristics identified in PrP(Sc) (enrichment in β-structures, increased hydrophobicity, partial resistance to proteinase K, and aggregation in amyloid fibrils). By annexin-V binding assay, and evaluation of the percentage of fragmented and condensed nuclei, we show that treatment with PrP90-231(TOX), used in pre-fibrillar aggregation state, induces CGN apoptosis. This effect was associated with a delayed, but sustained elevation of [Ca(2+)]i. Both CGN apoptosis and [Ca(2+)]i increase were not observed using PrP90-231 in PrP(C)-like conformation. PrP90-231(TOX) effects were significantly reduced in the presence of ionotropic glutamate receptor antagonists. In particular, CGN apoptosis and [Ca(2+)]i increase were largely reduced, although not fully abolished, by pre-treatment with the NMDA antagonists APV and memantine, while the AMPA antagonist CNQX produced a lower, although still significant, effect. In conclusion, we report that CGN apoptosis induced by PrP90-231(TOX) correlates with a sustained elevation of [Ca(2+)]i mediated by the activation of NMDA and AMPA receptors.
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Affiliation(s)
- Stefano Thellung
- Department of Internal Medicine, Section of Pharmacology and Centre of Excellence for Biomedical Research (CEBR) School of Medicine, University of Genova, Viale Benedetto XV, 2, 16132, Genoa, Italy
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Sorrentino S, Bucciarelli T, Corsaro A, Tosatto A, Thellung S, Villa V, Schininà ME, Maras B, Galeno R, Scotti L, Creati F, Marrone A, Re N, Aceto A, Florio T, Mazzanti M. Calcium binding promotes prion protein fragment 90-231 conformational change toward a membrane destabilizing and cytotoxic structure. PLoS One 2012; 7:e38314. [PMID: 22811758 PMCID: PMC3394757 DOI: 10.1371/journal.pone.0038314] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [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: 01/28/2012] [Accepted: 05/08/2012] [Indexed: 02/05/2023] Open
Abstract
The pathological form of prion protein (PrP(Sc)), as other amyloidogenic proteins, causes a marked increase of membrane permeability. PrP(Sc) extracted from infected Syrian hamster brains induces a considerable change in membrane ionic conductance, although the contribution of this interaction to the molecular mechanism of neurodegeneration process is still controversial. We previously showed that the human PrP fragment 90-231 (hPrP₉₀₋₂₃₁) increases ionic conductance across artificial lipid bilayer, in a calcium-dependent manner, producing an alteration similar to that observed for PrP(Sc). In the present study we demonstrate that hPrP₉₀₋₂₃₁, pre-incubated with 10 mM Ca⁺⁺ and then re-suspended in physiological external solution increases not only membrane conductance but neurotoxicity as well. Furthermore we show the existence of a direct link between these two effects as demonstrated by a highly statistically significant correlation in several experimental conditions. A similar correlation between increased membrane conductance and cell degeneration has been observed assaying hPrP₉₀₋₂₃₁ bearing pathogenic mutations (D202N and E200K). We also report that Ca⁺⁺ binding to hPrP₉₀₋₂₃₁ induces a conformational change based on an alteration of secondary structure characterized by loss of alpha-helix content causing hydrophobic amino acid exposure and proteinase K resistance. These features, either acquired after controlled thermal denaturation or induced by D202N and E200K mutations were previously identified as responsible for hPrP₉₀₋₂₃₁ cytotoxicity. Finally, by in silico structural analysis, we propose that Ca⁺⁺ binding to hPrP₉₀₋₂₃₁ modifies amino acid orientation, in the same way induced by E200K mutation, thus suggesting a pathway for the structural alterations responsible of PrP neurotoxicity.
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Affiliation(s)
| | - Tonino Bucciarelli
- Dipartimento di Scienze Biomediche, Università “G. d’Annunzio” di Chieti-Pescara, Chieti, Italy
| | - Alessandro Corsaro
- Sezione di Farmacologia, Dipartimento di Medicina Interna and Centro di Eccellenza per la Ricerca Biomedica (CEBR), University of Genova, Genova, Italy
| | - Alessio Tosatto
- Dipartimento di Bioscienze, University of Milan, Milan, Italy
| | - Stefano Thellung
- Sezione di Farmacologia, Dipartimento di Medicina Interna and Centro di Eccellenza per la Ricerca Biomedica (CEBR), University of Genova, Genova, Italy
| | - Valentina Villa
- Sezione di Farmacologia, Dipartimento di Medicina Interna and Centro di Eccellenza per la Ricerca Biomedica (CEBR), University of Genova, Genova, Italy
| | - M. Eugenia Schininà
- Dipartimento di Scienze Biochimiche, “Sapienza” University of Rome, Rome, Italy
| | - Bruno Maras
- Dipartimento di Scienze Biochimiche, “Sapienza” University of Rome, Rome, Italy
| | | | - Luca Scotti
- Dipartimento di Scienze Biomediche, Università “G. d’Annunzio” di Chieti-Pescara, Chieti, Italy
| | - Francesco Creati
- Dipartimento di Scienze del Farmaco, Università “G. d’Annunzio” di Chieti-Pescara, Chieti, Italy
| | - Alessandro Marrone
- Dipartimento di Scienze del Farmaco, Università “G. d’Annunzio” di Chieti-Pescara, Chieti, Italy
| | - Nazzareno Re
- Dipartimento di Scienze del Farmaco, Università “G. d’Annunzio” di Chieti-Pescara, Chieti, Italy
| | - Antonio Aceto
- Dipartimento di Scienze Biomediche, Università “G. d’Annunzio” di Chieti-Pescara, Chieti, Italy
| | - Tullio Florio
- Sezione di Farmacologia, Dipartimento di Medicina Interna and Centro di Eccellenza per la Ricerca Biomedica (CEBR), University of Genova, Genova, Italy
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Dolcetta-Capuzzo A, Villa V, Albarello L, Franchi GM, Gemma M, Scavini M, Di Palo S, Orsenigo E, Bosi E, Doglioni C, Manzoni MF. Gastroenteric neuroendocrine neoplasms classification: Comparison of prognostic models. Cancer 2012; 119:36-44. [DOI: 10.1002/cncr.27716] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 05/17/2012] [Accepted: 05/25/2012] [Indexed: 01/31/2023]
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Corsaro A, Thellung S, Villa V, Nizzari M, Aceto A, Florio T. Recombinant human prion protein fragment 90-231, a useful model to study prion neurotoxicity. OMICS 2012; 16:50-9. [PMID: 22321015 DOI: 10.1089/omi.2011.0038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Transmissible spongiform encephalopathies (TSE), or prion diseases, are a group of fatal neurodegenerative disorders of animals and humans. Human diseases include Creutzfeldt-Jakob (CJD) and Gerstmann-Straussler-Scheinker (GSSD) diseases, fatal familial insomnia, and Kuru. Human and animal TSEs share a common histopathology with a pathognomonic triad: spongiform vacuolation of the grey matter, neuronal death, glial proliferation, and, more inconstantly, amyloid deposition. According to the "protein only" hypothesis, TSEs are caused by a unique post-translational conversion of normal, host-encoded, protease-sensitive prion protein (PrP(sen) or PrP(C)) to an abnormal disease-associated isoform (PrP(res) or PrP(Sc)). To investigate the molecular mechanism of neurotoxicity induced by PrP(Sc) we developed a protocol to obtain millimolar amounts of soluble recombinant polypeptide encompassing the amino acid sequence 90-231 of human PrP (hPrP90-231). This protein corresponds to the protease-resistant prion protein fragment that originates after amino-terminal truncation. Importantly, hPrP90-231 has a flexible backbone that, similar to PrP(C), can undergo to structural rearrangement. This peptide, structurally resembling PrP(C), can be converted in a PrP(Sc)-like conformation, and thus represents a valuable model to study prion neurotoxicity. In this article we summarized our experimental evidence on the molecular and structural mechanisms responsible of hPrP90-231 neurotoxicity on neuroectodermal cell line SHSY5Y and the effects of some PrP pathogen mutations identified in familial TSE.
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Affiliation(s)
- Alessandro Corsaro
- Laboratory of Pharmacology, Department of Oncology Biology and Genetics, University of Genova, Italy
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Vismara L, Cimolin V, Menegoni F, Zaina F, Galli M, Negrini S, Villa V, Capodaglio P. Osteopathic manipulative treatment in obese patients with chronic low back pain: a pilot study. ACTA ACUST UNITED AC 2012; 17:451-5. [PMID: 22658268 DOI: 10.1016/j.math.2012.05.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 04/21/2012] [Accepted: 05/01/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Obesity is frequently associated with various musculoskeletal disorders including chronic low back pain (cLBP). Osteopathy is a discipline emphasizing the conservative treatment of the disease in an olistic vision. We designed a randomized controlled study to investigate whether Osteopathic Manipulative Treatment (OMT) combined with specific exercises (SE) is more effective than SE alone in obese patients with cLBP. METHODS nineteen obese females with cLBP, randomized into 2 groups: SE + OMT and SE were studied during the forward flexion of the spine using an optoelectronic system. A biomechanical model was developed in order to analyse kinematics and define angles of clinical interest. OUTCOME MEASURES kinematic of the thoracic and lumbar spine and pelvis during forward flexion, pain according to a visual analogue scale (VAS), Roland Morris Disability Questionnaire and Oswestry Low Back Pain Disability Questionnaire. RESULTS significant effects on kinematics were reported only for OMT + SE with an improvement in thoracic range of motion of nearly 20%. All scores of the clinical scales used improved significantly. The greatest improvements occurred in the OMT + SE group. CONCLUSIONS combined rehabilitation treatment including Osteopathic Manipulative Treatment (OMT + SE) showed to be effective in improving biomechanical parameters of the thoracic spine in obese patients with cLBP. Such results are to be attributed to OMT, since they were not evident in the SE group. We also observed a reduction of disability and pain. The clinical results should be considered preliminary due to the small sample size.
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Affiliation(s)
- Luca Vismara
- Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Via Cadorna 90, I-28824 Piancavallo (VB), Italy.
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Sirtori A, Brunani A, Villa V, Berselli ME, Croci M, Leonardi M, Raggi A. Obesity is a marker of reduction in QoL and disability. ScientificWorldJournal 2012; 2012:167520. [PMID: 22536122 PMCID: PMC3317537 DOI: 10.1100/2012/167520] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 12/08/2011] [Indexed: 12/20/2022] Open
Abstract
The purpose of this paper is to verify the association between outcome measures of health-related quality of life (HRQoL) and disability, BMI, gender, and age. Adult obese patients were clustered using HRQoL (IWQoL-Lite) and disability (WHO-DAS II) scores into three groups: mild, moderate, and high. One-way ANOVA with Bonferroni post hoc test was used to evaluate differences in age and BMI between subjects from different clusters, contingency coefficient to test the relationship between cluster groups and gender. In total, 117 patients were enrolled: subjects with higher disability and HRQoL decrement were older and had higher BMI. Women were more likely to present moderate disability and reduction in HRQoL, while men more likely presented mild disability and HRQoL reduction. Our data further confirm the connection between disability and HRQoL, high BMI and older age. These data obtained with outcomes measures might better address rehabilitation programs.
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Affiliation(s)
- Anna Sirtori
- Department of Internal Medicine, Istituto Auxologico Italiano IRCCS, Piancavallo, 28824 Verbania, Italy.
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Manzoni GM, Villa V, Compare A, Castelnuovo G, Nibbio F, Titon AM, Molinari E, Gondoni LA. Short-term effects of a multi-disciplinary cardiac rehabilitation programme on psychological well-being, exercise capacity and weight in a sample of obese in-patients with coronary heart disease: a practice-level study. PSYCHOL HEALTH MED 2011; 16:178-89. [PMID: 21328146 DOI: 10.1080/13548506.2010.542167] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [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: 10/18/2022]
Abstract
Given that many patients referred to cardiac rehabilitation (CR) are obese, diet therapy, exercise training, nutritional and psychological counselling for both obesity and psychological distress should be included as important components in all CR programmes. In this practice-level, observational study we evaluated the short-term within-group effects of a four-week multi-factorial inpatient CR programme specifically addressed to weight loss, fitness improvement and psychological health increase on 176 obese in-patients with coronary heart disease (CHD). Outcome measures were exercise capacity measured with estimated metabolic equivalents (METs), body mass index (BMI) and psychological well-being (PGWBI). Results show statistically significant improvements in all the PGWBI sub-scales and total score, except in general health (p = 0.393). No moderation effects were found for BMI class, age, diabetes and ejection fraction (EF). METs significantly increased by 30.3% (p < 0.001) and BMI decreased by 1.37 points (p < 0.001). Significant correlations were found between BMI and weight reductions with PGWBI anxiety and total score improvements. This multi-disciplinary CR programme including diet therapy, exercise training and psychological counselling provides indication for short-term within-group effectiveness on functional exercise capacity, BMI and PGWBI in a sample of obese in-patients with CHD. However, controlled studies are needed to corroborate the results we found.
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Affiliation(s)
- Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy.
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Castelnuovo G, Manzoni GM, Villa V, Cesa GL, Pietrabissa G, Molinari E. The STRATOB study: design of a randomized controlled clinical trial of Cognitive Behavioral Therapy and Brief Strategic Therapy with telecare in patients with obesity and binge-eating disorder referred to residential nutritional rehabilitation. Trials 2011; 12:114. [PMID: 21554734 PMCID: PMC3113986 DOI: 10.1186/1745-6215-12-114] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 05/09/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity are linked with binge eating disorder (BED). Effective interventions to significantly reduce weight, maintain weight loss and manage associated pathologies like BED are typically combined treatment options (dietetic, nutritional, physical, behavioral, cognitive-behavioral, pharmacological, surgical). Significant difficulties with regard to availability, costs, treatment adherence and long-term efficacy are present. Particularly Cognitive Behavioral Therapy (CBT) is the therapeutic approach indicated both in in-patient and in out-patient settings for BED. In recent years systemic and systemic-strategic psychotherapies have been implemented to treat patients with obesity and BED involved in familiar problems. Particularly a brief protocol for the systemic-strategic treatment of BED, using overall the strategic dialogue, has been recently developed. Moreover telemedicine, a new promising low cost method, has been used for obesity with BED in out-patient settings in order to avoid relapse after the in-patient step of treatment and to keep on a continuity of care with the involvement of the same clinical in-patient team. METHODS The comparison between CBT and Brief Strategic Therapy (BST) will be assessed in a two-arm randomized controlled clinical trial. Due to the novelty of the application of BST in BED treatment (no other RCTs including BST have been carried out), a pilot study will be carried out before conducting a large scale randomized controlled clinical trial (RCT). Both CBT and BST group will follow an in-hospital treatment (diet, physical activity, dietitian counseling, 8 psychological sessions) plus 8 out-patient telephone-based sessions of psychological support and monitoring with the same in-patient psychotherapists. Primary outcome measure of the randomized trial will be the change in the Global Index of the Outcome Questionnaire (OQ-45.2). Secondary outcome measures will be the percentage of BED patients remitted considering the number of weekly binge episodes and the weight loss. Data will be collected at baseline, at discharge from the hospital (c.a. 1 month after) and after 6-12-24 months from the end of the in-hospital treatment. Data at follow-up time points will be collected through tele-sessions. DISCUSSION The STRATOB (Systemic and STRATegic psychotherapy for OBesity), a comprehensive two-phase stepped down program enhanced by telepsychology for the medium-term treatment of obese people with BED seeking intervention for weight loss, will shed light about the comparison of the effectiveness of the BST with the gold standard CBT and about the continuity of care at home using a low-level of telecare (mobile phones). TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01096251
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Affiliation(s)
- Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, University of Bergamo, Italy
| | - Valentina Villa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Gian Luca Cesa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Italy
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Castelnuovo G, Manzoni GM, Villa V, Cesa GL, Molinari E. Brief Strategic Therapy vs Cognitive Behavioral Therapy for the Inpatient and Telephone-Based Outpatient Treatment of Binge Eating Disorder: The STRATOB Randomized Controlled Clinical Trial. Clin Pract Epidemiol Ment Health 2011; 7:29-37. [PMID: 21559234 PMCID: PMC3089039 DOI: 10.2174/1745017901107010029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [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: 04/12/2010] [Revised: 07/02/2010] [Accepted: 07/02/2010] [Indexed: 11/22/2022]
Abstract
This paper describes the results of the STRATOB (Systemic and STRATegic psychotherapy for OBesity) study, a two-arm randomized controlled clinical trial (RCT) comparing Brief Strategic Therapy (BST, Nardone or Arezzo model) with the gold standard CBT (Cognitive Behavioral Therapy) for the inpatient and telephone-based outpatient treatment of obese people with Binge Eating Disorder (BED) seeking treatment for weight reduction. Primary outcome measure of the randomized trial was change in the Global Index of the Outcome Questionnaire (OQ 45.2). Secondary outcome measures were BED remission (weekly binge episodes < 2) and weight loss. Data were collected at baseline, at discharge from the hospital (c.a. 1 month after) and after 6 months from discharge.. No significant difference between groups (BST vs CBT) was found in the primary outcome at discharge. However, a greater improvement was seen in the BST vs the CBT group (P<.01) in the primary outcome at 6 months. About secondary outcomes, no significant difference between groups were found in weight change both at discharge and at 6 months. Notably, a significant association emerged between treatment groups and BED remission at 6 months in favor of BST (only 20% of patients in BST group reported a number of weekly binge episodes > 2 vs 63.3% in CBT group).
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Affiliation(s)
- Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, University of Bergamo, Italy
| | - Valentina Villa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Gian Luca Cesa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Italy
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Castelnuovo G, Manzoni GM, Cuzziol P, Cesa GL, Corti S, Tuzzi C, Villa V, Liuzzi A, Petroni ML, Molinari E. TECNOB Study: Ad Interim Results of a Randomized Controlled Trial of a Multidisciplinary Telecare Intervention for Obese Patients with Type-2 Diabetes. Clin Pract Epidemiol Ment Health 2011; 7:44-50. [PMID: 21559233 PMCID: PMC3089038 DOI: 10.2174/1745017901107010044] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 07/02/2010] [Accepted: 07/02/2010] [Indexed: 01/22/2023]
Abstract
BACKGROUND Obesity increases the risk of many health complications such as hypertension, coronary heart disease and type 2 diabetes, needs long-lasting treatment for effective results and involves high public and private care-costs. Therefore, it is imperative that enduring and low-cost clinical programs for obesity and related co-morbidities are developed and evaluated. Information and communication technologies (ICT) can help clinicians to deliver treatment in a cost-effective and time-saving manner to a large number of obese individuals with co-morbidities. OBJECTIVE To examine ad interim effectiveness of a 12-month multidisciplinary telecare intervention for weight loss provided to obese patients with type 2 diabetes. DESIGN, SETTING, AND PARTICIPANTS A single-center randomized controlled trial (TECNOB study) started in December 2008. At present, 72 obese patients with type 2 diabetes have been recruited and randomly allocated to the TECNOB program (n=37) or to a control condition (n=39). However, only 34 participants have completed at least the 3-month follow-up and have been included in this ad interim analysis. 21 out of them have reached also the 6-month follow-up and 13 have achieved the end of the program. Study is still on-going. INTERVENTION All participants attended 1-month inpatient intensive program that involved individualized medical care, diet therapy, physical training and brief psychological counseling. At discharge, participants allocated to the TECNOB program were instructed to use a weight-loss web-site, a web-based videoconference tool, a dietary software installed into their cellular phones and an electronic armband measuring daily steps and energy expenditure. MAIN OUTCOME MEASURES Weight and disordered eating-related behaviors and cognitions (EDI-2) at entry to hospital, at discharge from hospital, at 3,6 and 12 months. RESULTS Ad interim analysis of data from 34 participants showed no statistically significant difference between groups in weight change at any time-point. However, within-group analysis revealed significant reductions of initial weight at discharge from hospital, at 3 months, at 6 months but not at 12 months. Control group had higher scores in Interpersonal distrust at 12 months. CONCLUSION This ad interim findings revealed that the effect of the inpatient treatment was high and probably overwhelmed the effect of the TECNOB intervention. Much statistical power and long-term follow-up may enhance the probability to detect the TECNOB effect over and above the great one exerted by the inpatient program.
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Affiliation(s)
- Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, University of Bergamo, Italy
| | - Paola Cuzziol
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, University of Bergamo, Italy
| | - Gian Luca Cesa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Stefania Corti
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Cristina Tuzzi
- Istituto Auxologico Italiano IRCCS, Laboratory of Nutrition Research, Ospedale San Giuseppe, Verbania, Italy
| | - Valentina Villa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Antonio Liuzzi
- Istituto Auxologico Italiano IRCCS, Diabetes Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Maria Letizia Petroni
- Istituto Auxologico Italiano IRCCS, Laboratory of Nutrition Research, Ospedale San Giuseppe, Verbania, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Italy
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Capodaglio P, Castelnuovo G, Brunani A, Vismara L, Villa V, Capodaglio EM. Functional limitations and occupational issues in obesity: a review. Int J Occup Saf Ergon 2011; 16:507-23. [PMID: 21144269 DOI: 10.1080/10803548.2010.11076863] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Four hundred million adults are obese. Such a pandemic involves people of working age. Excess weight imposes abnormal mechanics on body movements, which could account for the high incidence of musculoskeletal disorders in these subjects. This article reviews the physiological and biomechanical causes of the reduced work capacity in obese workers and speculates on the relationships between occupational exposure and obesity. The reduction in work capacity appears to be due to the following factors: reduced spine flexibility, decay in endurance, limited range of movement of the major joints, reduced muscle strength and capacity to hold prolonged fixed postures, impaired respiratory capacity and visual control. Work capacity in morbidly obese workers should always be evaluated to match specific job demands. Due to the relationship between obesity, musculoskeletal disorders, disability and health costs, prevention of obesity and ergonomic interventions on-site are a priority in the work place.
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Affiliation(s)
- Paolo Capodaglio
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxoxlogico Italiano IRCCS, Verbania-Piancavallo, Italy.
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Corsaro A, Thellung S, Bucciarelli T, Scotti L, Chiovitti K, Villa V, D'Arrigo C, Aceto A, Florio T. High hydrophobic amino acid exposure is responsible of the neurotoxic effects induced by E200K or D202N disease-related mutations of the human prion protein. Int J Biochem Cell Biol 2010; 43:372-82. [PMID: 21094273 DOI: 10.1016/j.biocel.2010.11.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 10/19/2010] [Accepted: 11/11/2010] [Indexed: 02/05/2023]
Abstract
Mutations in prion protein are thought to be causative of inherited prion diseases favoring the spontaneous conversion of the normal prion protein into the scrapie-like pathological prion protein. We previously reported that, by controlled thermal denaturation, human prion protein fragment 90-231 acquires neurotoxic properties when transformed in a β-rich conformation, resembling the scrapie-like conformation. In this study we generated prion protein fragment 90-231 bearing mutations identified in familial prion diseases (D202N and E200K), to analyze their role in the induction of a neurotoxic conformation. Prion protein fragment 90-231(wild type) and the D202N mutant were not toxic in native conformation but induced cell death only after thermal denaturation. Conversely, prion protein fragment 90-231(E200K) was highly toxic in its native structure, suggesting that E200K mutation per se favors the acquisition of a peptide neurotoxic conformation. To identify the structural determinants of prion protein fragment 90-231 toxicity, we show that while the wild type peptide is structured in α-helix, hPrP90-231 E200K is spontaneously refolded in a β-structured conformer characterized by increased proteinase K resistance and propensity to generate fibrils. However, the most significant difference induced by E200K mutation in prion protein fragment 90-231 structure in native conformation we observed, was an increase in the exposure of hydrophobic amino-acids on protein surface that was detected in wild type and D202N proteins only after thermal denaturation. In conclusion, we propose that increased hydrophobicity is one of the main determinants of toxicity induced by different mutations in prion protein-derived peptides.
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Affiliation(s)
- Alessandro Corsaro
- Laboratory of Pharmacology, Dept. Oncology, Biology and Genetics, University of Genova, Genova, Italy
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Manzoni GM, Cribbie RA, Villa V, Arpin-Cribbie CA, Gondoni L, Castelnuovo G. Psychological well-being in obese inpatients with ischemic heart disease at entry and at discharge from a four-week cardiac rehabilitation program. Front Psychol 2010; 1:38. [PMID: 21833207 PMCID: PMC3153756 DOI: 10.3389/fpsyg.2010.00038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Accepted: 07/12/2010] [Indexed: 12/03/2022] Open
Abstract
The purposes of this observational pre-post study were twofold: 1- to evaluate psychological health in obese patients with ischemic heart disease at admission to cardiac rehabilitation (CR) and 2 – to examine the effectiveness of a 4-week CR residential program in improving obese patients’ psychological well-being at discharge from CR. A sample of 177 obese patients completed the Psychological General Well-Being Inventory (PGWBI) at admission to the CR program and at discharge. The equivalence testing method with normative comparisons was used to determine the clinical significance of improvements after having established that baseline mean scores on the PGWBI scales were significantly lower than normal means. Results show that patients scored equally or better than norms on many PGWBI dimensions at admission to CR but scored significantly worse on Global Score, Vitality and Self-control. At discharge, mean scores that were impaired at baseline returned to normal levels at the more conservative equivalence interval. A 4-week CR program was thus effective in improving obese patients’ psychological well-being. The equivalence testing method allowed to establish the clinical significance of such improvement.
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Affiliation(s)
- Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Ospedale San Giuseppe, Verbania, Italy
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Raggi A, Brunani A, Sirtori A, Liuzzi A, Berselli ME, Villa V, Ceriani F, Leonardi M. Obesity-related disability: key factors identified by the International Classification of Functioning, Disability and Health. Disabil Rehabil 2010; 32:2028-34. [PMID: 20441415 DOI: 10.3109/09638281003797372] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE To identify obese patients' disability features considering the level of body impairments, activity limitations and participation restrictions in relation to environmental factors' effect. METHOD Adult obese inpatients (BMI > 35) were enrolled and were administered a set of 166 ICF categories. Count-based indexes were developed for each ICF component: correlations and regression on performance and capacity indexes were performed. RESULTS Fifty-one patients (62.7% females, mean age 38.1) entered in the study. Description of ICF-based disability components is reported. Capacity is better correlated with body functions (r = 0.619, P < 0.01) and body structures (r = 0.375, P < 0.01) than performance; on the contrary, environmental barriers are correlated better with performance (r = 0.531, P < 0.01) than with capacity. Impairments in body functions and environmental barriers are the best predictors of limitations both in capacity and in performance. CONCLUSIONS Through this multidisciplinary approach, supported by ICFs biopsychosocial model, we described functioning and disability in obese patients, highlighting the strong effect of body functions' impairments and the limited one of environmental factors. This approach can guide rehabilitation programmes, the promotion of positive health outcomes and the modification of patients' lifestyle, not only intended as an issue of barriers' elimination, but as the activation and maintenance of environmental facilitators.
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Affiliation(s)
- Alberto Raggi
- Neurology, Public Health and Disability Unit - Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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Castelnuovo G, Manzoni GM, Cuzziol P, Cesa GL, Tuzzi C, Villa V, Liuzzi A, Petroni ML, Molinari E. TECNOB: study design of a randomized controlled trial of a multidisciplinary telecare intervention for obese patients with type-2 diabetes. BMC Public Health 2010; 10:204. [PMID: 20416042 PMCID: PMC2873580 DOI: 10.1186/1471-2458-10-204] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 04/23/2010] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity is one of the most important medical and public health problems of our time: it increases the risk of many health complications such as hypertension, coronary heart disease and type 2 diabetes, needs long-lasting treatment for effective results and involves high public and private costs. Therefore, it is imperative that enduring and low-cost clinical programs for obesity and related co-morbidities are developed and evaluated. METHODS/DESIGN TECNOB (TEChnology for OBesity) is a comprehensive two-phase stepped down program enhanced by telemedicine for the long-term treatment of obese people with type 2 diabetes seeking intervention for weight loss. Its core features are the hospital-based intensive treatment (1-month), that consists of diet therapy, physical training and psychological counseling, and the continuity of care at home using new information and communication technologies (ICT) such as internet and mobile phones. The effectiveness of the TECNOB program compared with usual care (hospital-based treatment only) will be evaluated in a randomized controlled trial (RCT) with a 12-month follow-up. The primary outcome is weight in kilograms. Secondary outcome measures are energy expenditure measured using an electronic armband, glycated hemoglobin, binge eating, self-efficacy in eating and weight control, body satisfaction, healthy habit formation, disordered eating-related behaviors and cognitions, psychopathological symptoms and weight-related quality of life. Furthermore, the study will explore what behavioral and psychological variables are predictive of treatment success among those we have considered. DISCUSSION The TECNOB study aims to inform the evidence-based knowledge of how telemedicine may enhance the effectiveness of clinical interventions for weight loss and related type-2 diabetes, and which type of obese patients may benefit the most from such interventions. Broadly, the study aims also to have a effect on the theoretical model behind the traditional health care service, in favor of a change towards a new "health care everywhere" approach.
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Affiliation(s)
- Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, University of Bergamo, Bergamo, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, University of Bergamo, Bergamo, Italy
| | - Paola Cuzziol
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, University of Bergamo, Bergamo, Italy
| | - Gian Luca Cesa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Cristina Tuzzi
- Istituto Auxologico Italiano IRCCS, Laboratory of Nutrition Research, Ospedale San Giuseppe, Verbania, Italy
| | - Valentina Villa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Antonio Liuzzi
- Istituto Auxologico Italiano IRCCS, Diabetes Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Maria Letizia Petroni
- Istituto Auxologico Italiano IRCCS, Laboratory of Nutrition Research, Ospedale San Giuseppe, Verbania, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, University of Bergamo, Bergamo, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
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Brunani A, Liuzzi A, Sirtori A, Raggi A, Berselli ME, Villa V, Ceriani F, Tacchini E, Vicari V, Parisio C, Vismara L, Zanini A, Vinci C, Contini F, Braga E, Ricappi A, Camerlengo M, Ristea M, Leonardi M. Mapping an obesity clinical evaluation protocol to the International Classification of Functioning, Disability and Health. Disabil Rehabil 2009; 32:417-23. [DOI: 10.3109/09638280903171535] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Villa V, Manzoni GM, Pagnini F, Castelnuovo G, Cesa GL, Molinari E. Do coping strategies discriminate eating disordered individuals better than eating disorder features? An explorative study on female inpatients with anorexia and bulimia nervosa. J Clin Psychol Med Settings 2009; 16:297-303. [PMID: 19680792 DOI: 10.1007/s10880-009-9172-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Accepted: 07/17/2009] [Indexed: 12/01/2022]
Abstract
The purpose of this explorative research was to examine how the COPE (Coping Orientation to Problem Experienced Inventory), an established instrument for measuring coping styles, and EDI-2 (Eating Disorder Inventory-2), a widely used questionnaire for assessing psychological and behavioural features of eating disorders (ED), discriminate among healthy individuals, inpatients with anorexia nervosa (AN) and inpatients with bulimia nervosa (BN). A discriminant analysis approach was used. Results showed that coping styles such as positive attitude, planning and social support are even more discriminative variables than eating disorder features. Implications for further studies are discussed.
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Affiliation(s)
- Valentina Villa
- Psychology Research Laboratory, San Giuseppe Hospital, Istituto Auxologico Italiano IRCCS, 28824 Piancavallo, VB, Italy
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Corsaro A, Thellung S, Chiovitti K, Villa V, Simi A, Raggi F, Paludi D, Russo C, Aceto A, Florio T. Dual modulation of ERK1/2 and p38 MAP kinase activities induced by minocycline reverses the neurotoxic effects of the prion protein fragment 90-231. Neurotox Res 2009; 15:138-54. [PMID: 19384577 DOI: 10.1007/s12640-009-9015-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Revised: 08/15/2008] [Accepted: 09/18/2008] [Indexed: 11/27/2022]
Abstract
Several in vitro and in vivo studies addressed the identification of molecular determinants of the neuronal death induced by PrP(Sc) or related peptides. We developed an experimental model to assess PrP(Sc) neurotoxicity using a recombinant polypeptide encompassing amino acids 90-231 of human PrP (hPrP90-231) that corresponds to the protease-resistant core of PrP(Sc) identified in prion-infected brains. By means of mild thermal denaturation, we can convert hPrP90-231 from a PrP(C)-like conformation into a PrP(Sc)-like structure. In virtue of these structural changes, hPrP90-231 powerfully affected the survival of SH-SY5Y cells, inducing caspase 3 and p38-dependent apoptosis, while in the native alpha-helix-rich conformation, hPrP90-231 did not induce cell toxicity. The aim of this study was to identify drugs able to block hPrP90-231 neurotoxic effects, focusing on minocycline, a tetracycline with known neuroprotective activity. hPrP90-231 caused a caspase 3-dependent apoptosis via the blockade of ERK1/2 activation and the subsequent activation of p38 MAP kinase. We propose that hPrP90-231-induced apoptosis is dependent on the inhibition of ERK1/2 responsiveness to neurotrophic factors, removing a tonic inhibition of p38 activity and resulting in caspase 3 activation. Minocycline prevented hPrP90-231-induced toxicity interfering with this mechanism: the pretreatment with this tetracycline restored ERK1/2 activity and reverted p38 and caspase 3 activities. The effects of minocycline were not mediated by the prevention of hPrP90-231 structural changes or cell internalization (differently from Congo Red). In conclusion, minocycline elicits anti-apoptotic effects against the neurotoxic activity of hPrP90-231 and these effects are mediated by opposite modulation of ERK1/2 and p38 MAP kinase activities.
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Affiliation(s)
- Alessandro Corsaro
- Laboratory of Pharmacology and Neuroscience, Department of Oncology Biology and Genetics, University of Genova, Viale Benedetto XV, 2, Genova 16132, Italy
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Thellung S, Villa V, Corsaro A, Pellistri F, Venezia V, Russo C, Aceto A, Robello M, Florio T. ERK1/2 and p38 MAP kinases control prion protein fragment 90-231-induced astrocyte proliferation and microglia activation. Glia 2007; 55:1469-85. [PMID: 17705195 DOI: 10.1002/glia.20559] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Astrogliosis and microglial activation are a common feature during prion diseases, causing the release of chemoattractant and proinflammatory factors as well as reactive free radicals, involved in neuronal degeneration. The recombinant protease-resistant domain of the prion protein (PrP90-231) displays in vitro neurotoxic properties when refolded in a beta-sheet-rich conformer. Here, we report that PrP90-231 induces the secretion of several cytokines, chemokines, and nitric oxide (NO) release, in both type I astrocytes and microglial cells. PrP90-231 elicited in both cell types the activation of ERK1/2 MAP kinase that displays, in astrocytes, a rapid kinetics and a proliferative response. Conversely, in microglia, PrP90-231-dependent MAP kinase activation was delayed and long lasting, inducing functional activation and growth arrest. In microglial cells, NO release, dependent on the expression of the inducible NO synthase (iNOS), and the secretion of the chemokine CCL5 were Ca(2+) dependent and under the control of the MAP kinases ERK1/2 and p38: ERK1/2 inhibition, using PD98059, reduced iNOS expression, while p38 blockade by PD169316 inhibited CCL5 release. In summary, we demonstrate that glial cells are activated by extracellular misfolded PrP90-231 resulting in a proliferative/secretive response of astrocytes and functional activation of microglia, both dependent on MAP kinase activation. In particular, in microglia, PrP90-231 activated a complex signalling cascade involved in the regulation of NO and chemokine release. These data argue in favor of a causal role for misfolded prion protein in sustaining glial activation and, possibly, glia-mediated neuronal death.
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Affiliation(s)
- Stefano Thellung
- Department of Oncology, Biology and Genetics, University of Genova, Genova, Italy
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Chiovitti K, Corsaro A, Thellung S, Villa V, Paludi D, D'Arrigo C, Russo C, Perico A, Ianieri A, Di Cola D, Vergara A, Aceto A, Florio T. Intracellular accumulation of a mild-denatured monomer of the human PrP fragment 90-231, as possible mechanism of its neurotoxic effects. J Neurochem 2007; 103:2597-609. [PMID: 17944873 DOI: 10.1111/j.1471-4159.2007.04965.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Because of high tendency of the prion protein (PrP) to aggregate, the exact PrP isoform responsible for prion diseases as well as the pathological mechanism that it activates remains still controversial. In this study, we show that a pre-fibrillar, monomeric or small oligomeric conformation of the human PrP fragment 90-231 (hPrP90-231), rather than soluble or fibrillar large aggregates, represents the neurotoxic species. In particular, we demonstrate that monomeric mild-denatured hPrP90-231 (incubated for 1 h at 53 degrees C) induces SH-SY5Y neuroblastoma cell death, while, when structured in large aggregates, it is ineffective. Using spectroscopic and cellular techniques we demonstrate that this toxic conformer is characterized by a high exposure of hydrophobic regions that favors the intracellular accumulation of the protein. Inside the cells hPrP90-231 is mainly compartmentalized into the lysosomes where it may trigger pro-apoptotic 'cell death' signals. The PrP toxic conformation, which we have obtained inducing a controlled in vitro conformational change of the protein, might mimic mild-unfolding events occurring in vivo, in the presence of specific mutations, oxidative reactions or proteolysis. Thus, in light of this model, we propose that novel therapeutic strategies, designed to inhibit the interaction of the toxic PrP with the plasmamembrane, could be beneficial to prevent the formation of intracellular neurotoxic aggregates and ultimately the neuronal death.
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Affiliation(s)
- Katia Chiovitti
- Department of Biomedical Sciences, Section of Biochemistry, University G. D'Annunzio of Chieti, Italy
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