Group Psychotherapy Could Improve Depression in Cirrhotic Patients on the Liver Transplant Waiting List.

BACKGROUND: It is well-known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. However, there have been few studies of psychological intervention on these patients. OBJECTIVES: To determine symptoms of depression in patients on the LT waiting list and the impact of group psychotherapy. METHODS: Study population: patients on the LT waiting list who received group psychotherapy (n = 15). CONTROL GROUP: patients who did not receive psychotherapy (n = 10). Measurement instrument: Beck's depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months). The control group was given the questionnaire at the same 2 points in time as the study group. The psychotherapeutic method consisted of discussing patients' feelings, which dealt with several matters related to transplantation. Different coping strategies were considered. RESULTS: More than half of those surveyed initially had depressive symptoms. When the second survey was administered to the study population, all the patients improved in their psychopathological assessment. When the survey was administered to the control group, a worse psychopathological assessment was obtained in all cases. CONCLUSIONS: Our data suggest an improvement in depressive symptoms in patients on the LT waiting list after receiving group psychotherapy.

Quality of Life and Group Psychological Intervention in Patients With Cirrhosis on Liver Transplant Waiting List.

BACKGROUND: The patients on the liver transplant (LT) waiting list usually present with deterioration in their quality of life. Previous studies on psychological intervention have shown how the quality of life can be improved. OBJECTIVE: To analyze preliminary results of the influence of group psychotherapy on the quality of life of patients on the LT waiting list. METHOD: Fifteen patients on the LT waiting list who accepted receiving group psychotherapy were selected. The development of each 1 of these sessions was carried out at fortnightly periods for 6 months (12 sessions). Those patients who received a transplant and those patients who did not attend more than 6 group psychotherapy sessions were excluded. The Nottingham Health Profile was used to assess the quality of life. It consists of 38 items belonging to 6 health dimensions: energy, pain, physical mobility, emotional reaction, sleep, and social isolation. The study population was given a questionnaire before starting group psychotherapy and after it was finished. RESULTS: Of the 15 patients selected from the study population, 3 patients were given a transplant before the psychotherapy had finished, and 5 patients were excluded for not having attended more than 50% of the sessions. Therefore, the study was completed on 7 patients (n = 7). Overall, a better assessment can be seen in the second questionnaire. CONCLUSIONS: Group psychotherapy might favorably influence the quality of life of patients on the LT waiting list; therefore, it might be interesting to carry out studies on a larger scale in order to confirm these results.

Benefits of Group Psychotherapy in Cirrhotic Patients on the Liver Transplant Waiting List.

INTRODUCTION: It is well-known that patients on the liver transplant (LT) waiting list experience a high rate of psychopathologic symptoms. However, few studies have been published about the use of group psychotherapy for these patients. We sought to assess (1) the psychopathologic data in patients on the LT waiting list and (2) the attitude toward a group psychotherapy procedure and its efficacy. MATERIAL AND METHODS: In the pretransplant consultation phase, group therapy was offered to 20 patients on the LT waiting list. Patients who received psychotherapy were assessed previously using the Beck Depression Inventory. RESULTS: Fifteen patients were included in the study. Significant differences were found between the psychopathologic assessment and the level of hepatopathy. In the first session, we observed that patients with hepatocarcinoma were much more reluctant to participate in the group therapy. In the second session, the group showed a high level of anxiety connected with a fear of transplantation. In the third session, a transplant physician answered all their questions, and at the end of the session patient anxiety had decreased. During the following sessions, family bonds and sharing experiences with other transplant patients were emphasized. CONCLUSIONS: Patients were initially reluctant to participate in the group psychotherapy, although this changed as sessions proceeded. It is necessary to provide more information about the transplant procedure itself to decrease anxiety. Group therapy was valued positively by all patients who participated.

Cholesterol esters as growth regulators of lymphocytic leukaemia cells.

OBJECTIVE: Alterations in plasma lipid profile and in intracellular cholesterol homoeostasis have been described in various malignancies; however, significance of these alterations, if any, in cancer biology is not clear. The aim of the present study was to investigate a possible correlation between alterations in cholesterol metabolism and expansion of leukaemia cell numbers. MATERIALS AND METHODS: Lipid profiles in plasma and in primary leukaemia cells isolated from patients with acute or chronic lymphocytic leukaemia (ALL and CLL) were studied. RESULTS AND CONCLUSIONS: Decreased levels of HDL-C were observed in plasma of leukaemic patients, levels of total cholesterol, LDL-C, triglycerides and phospholipids were unchanged or only slightly increased. As compared to normal lymphocytes, freshly isolated leukaemic cells showed increased levels of cholesterol esters and reduction in free cholesterol. Growth stimulation of ALL and CLL cells with phytohemagglutinin led to further increase in levels of cholesterol esters. Conversely, treatment with an inhibitor of cell proliferation such as the mTOR inhibitor, RAD, caused decline in population growth rate of leukaemia cells, which was preceded by sharp reduction in rate of cholesterol esterification. On the other hand, exposure of leukaemic cells to two inhibitors of cholesterol esterification, progesterone and SaH 58-035, caused 60% reduction in their proliferation rate. In addition to demonstrating tight correlation between cell number expansion and cholesterol esterification in leukaemic cells, these results suggest that pathways that control cholesterol esterification might represent a promising targets for novel anticancer strategies.

Polychlorobiphenyls and polycyclic aromatic hydrocarbons in the sea-surface micro-layer and the water column at Gerlache Inlet, Antarctica.

The enrichment of PCBs (polychlorobiphenyls) and PAHs (polycyclic aromatic hydrocarbons) in the sea-surface micro-layer and depth profile of these pollutants in the water column were investigated at Gerlache Inlet, Terra Nova Bay, Antarctica. Depth profile samplings were repeated three times during the Antarctic summer (from November to February). PCBs and PAHs showed a concentration range in the water column of 30-120 pg l(-1) and 150-400 pg l(-1), respectively, and these values were very much dependent on the suspended matter content. A nearly two-fold decrease in the pollutant concentration was also observed in the depth profile obtained in February, i.e. late summer, which might be correlated both with the high content of suspended matter and the reduction of the pollutant input. Moreover, isomer ratios of PAHs, such as LMW/HMW and PHE/ANT, highlight that the main PAH source might be petrogenic in nature, whereas the pyrolytic source seems to be less important. Sea surface micro-layer (SML) and sub-surface sea water (SSW) samples were simultaneously collected in the same site by a remote controlled rotating drum-based sampling system, a prototype named MUMS (Multi-User Micro-layer Sampler). Sea surface micro-layer samples showed a total content of PCBs and PAHs in the range 400-450 pg l(-1) and 2000-3000 pg l(-1), respectively, whereas the mean content of the sub-surface sea water samples was 48 pg l(-1) and 325 pg l(-1), respectively. The mean enrichment factors of PCBs and PAHs in sea-surface micro-layer were about 10 and 7, respectively. The surface excess concentrations of PCBs and PAHs were about 35 000 and 200 000, respectively. A fairly good correlation was observed between the concentration of pollutants and water solubility. Based on the assumption that POPs are confined in a very thin top layer of the SML about 0.01-0.001 microm thick, namely the sea-surface nano-layer, and also on an estimated thickness of the sampled sea-surface layer of about 100 microm, an enrichment factor of 10(5)-10(6) for the sea-surface nano-layer was calculated. Such a very high concentration increase was related to the two-fold increase of PAH concentration observed in the underlying 20 cm of the water column in late summer.

Polychlorobiphenyls in Antarctica

The presence and the distribution of polychlorobiphenyls (PCBs) in Antarctic environmental components and the effect of the seasonal formation/melting process of pack ice on the pollution level of seawater were investigated. Seawater, marine, and lake sediment and soil samples were collected in a large area of the Ross Sea and Victoria Land during the 1988-1989, 1989-1990, 1990-1991, and 1991-1992 Italian expeditions. The results obtained highlighted a low and quite homogeneous PCB contamination of the studied area. Surface seawater samples from Gerlache Inlet and Wood Bay showed a typical PCB concentration of 130 pg/liter, and an increase after pack ice melting of about 30-40%. Marine sediment, lake sediment, and soil samples showed normalized mean PCB contents of 150, 240, and 130 (pg/g)/(m2/cm3), respectively.

Rapid and sensitive determination of urinary 2,5-hexanedione by reversed-phase high-performance liquid chromatography.

A rapid and sensitive method for the determination of 2,5-hexanedione (HD) (the principal metabolite of n-hexane) in urine samples by reversed-phase high-performance liquid chromatography (HPLC) is described. The sample preparation procedure was based on solid-liquid extraction after acid hydrolysis; it was optimized to enable accurate HD determination in less than 30 min. Analysis of spiked real samples showed a recovery of more than 85% at the 0.1-ppm level, with a relative standard deviation of 5% and a detection limit as low as 0.01 ppm. Intra-assay and inter-assay coefficients of variation at the 0.5-ppm level were 4 and 5%, respectively. The chromatographic peak assigned to HD was identified by collecting the HPLC eluate at the retention time of HD and analysing it using Fourier transform infrared spectrometry coupled with high-resolution gas chromatography. Urine samples of unexposed and exposed subjects were analysed following the proposed analytical procedure. HPLC and high-resolution gas chromatographic analyses were also compared on these samples. A correlation factor of 0.992 was obtained, which showed a good agreement between the two sets of data.