Oral glucose tolerance test unravels circulating miRNAs associated with insulin resistance in obese preschoolers.

BACKGROUND: Circulating microRNAs (miRNAs) may act as biomarkers of metabolic disturbances. OBJECTIVE: The aim of this study was to identify serum miRNAs signature of early insulin resistance in obese preschoolers. METHODS: Twelve obese children, aged 2-6 years, six insulin resistant (IR) and six controls were selected being age-matched, sex-matched and body mass index-matched. Profiling of 179 circulating miRNAs, known to be widely expressed in the bloodstream, was investigated by quantitative polymerase chain reaction at fasting and 120 min following a standard oral glucose tolerance test (OGTT). RESULTS: Twenty-one miRNAs were differentially regulated in IR obese preschoolers. miR-200c-3p, miR-190a and miR-95 were differently regulated both at fasting and 120 min after the OGTT. In controls, the fold changes of some miRNAs were correlated with Δglucose0-120 (miR-660, miR-26b-5p and miR-22-3p: p = 0.005 for all) and Δinsulin0-120 (miR-660 and miR-22-3p: p = 0.02 for both and miR-423-5p: p = 0.042). In IR patients, miR-1 fold changes were correlated with Δglucose0-120( r = -0.786; p = 0.036) and Δinsulin0-120( r = -0.821; p = 0.023). CONCLUSIONS: Our study identifies circulating miR-200c-3p, miR-190a and miR-95 as biomarkers of insulin resistance in obese preschoolers, being differentially regulated in IR patients both in fasting condition and after the OGTT. Expression of some circulating miRNAs seems reflecting glucose and insulin excursion following the OGTT differently in controls and IR obese preschoolers.

Orthorexia nervosa: validation of a diagnosis questionnaire.

AIM: To validate a questionnaire for the diagnosis of orhorexia oervosa, an eating disorder defined as "maniacal obsession for healthy food". MATERIALS AND METHODS: 525 subjects were enrolled. Then they were randomized into two samples (sample of 404 subjects for the construction of the test for the diagnosis of orthorexia ORTO-15; sample of 121 subjects for the validation of the test). The ORTO-15 questionnaire, validated for the diagnosis of orthorexia, is made-up of 15 multiple-choice items. RESULTS AND CONCLUSION: The test we proposed for the diagnosis of orthorexia (ORTO 15) showed a good predictive capability at a threshold value of 40 (efficacy 73.8%, sensitivity 55.6% and specificity 75.8%) also on verification with a control sample. However, it has a limit in identifying the obsessive disorder. For this reason we maintain that further investigation is necessary and that new questions useful for the evaluation of the obsessive-compulsive behavior should be added to the ORTO-15 questionnaire.

Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon.

AIM: To propose a diagnostic proceeding and to try to verify the prevalence of orthorexia nervosa (ON), an eating disorder defined as "a maniacal obsession for healthy foods". MATERIALS AND METHODS: 404 subjects were enrolled. Diagnosis of ON was based on both the presence of a disorder with obsessive-compulsive personality features and an exaggerated healthy eating behaviour pattern. RESULTS: Of the 404 subjects examined, 28 were found to suffer from ON (prevalence of 6.9%). The analysis of the physiological characteristics, the social-cultural and the psychological behaviour that characterises subjects suffering from ON shows a higher prevalence in men and in those with a lower level of education. The orthorexic subjects attribute characteristics that show their specific "feelings" towards food ("dangerous" to describe a conserved product, "artificial" for industrially produced products, "healthy" for biological produce) and demonstrate a strong or uncontrollable desire to eat when feeling nervous, excited, happy or guilty.

[Noise and communal dining facilities]. / Rumore e ristorazione collettiva.

Noise is a sound which is unwanted, either because of its effect on humans, its effect on fatigue or multifunctions of physical equipment, or its interference with the perception or detection of other sounds. It is a part of environmental pollution which can, in certain circumstances, reach worrying levels for the population (130 dB cause pain). Unsuitable exposure to noise for even short periods of time is responsible for symptomology involving the hearing organs (hypoacusis) and other parts of the body such as the cardiovascular, muscular and digestive systems via the connection between the central and the autonomous nervous systems. Noise in communal eating areas can be classed as coming from 3 sources: 1) operation of cooking machinery; 2) banging of pans and equipment; 3) voices of both staff and diners. The intensity of noise on these premises varies generally between 60 and 80 dB (discomfort threshold). The Regulations governing this subject are D.Lgs n.277 of 15/8/1991 regarding the protection of employees, D.P.C.M. of 1/3/1991 which establishes the maximum levels of noise both in the home and outside, and the more recent D.P.C.M. of 21/5/1999 referring to noise in public places, which includes restaurants. To contain the exposure to noise in public eating places, we believe that action should be taken at legal levels with stricter limits than the recently passed level of 105 dB, in the building planning departments and also with technological intervention in order to reduce the effects that noise has on the auditive and extra-auditive organs and thus limit possible sublimal messages which certainly do not benefit the psycho-physical well-being of the diners.

[Psychology and psychopathology of women undergoing voluntary abortion]. / Psicologia e psicopatologia della donna sottoposta ad aborto volontario.

When facing the abortion question the following are necessary: more complete information on the consequences of indiscriminate sexual relations; a wider spread knowledge of contraceptive practices; the institution of special aid to unmarried mothers so as to prevent abortion remaining the only possible solution for an unbearable situation and which hides a serious psychological risk.

[The rehabilitation of the mental patient cannot disregard his family's involvement]. / La riabilitazione del malato di mente, non può prescindere dal coinvolgimento della sua famiglia.

Rehabilitation, or rather the recovery of the mentally sick, often runs into serious difficulties precisely at the time when the disease state seems to be over. The family is one of the essential aspects of this problem because it is the family is traumatised by the disease of one of its members. The life of the family is so upset that it unconsciously opposes his recovery. The patient's problems upon his return to the family are further exacerbated by the pretext of the impossibility of living with somebody "different". Hence the need, independently of the patient's condition, for the members of his family to be prepared for his return to the family so as to guarantee him living room and conditions required for a relatively independent life. This adaptation of the family environment must be pursued right from the beginning of the disease.

[Socio-familial reinsertion of the mental patient. Psychological aspects of related difficulties]. / Reinserimento socio-familiare del malato mentale. Aspetti psicologici delle difficoltà ad esso connesse.

The problems of the reinsertion of the mentally sick into his family and into his social group are examined. As already seen in a previous paper on "involvement of the family in the rehabilitation of the mentally sick", the phenomenon of the "expressed emotion" is examined and the stereotype-like definition of the person who is "different" as a synonym of danger and risk analysed. In conclusion, it is pointed out that the fear of his dangerousness makes the procedure for rehabilitation the psychiatric patient in his social and family group a complex one.

[Psychoreactivity in voluntary abortion]. / Psicoreattività nell'aborto volontario.

PIP: Although voluntary abortion is a choice made by the woman, there are many psychological factors involved and often after the abortion many women have lasting psychological reactions which may go on for many months or years. Looking back upon a study conducted on 1000 women in Geneva in 1971, abortion was not always found to be a true choice, but rather the last remedy for reestablishing a balance that an unwanted child disturbs. Research conducted in Geneva, London, and New York showed that the case histories of women who had resorted to abortion revealed affective disorders and traumas of a conflicting nature toward their mothers going back to their childhood. These women displayed a distorted affectivity, both on the sexual plane and also in couple relationships. The desire for pregnancy seems to persist even after the abortion, but there is a contradictory affection because the child on the 1 hand is loved, but on the other is looked upon as a rival destined to do away with his parents. In 1973 WHO reported that many women who had resorted to abortion frequently suffered remorse and regret later followed by a sense of relief. However, 3-6 months after the abortion the event continued as an agonizing memory. Recent surveys taken in Switzerland proved that often the choice of an abortion made on a rational basis could clash with an unconscious but intense desire for pregnancy, and the sense of guilt which remained at a latent level was often responsible for the difficulty in getting through the trauma. The trauma that accompanies abortion is 1st somatic and then psychic. The somatic part can be partially avoided by refining the intervention techniques, but the psychic part can be dealt with only by psychological intervention and, unlike the somatic trauma, its effects last much longer. While the women is making the decision to have the abortion, she is in balance; when the abortion is actually performed, however, the choice no longer exists because the ultimate goal has been achieved and she falls out of balance due to her conflicting feelings. It is best that decisions of this nature be made slowly because the psychological effects of a hasty decision can go on long after abortion.^ieng