Risk evaluation of relapse into violent crime in offenders with mental disorders in two different rehabilitation programs: a case-control study.

INTRODUCTION: Over the last years, many research groups have been working on evaluating the most appropriate rehabilitation approaches in offenders with mental disorders, taking into account the need to prevent crime reiteration. The HKT-R (Historisch Klinisch Toekomst- Revised), recently validated in Italy, is a comprehensive tool that offers useful indications to healthcare operators on relapse hazard and major risk areas on which intensify rehabilitation treatments. The present study aims to assess the risk of violent crime recidivism in psychiatric patients during different rehabilitative pats. MATERIALS&METHODS: the risk of violent crime recidivism was assessed by using the HKT-R in 34 patients with mental disorders treated in ordinary psychiatric therapeutic rehabilitative units (CRAP - Comunità Terapeutiche Riabilitative Assistenziali Psichiatriche) and in CRAP-D (Comunità Terapeutiche Riabilitative Assistenziali Psichiatriche Dedicate) specialized in crime offenders. RESULTS AND CONCLUSIONS: Results have demonstrated a higher risk of violent behavior in CRAP-D, and a negative correlation between the risk of violent recidivism, global functioning of patients, and length of care program. These data suggest that residential rehabilita-tion programs, by improving personal and social functioning, could negatively impact the risk of violent crime recidivism, especially in patients with severe mental illness.

The upper limit of normal CSF opening pressure is related to bilateral transverse sinus stenosis in headache sufferers.

There are limited data on the relationship between normal cerebrospinal fluid (CSF) opening pressure and bilateral transverse sinus stenosis (BTSS); there are also several conflicting reports about the upper limit of normal CSF opening pressure. To evaluate the influence of BTSS on the upper limit of normal CSF opening pressure, we prospectively recorded lumbar CSF opening pressures in 217 adult patients with neurological symptoms who underwent cerebral magnetic resonance venography (MRV). The CSF opening pressures ranged between 65 and 286 mmH(2)O (mean = 149.3, s.d. = 47.5). The upper limit of opening pressure in patients with both normal appearance of transverse sinuses and unilateral transverse sinus stenosis on MRV (n = 167) was 195 mmH(2)O with a range of 65-195 mmH(2)O. All patients with BTSS were headache sufferers, and the upper limit of opening pressure in patients with BTSS (n = 50) was 286 mmH(2)O with a range of 91-286 mmH(2)O. All patients with opening pressures > 200 mmH(2)O displayed BTSS, whereas only 13% of patients with a pressure < 200 mmH(2)O displayed BTSS. Our findings demonstrate that the upper limit of normal CSF opening pressure is related to BTSS, and they also highlight that headache sufferers with opening pressures > 200 mmH(2)O should be tested for BTSS by MRV.

Does the default-mode functional connectivity of the brain correlate with working-memory performances?

The "default-mode" network is an ensemble of cortical regions that are typically deactivated during demanding cognitive tasks in functional magnetic resonance imaging (fMRI) studies. Using functional connectivity analysis, this network can be studied as a "stand-alone" brain system whose functional role is supposed to consist in the dynamic control of intrinsic processing activities like attention focusing and task-unrelated thought generation and suppression. Independent component analysis (ICA) is the method of choice for generating a statistical image of the "default-mode" network (DMN) using a task- and seed-independent distributed model of fMRI functional connectivity without prior specification of node region extent and timing of neural activation. We used a standard graded working-memory task (n-back) to induce fMRI changes in the default-mode regions and ICA to evaluate to DMN functional connectivity in nineteen healthy volunteers. Based on the known spatial variability of the ICA-DMN maps with the task difficulty levels, we hypothesized the ICA-DMN may also correlate with the subject performances. We confirmed that the relative extent of the anterior and posterior midline spots within the DMN were oppositely (resp. positively in the anterior and negatively in the posterior cingulate cortex) correlated with the level of task difficulty and found out that the spatial distribution of DMN also correlates with the individual task performances. We conclude that the working-memory function is related to a spatial re-configuration of the DMN functional connectivity, and that the relative involvement of the cingulate regions within the DMN might function as a novel predictor of the working-memory efficiency.

CASP-9: A susceptibility locus for multiple sclerosis in Italy.

Caspase-9 is a primary effector CASP that executes programmed cell death, which plays an important role in the development of multiple sclerosis (MS). Polymorphisms in the CASP-9 gene may influence its activity, thereby modulating the susceptibility to MS. To test this hypothesis, we evaluated a SNP in the CASP-9 gene in a set of Italian patients from Southern Italy and healthy control subjects. Our results suggest that the presence of the G/G genotype represents a higher risk factor in our MS population and a differential production of CASP-9 might be a contributory factor in determining the severity of MS.

[Role of mast cells in the physiopathology of gastric lesions caused by Helicobacter pylori]. / Ruolo dei mastociti nella fisiopatologia delle lesioni gastriche indotte da Helicobacter pylori.

Routine observation of stained histological preparations for the detection of Helicobacter pylori (HP) has shown a variable presence of mast cells in the mucosa of patients suffering from gastritis. Our aim was to verify whether any correlations exist between HP positivity, type of gastritis and presence of mast cells. We examined 300 bioptic fragments of gastric mucosa obtained by diagnostic oesophagogastroduodenoscopy. The study population consisted of 88 patients with chronic superficial gastritis and 12 with chronic atrophic gastritis (59 males and 41 females). HP detection was performed on Giemsa-stained preparations. Mast cell detection was performed on Giemsa- and PAS-stained preparations. Seventy percent of chronic superficial gastritis cases were found to be HP-positive and mast cells were present in 90% of these and absent in 10%. In the chronic atrophic gastritis cases 50% were HP-positive and mast cells were present in 50% and absent in the rest. HP is regarded as the causal agent of type B gastritis. On the basis of our data a significant correlation was found (86%) between HP-positivity and presence of mast cells in the inflammatory gastric mucosa.

[Assessment of hepatocyte AgNORs expression in chronic hepatopathy]. / Valutazione della espressione di AgNORs epatocitarie in corso di epatopatie croniche.

The high incidence of liver chronic diseases has aroused strong interest in researching and trying to discover the biomolecular basis. In this context the study of nucleolar organizing regions could be interesting as a prognostic factor for chronic hepatitis and for liver neoplastic disease. The Authors report on the results of their study performed on 39 selected samples from 4 different inflammatory hepatic disorders.

[Virtual reality: a simple joke or therapeutic instrument?]. / La realtà virtuale: semplice gioco o strumento terapeutico?

Virtual reality is a relatively new application for rehabilitative neurology, and achieve many successes in assessment and treatment of CNS damages. The Authors describe a prototype computer simulation for virtual environment reconstruction to assess the fundamental living skills of every day dedicated to persons in which CNS injury was occurred.