Exploratory evaluation of an obese population seeking bariatric surgery in an Italian public service.

Obesity is a difficult to treat multi-problematic disease. Bariatric surgery (BS) has been regarded as the most effective therapeutic option, however the outcomes strongly depend on baseline conditions and further behavioural modifications. Our aim was to assess the characteristics of severely obese patients seeking BS in a Public Health Service in Italy. Socio-demographic characteristics, eating habits and the presence of stressful situations associated to weight increase, as well as psychiatric disorders of 111 outpatients attending our BS Program were assessed. Twenty-seven percent of patients have familiar history of obesity (FHO). Differences between patients having or not having a FHO were found for several psychiatric conditions, including lower Bulimic symptoms (p=0.025) and lower use of Alcohol (p=0.045). A total of 28.8% of the participants reported a BED; those patients do not differ in BMI (p=0.437) from non-BED patients but had higher psychological disorders associated to eating disorder, as for example Bulimic symptoms (p=0.000), higher BES scores (p=0.000) and psychological distress, such as Depression (p=0.000). Nearly 50% of patients had any psychiatric disorders and depression was the most common disturbance (32.4%); anxiety disorder was present in 15.3% of patients. Moreover, patients who have disclosed traumatic episodes (11.7%) presented higher distress associated to eating disorder variables, such as BES (p=0.001) and EDI-2 BU scores (p=0.000) and presence of BED (p=0.001), and women are more likely to be in this group (p=0.043). Our report proposes that multiple causative factors play a role in obesity, and we need to take them all into account to plan a comprehensive pre- and post-surgical treatment plan.

Treatment dropout in drug-addicted women: are eating disorders implicated?

A high prevalence of eating disorders among drug-addicted female patients has been noted, and it could be associated to psychopathological underlying factors. Our aim was to assess eating disorder traits in women approaching a residential program for drug addiction. We hypothesized that these traits would correlate to more general psychopathological factors, and would influence treatment relapse. A sample of 204 substance dependent women attending a residential treatment was screened for psychopathological indices, and follow-up data were obtained at the end of the treatment. Clients had a high risk for eating disorders (15%), and lifetime prevalence was even higher (20%). Disordered eating was associated to psychopathological distress, in particular harm avoidance resulted significantly lower (p=0.005), evoking higher unresponsiveness to danger. Drug addiction treatment outcome is associated to completion of defined programs, and eating disorder was a key covariable in determining treatment relapse or success (p=0.03). Clinicians should be aware of this potential co-morbidity, and concurrent treatments should be attempted, in order to prevent symptomatic shifting.

Pathological gambling in two patients on dopamine replacement therapy for Parkinson's disease.

We describe two cases where increases in dopaminergic therapy were initiated by the patients due to perceived deterioration in symptoms of idiopathic Parkinson's disease. Shortly afterwards, both cases also met clinical criteria for pathological gambling. To date, only 29 cases of pathological gambling in patients with Parkinson's disease have been reported. This "pathological gambling disorder" is an addiction-like behavior triggered by excessive dopaminergic drugs and does not respond to standard therapy for pathological gambling. It only responds to an adjustment of Parkinson's disease therapy.

Cytochemical study on human spermatozoa metabolism during in vitro capacitation.

In eutherian mammalian spermatozoa the capacitation is coupled to a specific type of metabolism, that is glycolysis or oxidative respiration. A cytochemical study was carried out on cytochrome oxidase and lactate dehydrogenase in human spermatozoa collected at different times during in vitro capacitation. Human spermatozoa were incubated in Biggers, Whitten and Wittingham's medium supplemented with 15% heat-inactivated human serum. Both histoenzymological reactions based on oxidative polymerization of diaminobenzidine (cytochrome oxidase) or on tetrazolium salts reduction (lactate dehydrogenase) can be quantitated and have been evaluated by microdensitometric method (Vickers M85). The results suggest that human spermatozoa depend almost quite on the anaerobic glycolysis during in vitro capacitation.