Electroencephalographic and Neuroimaging Asymmetry Correlation in Patients with Attention-Deficit Hyperactivity Disorder.

The present study explores the correlation between electroencephalographic and neuroimaging asymmetry index from EEG-MRI functional connectome and EEG power analysis in inattention, motion, and mixed profile subgroups of ADHD. Sixty-two subjects from Healthy Brain Network Biobank of the Child Mind Institute dataset were selected basing on the quotient score. From both MRI and EEG asymmetry index, Pearson's correlation, ANOVA, and partial least square analysis were performed matching left and right brain parcels and channels. The asymmetry index significantly correlated across subjects between fMRI and power-EEG in the inattention group in frontal and temporal areas for theta and alpha bands, an anticorrelation in the same areas for delta band was found. Significant patterns of hemispheric asymmetry index have been reported, involving EEG bands that underlie cognitive impairments in ADHD. Alpha and theta bands were altered in the inattention group of patients, reflecting widespread deficiency of basic attentional processing.

Chlamydia trachomatis elicits TLR3 expression but disrupts the inflammatory signaling down-modulating NFκB and IRF3 transcription factors in human Sertoli cells.

Chlamydia trachomatis, the leading cause of bacterial sexually transmitted diseases worldwide, can disseminate and localize to the upper genital tract impairing reproductive function. Specifically, ascending C. trachomatis genital infection has been demonstrated to cause epididymitis or epididymo-orchitis, well-known risk factors for male infertility. C. trachomatis possesses the ability to infect primary human Sertoli cells, key elements for the spermatogenetic process and the immune protection of germ cells. Therefore, herein, we investigated the innate immune response in Sertoli cells following C. trachomatis infection, as well as its indirect effects on human spermatozoa. Specifically, we evaluated C. trachomatis mediated induction of Toll-like Receptors (TLR) 2, 3 and 4 as well as of downstream intracellular signaling molecules (NFκB and IRF3) and the levels of the related inflammatory mediators (IL-1α, IL-6, IFN-α, IFN-ß and IFN-γ), in an in vitro infection model of primary human Sertoli cells. The main result of our study shows that C. trachomatis induced TLR3-mediated recognition in human Sertoli cells, accompanied by the down-modulation of NFκB and IRF3-dependent signaling pathways followed by no production of pro-inflammatory cytokines. In conclusion, our findings suggest that C. trachomatis can disrupt the innate immune response in Sertoli cells and evade intracellular killing, potentially giving rise to a long-term infection that may exert negative effects on the male reproductive system.

A broad-spectrum review on multimodal neuroimaging in bulimia nervosa and binge eating disorder.

Bulimia nervosa (BN) and binge eating disorder (BED) are psychiatric conditions marked by emotional disorders managed through the ingestion of great amount of food, with consequent vomiting for avoiding weight gain. Such behavioral habits are dysfunctional and severely impact both psychological and physical health, also compromising neurobiological processes. In the present review, we focus on recent neuroimaging findings (2010-2019) that provide insight into the neural bases of BN and BED. We describe the role of different neuroimaging techniques (magnetic resonance imaging, both structural and functional, positron emission tomography, single-photon emission computerized tomography, electroencephalography and magnetoencephalography) in the delineation of pathophysiological aspects of BN and BED. Results highlight the main involvement of the frontal system and its relationships with temporal areas for reward and self-regulatory processes modulation. The network that regulates food-stimuli control seems to be widespread across the brain, catching the insula, precentral gyrus, frontal cortex and extending until the visual cortex for processing of body image. These results demonstrate diffuse brain vulnerability associated with BN and BED and can confirm that symptomatology maintenance results from several neurostructural and neurofunctional alterations.

Body art practices and health risks: young adults' knowledge in two regions of southern Italy.

BACKGROUND: In the past several decades the number of individuals, particularly young adults, acquiring body art has increased very seriously in occidental society. In order to verify young adults' practices and knowledge of the risks related to body art, an investigation was conducted among university freshmen in Bari (Apulia Region) and Naples (Campania Region), both in Southern Italy. METHODS: The study was carried out during the period 2008-2010 through an anonymous questionnaire distributed to 3,868 people selected among 26 Degree Courses of the University of Bari and Naples Parthenope. The two regional samples were matched for age and sex. RESULTS: On the whole, 84.4% declare to know the infectious risks associated with body art practices, but only 4.1% of them correctly identified the infectious diseases which can be transmitted through these procedures; while 59.2% of the sample declared that non-infectious diseases can occur after a tattoo or a piercing, but only 5.4% of them correctly identified allergies, cysts, bleeding and scars. The possible occurrence of infectious and non-infectious diseases has been acknowledged by most students in Apulia region (89.7 versus 79.1% and 64.8 versus 53.6% respectively). In this Region, of the 1,001 (32.4%) pierced and 597 (19.8%) tattooed youths 23.4% reported complications. Campania region youths reported a greater number of complications than Apulia did (30.3 versus 13.1%) and they also purchased more frequently their tattoos or piercings in unauthorized facilities (35.3% versus 15.9%). CONCLUSIONS: With regard to the knowledge of health risks associated to body art, it has been registered a higher awareness of infectious than non-infectious diseases. Information about freshmen's knowledge and practices could help in effective planning of health promotion strategies.

Is antibiotic prophylaxis in invasive urodynamics a useful procedure in postmenopausal subjects?

OBJECTIVES. To define the incidence rate of urinary tract infections (UTI) and the usefulness of antibiotic prophylaxis in postmenopausal female undergoing invasive urodynamics (IU). METHODS. 262 postmenopausal females underwent IU, being previously double-blindly randomized in 2 homogenous age-matched groups. Group 1 (130 patients) received oral antibiotic prophylaxis with a single 400 mg dose of norfloxacin. Group 2 (132 patients) was given placebo. The statistical analysis was performed using a Chi-Square test, in order to evaluate any difference between groups for UTI incidence rate. RESULTS. 54 patients out of 262 (20.6%) developed a UTI [24 out of 130 subjects who received antibiotic prophylaxis (18.4%), and 30 out of 132 subjects who received placebo (22.7%)]. As per the UTI incidence rate, no statically significant difference (p>.05) was shown between patients receiving and those not receiving the antibiotic prophylaxis. CONCLUSIONS. The UTI incidence rate in postmenopausal women undergoing urodynamics is not affected by the administration of antibiotic prophylax.

[Hygienic risks in swimming pool: knowledge and behaviours of consumers of three structures in Crema, Parma and Naples]. / Rischi igienico-sanitari in piscina: conoscenze e comportamenti degli utenti di tre impianti delle città di crema, Parma e Napoli.

The swimmers health's protection and the maintenance of good safety standards of structures can be guaranteed under observance of rules and the well management of the structures and activities. An anonymous questionnaire, with 38 items, was used in order to analyse and better understand the knowledge and behaviour of the users of three swimming pools in Crema, Naples and Parma. Socio-demographic features were similar in the three centres. One of the most important result was that the necessity of showers and foot-bath before entering the swimming pool is not well understood (77% and 78% respectively); caps and foot bath are, instead, almost always worn (98% and 97%). Knowledge on infection diseases transmitted by water is very poor, warts and mycosis being the best known. Sport structures are places where health and wellness can be affected. It is important to underline the role of behavioural rules as the use of showers, caps, and proper shoes. Authors recognize the swimming pool regulations as a valid tool for health promotion. It must be clear and easily understood and it has to be linked to a proper education pathway of all users and employees.

Integrated medical-psychiatric treatment of the "crisis phase" in severe protein-energy malnutrition secondary to major eating disorders.

C.A., a 23-year old male was admitted in the clinical nutrition medical ward for severe, complicated protein-energy malnutrition (PEM) [body mass index (BMI) 11.08 kg/m2; body weight kg 35.81 due to major eating disorders. C.A.'s personality was narcissistic, with a rigid psychic structure. During hospitalitation (lasted 72 days) two acute episodes (a possibly self-inflicted damage and a persecution feeling) occurred that we consider as part of the "crisis phase", the period in which the patient's restrictive behaviour is no longer able to keep his personality equilibrium stable. The patient was treated by an integrated medical and psychiatric approach, including periods of never forced parenteral nutrition, nutritional and intensive psychoterapeutic interventions. For a short period the patient received also a pharmacological support (aloperidol orally). Treatment was successful and the patient was discharged completely autonomous and followed up on an outpatient basis. After about one year follow-up he is still in good clinical condition and in sufficient psychological equilibrium.

Use and abuse of albumin: a survey of clinical records from an internal medicine ward.

BACKGROUND AND AIMS: This study was to review albumin prescriptions and indications in 4122 patients hospitalized in internal medicine wards in the years 1996, 1998 and 1999, before and after the ad hoc regulations issued in 1997 by the Italian Ministry of Health. METHODS: In 1996 (n=63), 1998 (n=59) and 1999 (n=55) 177 of these patients (4.3%) were given i.v. albumin. RESULTS: 161 (91%) of them had serum albumin values of <3.5 g/dl, while in only 36% were these values <2.5 g/dl. CONCLUSION: In the majority of cases albumin was erroneously prescribed, often to enhance diuretic efficacy or in protein energy malnutrition. Its prescription has not been influenced by the new recommendations.

Stable reversal of pathologic signs of primitive intestinal lymphangiectasia with a hypolipidic, MCT-enriched diet.

We report on a patient with protein-losing enteropathy due to primitive intestinal lymphangiectasia with an early reversal of clinical and biochemical signs and a stable late reversal of pathologic signs after treatment with a hypolipidic diet enriched with medium-chain triacylglycerols.

Fluoxetine for migraine prophylaxis: a double-blind trial.

UNLABELLED: Selective serotonin reuptake inhibitors have recently been used in the treatment of migraine. OBJECTIVE: We studied the safety and efficacy of fluoxetine in the prevention of migraine. PATIENTS: Between February 1997 and December 1997, we examined 52 patients (33 women) at the Headache Diagnosis and Therapy Service of the Second University of Naples. Ages ranged from 18 to 65 years, and all patients suffered from migraine without aura according to IHS 1988 criteria. The sample was divided into two groups: group A included 32 patients (19 women; mean age, 36.8 years [SD 12.4]) who received fluoxetine at a dosage of 20 mg per day; group B included 20 patients (14 women; mean age, 38.8 years [SD 15.6]) who received placebo. METHODS: Our study was a single-center, randomized, double-blind, parallel study of fluoxetine for the prophylactic control of migraine and consisted of two phases: 30 days of pharmacological wash out and 6 months of therapy with monthly follow-up. Patients were randomly assigned to two groups: A, fluoxetine or B, placebo. At the first visit, patients provided a detailed history and underwent neurological evaluation and a Zung test for depression. No pathological values were revealed. In order to monitor symptomatology, all patients received a form for the calculation of the total pain index at monthly follow-up. RESULTS: A comparison of the total pain index between basal values (calculated during the period of wash out) and monthly follow-up (calculated monthly during the period of 6 months of the therapy) showed significant reduction (P < .05) beginning from the third month of treatment in the fluoxetine group and no significant reduction in the placebo group. CONCLUSION: Even if preliminary and to be confirmed, these data seem to support the use of fluoxetine in the treatment of migraine.

Flunarizine in long-term migraine prophylaxis: clinical evidence.

The aim of our study was to evaluate the efficacy of long-term migraine prophylaxis with flunarizine. The efficacy of the drug was evaluated on the basis of the frequency, pain severity and duration of migraine attacks. Frequency, the most modified parameter, was reduced to about half of the pre-treatment level in one to three months time. The condition remained more or less stable from the third treatment month onwards. The results showed remarkable efficacy of long-term prophylaxis with flunarizine, and the response was better in younger patients with a short history of migraine.

Experience with our first 400 treatments with ESWL and URS.

From September 1988 to April 1989, 400 patients with stones in the calix (40%), in the renal pelvis (45%), in the ureter (15%) and with staghorn calculi (5%), underwent shock wave treatment. In the majority of patients therapy was carried out with general anesthesia. Disintegration was achieved in 95% of stones in the kidney and 44% of stones localized in the ureter following in situ ESWL. The ureteronephroscopy and stone push-up with replacement into the renal pelvis was performed in 56% of ureteral calculi. The average number of impulses to achieve disintegration was 1,850. In 20 patients 4,000 shock waves were necessary. We studied these patients with echotomography, CT scan and magnetic resonance imaging 48 hours after the treatment. The aim of this trial was to assess the efficacy and cost benefit ratio of the Tripter X1 lithotripter.

[The lithotripsy therapy center "Citta di Brescia". Our experiences with the first 400 treatments]. / Centro di litotrissia casa di cura "Città di Brescia" nostra esperienza sui primi 400 trattamenti.

From September 1988 to April 1989, 400 patients with stones in the calyx (40%), in the renal pelvis (45%), in the ureter (15%) and with staghorn calculi (5%) underwent shock wave treatment. In the majority of patients therapy was carried out with general anesthesia. Disintegration was achieves in 95% of stones in the kidney and 44% of stones localized in the ureter following "in situ" ESWL. The ureteroscopy and stone push-up with replacement into the renal ampulla was performed in 56% of ureteral calculi. The average number of impulses to achieve disintegration was 1850. In 20 patients were necessary 4000 SW; we studied this patients with echography, TAC and RMN 48 hours after the treatment. The objective of this trial is the assessment of the efficacy and cost benefit relation of lithotripter TRIPTER X1.

Combined therapy of staghorn calculi with ureteronephroscopy (URS) and extracorporeal shock wave lithotripsy (ESWL).

We report our experience with 25 cases of staghorn calculi treated by combined ureteronephroscopy and extracorporeal shock wave lithotripsy. The equipment used and the ultrasonic disintegration techniques are described. We believe that the procedure, followed by ESWL, may constitute, in selected cases, an alternative to conventional combination therapy.

Computerized tomography and magnetic resonance imaging after ESWL. Comparison at over 4,000 shock waves.

Twenty patients who received more than 3,000 shock waves at 20 kV during single treatment for renal calculi with the Tripter X1, were studied retrospectively after 48 hours with CT scan and magnetic resonance imaging (MRI). In 15 cases (85%) both diagnostic procedures were negative. In 2 cases both revealed a subcapsular haematoma and in another case perirenal urinary extravasation. We conclude that no substantial differences have been noted in postoperative complications in patients treated with 4,000 shock waves compared with those who received a smaller number of waves.