Clinical management of perinatal anxiety disorders: A systematic review.

BACKGROUND: In the last few decades, there has been a growing interest in anxiety disorders (AnxD) in the perinatal period. Although AnxD are diagnosed in 4-39% of pregnant women and in up to 16% of women after delivery, evidence on their clinical management is limited. METHODS: A systematic review was conducted on pharmacological and non-pharmacological treatment of AnxD in the perinatal period. Relevant papers published from January 1st 2015 were identified searching the electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Library. RESULTS: 18 articles met inclusion criteria. Selected studies supported the use of cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD), panic disorder (PD) and specific phobia both in pregnancy and postpartum. Selective serotonin reuptake inhibitors (SSRIs) led to significant OCD and PD improvement both in pregnancy and postpartum with no side effects for the babies. In the largest clinical sample to date, 65% of postpartum patients who entered the open-label trial of fluvoxamine (up to 300mg/day) experienced a 30% or greater decrease in the total score of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). During pregnancy, SSRIs and tricyclic antidepressants (TCAs) led to remission of panic symptoms and healthy outcomes for the babies. LIMITATIONS: Study design, mostly case reports, and enrolment of subjects mainly from outpatient specialty units might have limited community-wide generalisability. CONCLUSIONS: Keeping in mind the scantiness and heterogeneity of the available literature, the best interpretation of the available evidence appears to be that CBT should be the first treatment offered to pregnant and breastfeeding women with AnxD. However SSRIs can represent a first line treatment strategy, and not exclusively in cases where AnxD is refractory to CBT.

High resolution NMR microscopy of plants and fungi.

Nuclear magnetic resonance (NMR) microscopy is a completely noninvasive technique that can be used to acquire images with high spatial resolution through opaque objects such as plant organs and tissue parts. The image contrast can be chosen to represent the anatomical details or to visualize the spatial distribution of a range of physico-chemical parameters such as the apparent diffusion constant of water or the velocity of water flow within plants in vivo. In addition, images can be generated which show the spatial distribution of metabolites. Furthermore, it is possible to detect chemical compounds labelled with the stable isotope (13)C and to generate images showing the spatial distribution of the (13)C label in the intact plant. The ability to monitor water flow and transport of (13)C-labelled tracer in intact plants with NMR microscopy favours the use of this technique in the investigation of long-distance transport processes in plants. A short introduction into the technical principles of NMR microscopy is provided and the problems associated with applications to plants are summarized. The potential of the technique is explained with applications to Zinnia elegans plants, wheat grains and Brassica napus siliques.

Body image disturbance, parental bonding and alexithymia in patients with eating disorders.

BACKGROUND: To evaluate if body image disturbance and alexithymia, two major clinical features of eating disorders (ED), are predicted by an altered parental bonding. SAMPLING AND METHODS: 64 female ED outpatients and 68 female healthy controls were assessed by means of the Parental Bonding Instrument (PBI), the Body Uneasiness Test (BUT), and the Toronto Alexithymia Scale (TAS-20). Pearson's correlations and multiple stepwise regression analysis were applied to explore the contribution of PBI factors on BUT and TAS scores. RESULTS: BUT weight phobia, body image concerns, avoidance, depersonalization, Global Severity Index and positive symptom total were predicted by low parental care, while compulsive self-monitoring was predicted by parental overprotection. TAS total score and difficulty in describing feelings were predicted by low maternal care. CONCLUSIONS: Body image disturbance in ED may be conceptualized as a deficit in self-development, resulting from failures in parent-child interactions which impaired the ability to distinguish bodily needs from emotional experiences.

Diffusion in thin films on the surface of a porous solid.

A water-wet mono-dispersed glass bead system is saturated with two phases, a wetting phase of water and a non-wetting phase of tetrachloroethylene (no 1H signal). Pulsed field gradient NMR measurements of the one-dimensional probability density distribution P(Delta) (X) for the diffusive displacements of water molecules in times, Delta, are presented for the whole accessible water saturation range. At lower water contents the distributions show a distinctive shape, which is attributed to the distribution of the aqueous phase in thin surface wetting films connecting pendular rings where the beads are in contact. The data are reproduced well by a computer simulation of a random walk model based on diffusion of molecules within such a structure, allowing determination of the surface film thickness.