59 research outputs found
When is pharmacotherapy required for children suffering from Generalized Anxiety Disorder?
No full text
Pharmacokinetic evaluation of fluvoxamine for the treatment of anxiety disorders
No full textINTRODUCTION:
Fluvoxamine is one of the most widely prescribed antidepressants and presents data from 30 years of clinical experience.
AREAS COVERED:
The present review article describes the pharmacokinetic properties of fluvoxamine and their implications for the treatment of anxiety disorders (AD). A search in the main database sources (Medline, Isi Web of Knowledge and Medscape) has been performed in order to obtain a comprehensive and balanced evaluation of fluvoxamine about the implications of its pharmacokinetic properties for the treatment of AD. The word 'fluvoxamine' has been associated with 'pharmacokinetics', 'interactions', 'generalized anxiety disorder', 'social anxiety disorder', 'social phobia', 'panic disorder', 'anxiety' and 'tolerability'. No restriction criteria were established in relation to methodology or year of publication. Only English-language articles have been selected.
EXPERT OPINION:
Fluvoxamine presents high tolerability and safety so that it can be considered as a therapeutic option in case of panic disorder and social anxiety disorder. In contrast, its weakness is in extended interaction with CYP450 enzymatic system that may limit its use in elderly or patients with medical comorbidities. Finally, data of efficacy about generalized anxiety disorder are very limited and preliminary so that it is not possible to draw any sound conclusions
Infrared nanospectroscopy depth-dependent study of modern materials: morpho-chemical analysis of polyurethane/fibroin binary meshes
No full textInfrared scattering-type scanning near-field optical microscopy (IR s-SNOM) and imaging is here exploited together with attenuated total reflection (ATR) IR imaging and scanning electron microscopy (SEM) to depict the chemical composition of fibers in hybrid electrospun meshes. The focus is on a recently developed bio-hybrid material for vascular tissue engineering applications, named Silkothane & REG;, obtained in the form of nanofibrous matrices from the processing of a silk fibroin-polyurethane (SFPU) blend via electrospinning. Morphology and chemistry of single fibers, at both surface and subsurface level, have been successfully characterized with nanoscale resolution, taking advantage of the IR s-SNOM capability to portray the nanoscale depth profile of this modern material working at diverse harmonics of the signal. The applied methodology allowed to describe the superficial characteristics of the mesh up to a depth of about 100 nm, showing that SF and PU do not tend to co-aggregate to form hybrid fibers, at least at the length scale of hundreds of nanometers, and that subdomains other than the fibrillar ones can be present. More generally, in the present contribution, the depth profiling capabilities of IR s-SNOM, so far theoretically predicted and experimentally proven only on model systems, have been corroborated on a real material in its natural conditions with respect to production, opening the room for the exploitation of IR s-SNOM as valuable technique to support the production and the engineering of nanostructured materials by the precise understanding of their chemistry at the interface with the environment
Augmentative Asenapine in a Recurrent Manic Catatonic Patient with Partial Response to Clozapine
No full textCatatonia is a severe but treatable neuropsychiatric syndrome known since the middle of the nineteenth century. It has been considered for a long time as a subtype of schizophrenia, even though this association occurs only in 10% of cases. In contrast, it is frequently observed in bipolar patients. First-line treatment consists of benzodiazepines, while in case of resistance electroconvulsive therapy (ECT) and clozapine have shown positive results. In addition, recent studies reported the efficacy of some atypical antipsychotics. The present case shows the clinical response to augmentative asenapine in a catatonic manic patient with a partial response to clozapine
Effectiveness of yoga as a complementary therapy for anorexia nervosa: a systematic review
No full textAnorexia nervosa (AN) is a severe psychiatric condition associated with high disability and
mortality. The purpose of the present manuscript is to critically summarize evidence about the
effectiveness of yoga for this condition. A bibliographic search was conducted in the main database
sources (PubMed, Embase, and Scopus). Articles in English about the effectiveness of yoga in AN
were included. Two hundred thirty‐three articles were initially identified and 5 articles were included
in the present review. With the exception of one study, all had several methodological limitations
such as the presence of confounding factors (e.g., psychiatric comorbidity) or a too limited sample
of patients. However, globally yoga seems to ameliorate AN symptoms, especially those regarding
emotional dysregulation. Yoga is a candidate complementary treatment for the management of AN,
but more randomized controlled studies with larger samples and limited bias are necessary to draw
robust conclusions. It would be also interesting to verify in comparative trials the effectiveness of
yoga with respect to other treatments such as psychotherapy or the administration of pharmacological
compounds. Finally, the practice should be modified adapting to the specific needs of this type of
patient
Manufacturing and characterization of a bio-hybrid vascular prosthesis for hemodialysis composed of a silk fibroin-polyurethane mesh
No full textLAUREA MAGISTRALEI soggetti affetti da insufficienza renale terminale sono principalmente sottoposti ad emodialisi, una terapia sostitutiva che permette la depurazione e la filtrazione del sangue. L’accesso al flusso sanguigno può essere realizzato attraverso un graft arterovenoso (AVG) che ha il vantaggio di poter essere incannulato a poche ore dall’impianto ma può indurre iperplasia dell’intima, a causa della diversa compliance tra esso e i vasi adiacenti. Nel campo dell’ingegneria tissutale in situ sono in studio protesi vascolari innovative, composte di fibroina (SF) e poliuretano (PU), con lo scopo di ottenere un prodotto finale che, grazie alle caratteristiche dei materiali impiegati, riproduca le proprietà meccaniche dei vasi nativi. Questi graft sono stati prodotti attraverso elettrospinning e caratterizzati sia da un punto di vista meccanico sia morfologico, sviluppando a questo scopo un sistema di misura personalizzato. È stata quindi dimostrata la possibilità di modularne le caratteristiche meccaniche agendo sul rapporto SF/PU.Patients with end stage renal disease are mostly on hemodialysis, a substitutive therapy that performs blood cleaning and filtration. Bloodstream can be accessed through an arteriovenous graft (AVG) that allows early cannulation but may induce neointimal hyperplasia, due to the compliance mismatch between it and the adjacent vessels. Following the in situ approach of tissue engineering, innovative vascular prostheses, composed of silk fibroin (SF) and polyurethane (PU), are studied, to obtain a final product that, thanks of the characteristics of the raw materials, reproduce the mechanical properties of the native vessels. Such grafts have been manufactured employing electrospinning and characterized from a mechanical and a morphological point of view, developing a tailored measurement system, as well. Therefore, the possibility to modulate their mechanical properties by varying the SF/PU ratio was proved
Factors associated with psychotic symptoms among a sample of male prisoners with substance use disorder: A cross-sectional study
No full textBackground: Prisoners have a higher prevalence of substance use disorder (SUD) than the nonincarcerated population. Many studies report that an SUD increases the likelihood of psychotic symptoms/disorders. Inmates, therefore, may be at higher risk for psychotic disorders.
Objective: The main objectives of this study were to (1) estimate the prevalence of psychotic symptoms in a sample of male inmates with high levels of SUD and (2) verify if type of abuse or other sociodemographic/clinical features are risk factors of psychotic symptoms. In light of the high prevalence of childhood trauma (CT) among inmates, a further objective was to 3) assess whether exposition to CT can predict psychotic symptoms.
Method: We included three hundred and nineteen male prisoners, admitted to Monza prison between January 2017 and March 2019. We interviewed participants to collect sociodemographic and clinical information. We administered the Brief Psychiatric Rating Scale (BPRS) and the Drug Abuse Screening Test (DAST) to assess the presence of psychotic symptoms and SUD, respectively. Inmates also completed the Childhood Trauma Questionnaire (CTQ).
Results: Data were available for 141 inmates. Forty-five prisoners (31.9%) had psychotic symptoms. Multivariate logistic regression analysis showed that a history of previous incarceration (aOR = 2.98, p = 0.034), opioid abuse (aOR = 5.02, p = 0.008), suicide attempts (aOR = 5.55, p < 0.001), and childhood emotional abuse (aOR = 4.11, p = 0.027) significantly increased the likelihood of psychotic symptoms.
Conclusions: Psychotic symptoms are widespread among inmates and are associated with specific risk factors. Prison and jail staff should screen for these factors at the start of an inmate's detention to identify subjects at risk of psychotic symptoms
Biomarkers of Suicidal Behaviors : A Comprehensive Critical Review
No full textSuicide is a relevant worldwide public health problem. Many studies have shown that different demographic and clinical factors are potentially associated with suicidal behavior. Other studies have reported data about the role of biomarkers in the onset of suicidal behaviors. Specifically, researchers have found that suicidal risk may be increased by abnormalities in serotonergic system, hypothalamic-pituitary-adrenal axis, lipid metabolism, immune system and neuronal plasticity. The identification of specific biological parameters associated with self-harm may be helpful to implement prevention strategies and also to detect new therapeutic strategies. In this review, we summarize and analyze the results of main studies about neurobiological mechanisms related to suicidal behavior, also exploring the possible interconnection between the different biological systems
- …
