196,009 research outputs found
Are Major a Posteriori Dietary Patterns Reproducible in the Italian Population? A Systematic Review and Quantitative Assessment
No full textAlthough a posteriori dietary patterns (DPs) naturally reflect actual dietary behavior in a population, their specificity limits generalizability. Among other issues, the absence of a standardized approach to analysis have further hindered discovery of genuinely reproducible DPs across studies from the same/similar populations. A systematic review on a posteriori DPs from principal component analysis or exploratory factor analysis (EFA) across study populations from Italy provides the basis to explore assessment and drivers of DP reproducibility in a case study of epidemiological interest. First to our knowledge, we carried out a qualitative (i.e., similarity plots built on text descriptions) and quantitative (i.e., congruence coefficients, CCs) assessment of DP reproducibility. The 52 selected articles were published in 2001–2022 and represented dietary habits in 1965–2022 from 70% of the Italian regions; children/adolescents, pregnancy/breastfeeding women, and elderly were considered in 15 articles. The included studies mainly derived EFA-based DPs on food groups from food frequency questionnaires and were of “good quality” according to standard scales. Based on text descriptions, the 186 identified DPs were collapsed into 113 (69 food-based and 44 nutrient-based) apparently different DPs (39.3% reduction), later summarized along with the 3 “Mmixed-Salad/Vegetable-based Patterns,” “Pasta-and-Meat-oriented/Starchy Patterns,” and “Ddairy Products” and “Ssweets/Animal-based Patterns” groups, by matching similar food-based and nutrient-based groups of collapsed DPs. Based on CCs (215 CCs, 68 DPs, 18 articles using the same input lists), all pairs of DPs showing the same/similar names were at least “fairly similar” and ∼81% were “equivalent.” The 30 “equivalent” DPs ended up into 6 genuinely different DPs (80% reduction) that targeted fruits and (raw) vegetables, pasta and meat combined, and cheese and deli meats. Such reduction reflects the same study design, list of input variables, and DP identification method followed across articles from the same groups. This review was registered at PROSPERO as CRD42022341037
Disordered Eating Behaviors in Other Psychiatric Disorders
No full textIn the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) [1], disordered eating is not explicitly listed in the criteria for the diagnosis
of schizophrenia. However, “a lack of interest in eating or food refusal” is
reported in the “Associated Features Supporting Diagnosis.” Even though disorganized
eating behaviors did not formally make the list, the relationship between
peculiarities in nutritional patterns and psychoses has long been observed and highlighted.
Emil Kraepelin, in his book Dementia Praecox and Paraphrenia [2], recalls
how the “taking of food” may fluctuate “from complete refusal to the greatest voracity,”
while Eugen Bleuler, in his Textbook of Psychiatry [3], highlighted a tendency
of schizophrenics “to swallow all kinds of things.”Disordered eating behaviors are highly prevalent in many psychiatric disorders. In this chapter, we describe the most recent literature evidence demonstrating which eating symptoms have been found to correlate with each disease. Disordered eating occurs in schizophrenia, bipolar disorders, depressive disorders, anxiety disorders, obsessive-compulsive disorders, dissociative disorders, sleep-wake disorders, and personality disorders (especially in borderline personality disorders) to different extents. In the following paragraphs, we aim to describe this relationship
Glycation-Driven Inflammation: COVID-19 Severity in Pregnant Women and Perinatal Outcomes
No full textThe link between being pregnant and overweight or obese and the infectivity and virulence of the SARS CoV-2 virus is likely to be caused by SARS-CoV-2 spike protein glycosylation, which may work as a glycan shield. Methylglyoxal (MGO), an important advanced glycation end-product (AGE), and glycated albumin (GA) are the results of poor subclinical glucose metabolism and are indices of oxidative stress. Forty-one consecutive cases of SARS-CoV-2-positive pregnant patients comprising 25% pre-pregnancy overweight women and 25% obese women were recruited. The aim of our study was to compare the blood levels of MGO and GA in pregnant women with asymptomatic and symptomatic SARS-CoV-2 infection with pregnant women without SARS-CoV-2 infection with low risk and uneventful pregnancies and to evaluate the relative perinatal outcomes. The MGO and GA values of the SARS-CoV-2 cases were statistically significantly higher than those of the negative control subjects. In addition, the SARS-CoV-2-positive pregnant patients who suffered of moderate to severe COVID-19 syndrome had higher values of GA than those infected and presenting with mild symptoms or those with asymptomatic infection. Premature delivery and infants of a small size for their gestational age were overrepresented in this cohort, even in mild-asymptomatic patients for whom delivery was not indicated by the COVID-19 syndrome. Moreover, ethnic minorities were overrepresented among the severe cases. The AGE–RAGE oxidative stress axis on the placenta and multiple organs caused by MGO and GA levels, associated with the biological mechanisms of the glycation of the SARS-CoV-2 spike protein, could help to explain the infectivity and virulence of this virus in pregnant patients affected by being overweight or obese or having gestational diabetes, and the increased risk of premature delivery and/or low newborn weight
Fast thoracic MRI as an alternative to chest x-ray : A retrospective evaluation of 287 patients
No full textPurpose: To compare half-Fourier acquisition single-shot turbo spin-echo thoracic MRI (HASTE-MRI) with chest x-ray (CXR). Methods: A total of 287 patients (median age 53 years) undergoing both axial HASTE-MRI and CXR (<7 days apart) were retrospectively analyzed. Pulmonary nodules and consolidations, pleural effusion, and cardiac or aortic enlargement were considered. Detection rate (DR) and intra- and inter-technique agreement for both HASTE-MRI and CXR, were assessed. Results: Pulmonary nodule DR was 1.7% (5/287) at both techniques (perfect inter-technique agreement); inter-reader agreement was perfect for HASTE-MRI (κ = 1.000) and modest for CXR (κ = 0.393). Pleural effusion DR at HASTE-MRI (19.1%, 55/287) was higher (p < 0.001) than at CXR (13.9%, 40/287), but their agreement was almost perfect (κ = 0.812); inter-reader agreement was almost perfect for HASTE-MRI (κ = 0.902) and substantial for CXR (κ = 0.773). Pulmonary consolidation DR at HASTE-MRI (8.4%, 24/287) was similar (p = 0.625) to that at CXR (7.7%, 22/287), with an almost perfect inter-technique agreement (κ = 0.905); inter-reader agreement was moderate for both HASTE-MRI (κ = 0.639) and CXR (κ = 0.554). Cardiac enlargement DR at HASTE-MRI (45.3%, 130/287) was borderline significantly lower (p = 0.057) than that at CXR (48.1%, 138/287), with an almost perfect inter-technique agreement (κ = 0.902); inter-reader agreement was substantial for both HASTE-MRI (κ = 0.798) and CXR (κ = 0.744). Aortic dilation DR at HASTE-MRI (17.7%, 51/287) was significantly higher (p < 0.001) than that at CXR (9.7%, 28/287), with a substantial inter-technique agreement (κ = 0.648); inter-reader agreement was moderate for both HASTE-MRI (κ = 0.724) and CXR (κ = 0.346). Conclusion: HASTE-MRI and CXR showed at least a comparable DR for thoracic cardiac and non-cardiac findings
How Does SARS-CoV-2 Affect the Central Nervous System? A Working Hypothesis
No full textInterstitial pneumonia was the first manifestation to be recognized as caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, in just a few weeks, it became clear that the coronavirus disease-2019 (COVID-19) overrun tissues and more body organs than just the lungs, so much so that it could be considered a systemic pathology. Several studies reported the involvement of the conjunctiva, the gut, the heart and its pace, and vascular injuries such as thromboembolic complications and Kawasaki disease in children and toddlers were also described. More recently, it was reported that in a sample of 214 SARS-CoV-2 positive patients, 36.4% complained of neurological symptoms ranging from non-specific manifestations (dizziness, headache, and seizures), to more specific symptoms such hyposmia or hypogeusia, and stroke. Older individuals, especially males with comorbidities, appear to be at the highest risk of developing such severe complications related to the Central Nervous System (CNS) involvement. Neuropsychiatric manifestations in COVID-19 appear to develop in patients with and without pre-existing neurological disorders. Growing evidence suggests that SARS-CoV-2 binds to the human Angiotensin-Converting Enzyme 2 (ACE2) for the attachment and entrance inside host cells. By describing ACE2 and the whole Renin Angiotensin Aldosterone System (RAAS) we may better understand whether specific cell types may be affected by SARS-CoV-2 and whether their functioning can be disrupted in case of an infection. Since clear evidences of neurological interest have already been shown, by clarifying the topographical distribution and density of ACE2, we will be able to speculate how SARS-CoV-2 may affect the CNS and what is the pathogenetic mechanism by which it contributes to the specific clinical manifestations of the disease. Based on such evidences, we finally hypothesize the process of SARS-CoV-2 invasion of the CNS and provide a possible explanation for the onset or the exacerbation of some common neuropsychiatric disorders in the elderly including cognitive impairment and Alzheimer disease
Compulsory treatments in eating disorders: a systematic review and meta-analysis
No full textIntroduction: The aims of this systematic review and meta-analysis are to provide a summary of the current literature concerning compulsory treatments in patients with eating disorders (ED) and to understand whether compulsorily and involuntarily treated patients differ in terms of baseline characteristics and treatment outcomes. Methods: Relevant articles were identified following the PRISMA guidelines by searching the following terms: “treatment refusal”, “forced feeding”, “compulsory/coercive/involuntary/forced treatment/admission”, “eating disorders”, “feeding and eating disorders”, “anorexia nervosa”, “bulimia nervosa”. Research was restricted to articles concerning humans and published between 1975 and 2020 in English. Results: Out of 905 articles retrieved, nine were included for the analyses allowing the comparisons between 242 compulsorily and 738 voluntarily treated patients. Mean body mass index (BMI) was slightly lower in patients compelled to treatments. Mean illness duration, BMI at discharge and BMI variation showed no significant differences between the two groups. Average length of hospitalization was 3 weeks longer among compulsory-treated patients, but this did not result in a higher increase in BMI. No significant risk difference on mortality was estimated (three studies). Conclusions: Compulsory treatments are usually intended for patients having worse baseline conditions than voluntary ones. Those patients are unlikely to engage in treatments without being compelled but, after the treatments, albeit with longer hospitalisations, they do achieve similar outcomes. Therefore, we can conclude that forcing patients to treatment is a conceivable option. Level of evidence: Level I, systematic review and meta-analysis
Dataset from Alì M, Monti CB, Secchi F, Spairani R, Speciani M, Di Leo G, Sardanelli F. Fast thoracic MRI as an alternative to chest x-ray: A retrospective evaluation of 287 patients. Clin Imaging. 2020 Apr;60(2):244-248. doi: 10.1016/j.clinimag.2019.12.016. Epub 2019 Dec 23. PMID: 31968283.
No full textDataset from the article Alì M, Monti CB, Secchi F, Spairani R, Speciani M, Di Leo G, Sardanelli F. Fast thoracic MRI as an alternative to chest x-ray: A retrospective evaluation of 287 patients. Clin Imaging. 2020 Apr;60(2):244-248. doi: 10.1016/j.clinimag.2019.12.016. Epub 2019 Dec 23. PMID: 31968283.
Abstract
Purpose: To compare half-Fourier acquisition single-shot turbo spin-echo thoracic MRI (HASTE-MRI) with chest x-ray (CXR).
Methods: A total of 287 patients (median age 53 years) undergoing both axial HASTE-MRI and CXR (<7 days apart) were retrospectively analyzed. Pulmonary nodules and consolidations, pleural effusion, and cardiac or aortic enlargement were considered. Detection rate (DR) and intra- and inter-technique agreement for both HASTE-MRI and CXR, were assessed.
Results: Pulmonary nodule DR was 1.7% (5/287) at both techniques (perfect inter-technique agreement); inter-reader agreement was perfect for HASTE-MRI (κ = 1.000) and modest for CXR (κ = 0.393). Pleural effusion DR at HASTE-MRI (19.1%, 55/287) was higher (p < 0.001) than at CXR (13.9%, 40/287), but their agreement was almost perfect (κ = 0.812); inter-reader agreement was almost perfect for HASTE-MRI (κ = 0.902) and substantial for CXR (κ = 0.773). Pulmonary consolidation DR at HASTE-MRI (8.4%, 24/287) was similar (p = 0.625) to that at CXR (7.7%, 22/287), with an almost perfect inter-technique agreement (κ = 0.905); inter-reader agreement was moderate for both HASTE-MRI (κ = 0.639) and CXR (κ = 0.554). Cardiac enlargement DR at HASTE-MRI (45.3%, 130/287) was borderline significantly lower (p = 0.057) than that at CXR (48.1%, 138/287), with an almost perfect inter-technique agreement (κ = 0.902); inter-reader agreement was substantial for both HASTE-MRI (κ = 0.798) and CXR (κ = 0.744). Aortic dilation DR at HASTE-MRI (17.7%, 51/287) was significantly higher (p < 0.001) than that at CXR (9.7%, 28/287), with a substantial inter-technique agreement (κ = 0.648); inter-reader agreement was moderate for both HASTE-MRI (κ = 0.724) and CXR (κ = 0.346).
Conclusion: HASTE-MRI and CXR showed at least a comparable DR for thoracic cardiac and non-cardiac findings
A Perspective on Chronic and Long-Lasting Anorexia Nervosa
No full textAnorexia Nervosa (AN) is a severe eating disorder which typically develops in younger females. Many studies focus on this specific population, a majority of which will eventually partially or fully recover. A minority will become chronic despite extensive treatment. These patients are treatment-resistant and may not necessarily benefit from usual treatment. In this article we will reflect on possible mechanisms which may explain the maintenance of disease, and especially on the possible role of affective and anxiety disturbances. We will use, due to the lack of large-scale studies, data from risk and prognostic factors, treatment options and neurobiological correlates in chronic AN patients. Lastly, we will propose how these elements may advise further research and treatments
Antidepressant Therapeutic Drug Monitoring by Minimally Invasive Techniques in Eating Disorders Patients: Preliminary Results from a Pilot Study with Focus on Vortioxetine
No full textTherapeutic Drug Monitoring (TDM) is an evidence-based practice consistent with
the assumption that pharmacological plasmatic concentrations correlate better with
clinical effects than prescribed doses of the used drugs. TDM has several indications in
treated psychiatry patients: comorbidities, suspected non-compliance, severe adverse
effects and tailored pharmacotherapy. Antidepressant Drugs (AD) are prescribed in
patients with Eating Disorders (ED) to treat depression or anxiety disorders associated
with ED or to reduce binge-eating behaviours. TDM may represent a valid tool in this
population, considering the limited efficacy of ED’s pharmacological treatment and
the high rate of adverse effects. Nineteen outpatients affected by ED with a Body Mass
Index (BMI) < 20 or > 30 kg/m2 treated with antidepressants agreed to participate in
this study. Participants were treated with Sertraline (N=5), Fluoxetine (N=6), Vortioxetine
(N=4), Citalopram (N=2), Escitalopram (N=1), Fluvoxamine (N=1). Oral fluid samples and
whole blood dried microsamples by finger puncture using VAMS (Volumetric Absorptive
Microsampling) technique were obtained from patients. Sociodemographic and clinical
information were also collected
Are Reproducible Dietary Patterns Consistently Associated With Disease Outcomes or Their Drivers in Italy? A Systematic Review
No full textThe strength, direction, and trend of associations between specific diseases and reproducible a posteriori dietary patterns (DPs) based on principal component analysis (PCA) or exploratory factor analysis (EFA) have rarely been investigated across populations. We conducted a systematic review of PCA/EFA-based DPs identified in Italy to explore 2 methodological issues: 1) cross-study reproducibility of Italian DPs; 2) consistency of associations between reproducible DPs and the same/similar disease outcomes/DP drivers/correlates. The systematic review process and findings on DP cross-study reproducibility were published separately. This paper focuses on associations, summarizing the data in figures and tables, with post-hoc criteria for similarity among target variables, statistical methods, and adjustment for confounding. Predefined rules of inference were used to evaluate selected Hill's causal criteria (consistency, strength, and dose–response effects) and draw valid scientific conclusions on the association between PCA/EFA-based DPs and similar/the same target variables. Fifty-two articles, primarily on EFA-based DPs derived from food frequency questionnaires, were included. Regression models were used to explore the relationships between DPs and disease outcomes/DP drivers, aligning with original research questions, study designs, and literature on confounding. When considering similar target variables, 9 groups of reproducible DPs showed >50% statistically significant associations in the same direction across 1–3 groups of target variables, such as socioeconomic characteristics, incidence of chronic diseases, overall/cause-specific mortality, cardiovascular disease risk factors, pregnancy/breastfeeding-related and elderly-related outcomes. Groups targeting dairies/sweets and vegetable sources of fats showed >50% nonsignificant findings across all similar target variables. Overall, 54% of findings were nonsignificant. When considering the same target variable, the median number of DPs per group was equal to 2 (interquartile range: 2–2.5). Together with population comparability issues, this prevented us from reliably performing any meta-analyses. At this stage, valid scientific conclusions cannot be drawn to inform Italian nutritional recommendations. This study was registered at PROSPERO as registration number CRD42022341037
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