Emotional scene processing in biotypes of psychosis.

Social-emotional deficits in psychosis may be indexed by deviations in emotional scene processing, but event-related potential (ERP) studies indicate such deviations may not map cleanly to diagnostic categories. Neurobiologically defined psychosis subgroups offer an alternative that may better capture neurophysiological correlates of social-emotional deficits. The current study investigates emotional scene-elicited ERPs in Biotypes of psychosis in a large (N = 622), well-characterized sample. Electroencephalography was recorded in healthy persons (N = 129), Biotype-1 (N = 195), Biotype-2 (N = 131), and Biotype-3 (N = 167) psychosis cases. ERPs were measured from posterior and centroparietal scalp locations. Neural responses to emotional scenes were compared between healthy and psychosis groups. Multivariate group discrimination analyses resulted in two composite variates that differentiated groups. The first variate displayed large differences between low-cognition (Biotype-1, Biotype-2) and intact-cognition groups (Biotype-3, healthy persons). The second indicated a small-to-moderate distinction of Biotypes-2 and -3 from Biotype-1 and healthy persons. Two multivariate correlations were identified indicating associations between 1) self-reported emotional experience and generalized cognition and 2) socio-occupational functioning and late-stage emotional processing. Psychosis Biotypes displayed emotional processing deficits not apparent in DSM psychosis subgroups. Future translational research may benefit from exploring emotional scene processing in such neurobiologically-defined psychosis groups.

Mitral valve prolapse and abnormalities of haemostasis in children and adolescents with migraine with aura and other idiopathic headaches: a pilot study.

OBJECTIVE: To investigate the prevalence of mitral valve prolapse (MVP) and abnormalities of haemostasis in children and adolescents with migraine with aura (MA) compared with peers affected by other idiopathic headaches. MATERIALS AND METHODS: We recruited 20 MA patients (10 men and 10 women; age range 8-17 years) and 20 sex- and age-matched subjects with other idiopathic headaches. Both groups underwent colour Doppler transthoracic echocardiography to detect MVP and the following laboratory work-up: plasma prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, protein C, protein S, homocysteine, lupus anticoagulant, von Willebrand factor (vWF) ristocetin cofactor activity, immunoglobulins (Ig) G and M anticardiolipin antibodies (aCL). Factor V Leiden, factor II and methylenetetrahydrofolate reductase were investigated (we did not test the entire genes, but screened for specific point mutations). RESULTS: The prevalence of MVP was significantly higher in the MA subjects than in the patients affected by other idiopathic headaches (40% vs 10%; P < 0.05). Moreover, the MA patients showed a higher rate of above-normal IgM aCL titres (45% vs 10%; P < 0.05). Finally, in the group of patients with MVP we found a higher prevalence of aCL in those with MA compared with those affected by other idiopathic headaches. CONCLUSIONS: A proportion, at least, of the MA patients showed a more complex phenotype characterized by MVP and/or positive aCL titres. The pathogenetic role of these associations is obscure and larger studies are needed to confirm the usefulness of echocardiographic and laboratory investigations in this area and to identify possible new treatment approaches that might be explored in this group of MA patients.

Relationship among nutritional status, pro/antioxidant balance and cognitive performance in a group of free-living healthy elderly.

AIM: Nutrition plays a role in health promotion and well-being, but there is still a lack of knowledge about nutrition-related risk factors in aging cognitive impairment. The purpose of this project was to evaluate the link between nutritional status, cognitive performance and pro/antioxidant balance in healthy elderly subjects residing in a small metropolitan community. METHODS: The subjects were 69 free-living urban healthy elderly people (41 females and 28 males aged 84+/-7 years, mean +/- standard deviation SD, range 70-89). In this group of elderly subjects an analysis of the diet over the 3 days before the study entry was performed. The nutrients intake for individuals were compared with the Italian Recommended Dietary Allowances (RDA). We also collected residents' background information, nutritional status (Mini Nutritional Assessment, MNA), and data on daily nursing routines in institutions, including nutritional care. Plasma malondialdehyde and erythrocyte glutathione peroxidase activity were evaluated in elderly people as compared to a group of healthy young people (control group) as indices of the oxidative balance. RESULTS: The mean vitamin and mineral intake for participants met the RDAs except for calcium and vitamin D. No difference was observed as regards plasma malondialdehyde between young and elderly subjects: 4.5 (3-6.2) mmol/L vs 4.45 (2.4-5.8) mmol/L respectively, median with range, whereas the latter exhibited higher erythrocyte glutathione peroxidase activity: 16.0 (9.3-48) U/g hemoglobin (Hb) vs 15 (10-35) U/g Hb, respectively, median with range (P<0.05). A significant negative correlation (P<0.05, r=0.24) between dietary intake of vitamin D and malondialdeyde and between dietary intake of vitamin D and poor performance on cognitive tests (P<0.01, r=0.35) was observed. CONCLUSION: In line with previous findings, our results highlighted the potential impact of nutritional factors on cognitive performance in older adults.

[Effect of treatment with a food supplement (containing: selected sea fish cartilage, vitamin C, vitamin E, folic acid, zinc, copper) in women with iron deficiency: double blind, randomized, placebo-controlled trial]. / Ruolo cardine dell'assunzione di un integratore alimentare (contenente idrolizzato di cartilagine di pesce marino, vitamina C,vitamina E, acido folico, zinco, rame) nel trattamento della sideropenia in un gruppo di pazienti in etá fertile.

AIM: The term iron deficiency is used to indicate a condition in which the content of iron (Fe) in the organism is low, even before the consequent reduction in erythropoiesis comes about. This clinical situation is very frequent in patients in fertile age. The therapy commonly used (Fe salts) is often poorly tolerated. The use of a food supplement containing nutrients useful for improving the bioavailability of Fe and that is well tolerated can represent a valid alternative to iron therapy. METHODS: The present study examines 49 fertile women with iron deficiency, of normal weight and not undergoing estroprogestin treatment. The patients underwent 3 assessments: basal, after 30 and after 60 days to determine their complete haemochrome, blood iron, blood ferritin, blood transferrin, iron binding capacity, folates, TSH, FT3, and FT4. Following the basal assessment, patients were randomly assigned to 1 of 2 treatment groups: treatment A (25 patients): food supplement containing hydrolyzed sea fish cartilage, vitamin C, vitamin E, folic acid, zinc, copper (Captafer); treatment B (24 patients): placebo. RESULTS: The patients were then subdivided into 2 groups according to the basal blood iron (<60 microg/dL) or blood ferritin (<20 ng/mL) values. In the group presenting blood iron of <60 microg/dL only treatment A supplement produced a significant improvement in blood iron after 30 (P<0.001) and after 60 (P<0.005) days of treatment. The group with basal blood ferritin of <20 ng/mL presented blood iron levels of >60 microg/dL; in these patients after 60 days of treatment with the supplement, there was a significant increase in blood ferritin (P<0.05); the patients treated with placebo, on the other hand, did not show any significant difference compared to basal values. CONCLUSIONS: This study has shown that, in patients with iron deficiency, the use of a food supplement, consisting of nutrients that improve the bioavailability of Fe, leads to a significant improvement in blood iron and blood ferritin levels.

Pro-oxidant activity and methionine metabolism in chronic alcohol abusers: relationship to alcohol withdrawal and folate administration.

AIM: The aim of this study was to investigate whether alcohol withdrawal and folate administration could play a role on redox balance and metionine metabolism in heavy drinkers. METHODS: The derivatives of reactive oxygen metabolites (d-ROMs), homocysteine, total thiols, vitamin B12 and folate were evaluated in a selected group of 40 consecutive chronic alcohol abusers by comparison with 44 healthy moderate drinkers, as controls. RESULTS: Before alcohol withdrawal, d-ROMs were significantly higher (p<0.0001) in heavy drinkers than in controls: 368.5 (254.8-718.6) U.CARR vs 245 (200.7-360) U.CARR, respectively, median with range. Plasma homocysteine were significantly higher in alcoholics than in moderate drinkers (p<0.0001): 18 (9.5-82.2) micromol/L vs 9.1 (4.9-19.6) micromol/L, respectively. Heavy drinkers also exhibited higher serum thiols than moderate drinkers (p<0.003): 605.8 (448.2-717.7) micromol/L vs 554.8 (508.3-658.4) micromol/L, respectively. The patients showed lower plasma folate than controls (p<0.0001): 4.1 (1.9-9.7) ng/mL vs 8.8 (5.0-8.4) ng/mL, respectively, but similar vitamin B12 levels: 487 (299-786) pg/mL 621 (243-894) pg/mL. A negative correlation between homocysteine and folate was observed before withdrawal in alcoholics (r=-0.4546, p<0.038). Both serum thiols (549.7 micromol/L, range 402.4-616.6 micromol/L) and homocysteinemia (6.6 micromol/L, range 2.9-18.5 micromol/L) were significantly decreased (p<0.0001 and p<0.022, respectively) after a week of alcohol withdrawal and folate administration. CONCLUSION: Our findings show that both enhanced pro-oxidant activity and a derangement of methionine metabolism can be observed in heavy drinkers before alcohol withdrawal and folate administration. Furthermore, folate seems to be a strong determinant of both plasma homocysteine and thiol concentrations.

Increased erythrocyte glutathione peroxidase activity and serum tumor necrosis factor-alpha in HIV-infected patients: relationship to on-going prothrombotic state.

A condition of oxidative stress, due to perturbation of oxidant/antioxidant balance, has been suggested to play a role not only in the pathogenesis of human immunodeficiency virus (HIV) infection, but also in the promotion of a thrombophilic condition. Because various hemostatic dysfunctions usually considered as risk factors for thrombotic events were reported in HIV infection, this study was undertaken to investigate whether the oxidative phenomenon could promote a prothrombotic state in such condition. Erythrocyte glutathione peroxidase (GSH-Px), the major free-radical scavenger enzyme, and serum tumor necrosis factor-alpha (TNF-alpha) were evaluated in 33 consecutive HIV-infected out-patients and 35 matched HIV-negative healthy controls at a distance of any acute episode. Thrombin generation was explored by measuring the plasma levels of prothrombin fragment 1 + 2 (F1 + 2), whereas fibrin degradation products (D-dimer) and plasminogen activator inhibitor (PAI-1) activity were evaluated as indices of plasmin activity and fibrinolytic derangement. The anticoagulant pathway was investigated by measuring the plasma levels of antithrombin and protein C. Erythrocyte GSH-Px activity and serum TNF-alpha were significantly higher in HIV-infected patients when compared to controls. F1 + 2, D-dimer, and PAI-1 activity were increased in HIV-infected patients by comparison with controls. Normal antithrombin, but decreased protein C, was instead detected in HIV-infected patients. In the latter patients, serum TNF-alpha negatively correlated with both erythrocyte GSH-Px activity and plasma D-dimer. On the other hand, a positive correlation was shown between F1 + 2 and D-dimer and between D-dimer and GSH-Px activity. Furthermore, a trend toward increasing levels of GSH-Px with increasing PAI-1 activity was reported. These findings suggest a relationship between erythrocyte oxidative stress and the hypercoagulable condition during HIV infection.

Performance and clinical application of a new, fast method for the detection of hydroperoxides in serum.

BACKGROUND: Evidence has increased suggesting that a condition of oxidative stress, due to imbalance of oxidative/antioxidant systems, can produce alterations in important biological functions as a consequence of free radicals reactivity towards proteins, lipids, and DNA. Hence the possibility of accurately measuring the oxidative state in a biological system in a simple manner could be of fundamental importance for clinical diagnostics. METHODS: A new, spectrophotometric assay ("d-ROMs test", Diacron s.r.l., Grosseto, Italy), which allows the measurement of reactive oxygen metabolites derivatives, such as hydroperoxides, has been evaluated. RESULTS: The "d-ROMs test" showed good precision, accuracy and linearity. Mean serum d-ROMs above the normal range (344.5 +/- 68.3 U.CARR., mean +/- SD) were detected in a group of heavy drinkers, and well correlated with both g-GT (r=0.44, p<0.04) and MCV (r=0.73, p<0.000), usually considered as biochemical markers of alcohol abuse. CONCLUSIONS: The new test for the measurement of endogenous hydroperoxides proved to be simple, reliable, and cheap. Furthermore, it can be easily applied on automated analyzers. Then it could be used as an early index of oxidative damage, which precedes and partly contributes to degenerative process that affects cell membranes and other lipid containing structures.

Effects of moderate and high doses of alcohol on carotid atherogenesis.

The role of alcohol consumption on pathophysiology of atherosclerosis is not completely well established. Past studies were conducted with different methodological approaches, sometimes leading to opposing conclusions. The aim of this study was to determine the weight of alcohol intake on carotid atherosclerosis in a group of subjects asymptomatic for cardio-cerebrovascular diseases. They were examined by ultrasonographic assessment during the period 1993 through 1997. Common risk factors of atherosclerosis and drinking habit were assessed by a standardized questionnaire. In this survey we confirm the J-shaped relationship between atherosclerosis and alcohol consumption. The effect of alcohol intake is more evident if we consider the presence of multiple internal carotid stenosis, or those greater than 25%, as outcome variables. These effects are independent from the other risk factors included in logistic regression paradigms (age, arterial hypertension, dyslipidemia, diabetes mellitus, family history of cardio-cerebrovascular disease, smoking and social status). Our study supported that a high level of alcohol intake plays a role as an independent factor in carotid atherogenesis.

Oxidative stress and a thrombophilic condition in alcoholics without severe liver disease.

BACKGROUND AND OBJECTIVES: The degree of oxidative stress and its association with a thrombophilic condition, if any, were investigated in alcoholics before the onset of severe liver disease. DESIGN AND METHODS: Reactive oxygen species and total antioxidant capacity were evaluated using two new kinetic spectrophotometric methods in a selected group of 45 consecutive chronic alcohol abusers and 42 apparently healthy moderate drinkers, used as controls. The hemostatic system was explored by detecting the plasma levels of prothrombin fragment 1+2 (F1+2) and thrombin-antithrombin complexes (TAT) with enzyme-linked immunosorbent assays, while D-dimer plasma levels were measured with a turbidimetric immunoassay. RESULTS: Reactive oxygen species were significantly higher (p<0.001) in heavy drinkers than in controls: 328.1 (143.4-847.2) U.CARR vs 250 (200.7-366.8) U.CARR, respectively. The total antioxidant capacity was similar in chronic alcohol abusers and in moderate drinkers: 360.2 (336.8-374.4) microMol HClO/mL vs 369 (362-378.4) microMol HClO/mL, respectively. All molecular markers of hemostatic system activation were significantly increased in chronic alcohol abusers in comparison with those in moderate drinkers, as follows: TAT: 2.5 (1.4-13) microg/L vs 1.5 (1-4.1) mocrog/L, respectively (p<0.001); F1+2: 1.7 (0.5-5.2) nMol/L vs 0.9 (0.4-1.1) nMol/L, respectively (p<0.01); D-dimer: 235.5 (208-462) ng/mL vs 163.5 (71-233) ng/mL, respectively (p<0.001). INTERPRETATION AND CONCLUSIONS: Our results suggest that oxidative stress and a thrombophilic condition can be observed in heavy drinkers without severe liver disease. The new test available for measuring reactive oxygen species in serum proved to be reliable and useful as an early marker of tissue damage.

[Food intake and nutritional status in a group of healthy elderly residing in a nursing home]. / Valutazione dello stato di nutrizione e degli intake alimentari in un gruppo di anziani autosufficienti residenti in una residenza sanitaria assistenziale.

BACKGROUND: Aging is accompanied by a variety of economic, psychologic, and social changes that can compromise the nutritional status. Nutrition is an important aspect of healthful behaviour and a major component of general wellbeing of individuals throughout their life cycle. Nutritional intake appears to be an important factor contributing to aging. So, the purpose of this project was to evaluate diet and nutritional status. METHODS: Fifty-one healthy elderly subjects aged 70 years and older (31 F and 20 M), residing in a nursing home have been studied. Nutrient intake was assessed using 24-hour recalls; nutritional status was assessed using anthropometric measurements. The nutrient intakes for individuals were compared with the Italian Recommended Dietary Allowances (RDAs). RESULTS: Mean energy intake was 1,625 kcal; the average percentages of carbohydrate, protein, and fat were 54%, 16%, and 30%, respectively. The mean vitamin and mineral intake for participants met the RDAs except for calcium and selenium intakes. The mean fibre intake was low. The analysis of food products intake indicated that the above mentioned inadequacy in nutrient intake was the result of low consumption of milk and milk products containing calcium and a low consumption of integral foods or fruits containing fibre. CONCLUSIONS: The significance of sound nutrition education and the adverse impact of consumer misinformation about the benefits of these food choices becomes clear with the recognition that nutritional status influences the rate of physiologic and functional declines with age. This approach will require new efforts in consumer education sensitive to the needs and beliefs of older people.

[Dietary restriction and oral administration of antioxidant and omega-3: what are the effects on the clinical variables in a group of obese women?]. / La dietoterapia ipocalorica bilanciata personalizzata ed il trattamento con integratori a base di antiossidanti e omega-3 (quali gli effetti sulle variabili cliniche di outcome in un gruppo di donne in sovrappeso?)

BACKGROUND: Obesity is now recognized as a major risk factor for many pathologies. The state of obesity is associated with an increase in reactive oxygen species; persistent overconsumption of calories in the obese may be exposing them to excessive damage besides maintaining the state of obesity. It is possible that dietary modification and association with assumption of antioxidant and omega-3 oral integration contributes to a reduction in reactive oxygen species generation and a corresponding reduction in indexes of oxidative damage, including lipid peroxidation. METHODS: Given this back-ground, the pro/anti-oxidant balance, biochemical parameters and the body composition were studied in two groups of obese women: a first group of 10 obese women were studied before and after eight weeks of dietary restriction and a second group of 12 obese women were studied before and after eight weeks of dietary restriction and oral administration of antioxidant and omega-3. RESULTS: In summary, as regards the preliminary results of clinical outcome parameters, interestingly enough the glycemic levels fall markedly in association with both dietary restriction and oral integration with antioxidant and omega-3. Another important finding of this study is that of calcium levels and phase angle (measured by impedenzometry) increase in the group treated with dietary restriction and oral administration of antioxidant and omega-3. CONCLUSIONS: Studies that aimed to explore whether oxidative status predicts clinical outcome would provide important details on the putative link between oxidative status and state of obesity.

Adipose tissue and cytokines.

Adipose tissue is not simply a storage depot for excess energy intake, it is also able to produce and release several substances with local (autocrine) and systemic (endocrine) actions. An up-to-date review of our knowledge in this area is given here. Several of the compounds deriving from adipose tissue have been shown to play a role in obesity-related health complications. The production of cytokines, such as Tumor Necrosis Factor-alpha (TNF-alpha), IL-6, and leptin, is implicated in the development of several disorders. Insulin resistance is one of the most clinically significant.

Biological variability of myoglobin in healthy elderly and younger subjects.

To study the effect of age on serum myoglobin more clearly, the analytical, intra-individual and inter-individual components of variation were estimated from duplicate analyses of specimens collected from 18 healthy elderly subjects [ages 74-97 years; 9 men (EM)], and 14 healthy younger subjects [ages 25-31 years; 7 men (YM)] over a period of 6 weeks. The mean values (microgram/L) were EM: 53.7; EW: 44.9; YM: 34.2; YW:24.8. Estimated analytical (CVA), intra- (CVI) and inter-individual (CVG) variations as CV% were: CVA: 2.2. CVI: EM: 13; EW: 9.9; YM: 12.4; YW: 9.6. CVG: EM: 37.6; EW: 28; YM: 18.5; YW: 13.4. The data obtained were used to derive the desirable analytical goal for imprecision (i.e., < or = 6.5% in EM; < or = 4.9% in EW and < or = 6.2% in YM; < or = 4.8% in YW); inaccuracy (i.e., < or = 9.9% in EM; < or = 7.7 in EW and < or = 5.5% in YM; < or = 4.12% in YW); the change required for serial results to be significantly different (i.e., 36% in EM; 28% in EW and 34% in YM; 27.2% in YW), the numbers of specimen collections required to produce a more precise estimate of the homeostatic set point of an individual within 5% (i.e., 26 in EM; 16 in EW and 24 in YM; 15 in YW), and the index of individuality (i.e., 0.34 in EM; 0.35 in EW and 0.67 in YM; 0.71 in YW). This study shows that intra-individual biological variation of myoglobin in healthy elderly subjects is not different from that in young subjects. Inter-individual variation, instead, is greatly influenced by differences in age and sex.

Biological variation in protein C, protein S and antithrombin concentrations in plasma of healthy subjects.

The analytical, intra- and inter-individual components of biological variation were estimated for protein C, protein S and antithrombin over a period of 6 weeks in a cohort of 17 apparently healthy subjects. Expressed as percentage activity (protein C and antithrombin) as a percentage concentration in normal human plasma (protein S), the mean values for men and women show no significant differences (p > 0.05) for any of the analytes studied. Calculated analytical goals (CV, %) for precision required for optimal patient care are: protein C, 2.9; protein S, 2.9 and antithrombin 2.7. A single numerical index, called "index of fiduciality", was also calculated to demonstrate that the analytical performance of our method was satisfactory. The generally applicable differences (% activity or % concentration) required for two results to be significantly different (p < or = 0.05) were calculated as: protein C, 17; protein S, 16 and antithrombin, 16. The usefulness of critical differences as guidelines for the interpretation of changes in serial results was investigated using an "index of heterogeneity" of intra-individual variation. The marked degree of individuality demonstrated for all the quantities indicates that, if conventional population-based ranges are used uncritically, major changes in analyte concentration may not be correctly identified for some patients, because observed values continue to lie within the reference range. The utility of conventional population-based reference intervals was determined by calculating a single numerical index, called "index of individuality". For protein C, protein S and antithrombin we found that five of a patient's specimens are required to achieve a 95% chance that the mean is within +/- 5% of the true value.

Fibrinolytic parameters in patients undergoing total hip replacement: relationship with the development of asymptomatic deep vein thrombosis and diagnostic usefulness of venous occlusion.

BACKGROUND AND OBJECTIVE: It has been suggested that impaired fibrinolytic activity contributes to deep vein thrombosis in orthopedic surgery. Studying the fibrinolytic system following venous occlusion has been proposed as a good method of detecting the risk of this postoperative complication. The objective of this work was to verify whether venous occlusion represents a reliable method of detecting an impaired fibrinolytic response after total hip replacement. METHODS: Thirty-two consecutive patients undergoing total hip replacement were studied. Citrated blood samples were taken from each patient the day before surgery and on postoperative days 1, 3, and 7, before and after venous occlusion, in order to evaluate plasma levels of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1). All patients underwent bilateral phlebography 10 days after surgery. RESULTS: Seven out of 32 patients (21.9%) developed deep venous thrombosis (DVT) according to the venographic test. After surgery, an increase in t-PA antigen levels was detected both in patients who developed DVT and in those who did not, with a significant increase on the first and seventh days after surgery only in the non-DVT group. After 10-min venous occlusion, t-PA antigen levels increased at all postoperative recordings in both groups of patients, but most significantly on days 1 and 7 after surgery. PAI-1 antigen plasma levels, when measured before venous occlusion, increased only in non-DVT patients on the seventh postoperative day. After venous occlusion, a difference was found between the two groups only postoperatively on day 7 with regard to PAI-1 levels. INTERPRETATION AND CONCLUSIONS: According to our results, no impaired fibrinolytic response was found in DVT patients. In addition, venous stasis seems to give no further information with respect to basal values in the early detection of postoperative thromboembolic complications in orthopedic patients.

Reference values of neuroactive amino acids in the cerebrospinal fluid by high-performance liquid chromatography with electrochemical and fluorescence detection.

Sampling and HPLC analysis procedures for CSF amino acid determinations were evaluated. In order to increase sensitivity, a precolumn derivatization of amino acids by o-phthalaldehyde-mercaptoethanol reagent was used. By using fluorimetric and electrochemical detection in series, positive peak identification can be obtained in a single chromatographic run. It is recommended to analyze freshly collected CSF. Amino acids are stable for short periods over a wide range of temperature, but storage at -80 degrees C is recommended. The CSF samples for the calculation of the reference values were taken from 40 healthy subjects, hospitalized for lumbar disk herniation, placed on the same diet and kept drug-free for at least 1 week. The mean values (mumol/l) and the ranges (in parentheses) were: 0.27 (0.09-0.63), 0.62 (0.18-1.15), 5.32 (3.05-11.50), 6.16 (2.90-13.30), 0.16 (0.03-0.22) for aspartic acid, glutamic acid, glycine, taurine and gamma-aminobutyric acid respectively.