Delay in the fine-tuning of locomotion in infants with meconium positive to biomarkers of alcohol exposure: a pilot study.

INTRODUCTION: Prenatal alcohol exposure causes a variety of impairments to the fetus called Fetal Alcohol Spectrum Disorders (FASD). Since it is very difficult to identify women that consume alcohol during pregnancy, different methods have been studied to evaluate alcohol exposure. Ethyl Glucuronide (EtG) and Fatty Acid Ethyl Esters (FAEEs) are commonly used to measure alcohol consumption in individuals at-risk for alcohol abuse, including pregnant women. MATERIALS AND METHODS: We conducted a study of two cohorts of 1.5 year-old infants (of mothers without a history of alcohol abuse) with or without meconium samples positive to both EtG and FAEEs and we evaluated their cognitive-behavioral development by the Griffiths Mental Developmental Scale (GMDS) method. Our protocol included 8 infants with meconium positive to alcohol metabolites (EtG and FAEEs) and 7 with meconium negative to alcohol metabolites. RESULTS: None of the 8 alcohol metabolites positive meconium infants exhibited distinctive facial features and growth retardation of severe FASD, showing that other factors may contribute to the FASD onset but elevations in EtG and FAEEs in the meconium were significantly associated with disrupted neurodevelopment and adaptive functions within the first year and a half of life. Indeed, we found out that infants with meconium positive for both EtG and FAEEs, although without displaying any FASD morphological features, had a delay in the fine regulation of their own locomotory capabilities. CONCLUSIONS: Further analyses and larger studies are needed to estimate the right link between prenatal alcohol exposure and the different range of disorders connected but this study provides an additional step in the field of FASD in order to suggest early treatments for at-risk newborns and infants.

Diagnosis of alcohol use disorder from a psychological point of view.

Alcohol use disorder (AUD) is one of the most common psychiatric disease in the general population, characterized by having a pattern of excessive drinking despite the negative effects of alcohol on the individual's work, medical, legal, educational, and/or social life. Currently, the bio-psycho-social model describes properly AUD as a multidimensional phenomenon including biological, psychological, and socio-cultural variables affecting the nature, maintenance, and expression of the disorder. The AUD diagnostic process is crucial since the treatment success depends heavily on the accuracy and the adequacy of the diagnosis. The diagnosis is based on a comprehensive assessment of the patient's characteristics and uses interviews and psychometric instruments for collecting information. This paper will provide insights into the most important psychological dimensions of AUD and on the best psychometric instruments for proposing AUD diagnosis.

Treatment of alcohol use disorder from a psychological point of view.

The development of a treatment for alcohol use disorder (AUD) is a crucial and complex moment. Indeed, the information gathered by a team of professionals (physicians, psychologists and social workers) (bio-psycho-social model of AUD) interact to choose the most appropriate cure. As for AUD psychological treatment, it is of considerable importance to avoid clinical treatments leading to drop-out for improving the patients quality of life. Psychoanalytic and behavioral techniques were early utilized as psychological treatment of AUD, however, evidence-based approaches as motivational interviewing (MI) and cognitive behavioral therapy (CBT) are recently used in AUD. In this work we review the more effective and appropriate AUD psychological treatments.

Group Membership and Adolescents' Alcohol Intake: The Role of Drinking Motives.

OBJECTIVE: Group norms and drinking motives are crucial predictors of adolescents' alcohol intake. The current study examined the role of drinking motives in the association between descriptive group norms and alcohol intake. METHOD: A sample of 525 Italian adolescents (56% men) was surveyed. Participants completed measures of group norms, drinking motives, and personal drinking. RESULTS: Hierarchical multiple regression analysis revealed that stronger group norms were positively related to increased alcohol intake. Drinking for enhancement and social motives also were related to increased alcohol intake. Mediation analysis showed that group norms were related to alcohol intake through social and enhancement drinking motives. CONCLUSIONS: Drinking motives provide fruitful insights into the relationship between descriptive group norms and excessive alcohol use among adolescents. Implications for future research are discussed.

Maternal risk factors for fetal alcohol spectrum disorders in a province in Italy.

BACKGROUND: Maternal risk factors for fetal alcohol spectrum disorders (FASD) in Italy and Mediterranean cultures need clarification, as there are few studies and most are plagued by inaccurate reporting of antenatal alcohol use. METHODS: Maternal interviews (n = 905) were carried out in a population-based study of the prevalence and characteristics of FASD in the Lazio region of Italy which provided data for multivariate case control comparisons and multiple correlation models. RESULTS: Case control findings from interviews seven years post-partum indicate that mothers of children with FASD are significantly more likely than randomly-selected controls or community mothers to: be shorter; have higher body mass indexes (BMI); be married to a man with legal problems; report more drinking three months pre-pregnancy; engage in more current drinking and drinking alone; and have alcohol problems in her family. Logistic regression analysis of multiple candidate predictors of a FASD diagnosis indicates that alcohol problems in the child's family is the most significant risk factor, making a diagnosis within the continuum of FASD 9 times more likely (95%C.I. = 1.6 to 50.7). Sequential multiple regression analysis of the child's neuropsychological performance also identifies alcohol problems in the child's family as the only significant maternal risk variable (p < .001) when controlling for other potential risk factors. CONCLUSIONS: Underreporting of prenatal alcohol use has been demonstrated among Italian and other Mediterranean antenatal samples, and it was suspected in this sample. Nevertheless, several significant maternal risk factors for FASD have been identified.

Fetal Alcohol Spectrum Disorder (FASD): neurobehavioral profile, indications for diagnosis and treatment.

It is now known that exposure to alcohol in utero produces a wide spectrum of morphological and behavioural outcomes in the offspring, commonly referred as fetal alcohol spectrum disorders (FASD). A large body of literature documents cognitive deficits and behavioural-emotional difficulties in children with FASD. Researchers have found that individuals with FASD often experience a range of adverse life outcomes, called secondary disabilities, which include disrupted school experience, troubles with the law, confinement, inappropriate sexual behaviours on repeated occasions, and alcohol/drug related problems. Additionally, despite considerable data published on cognitive and behavioural disabilities in children with FASD, relatively little information is available on behavioural or pharmacological interventions for alcohol affected children. This paper will provide a comprehensive review of the neuropsychological and behavioural effects of prenatal alcohol exposure, including a discussion of the emerging neurobehavioral profile. Finally, we will summarize published intervention studies of FASD focusing on their strengths and weaknesses.

Prevalence of children with severe fetal alcohol spectrum disorders in communities near Rome, Italy: new estimated rates are higher than previous estimates.

OBJECTIVE: To determine the population-based epidemiology of fetal alcohol syndrome (FAS) and other fetal alcohol spectrum disorders (FASD) in towns representative of the general population of central Italy. METHODS: Slightly revised U.S. Institute of Medicine diagnostic methods were used among children in randomly-selected schools near Rome. Consented first grade children (n=976) were screened in Tier I for height, weight, or head circumference and all children≤10th centile on one of these measurements were included in the study. Also, teachers referred children for learning or behavioral problems. Children meeting either of these two criteria, along with randomly-selected controls, advanced to Tier II which began with a dysmorphology examination. Children with a possible FASD, and controls, advanced to Tier III for neurobehavioral testing, and their mothers were interviewed for maternal risks. Final diagnoses using indicators of dysmorphology, neurobehavior, and maternal risk were made in formally-structured, interdisciplinary case conferences. RESULTS: Case control comparisons of physical, neurobehavioral, and maternal risk variables are presented for 46 children with an FASD and 116 randomly-selected controls without a diagnosis on the FASD continuum. Rates of diagnoses within the FASD continuum are then estimated from these in-school data via three different methods. The range of rates of FAS produced by these methods is between 4.0 to 12.0 per 1,000; Partial FAS ranges from 18.1 to 46.3 per 1,000; and an FASD was found in 2.3% to 6.3% of the children. CONCLUSIONS: These rates are substantially higher than previous estimates of FAS and overall FASD for the general populations of Western Europe and the U. S., and raise questions as to the total impact of FASD on mental deficit in mainstream populations of Western Europe and the United States where the majority are middle class and are not believed to be characterized by heavy episodic drinking.

Mushroom tyrosinase in polyelectrolyte multilayers as an optical biosensor for o-diphenols.

Determination of phenolic derivatives is very important in medical, food and environmental samples because of their relevant significance in health care and pollution monitoring. Tyrosinase-based biosensors are promising tools for this purpose because of several advantages with respect to currently used detection methods. A key aspect in the development of a biosensor is the effective immobilization of the enzyme. In this work, ordered tyrosinase films on an optical transparent support were immobilized by a "layer-by-layer" (LbL) assembly, alternating the enzyme with the polycation polymer poly(dimethyldiallylammonium chloride). As confirmed by UV-vis spectroscopy, the LbL deposition allowed a high loading of enzyme. The immobilized tyrosinase functionality was proven and its kinetic parameters were spectrophotometrically determined. The prepared biosensor was used to optically detect the o-diphenolic compound l-3,4-dihydroxyphenyl-alanine (L-DOPA) and exhibited good repeatability and time stability. The sensing properties of the system were studied by means of both absorption and fluorescence spectroscopy. The bioassay based on the absorbance measurements gave a LOD of 23 microM and a linear response up to 350 microM. The bioassay based on the fluorescence measurements gave a LOD of 3 microM and a linear response in the range of tens of micromolar (the exact value depends on the number of mushroom tyrosinase layers). Biosensor sensitivity could be modulated varying the number of the immobilized enzyme layers.

Neuropsychological characteristics of Italian children with fetal alcohol spectrum disorders.

BACKGROUND: Children with fetal alcohol spectrum disorders (FASD) display many problems ranging from deficits in intelligence to behavioral difficulties. Thus, many studies have aimed at defining the neuropsychological characteristics of children with FASD. The current article describes the neuropsychological characteristics of Italian children with severe diagnosis within FASD and compares them with controls. It was expected that intellectual functioning, language comprehension, academic skills, and inattention/hyperactivity would discriminate children with FASD from randomly selected peers without FASD. METHODS: This article presents data from a second cohort of children examined in 2005 as part of an in-school epidemiological study of FASD in Italy. Of 80 children, 23 diagnosed with a FASD, and 57 randomly selected control children from the same first-grade classes, participated. After screening for FASD via growth and dysmorphology, the children were administered a test of general intelligence (WISC-R) as well as tests of nonverbal reasoning (Raven Colored Progressive Matrices), language comprehension (Rustioni), academic achievement (IPDA), and problem behavior (Disruptive Behavior Disorder Rating Scale). RESULTS: Children diagnosed with a FASD achieved lower scores than control children on Verbal, Performance, and Full Scale IQ. Profile analysis of the WISC-R indicates overall differences between the groups. However, some intact functioning within the FASD group was found, as the Similarities and Vocabulary subtests were similar to the controls. After an alpha adjustment to 0.004, the Block Design, Object Assembly, and Mazes subtests were significantly different from controls. On tests of nonverbal reasoning, language comprehension, and academic achievement, the children with a FASD scored significantly lower. Moreover, teachers rated children with a severe diagnosis within FASD as showing more inattentive symptoms than controls, while hyperactive/impulsive characteristics among children with a FASD were comparable with the control children. Significant correlations between head circumference, child dysmorphology, WISC-R, and Raven CPM scores are also reported. CONCLUSIONS: This study indicates that a sample of Italian children with a FASD, when compared with control children, display poorer functioning on measures of general intelligence, nonverbal reasoning, academic achievement, and teacher-rated problem behaviors. The findings also contribute to the formulation of a neuropsychological profile of children diagnosed with a FASD.

Structure of SDS micelles with propylene carbonate as cosolvent: a PGSE-NMR and SAXS study.

The effect of propylene carbonate on SDS micelles was investigated by means of pulsed gradient spin-echo (PGSE) NMR, small-angle X-ray scattering (SAXS), conductivity and ion-selective electrode (ISE) measurements. The knowledge of the cosolvent partition between continuous phase and micelles (obtained by means of PGSE-NMR) allowed the identification of relevant dilution paths. Along these paths the system is composed of identical micelles that become more and more diluted. The extrapolation of measured self-diffusion coefficient to infinite dilution (where direct and hydrodynamic interactions are negligible) permits the determination of hydrodynamic size of the micelles. Moreover, the micelle ionization degree (measured by means of ISE) combined with PGSE-NMR and conductivity data furnishes an estimate of the aggregation number without any assumptions on micellar shape. On the other hand, troublesome hydrodynamic interactions are irrelevant to SAXS, and scattering data collected at fixed composition can be analyzed according to a reasonable model by exploiting the insight on the propylene carbonate partition gained through PGSE-NMR. By means of these approaches, we have found that propylene carbonate acts mainly as cosurfactant for the SDS micelles, decreasing their size and aggregation number by increasing the mean headgroup area of SDS.

Neurobehavioral characteristics of children with fetal alcohol spectrum disorders in communities from Italy: Preliminary results.

BACKGROUND: There has been considerable effort expended on defining neurobehavioral characteristics of children with fetal alcohol spectrum disorders (FASD). Children with FASD display a range of cognitive deficits and behavioral problems. In this article, we report on the neurobehavioral characteristics of children with FASD in selected communities in Italy. It was expected that both inattentive and hyperactive/impulsive characteristics would discriminate children with FASD from controls and that the groups would also differ on intellectual functioning, language comprehension, and academic skills. METHODS: Eighty-two children, 22 diagnosed with FASD and 60 control children, participated in this study. The children were administered tests of nonverbal reasoning, language comprehension, academic achievement, and behavior. RESULTS: On tests of nonverbal reasoning and language comprehension, the FASD group earned lower scores than did controls. Moreover, on a test of academic achievement the FASD group scored lower. When comparing these 2 groups on disruptive behavioral symptomatology, similar results were obtained, the FASD group showing greater attentional difficulties and hyperactivity/impulsivity behaviors and more overall behavioral problems. Stepwise logistic regression analysis showed that a model containing inattention and error scores on the language comprehension task correctly classified 85% of the participants. Compared with the control group, a significantly greater proportion of children with FASD met the Diagnostic and Statistical Manual of Mental Disorders-fourth edition (DSM-IV) criteria of ADD, inattentive type, as reported by teachers. In contrast, hyperactive symptoms among children with FASD were comparable with the control group. Teachers rated children with FASD as having more inattentive behaviors and as performing lower in academic skills than controls. The association between reported hyperactivity symptoms and achievement scores was nonsignificant for both language and math scores, suggesting that it is not the hyperactivity causing problems, but the child's inattention. CONCLUSIONS: This research indicates that a nonclinic-referred sample of Italian children with FASD display a profile of neurobehavioral functioning consistent with that reported by other researchers. Furthermore, the neurobehavioral characteristic most identified with children diagnosed with FASD was inattention followed by hyperactivity.

Epidemiology of FASD in a province in Italy: Prevalence and characteristics of children in a random sample of schools.

BACKGROUND: Accurate estimates of the prevalence and characteristics of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) in a Western European population are lacking and are of particular interest in settings where the usual pattern of alcohol consumption is thought to be daily drinking with meals. To address these issues, an epidemiology study of FAS and other FASD was undertaken in Italian schools. METHODS: Primary schools (n = 25) in 2 health districts of the Lazio region were randomly selected and recruited for the study. Five hundred forty-three children, 50% of those enrolled in first-grade classes, received parental permission to participate in a 2-tiered, active case ascertainment screening process. Detailed evaluation of children selected in a preliminary screening phase was carried out on those who were small for height, weight, and head circumference and/or referred by teachers for suspected learning and behavioral problems. Detailed evaluation was carried out on each child's: (1) physical growth and dysmorphology, (2) psychological development and behavior, and (3) prenatal exposure to alcohol and other risk factors for FASD via maternal interviews. A group of 67 randomly selected children without FASD from the same classes was utilized as a comparison group. RESULTS: Using 2 denominators for prevalence estimation, a conservative one and a strict sample-based estimate, the prevalence of FAS in this province of Italy was 3.7 to 7.4 per 1,000 children. When cases of partial FAS (PFAS) and a case of alcohol-related neurodevelopmental deficits (ARND) were added to FAS cases, the rate of FASD was 20.3 to 40.5 per 1,000 and estimated at 35 per 1,000 overall or between 2.3 and 4.1% of all children. This exceeds previously published estimates of both FAS and FASD for the western world. Detailed data are presented that demonstrate the utility of the guidelines of the revised Institute of Medicine diagnostic criteria for FASD. Children with FASD are significantly more impaired/affected (p < 0.05) than randomly selected comparison children on all measures of growth deficiency, key facial features of FASD, overall dysmorphology scores, language comprehension, nonverbal IQ, and behavior. Maternal reports of current drinking were significantly higher for mothers of FASD children than comparison mothers, but reported rates of overall drinking during pregnancy were not significantly different. In contrast to expectations, daily drinking among mothers of the comparison group was not common. However, dysmorphology scores of the children were significantly correlated with drinking in the second and third trimesters, drinks per current drinking day, and current drinks per month. Finally, children with the physical features of FASD had lower IQs; nonverbal IQ was significantly correlated with head circumference and negatively correlated with overall dysmorphology score, smooth philtrum, and several other facial and physical anomalies characteristic of FAS. CONCLUSIONS: Using careful measures of ascertainment in a primary school setting, these results provide relatively high estimates of the prevalence of FASD and raise the question of whether FASD is more common in the western world than previously estimated.

Fetal alcohol syndrome disorders: experience on the field. The Lazio study preliminary report.

In Italy, little is known about the problems related to alcohol drinking during pregnancy. In this paper, the Italian literature about this subject is briefly reviewed. This first Italian experience of a field study, aimed to the assessment of the prevalence of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) in an area in the Rome province (Lazio region) is reported. This in-field study was performed in the school years 2003-2004 and 2004-2005 in cooperation with American researchers, most from University of New Mexico (Albuquerque), and Italian researchers from University "la Sapienza" of Rome. First grade children (n(o) = 1,086) of primary school were contacted to enter in the in-school study for the detection of FAS and FASD and were examined by the experts team of clinicians, pediatrics, psychologists. Preliminary consideration and the implications of this study for FASD prevention are discussed.

Nanostructured fluids based on propylene carbonate/water mixtures.

The microstructure of aggregates formed by sodium dodecyl sulfate (SDS) and 1-pentanol in mixtures of water and a polar aprotic solvent (propylene carbonate, PC) was investigated by means of pulsed gradient spin-echo NMR, dynamic light scattering, viscosity, and conductivity measurements. PC partitions itself between micelles and aqueous bulk. The fraction of micellized propylene carbonate remains constant along PC-dilution, and the phase separation takes place when the composition of continuous phase attains the PC/water miscibility gap. The micellized PC is present mainly in the micelle's palisade and strongly increases the total interfacial area, thus acting as a cosurfactant. At high PC content, the system is composed by very small aggregates (around 10 A in radius) made by few SDS molecules (10-6) and PC and pentanol. The resulting system can be described as a nanostructured fluid with a huge interfacial area and a small dispersed phase.

[Alcohol and women: clinical aspects]. / Alcol e donna: aspetti clinici.

Alcohol-related pathologies lead to most serious expressions, both at clinical and social level. The diffused social acceptance of consumption and abuse behavior and the lack of alcohol education for professionals (physicians, psychologists, social workers etc.) make difficult to put in the right frame this issue. Just a multidimensional approach can make the problem understandable. The history of alcohol consumption during the time gives us an exhaustive picture of the negative consequences of alcohol consumption. Alcohol consumption during pregnancy is a problem still underestimated and represents a serious risk for the health of the newborns: children alcohol-exposed in uterus are at risk to develop many pathologies and even the fetal-alcohol syndrome (FAS) that leads to facial anomalies, growth deficiencies and neurological damages. Therefore interventions coping with this kind of issues are needed in order to enhance people's health.