Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood.

BACKGROUND: To develop latent classes of exposure to traumatic experiences before the age of 13 years in an urban community sample and to use these latent classes to predict the development of negative behavioral outcomes in adolescence and young adulthood. METHOD: A total of 1815 participants in an epidemiologically based, randomized field trial as children completed comprehensive psychiatric assessments as young adults. Reported experiences of nine traumatic experiences before age 13 years were used in a latent class analysis to create latent profiles of traumatic experiences. Latent classes were used to predict psychiatric outcomes at age ⩾13 years, criminal convictions, physical health problems and traumatic experiences reported in young adulthood. RESULTS: Three latent classes of childhood traumatic experiences were supported by the data. One class (8% of sample), primarily female, was characterized by experiences of sexual assault and reported significantly higher rates of a range of psychiatric outcomes by young adulthood. Another class (8%), primarily male, was characterized by experiences of violence exposure and reported higher levels of antisocial personality disorder and post-traumatic stress. The final class (84%) reported low levels of childhood traumatic experiences. Parental psychopathology was related to membership in the sexual assault group. CONCLUSIONS: Classes of childhood traumatic experiences predict specific psychiatric and behavioral outcomes in adolescence and young adulthood. The long-term adverse effects of childhood traumas are primarily concentrated in victims of sexual and non-sexual violence. Gender emerged as a key covariate in the classes of trauma exposure and outcomes.

Smoking quit success genotype score predicts quit success and distinct patterns of developmental involvement with common addictive substances.

Genotype scores that predict relevant clinical outcomes may detect other disease features and help direct prevention efforts. We report data that validate a previously established v1.0 smoking cessation quit success genotype score and describe striking differences in the score in individuals who display differing developmental trajectories of use of common addictive substances. In a cessation study, v1.0 genotype scores predicted ability to quit with P=0.00056 and area under receiver-operating characteristic curve 0.66. About 43% vs 13% quit in the upper vs lower genotype score terciles. Latent class growth analyses of a developmentally assessed sample identified three latent classes based on substance use. Higher v1.0 scores were associated with (a) higher probabilities of participant membership in a latent class that displayed low use of common addictive substances during adolescence (P=0.0004) and (b) lower probabilities of membership in a class that reported escalating use (P=0.001). These results indicate that: (a) we have identified genetic predictors of smoking cessation success, (b) genetic influences on quit success overlap with those that influence the rate at which addictive substance use is taken up during adolescence and (c) individuals at genetic risk for both escalating use of addictive substances and poor abilities to quit may provide especially urgent focus for prevention efforts.

Treatment with PB125® Increases Femoral Long Bone Strength in 15-Month-Old Female Hartley Guinea Pigs.

Nuclear factor-erythroid 2-related factor-2 (Nrf2) is a transcription factor that serves as a master regulator of anti-inflammatory agents, phase I xenobiotic, and phase II antioxidant enzymes, all of which provide a cytoprotective role during disease progression. We hypothesized that oral administration of a purported phytochemical Nrf2-activator, PB125®, would increase long bone strength in aging Hartley guinea pigs, a model prone to musculoskeletal decline. Male (N = 56) and female (N = 56) guinea pigs were randomly assigned to receive daily oral treatment with either PB125® or vehicle control. Animals were treated for a consecutive 3-months (starting at 2-months of age) or 10-months (starting at 5-months of age) and sacrificed at 5-months or 15-months of age, respectively. Outcome measures included: (1) ANY-maze™ enclosure monitoring, (2) quantitative microcomputed tomography, and (3) biomechanical testing. Treatment with PB125® for 10 months resulted in increased long bone strength as determined by ultimate bending stress in female Hartley guinea pigs. In control groups, increasing age resulted in significant effects on geometric and structural properties of long bones, as well as a trending increase in ultimate bending stress. Furthermore, both age and sex had a significant effect on the geometric properties of both cortical and trabecular bone. Collectively, this work suggests that this nutraceutical may serve as a promising target and preventive measure in managing the decline in bone mass and quality documented in aging patients. Auxiliary to this main goal, this work also capitalized upon 5 and 15-month-old male and female animals in the control group to characterize age- and sex-specific differences on long bone geometric, structural, and material properties in this animal model.

Objectively measured physical activity levels of Venetian adults.

AIM: Venice, Italy, provides a unique environment to study physical activity as there are no automobiles, and walking is the most common means of transportation. The purpose of the present investigation was to objectively assess the physical activity (PA) levels of residents in Venice, Italy, using an accelerometer. METHODS: Twenty-seven Venetians (12 men and 15 women, 48 ± 16 yr, 169.4 ± 6.6 cm, 71.7 ± 11.1 kg) had worn an accelerometer (Lifecorder Ex) for 7 consecutive days in order to determine daily number of steps, time spent in light (LPA), moderate (MPA), or vigorous intensity (VPA) and moderate to vigorous intensity (MVPA) as well as energy expenditure associated with PA (PAEE). The time for all PA and MVPA lasting at least 1 minute, 3 minutes, 5 minutes and 10 minutes were also assessed. RESULTS: The PAEE, number of steps, LPA, MPA, VPA and MVPA averaged over 7 days of week were 1575 ± 524 kJ∙day⁻¹, 11920 ± 3667 steps∙day⁻¹, 77 ± 23 min∙day 43 ± 19 min∙day⁻¹, and 45 ± 21 min∙day⁻¹. The time for MVPA lasting >10 min was 0.3 ± 0.9 min∙day⁻¹. CONCLUSION: The amount and intensity of PA in Venetian adults is substantially higher than in most other populations previously evaluated, particularly American adults. The effects of the highly active Venetian lifestyle on important health outcomes remain unclear, but warrant further investigation.

Self Help Plus: study protocol for a cluster-randomised controlled trial of guided self-help with South Sudanese refugee women in Uganda.

BACKGROUND: Exposure to armed conflict and forced displacement constitute significant risks for mental health. Existing evidence-based psychological interventions have limitations for scaling-up in low-resource humanitarian settings. The WHO has developed a guided self-help intervention, Self Help Plus (SH+), which is brief, implemented by non-specialists, and designed to be delivered to people with and without specific mental disorders. This paper outlines the study protocol for an evaluation of the SH+ intervention in northern Uganda, with South Sudanese refugee women. METHODS: A two-arm, single-blind cluster-randomised controlled trial will be conducted in 14 villages in Rhino Camp refugee settlement, with at least 588 women experiencing psychological distress. Villages will be randomly assigned to receive either SH+ with enhanced usual care (EUC), or EUC alone. SH+ is a five-session guided self-help intervention delivered in workshops with audio-recorded materials and accompanying pictorial guide. The primary outcome is reduction in overall psychological distress over time, with 3 months post-treatment as the primary end-point. Secondary outcomes are self-defined psychosocial concerns, depression and post-traumatic stress disorder symptoms, hazardous alcohol use, feelings of anger, interethnic relations, psychological flexibility, functional impairment and subjective wellbeing. Psychological flexibility is a hypothesised mediator, and past trauma history and intervention attendance will be explored as potential moderators. DISCUSSION: This trial will provide important information on the effectiveness of a scalable, guided self-help intervention for improving psychological health and wellbeing among people affected by adversity. TRIAL REGISTRATION: ISRCTN50148022; registered 13/03/2017.

[Continent cecal-colonic reservoir. Surgical technique]. / Serbatoio cieco-colico continente. Technica operatoria.

The Authors discuss a recent case report treated with radial cystectomy associated with a secondary urinary derivation using the caecum-colon reservoir. After having reviewed the various surgical procedures involving the urinary derivations, the Authors describe the technique used by them paying particular attention to the positive aspects of having a low filling pressure reservoir controlled by a valid sphincter ileum-caecum valve. Considering the good postoperative result with this method, the Authors regard this procedure as an alternative to other urinary derivation techniques when carried out with correct indications.

[Intracavitary echography with a 12.5 MHz microprobe: a new study method in the pathology of the urinary tract]. / Ecografia endocavitaria con microsonda rotante da 12.5 MHz: una nuova metodica di studio delle patologie dell'apparato urinario.

Endoluminal sonography performed with 12.5 MHz miniature transducer-containing catheters with diameter of 6 or 9 Fr., is a new technique for the study of urinary tract. We studied: U.S. scan of 10 corpes and 10 operatory specimens (bladders and kidneys) with anatomic measurement in vitro. U.S. scan of 20 patients "in vivo" with pathologies involving bladder and upper urinary tract. We studied the normal anatomy of bladder and ureter by U.S. and we detected the structures beyond the ureteral lumen as: vessels, lymph nodes, muscle. Our indications for the utility of this new U.S. technique are: Detection and staging of superficial T.C.C. of the bladder. Detection of dangerous vessels near the U.P.F before endopielotomy. Excretory tract minus (endoluminal ultrasound is helpful in differentiating such pelvic filling defects as blood clots, no opaque stones and transitional cell carcinoma).

[Pathology of urologic importance associated with acquired immunodeficiency syndrome]. / Patologia di interesse urologico associata a sindrome da immunodeficienza acquisita.

Infection by the HIV virus affects the urogenital system in a minor percentage of cases in comparison to other organs such as the lungs, the central nervous system and the haemolymphopoietic system. In recent years however, with the continued spread of the disease also urologists find themselves dealing with the various urogenital pathologies that are presented in seropositive or fully-blown Aids patients. The Authors present their experience and describe the problems correlated to the dealing with acquired immune deficiency syndrome patients that are affected with urogenital pathologies.

[Andrological complications after pancystoprostatovesiculectomy surgery: utility of the bulbocavernosus reflex]. / Complicanze andrologiche dopo intervento di pancistoprostatovesciculectomia: utilità del riflesso bulbo-cavernoso.

The technique for radical cystoprostatectomy was modified to avoid injury to the branches of pelvic plexus that innervate the corpora cavernosa (monolateral neurovascular bundle preservation or "Nerve sparing technique"). The studies of Walsh and coll. demonstrated that the branches of pelvic plexus that innervate the corpora cavernosa are situated between the rectum and urethra and penetrate the urogenital diaphragm near to the muscular wall of the urethra. Injuries to the pelvic plexus can occur during 1) division of posterior pedicle of bladder (the seminal vesicle can be used as a landmark intraoperatively to avoid injury to pelvic plexus), 2) during apical dissection of prostate with transection of the urethra. The return of sexual function postoperatively is related to preservation of autonomic innervation; the excision of the neurovascular bundle on one side may prevent impotence in 68% patients. Our study was undertaken to identify the cause of impotence in men undergoing radical cystoprostatectomy with "Nerve sparing technique" using bulbo cavernous reflex. Our results suggest that bulbo cavernosus reflex may not be a sensitive clinical tool to establish a diagnosis of neurogenic erectile dysfunction after pelvic surgery. The Authors examine the recent neuro-uro-physiological diagnostic methods for the study of neurogenic erectile dysfunction.

[Terazosin in the treatment of benign prostatic hypertrophy]. / La terazosina nella terapia dell'ipertrofia prostatica benigna.

Benign prostatic hypertrophy provokes clinical manifestations correlated on one hand to a static obstructive component, due to the increase in glandular size, and on the other hand to a dynamic component, controlled by the alpha adrenergic autonomic system which gives the smooth muscular tonus of the prostatic adenoma. The alpha adrenergic receptor block reduces the dynamic component, improves the clinical and urodynamic parameters determined by the infra-bladder obstruction in patients with BPH. The selective alpha 1, long acting antagonists especially, such as terazosin, offer a safe and efficient therapy for selected patients suffering from BPH. They also have the indisputable benefit of mono-administration. In this study the basic concepts of BPH treatment with terazosin are discussed.

[Prognostic predictive factors of the clinical response to immunotherapy with subcutaneous interleukin-2, in patients with metastatic renal carcinoma: analysis of 60 cases]. / Fattori prognostici predittivi della risposta clinica alla immunoterapia con Interleuchina-2 per via sottocutanea, in pazienti con carcinoma renale metastatico (CRM): analisi di 60 casi.

The intravenous immunotherapy with high-dose interleukin-2 (IL-2) would constitute one of the most effective treatments of metastatic renal cell carcinoma (RCC). More recently, IL-2 subcutaneous therapy has also appeared active, either alone or in association with interferon, with results comparable to those found with the intravenous route of injection, but with a lower toxicity. On this basis, we have designed a protocol of treatment with low-dose IL-2 alone given subcutaneously as a first or a second line therapy in metastatic RCC. The study included 60 consecutive patients (pts) (M/F: 39/21, median age 56 years, range 26/74). IL-2 was given at a dose of 3 millions IU twice/day for 5 days/week, for 6 weeks, corresponding to one cycle. In non progressed pts a second cycle was repeated after a 28-day rest period. Dominant metastasis sites were, as follows: soft tissues: 8; bone: 11; lung: 29; liver: 3; liver plus lung: 7; adrenal: 2. The minimum follow-up was 18 months and the median follow-up was 34 months (range 18-48). A complete response (CR) was achieved in 2/60 (3%) pts. A partial response (PR) was obtained in 15/60 (25%). Therefore, tumor objective rate (CR + PR) was 17/60 (28%). The median duration of response was 13 months (4-33).(ABSTRACT TRUNCATED AT 250 WORDS)

[Recurrence of acute lymphoid leukemia in the bladder: a rare cause of bilateral hydronephrosis]. / Recidiva di leucemia linfoide acuta a livello vescicale: una rara causa di idronefrosi bilaterale.

While the invasion of the bladder by neoplastic cells during acute lymphatic leukaemia in children has been reported by various authors, the leukaemic invasion of the bladder in adults is extremely rare. We report a case of recurrence of A.L.L. in the bladder presenting colicky symptomatology and obstruction of the excretory tracts.

[Traumatic injuries++ of the external genitalia: a case of avulsion of the penile skin]. / Lesioni traumatiche dei genitali esterni: su un caso di avulsione della cute del pene.

The Authors report their recent experience about a penis trauma with a subtotal organ skinning. After the literature analysis, the AA. explain the case, with a particular attention to the surgical repairing technique. The surgical outcomes are discussed and it is re-marked the necessity of a precise diagnostic approach and follow up, also to prevent possible unerectional chains.

[Penile metastasis of prostatic carcinoma: a case report]. / Metastasi peniena da carcinoma prostatico: case report.

Penile metastases are uncommon lesions: most often secondary to a primary pelvic cancer (prostate, bladder and rectum) they have a unfavourable prognosis. The appearance of disseminations is still controversial and there is not an efficacious therapy. Priapism may be present or not. The Authors report their experience on a penile metastasis secondary to prostatic cancer and about the evolution of this pathology. A review of the Literature is done.

Reversal of clinical resistance to LHRH analogue in metastatic prostate cancer by the pineal hormone melatonin: efficacy of LHRH analogue plus melatonin in patients progressing on LHRH analogue alone.

OBJECTIVE: Experimental and preliminary clinical studies have suggested that the pineal hormone melatonin (MLT) may stimulate hormone receptor expression on both normal and cancer cells. Moreover, MLT has appeared to inhibit the growth of some cancer cell lines, including prostate cancer, either by exerting a direct cytostatic action, or by decreasing the endogenous production of some tumor growth factors, such as prolactin (PRL) and insulin-like growth factor-1 (IGF-1). On this basis, a study was carried out to evaluate the clinical efficacy of a neuroendocrine combination consisting of the LHRH analogue triptorelin plus MLT in metastatic prostate cancer progressing on triptorelin alone. MATERIAL AND METHODS: The study including 14 consecutive metastatic prostate cancer patients with poor clinical conditions (median age: 70.5 years; median PS: 50%), refractory or resistant to a previous therapy with the LHRH analogue triptorelin alone. Triptorelin was injected i.m. at 3.75 mg every 28 days, and MLT was given orally at 20 mg/day in the evening every day until progression, starting 7 days prior to triptorelin. RESULTS AND CONCLUSIONS: A decrease in PSA serum levels greater than 50% was obtained in 8/14 (57%) patients. Moreover, PSA mean concentrations significantly decreased on therapy of triptorelin plus MLT. In addition, a normalization of platelet number was obtained in 3/5 patients with persistent thrombocytopenia prior to study. Mean serum levels of both PRL and IGF-1 significantly decreased on therapy. Finally, a survival longer than 1 year was achieved in 9/14 (64%) patients. This preliminary study would suggest that the concomitant administration of the pineal hormone MLT may overcome the clinical resistance to LHRH analogues and improve the clinical conditions in metastatic prostatic cancer patients.