Strategies for controlling sleep-related intrusive thoughts, and subjective and objective sleep quality: how self-reported poor and good sleepers differ.

OBJECTIVES: Along with changes in subjective and objective sleep patterns, metacognitive control of intrusive and unwanted thoughts at bedtime has been shown to significantly influence sleep quality. The present study examined individual differences between self-reported poor and good sleepers' thought control strategies, as well as their subjective and objective sleep quality, considering adults in a broad range of ages. METHOD: The study involved 147 individuals aged 18-79 years, divided into self-reported poor and good sleepers using the Pittsburgh Sleep Quality Index (PSQI). Participants' thought control strategies were assessed using the Thought Control Questionnaire for Insomnia - Revised (TCQI-r). Subjective sleep parameters were recorded in a sleep diary, and objective sleep parameters were measured over 7 days using actigraphy. RESULTS: Self-reported poor sleepers employed aggressive suppression, reappraisal and worry strategies more than self-reported good sleepers. On logistic regression, the use of reappraisal and worry strategies distinguished between poor and good sleepers, while age did not. Self-reported poor sleepers objectively had a much longer sleep onset latency, a shorter total sleeping time, and a lower sleep efficiency, as well as subjectively longer times awake again after sleep onset, and a lower sleep efficiency than self-reported good sleepers. CONCLUSION: Together with some subjective and objective sleep parameters, the use of certain thought control strategies (reappraisal and worry, in particular) seems to be one of the crucial aspects accounting for individual differences between self-reported poor and good sleepers.

Modeling tumor growth inhibition and toxicity outcome after administration of anticancer agents in xenograft mice: A Dynamic Energy Budget (DEB) approach.

Host features, such as cell proliferation rates, caloric intake, metabolism and energetic conditions, significantly influence tumor growth; at the same time, tumor growth may have a dramatic impact on the host conditions. For example, in clinics, at certain stages of the tumor growth, cachexia (body weight reduction) may become so relevant to be considered as responsible for around 20% of cancer deaths. Unfortunately, anticancer therapies may also contribute to the development of cachexia due to reduced food intake (anorexia), commonly observed during the treatment periods. For this reason, cachexia is considered one of the major toxicity findings to be evaluated also in preclinical studies. However, although various pharmacokinetic-pharmacodynamic (PK-PD) tumor growth inhibition (TGI) models are currently available, the mathematical modeling of cachexia onset and TGI after an anticancer administration in preclinical experiments is still an open issue. To cope with this, a new PK-PD model, based on a set of tumor-host interaction rules taken from Dynamic Energy Budget (DEB) theory and a set of drug tumor inhibition equations taken from the well-known Simeoni TGI model, was developed. The model is able to describe the body weight reduction, splitting the cachexia directly induced by tumor and that caused by the drug treatment under study. It was tested in typical preclinical studies, essentially designed for efficacy evaluation and routinely performed as a part of the industrial drug development plans. For the first time, both the dynamics of tumor and host growth could be predicted in xenograft mice untreated or treated with different anticancer agents and following different schedules. The model code is freely available for downloading at http://repository.ddmore.eu (model number DDMODEL00000274).

Using dolls for therapeutic purposes: A study on nursing home residents with severe dementia.

OBJECTIVES: Among the psychosocial interventions intended to reduce the behavioral and psychological symptoms of dementia (BPSD), doll therapy (DT) is increasingly used in clinical practice. Few studies on DT have been based on empirical data obtained with an adequate procedure; however, none have assessed its efficacy using an active control group, and the scales used to assess changes in BPSD are usually unreliable. The aim of the present study was to measure the impact of DT on people with severe dementia with a reliable, commonly used scale for assessing their BPSD, and the related distress in formal caregivers. Effects of DT on the former's everyday abilities (ie, eating behavior) were also examined. METHOD: Twenty-nine nursing home residents aged from 76 to 96 years old, with severe dementia (Alzheimer's or vascular dementia), took part in the experiment. They were randomly assigned to an experimental group that used dolls or an active control group that used hand warmers with sensory characteristics equivalent to the dolls. Benefits of DT on BPSD and related formal caregiver distress were examined with the Neuropsychiatric Inventory. The effects of DT on eating behavior were examined with the Eating Behavior Scale. RESULTS: Only the DT group showed a reduction in BPSD scores and related caregiver distress. DT did not benefit eating behavior, however. CONCLUSIONS: This study suggests that DT is a promising approach for reducing BPSD in people with dementia, supporting evidence emerging from previous anecdotal studies.

Severe ASIA syndrome associated with lymph node, thoracic, and pulmonary silicone infiltration following breast implant rupture: experience with four cases.

Silicone has been considered biologically inert; thus it has been employed in many medical devices and nowadays is commonly used in plastic surgery for mammary prosthesis. It is well tolerated in most cases. However, autoimmune disorders and siliconomas with granulomatous reactions after silicone implant rupture have been described. We report cases of four women who developed systemic disorders following rupture of silicone breast implants resulting in lymph node and thoracic silicone infiltration. The symptoms in these cases, including arthralgia, myalgia, generalized weakness, severe fatigue, sleeping disturbances, cognitive impairment, memory loss, irritable bowel syndrome, and weight loss, clearly match the criteria of the recently defined autoimmune/inflammatory syndrome induced by adjuvants (ASIA).

Mathematical modeling of growth and death dynamics of mouse embryonic stem cells irradiated with γ-rays.

Following ionizing radiation, mouse embryonic stem cells (mESCs) undergo both apoptosis and block at G2/M phase of the cell cycle. The dynamics of cell growth and the transition through the apoptotic phases cannot be directly inferred from experimental data, limiting the understanding of the biological response to the treatment. Here, we propose a semi-mechanistic mathematical model, defined by five compartments, able to describe the time curves of untreated and γ-rays irradiated mESCs and to extract the information therein embedded. To this end, mESCs were irradiated with 2 or 5 Gy γ-rays, collected over a period of 48 h and, at each time point, analyzed for apoptosis by using the Annexin V assay. When compared to unirradiated mESCs, the model estimates an additional 0.2 probability to undergo apoptosis for the 5 Gy-treated cells, and only a 0.07 (not statistically significantly different from zero) when a 2 Gy-irradiation dose is administered. Moreover, the model allows us to estimate the duration of the overall apoptotic process and also the time length of its early, intermediate, and late apoptotic phase.

Assessment of patients with idiopathic inflammatory myopathies and isolated creatin-kinase elevation.

Idiopathic inflammatory myopathies (IIM) are a group of diseases characterized by inflammation of the skeletal muscle. Weakness, mainly affecting the proximal muscles, is the cardinal muscular symptom in IIM. In patients with dermatomyositis, peculiar skin lesions are observed. The assessment of patients with IIM includes clinical and laboratory evaluation, and clinimetric measurements. Different tools have been proposed to measure muscular and extramuscular disease activity and damage in patients with IIM. A core set of measurements to use in clinical practice was recently proposed. Among laboratory features the increase of serum creatine kinase (CK) is considered a hallmark of muscle inflammation/damage. However, subjects with persistent CK elevation, without any evidence of a definite myopathy, are often seen in clinical practice and need a careful assessment. Indeed, CK blood levels can also increase in non-myopathic conditions, e.g. in case of intense physical exercise, assumption of some drugs (statins), muscular dystrophy, muscular trauma or in case of neuro-muscular disorders which all should be considered in the diagnostic work-up. The assessment of patients with IIM and hyperCKemia will be discussed in this paper.

Clinical guidelines and definitions of autoinflammatory diseases: contrasts and comparisons with autoimmunity-a comprehensive review.

Autoinflammatory diseases (AIDs) and autoimmune diseases (ADs) are characterized by an aberrant chronic activation of the immune system which causes tissue inflammation and damage in genetically predisposed individuals. Pathogenetic mechanisms underlying this damage differ between these two types of diseases; in AIDs, the innate immune system is directly responsible for tissue inflammation, while in ADs it works by activating the adaptive immune system, which becomes the main effector of the inflammatory process. Despite the fact that AIDs have only been recently defined, they are older than ADs. The innate immune system is found in plants and animals, and it developed earlier than the adaptive immune system, which first appeared in jawed vertebrates. According to genetic background and clinical, serological, and radiological findings, AIDs and ADs might be considered as a single spectrum of disorders, with a wide range of manifestations. Indeed, autoinflammatory-like diseases have been reported in simple organisms such as Drosophila melanogaster and Caenorhabditis elegans. We analyzed here the main pathogenetic and clinical features of these two groups of diseases mostly dealing with their similarities and differences.

Evidence-based practice recommendations for memory rehabilitation.

Memory impairment is a common consequence of neurological injury or disease, causing significant disability in everyday life, and is therefore a critical target for rehabilitation intervention. Here we report a review of the available evidence on the efficacy of restitution-oriented therapies and compensatory approaches for memory rehabilitation. A total of 110 studies was systematically classified and analyzed in order to generate evidence-based clinical recommendations for treatment providers. Different key aspects, such as types of brain damage, treatments characteristics and outcome measurements guided the evaluation of the literature as to appraise the potential interaction between patients characteristics, interventions and outcomes. The general conclusion is that memory re-training programs and compensatory approaches are probably effective in ameliorating memory disorders in patients with focal brain lesions, with some evidences of changes in memory functioning extending beyond the trained skills. Externally directed assistive devices and specific learning strategies are effective (with a level D and B of evidence, respectively) in retaining information relevant for daily needs also in patients with degenerative diseases. Some methodological concerns, such as the heterogeneity of subjects, interventions and outcomes studied, may limit the generalization of the present recommendations.

The effect of age and individual differences in attentional control: a sample case using the Hayling test.

Individual differences in working memory (WM) have been shown to reflect the ability to control attention in order to prevent interference. This study examines the role of WM capacity in resisting interference in the Hayling task, in samples of younger and older adults. In each age group, high and low WM span individuals had to complete high-cloze sentences with either expected words (initiation) or words providing no meaning to the sentences (interference). Results showed increased response times and decreased correct responses in interference, as compared to initiation. As interference increased, older adults demonstrated lower accuracy than younger ones. Further, low spans demonstrated higher interference costs than high spans on accuracy, while the reverse pattern was found for response times. Our findings suggest that both age and individual differences in WM capacity need to be considered to account for differences in the ability to resist to interference.

Adult age differences in the Color Stroop Test: a comparison between an Item-by-item and a Blocked version.

The Color Stroop Test is consensually considered as a task to assess the efficiency of inhibitory mechanisms. If the Stroop interference effect is largely undisputed, it is also acknowledged that the size of this effect varies as a function of various task manipulations, such as the task format. The aim of the present study was to compare the size of adult age-related differences in inhibition as assessed by two different versions of the Color Stroop Test: a standard Blocked paper-and-pencil version and a computerized Item-by-item one. Results showed pronounced age-related differences in the interference effect in the Blocked version, but not in the Item-by-item one. These findings are discussed in terms of the characteristics of the tasks. The choice of the appropriate version with respect to clinical aims is also addressed.

Continuity and discontinuity of psychopathology: a study of patients examined as children and as adults. III--The infancy of "adult personality disorders".

We undertook a prospective study of all the children who, having consulted the Child Psychiatry Services (Service Médico-Pédagogique) between 1963 and 1967, later consulted the Adult Public Psychiatry Service (720 cases). We looked for specific clinical clusters which would enable us to differentiate statistically the groups of children according to their adult diagnoses. We present here the results for the group of children who were diagnosed as suffering from "personality disorders" in adulthood. We were able to establish an infantile cluster that significantly differentiated these children. It includes: aggressiveness, oppositional behaviour, unsociability, conflicts with peers. 54.6% had already been diagnosed as suffering from personality disorders in childhood. According to these results, the more a consulting child fits this profile, the greater the risk that he will suffer from a "personality disorder" in adulthood. We discuss the continuity/discontinuity of the symptomatology, and the implications for diagnoses of "personality disorders" and "borderline personalities".

[Continuity and discontinuity of psychopathology: a study of patients examined as children and as adults. II. Childhood antecedents of drug dependent adults]. / Continuité et discontinuité de la psychopathologie: une étude sur des patients examinés comme enfants et comme adultes. II--L'enfance des toxicomanes adultes.

The demographic stability of the Swiss Canton of Geneva provided us with the necessary conditions for a follow-up study of the entire childhood population who, having consulted the Child Psychiatry Services between 1963 and 1967, later consulted the adult public psychiatric services (720 cases). We looked for specific clusters of clinical signs which would enable us to differentiate, statistically speaking, the groups of children according to their adult diagnosis. We present here the results for the group of children who were diagnosed at adulthood as drug addicts (DSM III R). We found a specific cluster significantly differentiating these children from the other populations. It includes: a personality disorder (undifferentiated behaviour, and solitary and aggressive behaviour), environmental factors (monoparental, rejecting family) and a lack of mental deficiency.

[Continuity and discontinuity of psychopathology: a study of patients examined as children and as adults. I. Antecedents of adult schizophrenic disorders]. / Continuité et discontinuité de la psychopathologie: une étude sur des patients examinés comme enfants et comme adultes. I--L'enfance de troubles schizophrènes adultes.

The demographical stability of the Canton of Geneva made it possible for us to do a prospective study of all the children who had consulted the Child Psychiatry Service between 1963 and 1967 and who later consulted the public adult psychiatry services. On the basis of the adult diagnoses, wo looked for specific clinical "clusters" in childhood which would allow us to differentiate statistically the groups of children. We present here the results of the group of children who developed schizophrenia in adulthood. We found a specific childhood "cluster" which clearly distinguishes these children from the others. It includes: serious relational disorders, neurodevelopmental impairment, attention deficit and school learning disorders.

A double-blind clinical trial for the evaluation of the therapeutical effectiveness of a calf thymus derivative (Thymomodulin) in children with recurrent respiratory infections.

The effectiveness of an orally administrable thymic derivative (Thymomodulin) for the treatment of the recurrent respiratory infections (RRI) in children has been studied in a double-blind clinical trial with historical comparison. In the Thymomodulin treated group a significant decrease of the monthly frequency of RRI has been observed in comparison with the previous year (P less than 0.05) and with the placebo treated group (P less than 0.002). The evaluation of the laboratory data at the beginning of the study didn't show in the two groups typical alterations of the common hematological and immunological parameters, but at the end of the trial a statistically significant increase of the levels of salivary IgA has been noticed only in the Thymomodulin treated group (P less than 0.02).

[Respiratory atopy and season of birth: epidemiologic considerations]. / Atopia respiratoria e stagione di nascita: considerazioni epidemiologiche.

Numerous environmental conditions have been considered factors which may favour atopic disease. 320 children (233 males and 87 females, aged from 1 year and 10 months to 16 years and 6 months) were followed at the Out-patients' Department for Allergology of the V Pediatric Clinic (University of Milano). These children were examined in order to determine possible environmental factors, which could be related to subsequent allergic sensitization in infancy. We excluded all the subjects with a high atopic risk owing to: gestational age under 36 weeks, weight at birth under 2,500 Kg, respiratory distress in infancy, bronchiolitis in the first 6 months of life, particularly unfavourable conditions of the domestic microclimate. We did not find any correlation between the length of the period of breast feeding alone and the subsequent appearance of atopic sensitization. The only factor which could be related to atopic sensitization was the season of birth: the majority of atopic subjects were born in the period of maximum exposure to their respective allergens. Our data underline the difficulty in planning any efficacious prophylactic measure against respiratory allergy, limiting our possibilities to the improvement of assistance during pregnancy and to newborns and to the realization of better hygienic and environmental conditions.