Cognitive dysfunction and psychopathology: a cohort study of adults with intellectual developmental disorder.

BACKGROUND: Cognitive impairment of intellectual developmental disorders (IDD) is determined by several different combinations of specific cognitive alterations. People with IDD present a rate of mental health problems that is up to 4 times higher than that of the general population. Despite this, the relationship between specific cognitive dysfunctions and co-occurring mental disorders has not been adequately studied. The aim of the present paper is to investigate the association between specific cognitive dysfunctions and specific psychiatric symptoms and syndromes in people with IDD. METHODS: One hundred and twenty adults with mild to moderate IDD living in residential facilities underwent a clinical and instrumental assessment for specific cognitive and psychopathological features. RESULTS: Participants with IDD and ASD have significantly lower scores compared to those without respect to who has not the diagnosis on the Processing Speed Index (PSI) and Perceptual Reasoning Index (PRI) on the WAIS-IV and higher time scores on the TMT A. Moreover, there is a significant association between years of hospitalisation and TMT B and TMT B A time scores; the longer a participant with IDD was hospitalised, the worse their performance on the TMT. Although not statistically significant, many psychopathological clusters showed substantial cognitive profiles. CONCLUSIONS: Although further research is needed, neuropsychological and IQ tests scores seem to be differently associated to various psychopathological conditions co-occurring with IDD, and with ASD especially. Cognitive assessment seems to support diagnosis and treatment of psychopathological co-occurrences in persons with IDD, also in consideration of indirect implications including a better knowledge of the patient's characteristics beyond IQ deficit.

The WNT receptor ROR2 drives the interaction of multiple myeloma cells with the microenvironment through AKT activation.

Multiple myeloma is the second most frequent hematological cancer after lymphoma and remains an incurable disease. The pervasive support provided by the bone marrow microenvironment to myeloma cells is crucial for their survival. Here, an unbiased assessment of receptor tyrosine kinases overexpressed in myeloma identified ROR2, a receptor for the WNT noncanonical pathway, as highly expressed in myeloma cells. Its ligand, WNT5A is the most abundant growth factor in the bone marrow of myeloma patients. ROR2 mediates myeloma cells interactions with the surrounding bone marrow and its depletion resulted in detachment of myeloma cells from their niche in an in vivo model, triggering apoptosis and thus markedly delaying disease progression. Using in vitro and ex vivo 3D-culture systems, ROR2 was shown to exert a pivotal role in the adhesion of cancer cells to the microenvironment. Genomic studies revealed that the pathways mostly deregulated by ROR2 overexpression were PI3K/AKT and mTOR. Treatment of cells with specific PI3K inhibitors already used in the clinic reduced myeloma cell adhesion to the bone marrow. Together, our findings support the view that ROR2 and its downstream targets represent a novel therapeutic strategy for the large subgroup of MM patients whose cancer cells show ROR2 overexpression.

[Work-related stress in healthcare workers: evaluation of effectiveness of a short training course in the hospital environment]. / Stress lavorativo nei lavoratori della sanità: valutazione dei benefici a breve-medio termine di un corso di formazione in ambito ospedaliero.

The efficacy evaluation of training courses in organizations is not widespread; however it is a fundamental issue for an appropriate allocation of available economic resources. The aim of this work is the evaluation of efficacy of a training course for the development of human resources attended by health professionists in S. Gerardo Hospital, Monza. A structured questionnaire was administered to evaluate efficacy. An experimental group of 300 health professionists attending the training course and a control group of 300 health professionists not attending the course, were asked to fill-in the questionnaire at baseline (t0), one month later--after the course--(t1: post-test), and six months later (t2: follow-up). Results highlight the medium-term (t1) efficacy of the training course and a reduced long-term (t2) efficacy in promotion of psychological adjustment and personal resources. This experience is an example of efficacy evaluation of training course in organizations using ad hoc experimental design.

[The evaluation of work related stress in occupational health: diagnostic experience and therapeutic prospects]. / La valutazione dello stress occupazionale nella pratica clinica di medicina del lavoro esperienza diagnostica e prospettive di interventi terapeutici.

The clinical cases of psychosocial disturbances that the Occupational Doctors find in their daily activity frequently are characterized by difficult differential diagnosis. These cases frequently must be faced with limitations of the work ability not easy to define and with unclear prognosis too. A useful help in the evaluation of these cases can be offered by the Clinical Units for the evaluation of work related stress, for the specialized joined support of Psychologist and of Occupational Doctors these Units can assure. We report the protocols of diagnosis of our clinical unit and the main characteristics of the patients more recently evaluated.

[Metabolism of vincamine in the rat]. / Metabolismo della vincamina nel ratto.

The metabolism of vincamine hydrochloride was studied in the rat after oral administration of the drug. Vincamine is almost completely metabolized, only a small fraction of the original compound being excreted in the urine. The metabolites detected in blood, urine and tissues were purified by preparative thin layer and column chromatography in several solvent systems, and analyzed by mass spectrometry. It was found that the main urinary metabolites were vincamine conjugates (sulphates and glucuronides). Two new metabolites were detected in all the biological fluids and specimens analyzed: these compounds are more polar than vincamine and their structure was characterized by mass spectrometry, I.R. and U.V. spectroscopy and confirmed by synthesis in our laboratory.