HSV-2 vaccine: current status and insight into factors for developing an efficient vaccine.

Herpes simplex virus type 2 (HSV-2), a globally sexually transmitted virus, and also one of the main causes of genital ulcer diseases, increases susceptibility to HIV-1. Effective vaccines to prevent HSV-2 infection are not yet available, but are currently being developed. To facilitate this process, the latest progress in development of these vaccines is reviewed in this paper. A summary of the most promising HSV-2 vaccines tested in animals in the last five years is presented, including the main factors, and new ideas for developing an effective vaccine from animal experiments and human clinical trials. Experimental results indicate that future HSV-2 vaccines may depend on a strategy that targets mucosal immunity. Furthermore, estradiol, which increases the effectiveness of vaccines, may be considered as an adjuvant. Therefore, this review is expected to provide possible strategies for development of future HSV-2 vaccines.

[Ulcerative rectocolitis: review of clinical characteristics in patients with distal colitis and extended colitis]. / Rettocolite ulcerosa: revisione delle caratteristiche cliniche nei pazienti con colite distale e colite estesa.

Ulcerative colitis is an inflammatory disease which, starting from the rectum, affects more or less extended tracts of the colon. Given that distal and extended forms are generally described as a single nosological entity, the authors aimed to verify whether there are any clinical differences between the two groups of patients with varying extents of disease. A retrospective review was made of data relating to 189 patients suffering from ulcerative colitis observed over a 90-months period. Only 111 cases were included in the study: all patients had undergone an endoscopic and histological diagnosis with a follow-up of over one year. Seventy-eight patients (41.26%) were excluded from the study because they had been lost during follow-up, or follow-up had lasted less than one year, or it had not been possible to perform pancolonoscopy. The 111 patients examined were subdivided into 2 groups: one (39 patients) with distal colitis, namely involving the rectum or recto-sigmoid, and the other (72 patients) with more extended disease. The extension of disease was evaluated on the basis of histological findings. The mean follow-up was 5 years and 11 months. The two groups were comparable for age, sex, number of annual attacks, maximum duration of disease-free periods, clinical evolution, predominant symptoms, extraintestinal symptoms and surgical treatment. Results were processed using Student's t test and the chi-square test.(ABSTRACT TRUNCATED AT 250 WORDS)

Alexithymia in inflammatory bowel disease. A case-control study.

The purported association between alexithymia and inflammatory bowel disease (IBD) was investigated in a group of 112 IBD patients (89 with ulcerative colitis and 23 with Crohn's disease) using the well-validated 20-Item Toronto Alexithymia Scale. Alexithymia was assessed also in a group of 112 normal subjects matched for gender, age, and education. The IBD group was significantly more alexithymic than the control group, and no significant difference was found between the ulcerative colitis and Crohn's disease patients. Alexithymia was unrelated to the duration of illness and the level of disease activity. Although the rate of alexithymia in the IBD group (35.7%) was significantly higher than the rate in the control group (4.5%), it is lower than rates of alexithymia that have been found among psychiatric patients with disorders that also have been linked theoretically and clinically with alexithymia.

Psychological distress and levels of disease activity in inflammatory bowel disease.

The aim of this study was to evaluate the association between anxiety and depression, and levels of disease activity (LDA) in IBD patients. One hundred and fifty IBD patients (91 males and 59 females) were assessed by means of the Hospital Anxiety and Depression scale, and divided into three LDA groups according to standard clinical criteria: LDA1 = absence, LDA2 = mild, LDA3 = moderate and severe. Using the analysis of variance and the Scheffé test, a significant difference was found in the anxiety score, but not in the depression score, between LDA1 and LDA3 (p < 0.005). The risk of developing anxiety and depression in relation to LDA was estimated by multiple logistic regression. A significant linear trend (p < 0.01) to develop anxiety was found in the highest LDA. Our study showed that anxiety was significantly associated with a higher disease activity and suggested that anxiety should be appropriately evaluated and treated with the exacerbated symptoms in IBD patients.

[Body Image Index in the Rorschach test in ulcerative proctocolitis]. / Body-Image Index al test di Rorschach nella rettocolite ulcerosa.

The use of the Rorschach test allows the body image to be examined using the Body-Image Index formulated by Fisher-Cleveland. This index is obtained by calculating the responses to Penetration and Barrier. The hypothesis is that the diseases which affect the inside of the body are more greatly correlated to a high P score and a low B score (high P-low B type personality). The paper examines the Body-Image Index in a sample of 41 patients suffering from ulcerous rectocolitis comprising 24 males and 17 females with a mean age of 32 years. The personality profile obtained is of the "high P-low B" type with a P/R% ratio which is clearly higher than the central mean value (28.7% vs 8%) and a B/R% ratio which is clearly lower than the central mean value (4.2% vs 18%). The personality of the patients in this group was marked by a tendency to anxiety and a tendency to express aggression within their bodies (anger-in) which was field-dependent, difficulty in tolerating stress, a tendency to react somatically to conflicts, a low degree of body image stability and a constant need for an external holding object.

[Pathology of adaptation according to Sami-Ali and index of conformity to the Rorschach test in ulcerative rectocolitis]. / Patologia dell'adattamento secondo Sami-Ali e indice di conformismo al test di rorschach nella rettocolite ulcerosa.

According to Sami-Ali's theoretical model the psychosomatic personality is characterised by an adaptation pathology whose main elements are the repression of imaginative thought and conformity to socio-cultural standards. This study examines adaptation pathology using the Rorschach test. The Authors have formulated a conformity index by relating kinestheses (M) and banal perceptions (BAN). The study was carried out on a sample of 41 patients suffering from ulcerous rectocolitis comprising 24 males and 17 women with a mean age of 32 years. As expected in the hypothesis 97.6% of the sample showed M values below the norm, and 68.3% had Ban values higher than normal, whereas the conformity index was positive and tendentially positive in 65.9% of cases. These findings confirm Sami-Ali's theory. Subjects with ulcerous rectocolitis form part of the adaptation pathology which characterised the psychosomatic personality, with an inverse proportionality between imaginative activity (kinesthesia below normal) and conformism (banal perceptions above the norm).

[Psychological disorders in patients with enterostomy. The influence of age]. / Disturbi psicologici in pazienti portatori di enterostomia. Influenza dell'età.

A retrospective study of patients who had undergone enterostomy and subsequent follow-up in the past 9 years was carried out with the aim of identifying differences with relation to symptoms of depression, the deterioration of social relations and sexual disturbances between elderly (age greater than or equal to 65) and non-elderly patients (age less than 65). Depressive symptoms were present to a greater extent in elderly (48.6%) than in non-elderly patients (34.8%), whereas sexual disturbances were experienced more in non-elderly (34.8%) than elderly (21.6%) patients. No striking differences were noted with regard to the deterioration of social relations. The differences observed, although marked in terms of percentage, were not statistically significant given the relatively small number of cases examined.

Alexithymia and breast cancer. Survey of 200 women undergoing mammography.

The Schalling Sifneos Personality Scale (SSPS) and the Middlesex Hospital Questionnaire (MHQ) have been used in 381 women just before mammography at the Breast Center of the Radiology Institute, University of Bari (Italy). Of the 200 women who accepted to complete the questionnaires 13 were found positive for cancer. Student's t test comparison of the mean SSPS and MHQ scores of the positive for cancer with the negative showed that women with breast cancer have more pronounced alexithymic but not neurotic traits. Our findings suggest that patients with cancer may have something in common with those suffering from so-called psychosomatic pathologies who have a constrained imagination and fantasy and difficulty in verbalizing their emotions. Thus, this study indicates a relationship between alexithymia and cancer.