Italian study on buckwheat allergy: prevalence and clinical features of buckwheat-sensitized patients in Italy.

Buckwheat allergy is considered a rare food allergy outside of Asia. In Europe, buckwheat has been described mainly as a hidden allergen. Data on the prevalence of buckwheat hypersensitivity in non-Asian countries is very poor. The aim of this multicenter study was to evaluate the prevalence of buckwheat sensitization and its association with other sensitizations among patients referred to allergy clinics in different geographic areas of Italy. All patients referred to 18 Italian allergy clinics from February through April 2011 were included in the study and evaluated for sensitization to buckwheat and other allergens depending on their clinical history. A total of 1,954 patients were included in the study and 61.3 percent of them were atopic. Mean prevalence of buckwheat sensitization was 3.6 percent with significant difference between Northern (4.5 percent), Central (2.2 percent) and Southern (2.8 percent) regions. This is, to our knowledge, the largest epidemiological survey on buckwheat allergy reported outside of Asia. Buckwheat is an emerging allergen in Italy, being more frequently associated to sensitization in Northern regions.

Potential application of coal-fuel oil ash for the manufacture of building materials.

In this paper coal-fuel oil ash has been characterized in terms of leaching behaviour and reactivity against lime and gypsum in hydratory systems for the manufacture of building materials. Its behaviour was also compared to that of coal ash. Metal release was measured in a dynamic leaching test with duration up to 16 days. The results have shown that coal-fuel oil ash behaves very similarly to coal ash. The reactivity of coal-fuel oil ash against lime and gypsum was measured in mixtures containing only lime and in mixtures containing both lime and gypsum. These systems were hydrated at 25 and 40 degrees C under 100% R.H. The results have shown that the main hydration products are the same as those that are usually formed in similar coal ash-based systems. That is, calcium silicate hydrate in coal-fuel oil ash/lime systems and calcium silicate hydrate plus calcium trisulphoaluminate hydrate in coal-fuel oil ash/lime/gypsum systems. From the quantitative point of view, hydration runs showed that the amounts of both chemically combined water and reacted lime measured in the case under investigation are very similar to those found in similar coal ash-based systems. Finally, the measurement of unconfined compressive strength proved that the systems have potentiality for the manufacture of pre-formed building blocks.

The (87)Sr/(86)Sr strontium isotopic systematics applied to Glera vineyards: a tracer for the geographical origin of the Prosecco.

Glera vineyards from the Prosecco wine district in northern Italy have been characterised in terms of the (87)Sr/(86)Sr isotope-ratio of musts from the 2010, 2011 and 2012 vintages, coupled with the isotopic analysis of Sr in the labile fraction of the soils of provenance. For a single vineyard, detailed Sr isotopic analyses were carried out in sequentially extracted soil fractions at three different depths, and in the grape components (skin, seeds, must and stem), in order to verify the lack of Sr isotopic fractionation within the plant. The (87)Sr/(86)Sr in must, seeds and stem overlaps within experimental uncertainties; skins are shifted towards a lower Sr isotopic composition. A large range of Sr isotopic compositions ((87)Sr/(86)Sr between 0.70706 and 0.71215) characterizes musts from the different vineyards, notwithstanding the relatively limited extension of the investigated geographic area. A statistically significant correspondence between the soil labile fraction and must is observed.

Muscle LIM protein/CSRP3: a mechanosensor with a role in autophagy.

Muscle LIM protein (MLP) is a microtubule-associated protein expressed in cardiac and muscle tissues that belongs to the cysteine-rich protein (CSRP/CRP) family. MLP has a central role during muscle development and for architectural maintenance of muscle cells. However, muscle cells rely on autophagy during differentiation and for structural maintenance. To study the role of MLP in autophagy, we have used C2C12 mouse myoblasts silenced or overexpressing MLP. Our results show that MLP contributes to the correct autophagosome formation and flux by interacting with LC3 as demonstrated by co-immunoprecipitation and PLA assay. In fact, MLP silencing results in decreased LC3-II staining and absent degradation of long-lived proteins. Moreover, MLP silencing impaired myoblasts differentiation as measured by decreased expression of MyoD1, MyoG1 and myosin heavy chain. Ultrastructural analysis revealed the presence of large empty autophagosomes in myoblasts and multimembranous structures in myotubes from MLP-silenced clones. Impaired autophagy in MLP-silenced cells resulted in increased susceptibility to apoptotic cell death. In fact, treatment of MLP-silenced C2C12 myoblasts and myotubes with staurosporine resulted in increased caspase-3 and PARP cleavage as well as increased percentage of cell death. In conclusion, we propose that MLP regulates autophagy during muscle cell differentiation or maintenance through a mechanism involving MLP/LC3-II interaction and correct autophagosome formation.

Increased health care utilization as a function of participation in trauma research.

OBJECTIVE: This study was designed to compare, in a primary care setting, the health care utilization of women who participated in a trauma research study with the health care utilization of women who did not. METHOD: Health care utilization in the 12 months before and the 12 months after participation in trauma research was determined for both participants (N = 116) and a group of control subjects (N = 100) matched for day of service. RESULTS: Pairwise t test results indicated that for the women who participated in the research, all measures of health care utilization significantly increased in the 12 months after the trauma study; for the control subjects, only the number of ongoing prescriptions significantly increased. Sign tests confirmed that a significantly greater number of research participants demonstrated a positive difference (increase in utilization) for all health care variables, whereas only ongoing prescriptions demonstrated a significant systematic increase among control subjects. CONCLUSIONS: The findings suggest that participation in trauma research may increase subsequent health care utilization.

Prevalence of borderline personality symptoms in two groups of obese subjects.

OBJECTIVE: The purpose of this study was to compare the prevalence of borderline personality symptoms and self-harm behavior in two distinct groups of obese subjects. METHOD: Obese women, 17 from an eating disorders program and 60 from a primary care setting, were administered the borderline personality scale of the Personality Diagnostic Questionnaire--Revised, the Diagnostic Interview for Borderline Patients, and the Self-Harm Inventory. RESULTS: There was a significant between-group difference on all study measures, with subjects in the eating disorders program displaying more psychopathology. CONCLUSIONS: Study group membership appears to have a significant effect on the prevalence of psychopathology in obese women.

Borderline personality symptomatology, experience of multiple types of trauma, and health care utilization among women in a primary care setting.

BACKGROUND: This project was designed to explore the relationship between recollected trauma history, borderline personality symptomatology, and health care utilization among women in a primary care setting. METHOD: Women (N = 116) consecutively recruited during routine gynecological appointments were given a set of questionnaires that explored 5 types of trauma (i.e., sexual, physical, and emotional abuse; physical neglect; witnessing violence) as well as borderline personality symptomatology. The preceding 12 months of participants' medical records were blindly reviewed to determine several measures of health care utilization (i.e., number of telephone contacts to the facility, physician visits, ongoing and acute prescriptions, specialist referral). RESULTS: Multiple forms of trauma were related to increased telephone contacts, physician visits, acute prescriptions, and ongoing prescriptions. Borderline personality symptomatology was related to physician visits and ongoing prescriptions. Neither was related to the number of specialist referrals. Total number of types of trauma and borderline personality symptomatology scores were moderately related to each other (r = .36, p < .01). CONCLUSION: With the exception of specialist referrals, the experience of multiple types of trauma and borderline personality symptomatology contribute to higher health care utilization among women in a primary care setting, but not to a substantial degree. The experience of trauma and borderline personality symptomatology appear partially related to each other. This relationship has several implications.

Patterns of self-harm behavior among women with borderline personality symptomatology: psychiatric versus primary care samples.

The current study investigated differences in self-harm behavior among individuals with borderline personality symptomatology from two different clinical settings. Participants were women, between the ages of 18 and 45, from an outpatient mental health setting or a primary care setting. Each participant completed the Self-Harm Inventory (SHI) and the borderline personality scale of the Personality Diagnostic Questionnaire-Revised (PDQ-R). Using a predetermined cut-off for substantial borderline personality symptomatology on the SHI, group comparisons with chi(2) analyses indicated that "overdosed" and "hit self" were significantly more common in the mental health subsample whereas "abused laxatives" was significantly more common in the primary care subsample. Using a predetermined cut-off for borderline personality on the PDQ-R, chi-square analyses indicated that "overdosed" and "hit self" remained significantly more common in the mental health subsample. Despite these differences, there was remarkable similarity of symptoms between groups. The implications of these findings are discussed.

Perceptions of parents' health status and relationship to somatic preoccupation.

OBJECTIVES: This study was designed to examine the potential relationship of family factors to somatic preoccupation. METHOD: A total of 116 internal medicine patients completed research booklets exploring perceptions of parents' health, childhood trauma, borderline personality symptomatology [Personality Diagnostic Questionnaire-Revised (PDQ-R)], and somatic preoccupation (Bradford Somatic Inventory). RESULTS: Simple correlations revealed that most of the relationships between somatic preoccupation and remaining study variables were statistically significant (e.g., poor parental health status correlated to somatic preoccupation). Using path analysis, poor perception of mother's health demonstrated an indirect effect on somatic preoccupation via borderline personality symptomatology, whereas, poor perception of father's health demonstrated an indirect effect on somatic preoccupation via childhood trauma. Neither parents' health status demonstrated direct effects on somatic preoccupation. CONCLUSIONS: There appear to be parent gender differences in the mediation of the relationship between poor parental health status and somatic preoccupation in the offspring. The implications of these findings are discussed.

The comorbidity, relationship and treatment implications of borderline personality and obesity.

Studies indicate that a significant minority of obese individuals in clinical studies meet criteria for borderline personality. Although the relationship between obesity and borderline personality remains unexplained, the following article discusses the implications of treating obesity among individuals with this personality disorder. Longitudinal intervention, normalizing or regulating eating patterns, and reframing weight plateaus are emphasized.

Healthcare utilization among women with eating disordered behavior.

This study was designed to explore relationship between self-reported eating disordered behavior (without formally established eating disorder diagnoses) and healthcare utilization among women in a primary care setting. Through a self-report questionnaire, 150 participants between the ages of 17 and 49 were asked if they had ever vomited, starved themselves, or abused laxatives in a manner that was intentional and self-harming (i.e., eating disordered behavior identified as pathologic by the participant). Participants who reported a history of disordered eating (n = 17) exhibited higher scores on two of five measures of healthcare utilization (mean number of telephone contacts and mean number of specialist referrals) compared with participants without eating disorders (n = 133). These data suggest that eating disordered behavior may be a predictor of increased healthcare utilization among women in primary care settings.

An investigation of primary care patients receiving extended treatment with selective serotonin reuptake inhibitors.

OBJECTIVE: To determine the psychiatric characteristics of a sample of primary care patients receiving extended treatment with selective serotonin reuptake inhibitors (SSRIs) as well as to assess the appropriateness of extended treatment. STUDY DESIGN: A prospective case series of patients (convenience sample) assessed with survey, psychological testing, interview, and medical record review. METHODS: Participants (n = 39) were patients in a health maintenance organization primary care setting receiving treatment with SSRI-type antidepressants for 12 months or longer, with no psychiatric evaluation or treatment immediately before commencement of antidepressant therapy. Each participant completed measures of self-destructive behavior and personality disturbance, underwent a clinical psychiatric interview, and had their medical record reviewed to determine psychiatric diagnoses by the primary care physician at the initiation of antidepressant treatment. RESULTS: On psychiatric interview, 64.1% of participants were diagnosed with major depression, the majority recurrent (46.2% of the entire sample); 46.2% with dysthymia; and 38.5% with panic disorder. Psychiatric morbidity in this sample was reflected by recurrent depressive episodes, long-standing depression, comorbid psychiatric diagnoses on interview (average of 1.8 diagnoses per participant), self-harm behaviors, and personality pathology. Seventy-seven percent of primary care diagnoses gleaned from medical records reflected depressive diagnoses. The approximate "match" rate for a depression-spectrum diagnosis between psychiatric interviewer and primary care physicians was 90%; however, on psychiatric interview, 16.7% of participants had bipolar disorder and 38.5% had panic disorder, which were not noted in the primary care medical record. CONCLUSIONS: Patients in primary care settings receiving extended treatment with SSRIs may have complex psychopathology for which long-term antidepressant treatment appears appropriate.

The prevalence of borderline personality disorder among individuals with obesity: a critical review of the literature.

Through a MEDLINE and PsycLIT database search, all US studies relating to the prevalence of borderline personality disorder (BPD) among obese individuals were reviewed. The highest rates of BPD among these individuals were found in samples recruited from psychologically oriented settings (i.e., eating disorders program, mental health setting). Lowest rates were found among those seeking weight loss in non-psychological programs or those in primary care settings. Among those studies examining individuals with binge-eating disorder (BED), all indicated a higher-than-community prevalence of BPD. These data suggest that the prevalence of BPD appears increased among those obese individuals seeking psychological care or who have BED.

Dysthymic disorder: the depression that never quits.

Dysthymic disorder, an insidious and chronic depressive mood disorder that waxes and wanes in intensity over several years, is fairly prevalent in healthcare settings. Although the explicit etiology is unknown, serotonergic dysfunction may be involved. Dysthymia appears to have a high rate of comorbidity, including both psychiatric and medical disorders. The primary care physician should maintain an awareness of this mood disorder, be able to screen efficiently for signs and symptoms, and be able to differentiate major depression from dysthymia. The foundation of treatment is pharmacotherapy, in particular with serotonergic antidepressants, although response is moderate at best. Antidepressants are initiated at low doses and drug trials are conducted for 3-month periods if not precluded by side effects. When reasonably effective, antidepressants should be continued for 2 to 3 years or more. Adjunctive interventions in the treatment of dysthymia are based on comorbid psychiatric or medical conditions. Although dysthymia is an insidious, difficult-to-treat disorder, intervention is worthwhile. Further research may elucidate more effective interventions for this challenging disorder.

Borderline personality disorder. Interpersonal and behavioral problems that sabotage treatment success.

Patients with borderline personality disorder may be the most psychologically challenging patients a primary care physician ever encounters. Early diagnosis is important to avoid interpersonal enmeshment and personalization in dealings with these patients, who often appear intact initially. The acronym PISIA is useful in recalling the major characteristics of the disorder: psychotic episodes, impulsivity, superficially intact social adaptation, interpersonal-relationship problems, and affective disorders. Specific techniques (eg, setting limits, separating medical and psychological issues, consulting a psychiatrist to determine a psychotropic drug regimen) promote effective treatment of these difficult patients.

Adult somatic preoccupation and its relationship to childhood trauma.

Somatic preoccupation has been associated with a variety of comorbid psychiatric conditions including childhood trauma, personality disorder, and depression. The current study was undertaken to simultaneously explore the inter-relationship of these psychiatric variables as conceptualized in a path model. Participants (N = 120), both men and women, seen for nonemergent health care in a resident-staffed internal medicine clinic, were given questionnaires exploring the presence of childhood trauma, borderline personality symptomatology, current depression, worry, and somatic preoccupation. With one exception, all simple correlation coefficients among study variables were relatively substantial. By sequencing variables into an a priori model and using a path analytic approach, several indirect and direct relationships among variables were evident. Most important, childhood trauma exhibited a direct effect on somatic preoccupation as well as indirect effects through borderline personality disturbance and current depression. These data suggest that childhood trauma may be a precursor for somatic preoccupation during adulthood.

Health care utilization and history of trauma among women in a primary care setting.

Participants were 150 women seen consecutively by a female family physician in an HMO setting for nonemergent medical care. Each participant completed a questionnaire that explored three areas of trauma. Twelve months after the administration of the questionnaire, medical records of each participant were reviewed for several measures of health care utilization (i.e., number of telephone contacts, physician visits, ongoing prescriptions, acute prescriptions, specialist referrals). Age, education, and current marital status were unrelated to medical utilization. Participants' acknowledged history of physical and emotional abuse significantly correlated with most measures of health care utilization, whereas sexual abuse generally did not. The implications of these findings are discussed.

History of trauma and attempted suicide among women in a primary care setting.

The results of past research have demonstrated apparent links between suicidality and a history of sexual abuse or physical abuse. However, the relative predictive power of such abuse histories in explaining sucidality remains unknown, as does the potential relationship between sucidality and emotional abuse, physical neglect, and witnessing violence. In the current study, 151 women who presented for nonemergent medical care indicated whether they had experienced each of five types of abuse and whether they had ever attempted suicide. Similar to past research, increased rates of having attempted suicide were evident among women who had been sexually or physically abused. Rates of past suicide attempts were also higher among those who had experienced emotional abuse or had witnessed violence. However, many women indicated having experienced multiple forms of trauma. In a multivariate analysis, only sexual abuse and physical abuse were uniquely predictive of having attempted suicide. Results are discussed with regard to the potential importance of bodily intrusiveness during abuse as most predictive of subsequent suicidality.

[Labor force mobility in an area of periphery: three cases from the Caribbean]. / La circolazione delle persone in un'area della periferia: tre casi nei Caraibi.

"This article deals tentatively with the issue of [labor] migration within an area of the periphery, the Caribbean. Over approximately the last century migration within this area has coexisted with emigration towards North America and the former 'mother countries' in Europe. The focus is on three specific cases: Aruba in the Dutch Antilles, Suriname (former Dutch Guyana) and the island of Hispaniola ([Dominican Republic] and Haiti). These three cases bear evidence to a number of developments in legal and illegal migration today." (SUMMARY IN ENG AND FRE)