Patients with inflammatory bowel diseases (IBD) are at increased risk of osteoporosis due to chronic inflammation, corticosteroids, surgery and deficiency of micronutrients. Inadequate intake of calcium and vitamin D (VitD) are frequent and represent easily reversible risk factors. More recently attention has been focussed on the role of vitamin K (VitK) in the alterations of bone metabolism, but few data are available on the dietary intake of VitK in IBD. The aim of the study was to assess the dietary intake of VitK, VitD and Calcium in IBD and seek correlations with demographics and disease characteristics. A food frequency questionnaire, validated for calcium intake, integrated with questions on the main dietary sources of VitD and VitK, was administered to 208 IBD patients (90 Crohn’s disease (CD) and 118 ulcerative colitis (UC), 112 males and 96 females, mean age 50 years) and 195 controls. Data were compared with Institute of Medicine’s Dietary reference intakes: Recommended Dietary Allowance (RDA) for Calcium and VitD and Adequate Intake (AI) for VitK. The dietary intake of VitK, VitD and calcium expressed as per cent of RDA/AI was significantly lower (p < 0.01) in IBD than in controls. The risk of inadequate VitD and VitK intake was higher in IBD than in controls: 91.8% vs. 84.1% and 55.8% vs. 30.3% (OR 2.1, 95% CI 1.1–4, p = 0.0186 and OR 2.9, 1.9–4.4, p < 0.001, respectively). IBD males had reduced intake of all micronutrients compared with controls, while in females the difference was significant only for VitK. The difference vs. controls was significant in all age groups for VitK (p < 0.01) and in patients ageing > 40 years for calcium. VitD intake showed a no significant trend. No differences between Crohn’s disease and Ulcerative colitis were observed.The difference of VitD dietary intakes between active and inactive IBD was significant (46.5% vs. 57.2%, p = 0.015). The intake of VitD was lower in IBD patients ageing >60 years, compared with other age groups. Conversely, the calcium and VitK intakes were similar. Dietary calcium, VitK and VitD intakes were significantly reduced in IBD vs. controls. IBD patients with active IBD had lower VitD intake than those in remission. The correction of dietary habits may reverse some risk factors for osteoporosis in a large proportion of IBD patients. Focussing attention on micronutrients may help identifying those patients who may profit from calcium, VitD and VitK supplementation, and prompt effective dietary counselling.

IntroductionSecond-generation long-acting injectable antipsychotics (LAIs) constitute a valuable alternative for the treatment of schizophrenia and combine advantages of both long-acting injectable drugs and atypical antipsychotics. Realistic, naturalistic studies are necessary to evaluate the impact of LAIs on specific cluster of symptoms.ObjectivesTo collect clinical and functioning outcomes in outpatients with schizophrenia treated with LAIs during a follow-up period of 6 months.AimsTo determine the impact on symptoms and functioning of second-generation LAIs.MethodsIt is a 6-month naturalistic, observational, prospective, non-interventional study of patients diagnosed with DSM-V schizophrenia disorder. Clinical data were assessed by the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF). For statistical analysis, we used the Wallwork's five-factor model of the PANSS.ResultsA total of 50 schizophrenia patients (70% male; mean age: 36.2 ± 10.4) referred to the Depot Clinic at Sant’Andrea Hospital in Rome was included. Eight patients received treatment with risperidone LAI (RLAI), 20 with paliperidone-palmitate LAI (PLAI), 10 with olanzapine-pamoate LAI (OLAI) and 12 with aripiprazole LAI (ALAI). LAIs were overall associated with improved functioning and positive symptoms; OLAI, ALAI e PLAI correlated with improved negative symptoms, RLAI, OLAI e PLAI with improved disorganised/concrete symptoms, OLAI e PLAI with improved excited symptoms; ALAI improved depressive symptoms.ConclusionOver the 6-month period, LAIs were associated with improved functioning and illness severity in schizophrenia patients with different symptoms profile. Treatment with PLAI and OLAI showed the major clinical advantages, whereas only ALAI correlated with improved depressive symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Alzheimer's Disease (AD) is the most important cause of neurodegenerative dementia and its main pathological hallmarks include neuritic plaques and neurofibrillary tangles, involved in the beta amyloid cascade. Nevertheless, changes in cerebral hemodynamic might play a role in the cognitive decline. The aims of this study were to assess in AD subjects the cerebral vasomotor reactivity and to evaluate the possible correlation between this reactivity and the cognitive deficit. Thirty-six subjects (mean age ± SD, 68,58 ± 6,16 years) were consecutively enrolled. We recruited twenty-five subjects affected by AD, matched for age and education to eleven healthy control. Subjects with a Mini Mental State Evaluation (MMSE) score less than 15, cerebrovascular disease history, severe leucoencephalopathy and carotid stenoses major than 40% were excluded. All the subjects underwent MRI imaging, Neuropsychological evaluation and Carotid Duplex Utrasonography. Cerebral vasomotor reactivity was assessed using the transcranial Doppler-based breath-holding index test (BHI). Both Cerebral blood flow velocity at the steady-state (CBFV) and BHI values were significantly lower in AD subject than in healthy control (46,34 ± 7,61 cm/s vs 55,1 ± 8,09 cm/s, p=0,007; 0,99 ± 0,26 vs 1,21 ± 0,24, p=0,031). Furthermore, we found a correlation between CBFV value and MMSE score (p=0,003, r=0,654; Spearman's correlation), but no correlation between BHI value and MMSE score. No significant relationship was found between White Matter Lesions on MRI and both CBFV and BHI values. However, the AD subjects with carotid stenoses had a lower CBFV and BHI values than those without carotid stenoses (43,12 ± 7,56 cm/s vs 48,68 ± 7,07 cm/s, p=0,008; 0,9 ± 0,23 vs 1,06 ± 0,27, p=0,04; respectively). Considering the correlation between each neuropsychological test and the cerebrovascular reactivity indices, we only found a significant correlation with the Digit Span test score (CBFV: r= 0,542, p=0,046; BHI: r= 0,525, p =0,05; Spearman's correlation). Our study suggests that AD subjects have changes in both dynamics and structure of their cerebral blood flow circulation. In particular, the CBFV reduction is correlated with the severity of the cognitive decline, suggesting that it can influence the cognitive decline in AD subjects.

OBJECTIVE:To explore gray (GM) and white matter (WM) abnormalities and the relationships with neuropsychopathology in first-episode schizophrenia (FES).METHOD:Nineteen patients with first episode of non-affective psychosis and 18 controls underwent a magnetic resonance voxel-based morphometry. Additionally, WM fractional anisotropy (FA) was calculated. For correlative analysis, symptoms and neuropsychological performances were scored by PANSS and by a comprehensive neuropsychological assessment respectively.RESULTS:Patients showed significantly decreased volume of left temporal lobe and disarray of all major WM tracts. Disorganized PANSS factor was inversely related to left cerebellar GM volume (corrected P = 0.03) and to WM FA of the left cerebellum, inferior fronto-occipital fasciculi (IFOF), and inferior longitudinal fasciculi (corrected P < 0.05). PANSS negative factor was inversely related to FA in the IFOF and superior longitudinal fasciculi (corrected P < 0.05). Impairment in facial emotion identification showed associations with temporo-occipital GM volume decrease (corrected P = 0.003) and WM disarray of superior and middle temporal gyri, anterior thalamic radiation, and superior longitudinal fasciculi (corrected P < 0.05). Speed of processing and visual memory correlated with WM abnormalities in fronto-temporal tracts.CONCLUSION:These results confirm how the structural development of key brain regions is related to neuropsychopathological dysfunction in FES, consistently with a neurodevelopmentally derived misconnection syndrome.

IntroductionWhite matter abnormalities play a prominent role in the pathogenesis of schizophrenia. Diffusion tensor imaging (DTI) studies showed a widespread decrease in fractional anisotropy (FA) in psychotic disorders.AimsTo examine white and grey matter abnormalities in first episode psychosis (FEP).MethodsWe obtained T1-weighted and DTI magnetic resonance images (1.5 T) from 8 right-handed drug-naïve FEP patients and 8 healthy controls. The DTI data set was used to calculate FA maps; we carried-out optimized voxel-based morphometry (VBM) analysis of grey matter (GM) and FA maps using SPM2.Patients were assessed with a neuropsychological battery comprising the Trail Making Test, the Stroop Colour Word Test, the Wisconsin Card Sorting Test and a test of Facial Affect recognition.ResultsThe voxelwise analysis showed decreased FA in the superior longitudinal and inferior fronto-occipital fasciculi, bilaterally, and in the left uncinate fasciculus. We observed reduced GM volume in the left frontal cortex (Brodmann areas [BA] 47, 13, 11, 10, and 9) and in right frontal (BA6), temporal (BA34) and occipital (BA 18, 19, and 30) cortex.Neuropsychological assessment showed impaired executive function and deficit in facial affect recognition.ConclusionOur findings showed fronto-temporal disconnectivity in FEP and structural alterations in both cortical and subcortical regions.Neuroanatomical findings are consistent with patients’ neuropsychological performance.Further studies to establish a relationship between white and grey matter disarray on one hand and neuropsychological testing are needed.

Background: Hydrogen breath tests are widely used in clinical practice. For a correct evaluation of data, low basal H 2 excretion is required, thus, 12-hour fasting is usually prescribed. An additional reduction in the intake of complex carbohydrates in the preceding 24 h is suggested in some centers. The issue, however, has never been directly investigated. Aim: The aim of the present study was to analyze the effect of the pretest diet on the basal H 2 excretion and the number of subjects excluded from the test due to high basal H 2 excretion. Methods: Two cohorts of 500 consecutive patients undergoing a lactose tolerance test in the years 19971998 (when 12-hour fasting was required) and in 2007-2008 (when a low-carbohydrate diet in the preceding 24 h was also prescribed) were retrospectively reviewed. Results: The mean basal H 2 excretion was significantly lower (p < 0.0001) in the low-carbohydrate diet group (2.46 +/- 6.8 vs. 4.73 +/- 3.3 ppm). In 1997-1998, 46/500 patients (9.2%) were excluded from the test due to basal H 2 values as compared to 7/500 (1.4%) in the period 2007-2008. Discussion: To the best of our knowledge, ours is the first study to provide objective data on the advantage offered by reducing the intake of complex carbohydrates before H 2 breath tests. Copyright (C) 2010 S. Karger AG, Basel

A 43-year-old woman one day experienced a dissociative fugue which she could not recall. She was married, nulliparous, with no history of dissociative disorder or other psychiatric disorders. She had been sexually abused during late childhood–early adolescence. She was examined thoroughly from both psychiatric and medical standpoints to exclude organic causes for her condition. Magnetic Resonance Imaging showed only some non-specific abnormalities. On personality tests, a histrionic structure of personality emerged, with obsessive and narcissistic traits accompanied by rigidity and anxiety, dysphoria and high risk for depression; some impairment was found in executive function tests. Final diagnosis was one of dissociative fugue. In fact, organic traits were not sufficient to establish a diagnosis of Transient Global Amnesia.

BACKGROUND:Subjects affected by aMCI are considered at high risk for AD. Nevertheless, the role of both vascular risk factors and WMH is matter of debate.PATIENTS AND METHODS:We enrolled consecutively 21 aMCI subjects according to Petersen Criteria; the study included routine screening for dementia, neuropsychological evaluation and brain MRI. Six vascular risk factors were assessed and WMH was quantified by means of a semiautomatic lesion-detection program.RESULTS:Conversion to AD, according to NINCDS-ADRDA criteria, was 47.6%. Converters tended to be more affected by the most of vascular risk factors while no difference was noted in WMH. The best predictors of conversion to AD were scores obtained at several neuropsychological examination.CONCLUSION:Our results show that criteria for aMCI identify subjects with a high risk to develop AD. WMH doesn't seem to have a role in progression from aMCI to AD, while some vascular risk factors seem to promote it.

You have accessJournal of UrologyModerated Poster, Monday, May 22, 2006, 1:00 - 3:00 pm1 Apr 2006830: Sequential Bacillus Calmette-Guèrin and Electromotive Mitomycin-C Versus Bacillus Calmette Guèrin Alone for High Risk Superficial Bladder Cancer: Long-Term Follow-Up Results of a Prospective Controlled Study Savino M. Di Stasi, Antonella Giannantoni, Arcangelo Giurioli, Giuseppe Vespasiani, Germano Zampa, Luigi Storti, Francesco Attisani, Andrea De Carolis, Marco Valenti, and Robert L. Stephen Savino M. Di StasiSavino M. Di Stasi More articles by this author , Antonella GiannantoniAntonella Giannantoni More articles by this author , Arcangelo GiurioliArcangelo Giurioli More articles by this author , Giuseppe VespasianiGiuseppe Vespasiani More articles by this author , Germano ZampaGermano Zampa More articles by this author , Luigi StortiLuigi Storti More articles by this author , Francesco AttisaniFrancesco Attisani More articles by this author , Andrea De CarolisAndrea De Carolis More articles by this author , Marco ValentiMarco Valenti More articles by this author , and Robert L. StephenRobert L. Stephen More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)33066-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "830: Sequential Bacillus Calmette-Guèrin and Electromotive Mitomycin-C Versus Bacillus Calmette Guèrin Alone for High Risk Superficial Bladder Cancer: Long-Term Follow-Up Results of a Prospective Controlled Study." The Journal of Urology, 175(4S), p. 268 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 4SApril 2006Page: 268 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Savino M. Di Stasi More articles by this author Antonella Giannantoni More articles by this author Arcangelo Giurioli More articles by this author Giuseppe Vespasiani More articles by this author Germano Zampa More articles by this author Luigi Storti More articles by this author Francesco Attisani More articles by this author Andrea De Carolis More articles by this author Marco Valenti More articles by this author Robert L. Stephen More articles by this author Expand All Advertisement Loading ...

OBJECTIVE:To evaluate the health-related quality of life in myotonic dystrophy type 1 and its relationships with clinical, genetic, neuropsychological and emotional factors.DESIGN:Case-control study of a continuous series of patients with myotonic dystrophy type 1.PATIENTS AND METHODS:Twenty patients, and 20 age-, sex- and education-matched healthy controls underwent the MOS 36-Item Short-Form Health Survey (SF-36), an extensive neuropsychological battery and emotional functioning tests.RESULTS:Patients' SF-36 mean scores were lower than those of controls in all dimensions. The neuropsychological study showed a significant impairment in visuospatial and verbal abstract reasoning (p=0.001), visuospatial memory (p=0.002) and attentive functions (p=0.03) in patients with myotonic dystrophy type 1. The emotional assessment showed significantly high scores in anxiety (p=0.002) and depression (p=0.001), which occurred in approximately 50% of patients. Both physical and mental SF-36 areas were inversely correlated with age, duration and grade of disease, depression and anxiety and positively correlated with attentive control. SF-36 areas were not correlated with cytosine thymine guanidine expansion.CONCLUSION:Health-related quality of life is severely impaired in myotonic dystrophy type 1 and it is negatively influenced by severity and duration of disease as well as by specific cognitive deficits and changes in emotional functioning. Therapeutic intervention in this field could contribute to ameliorate health-related quality of life in myotonic dystrophy type 1.

We present the case of a man affected by amnestic mild cognitive impairment (aMCI) who showed bilateral hippocampal sclerosis at magnetic resonance imaging (MRI). We argue the concept that aMCI is heterogeneous syndrome and suggested the utility of coronal T2‐weighted MRI images in the routine dementia workup.