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Therapeutic termination of pregnancy and women’s mental health:Determinants and consequences

World Journal of Psychiatry 2021年第11期11卷 937-953页

作者： Ester di Giacomo Rodolfo Pessina Mario Santorelli Daniele Rucco Valeria Placenti Francesca Aliberti Fabrizia Colmegna massimo clerici School of Medicine and Surgery University Milan BicoccaMonza 20900LombardyItaly Department of Psychiatric ASST MonzaMonza 20900LombardyItaly Psychiatric Residency Training Program University Milan BicoccaMonza 20900LombardyItaly PhD Program in Psychology Linguistics and Cognitive NeuroscienceUniversity Milan BicoccaMilano 20126LombardyItaly Psychiatric Residency Training Program University of GenovaGenova 16126LiguriaItaly

The therapeutic termination of pregnancy(TToP)is an induced abortion following a diagnosis of medical *** is applied to avoid the risk of substantial harm to the mother or in cases of fetal *** type of induced abortion is provided after the second semester of gestation if fetal illness or the pregnancy cause physical danger or pathological mental distress to the *** and economic determinants could influence the desire for children and family planning in couples,as well as the use of effective contraception and the choice to perform an induced ***,pre-existing mental health problems could affect the decision between carrying on a problematic pregnancy or having ***,the TToP is a reproductive event with an important traumatic burden,but also with an intrinsic therapeutic effect and it can produce different psychological and psychopathological effects on women and *** aim of this review is to evaluate what demographic,reproductive and psychopathological determinants are involved in the choice of undergoing a TToP in ***,we will examine both positive and negative consequences of this procedure on women’s mental health,underlying which factors are related to a worse outcome in order to provide the best clinical support to vulnerable groups.

关键词： Therapeutic abortion Women’s health Depression PostTraumatic stress disorder Perinatal care Psychiatry

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Child abuse and psychopathy: Interplay, gender differences and biological correlates

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World Journal of Psychiatry 2021年第12期11卷 1167-1176页

作者： Ester di Giacomo Mario Santorelli Rodolfo Pessina Daniele Rucco Valeria Placenti Francesca Aliberti Fabrizia Colmegna massimo clerici School of Medicine and Surgery University of Milano BicoccaMonza 20900Italy Department of Psychiatry ASST MonzaMonza 20090Italy School of Medicine and Surgery Psychiatric Residency Training ProgramUniversity of Milano BicoccaMonza 20900Italy Department of Psychology Linguistics and Cognitive NeuroscienceUniversity of Milano BicoccaMonza 20900Italy Department of Psychiatric Residency Training Program University of GenovaGenova 16126Italy Department of Medicine and Surgery University of Milano-BicoccaMonza 20900Italy

Child abuse is an important source of mental and physical adverse consequences for victims,their family,and their *** impact of violence during childhood on the development of the victim is a very sensitive *** than internalizing symptoms,it is interesting to analyze the possibility that a victim may assume the role of *** this aim,we evaluate Literature and examine the interplay among different types of child abuse(emotional neglect,emotional abuse,physical neglect,physical abuse and sexual abuse)and the development of *** consider the role of post-traumatic stress disorder and that of personal environment as potential mediators between abuse and ***,an in-depth analysis on possible differences due to the victim's gender is ***,analysis focused on genetic variants,such as the polymorphism of 5HTT and MAO-A,or a biological alteration,like the difference in daily cortisol levels that could be related to the development of psychopathy after a trauma.

关键词： Child abuse Sexual abuse Physical abuse Psychopathy Neglect Intergenerational transmission

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Anhedonia and Reward System: Psychobiology, Evaluation, and Clinical Features

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International Journal of Clinical Medicine 2012年第7期3卷 697-713页

作者： Giovanni Martinotti Daniele S. Hatzigiakoumis Ofelia De Vita massimo clerici Filippo Petruccelli massimo Di Giannantonio Luigi Janiri Department of Human and Social Sciences University of Cassino Cassino Italy Department of Neuroscience and Imaging “G. d’Annunzio” University of Chieti-Pescara Chieti Italy Department of Neurosciences and Biomedical Technologies University of Milan Bicocca Medical School Monza Italy Institute of Psychiatry and Psychology Catholic University of the Sacred Heart Rome Italy

Anhedonia can be defined as a condition in which the hedonic capacity is totally or partially lost. From a psychobiological perspective, several researchers proposed that anhedonia has a putative neural substrate, the dopaminergic mesolimbic and mesocortical reward circuit, which involves the ventral tegmental area, the ventral striatum and part of the prefrontal cortex. Anhedonia is, besides depressed mood, one of the two core symptoms of depression;furthermore it is one of the most important negative symptom in schizophrenia. Anhedonia is also present in substance use disorders as part of the abstinence symptomatology, and interrelations between hedonic capability, craving and protracted withdrawal have been found, particularly in opiate-dependent subjects. Although anhedonia is regarded as an important symptom in psychopathology, so far it has received relatively little attention. In general, two main approaches have been utilized to investigate and assess anhedonia or hedonic capacity: laboratory-based measures and questionnaires. Among measurement scales, the most commonly used are the Snaith-Hamilton Pleasure Scale (SHAPS), the Fawcett-Clark Pleasure Scale (FCPS), and the Revised Chapman Physical Anhedonia Scale (CPAS). Nevertheless, other measurement scales, particularly used within broader psychopathological dimensions, are the Anhedonia-Asociality subscale (SANSanh) of the Scale for the Assessment of Negative Symptoms (SANS) and the Bech-Rafaelsen Melancholia Scale (BRMS). In this paper we analyze these different scales, individuating their strengths and limits and their current clinical applications.

关键词： Anhedonia Pleasure Dopaminergic Reward System Substance Dependence SHAPS CPAS SAS FCPS SANS BRMES VAS TEPS

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Microbiology laboratory and the management of motherchild varicella-zoster virus infection

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World Journal of Virology 2016年第3期5卷 97-124页

作者： massimo De Paschale Pierangelo clerici Microbiology Unit ASST-Ovest Milanese Hospital of Legnano

Varicella-zoster virus, which is responsible for varicella(chickenpox) and herpes zoster(shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella(particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times:(1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection;(2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear(atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation;(3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and(4) when the baby is born and it is necessary to confirm a diagnosis of varicella(and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn.

关键词： Mother-child infection Congenital varicella syndrome Varicella-zoster virus Neonatal varicella Microbiology laboratory

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Serological diagnosis of Epstein-Barr virus infection: Problems and solutions

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World Journal of Virology 2012年第1期1卷 31-43页

作者： massimo De Paschale Pierangelo clerici Microbiology Unit Hospital of Legnano

Serological tests for antibodies specific for Epstein-Barr virus(EBV) antigens are frequently used to define infection status and for the differential diagnosis of other pathogens responsible for mononucleosis syndrome. Using only three parameters [viral capsid antigen(VCA) Ig G, VCA Ig M and EBV nuclear antigen(EBNA)-1 Ig G],it is normally possible to distinguish acute from past infection: the presence of VCA Ig M and VCA Ig G without EBNA-1 Ig G indicates acute infection, whereas the presence of VCA Ig G and EBNA-1 Ig G without VCA Ig M is typical of past infection. However, serological findings may sometimes be difficult to interpret as VCA Ig G can be present without VCA Ig M or EBNA-1 Ig G in cases of acute or past infection, or all the three parameters may be detected simultaneously in the case of recent infection or during the course of reactivation. A profile of isolated EBNA-1 Ig G may also create some doubts. In order to interpret these patterns correctly, it is necessary to determine Ig G avidity, identify anti-EBV Ig G and Ig M antibodies by immunoblotting, and look for heterophile antibodies, anti-EA(D) antibodies or viral genome using molecular biology methods. These tests make it possible to define the status of the infection and solve any problems that may arise in routine laboratory practice.

关键词： Epstein-Barr virus infection Serology Immunoblotting Avidity IgG Epstein-Barr virus-DNA

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Immune Activation in HIV-Infected Patients Treated with Different ARV Regimens

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World Journal of AIDS 2012年第2期2卷 97-102页

作者： Alessia Uglietti Sergio Lo Caputo Marinella Lauriola Michele De Gennaro Elisabetta Chiesa massimo Coen Roberta Terzi Dorothy H. Bray Renato Maserati Daria Trabattoni Mario clerici Departments of Infectious Diseases of the Campo di Marte Hospital Milano Italy Departments of Infectious Diseases of the Chair of Immunology University of Milano Milano Italy Departments of Infectious Diseases of the Chair of Immunology University of Milano Milano Italy Departments of Infectious Diseases of the Fondazione Don C. Gnocchi Scientific Institute for Patient Care and Research Milano Italy Departments of Infectious Diseases of the Foundation IRCCS Policlinico San Matteo Hospital Milano Italy Departments of Infectious Diseases of the Immunoclin Ltd. Paris France Milano Italy Departments of Infectious Diseases of the Luigi Sacco Hospital Milano Italy Departments of Infectious Diseases of the Santa Maria Annunziata Hospital Milano Italy

Objectives: To evaluate the effects of starting therapy with either Truvada (TVD) or Combivir (CBV) in combination with Efavirenz (EFV) or a boosted Protease Inhibitor (LPV/r, ATV/r, fAPV/r and SQV/r) on clinical, immunological, and virological parameters in HIV-infected antiretroviral (ARV) naive patients. Methods: Twenty-seven patients were prospectively enrolled and received TVD-EFV, 32 TVD-PI/r, 24 CBV-EFV, and 23 CBV-PI/r. Immunovirological analyses were performed at baseline and after 3, 6, 9 and 12 months after initiation of therapy;a full set of data is available for 51 patients. Results: Median CD4+ cell counts and HIV-RNA plasma viremia were comparable in the four groups of patients (TVD-EFV, TVD-PI/r, CBV-EFV, CBV-PI/r) at baseline. At month 12 HIV RNA plasma viremia was <50 cps/ml in all patients. Median CD4 cell counts increases were higher, although not significantly, in CBV-EFV and TVD-EFV patients. Finally, CD8+/CD38+/CDRO+T lymphocytes were significantly decreased after 12 months of therapy in all patients with, possibly, a faster effect seen in the EFV groups. Conclusions: Immunologic parameters are similarly affected by different ARV combinations, even if EFV-associated immunomodulation might be marginally better.

关键词： HIV Immune Activation Antiretroviral Therapy

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Can the detection of IgA anti-Mycoplasma pneumoniae added to IgM increase diagnostic accuracy in patients with infections of the lower respiratory airways?

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World Journal of Clinical Infectious Diseases 2016年第4期6卷 67-72页

作者： massimo De Paschale Teresa Cerulli Debora Cagnin Alessia Paganini Maria Teresa Manco Luisa Belvisi Cristina Morazzoni Laura Marinoni Carlo Agrappi Paola Mirri Pierangelo clerici Microbiology Unit ASST-Ovest Milanese Hospital of Legnano

AIM To evaluate the increase in diagnostic yield, by using IgA in addition to IgM, instead of IgM alone, in relation to the age of the *** The study considered 1067 blood samples from patients with clinical signs of lower respiratory tract infections, tested for anti-Mycoplasma IgG, IgM and IgA *** The increase in diagnostic yield with IgA, compared to IgM detection alone was of 3.5% with statistically significant differences between age groups(0.8% for those equal/under 50 years of age and 4.3% for those over 50).CONCLUSION Our findings demonstrate that IgA detection lead to a twofold increase in the number of diagnoses among the older age groups, but it did not result in relevant increase among the younger age groups.

关键词： Community-acquired infections Diagnostic yield Elderly patients IgA Mycoplasma pneumoniae

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