The present research expanded on the literature investigating mother-child feeding and playing interactions during the transition to self-feeding (18-30 months) in the preterm population. Maternal and infant factors were also considered. A total of 69 mother-child dyads (44 preterm and 25 full-term) participated in the research. Assessments took place at 18, 24, and 30 months of the child. At each assessment, mother-child interactions during feeding (Study 1) and during a doll-play (DP) situation representing feeding (Study 2) were video recorded and later coded, respectively through the SVIA (Ammaniti et al., 2006) and the EAS (Biringen, 2008). Moreover, the child’s development was assessed through the Griffiths Scale (Griffiths, 1996, 2006) and mothers filled the BDI-II (Beck & Steer, 1996), the STAI (Spielberg, 1983), and an anamnestic questionnaire built Ad-Hoc. Results of Study 1 showed a greater occurrence of dysfunctional feeding interactions in the preterm compared to the full-term group from 18 to 30 months. Specifically, preterm dyads reported greater maternal negative affective state, greater interactional conflict and lower dyadic reciprocity. Moreover, a significantly lower percentage of children in the preterm group reached eating autonomy compared to the full-term group during the 18-30 months period. Furthermore, adverse past feeding history (difficult breastfeeding and reflux) and lower total scores on the Griffiths were associated to a higher risk of child’s food refusal. Results of Study 2 showed that the preterm group displayed lower emotional availability than the full-term group during mother-child DP interactions from 18 to 30 months, with lower maternal sensitivity, greater maternal intrusiveness, and lower child’s involvement. These findings indicate that special attention should be paid to support mother-child interactions during the transition to self-feeding in the preterm population in order to foster the mother-child relationship and promote the child’s healthy eating behavior and affective development.

Microvesicles (MVs) are small extracellular vesicles divided in exosomes (40-100nm), shedding microvesicles (100nm–1µm), and apoptotic bodies (1-5µm). MVs contain bioactive molecules, nucleic acids and proteins and are physiologically secreted by cells in order to guarantee cell-to-cell communication. The presence of viral miRNA in exosomes and viral DNA in apoptotic bodies was demonstrated. Viral DNA sequences like EBV and HPV have been identified in numerous cancers tissues, like in breast cancer, in the absence of a primary infection. Two meta-analyses studies analyzed the presence of HPV and EBV sequences in breast cancer tissues worldwide, and identified the viral nucleic acids in the 23% and 29% of the samples, respectively. However, the mechanisms of viral DNA acquisition in this cancer have not been investigated. This paper demonstrates the presence of viral nucleic acids in MVs coming from cell line models of onco-viral dependent transformation, including cervical carcinoma (HPV) and lymphoma (EBV), and their transfer through MVs to viral negative epithelial cells and fibroblasts. The presence and transfer of murine mitochondrial DNA in MVs coming from murine cancer-associated fibroblasts is also demonstrated, as well as its transfer to human recipient cells. This study also shows the presence of viral HPV16/18/31 DNA in the circulating MVs from two different cohorts: one of newly diagnosed breast cancer patients, collected in Bologna, Italy, and the other one of patients affected by hormonal therapy-resistant breast cancer, collected in New York, USA. The presence of DNaseI-resistant DNA in the RNA fraction prompted us to study the physical-chemical status of the viral DNA sequences packaged in the MVs coming from viral positive cell lines; the DNA is found in the form of DNA:RNA hybrids (R-loops), which are known to be more stable structures, mostly synthesized in hypoxic conditions.

Introduzione. Nonostante il dolore sia un’esperienza comune a tutti gli esseri umani, è molto difficile darne una definizione esauriente sia esso fisico che psicologico. A tutt’oggi il dolore mentale è stato poco indagato. L’obiettivo principale del seguente progetto di ricerca è di delineare una più accurata definizione del costrutto di dolore mentale, verificare l’applicabilità dell’Orbach and Mikulincer Mental Pain Scale (OMMP) nella valutazione psicologica e la validazione della versione italiana di tale strumento. Metodologia. Sono stati condotti tre studi: il primo, su un campione di 15 soggetti, per verificare e confermare la validità di facciata dell’OMMP; il secondo, realizzato su un campione di 442 soggetti, oltre ad indagare le caratteristiche sociodemografiche associate con la dimensione del dolore mentale, si concentra sulla valutazione delle proprietà psicometriche dello strumento; il terzo è stato eseguito allo scopo di verificarne la struttura fattoriale ed indagare la relazione che intercorre tra dolore mentale e gli altri costrutti psicologici (n = 728). Risultati. Dai dati ottenuti è possibile delineare il profilo sociodemografico dei soggetti della popolazione generale con un maggior livello di dolore mentale: l’essere giovani, nubili/celibi e avere un livello di istruzione inferiore. L’analisi fattoriale esplorativa, non ha confermato la struttura a otto dimensioni descritta dagli autori, rivelandone una a quattro (19 item), e gli indici dell’analisi fattoriale confermativa lo supportano. Infine, le dimensioni del dolore si mostrano correlate con il distress psicologico. Discussioni e conclusioni. Il presente lavoro ha confermato la multidimensionalità del costrutto di dolore mentale nella popolazione italiana ed ha confermato la validità e l’attendibilità del OMMP_19_ITA. All’interno di diversi quadri psicopatologici è stata rilevata la presenza di un maggior livello di dolore mentale. / Introduction. Despite the pain is a common experience to all human beings, it is still very difficult to give a comprehensive definition both physical and psychological. Up till now, mental pain has been understudied The main objective of the following research project is to outline a more accurate definition of the mental pain construct, to verify the applicability of the Orbach and Mikulincer Mental Pain Scale (OMMP) in the psychological evaluation and validation of the Italian version of such tool. Methodology. Three studies were conducted: the first one, on a sample of 15 subjects, to verify and confirm the validity of the OMMP face; the second, conducted on a sample of 442 subjects, as well as investigate the socio-demographic characteristics associated with the mental pain dimension, focuses on the evaluation of the psychometric properties of the instrument; the third instead, was performed in order to verify the factorial structure and investigate the relation between mental pain and other psychological constructs (n = 728). Results. From the data obtained it is possible to outline the socio-demographic profile of the subjects of the general population with a higher level of mental pain: being young, maiden / celibate and have a lower level of education. The factorial explorative analysis, has not confirmed the eight-dimensional structure described by the authors, revealing a four one (19 item), and indexes of the confirmatory factorial analysis support it. Finally, the dimensions of the pain are shown correlated with the psychological distress. Discussions and conclusions. This work confirmed the multidimensionality of mental pain construct in the Italian population and also confirmed the validity and reliability of the OMMP_19_ITA. Within different psychopathological was detected the presence of a higher level of mental pain.

West Nile virus (WNV) is a neurotropic flavivirus that is maintained in an enzootic cycle between mosquitoes and birds, but can also infect and cause disease in humans and other vertebrate species. Most of WNV infections in humans are asymptomatic, but approximately 20% of infected people develop clinical symptoms, although severe neurological diseases are observed in less than 1% of them. WNV is the most widely distributed arbovirus in the world and has been recently associated with outbreaks of meningo-encephalitis in Europe, including Italy, caused by different viral strains belonging to distinct lineages 1 and 2. The hypothesis is that genetic divergence among viral strains currently circulating in Italy might reflect on their pathogenic potential and that the rapid spread of WNV with increased pathogenicity within naïve population suggest that epidemic forms of the virus may encode mechanisms to evade host immunity. Infection with WNV triggers a delayed host response that includes a delay in the production of interferon-α (IFN-α). IFNs are a family of immuno-modulatory cytokines that are produced in response to virus infection and serve as integral signal initiators of host intracellular defenses. The increased number of human cases and the lack of data about virulence of European WNV isolates highlight the importance to achieve a better knowledge on this emerging viral infection. In the present study, we investigate the phenotypic and IFN-α-regulatory properties of different WNV lineage 1 and 2 strains that are circulating in Europe/Italy in two cell lines: Vero and 1321N1. We demonstrate that: Vero and 1321N1 cells are capable of supporting WNV replication where different WNV strains show similar growth kinetics; WNV lineage 2 strain replicated in Vero and 1321N1 cells as efficiently as WNV lineage 1 strains; and both lineages 1 and 2 were highly susceptible to the antiviral actions of IFN-α.

In 51 (33 adult-18 paediatric) allogeneic hematopoietic stem cell transplant recipients we aimed to evaluate: i) the incidence of EBV infection and potential risk factors; ii) the suitability of whole blood (WB) as clinical specimen to monitor the risk of patients to develop EBV-related post-transplant lymphoproliferative disorder (EBV-PTLD); iii) the clinical utility of combined virological-immunological monitoring; iv) the management of infection and the incidence of EBV-PTLD. Quantitative real-time PCR assay was performed on WB samples for all patients. EBV-DNA quantification also in peripheral blood mononuclear cells (PBMCs) samples was adopted for actively EBV infected patients. Immunological monitoring of infection was performed by Enzyme-linked ImmunoSPOT assay evaluating the EBV-specific cell-mediated immunity (CMI). The incidence of EBV infection was 51% and the frequency of EBV-PTLD was 3.9%. Reduced-intensity conditioning (RIC) in combination with in vivo T-cell depletion was associated with higher frequencies of infection (P=0.036). A significant correlation (P<0.001) between EBV-DNA levels in WB and PBMC samples was obtained in adult (r=0.787) and paediatric (r=0.976) patients. A similar kinetics of EBV-DNA in blood compartments was observed. Clinically, both specimen types appeared to be equally informative. The lack of EBV-specific CMI during/after active infection was associated with a higher median peak level of EBV-DNA in WB (P=0.013) and a greater severity of infection. The 54.5% of the patients without EBV-specific CMI needed anti-CD20 therapy and the 27.2% developed EBV-related complications, including a lethal PTLD. All patients with EBV-specific CMI controlled EBV replication and were asymptomatic. WB proved to be a suitable clinical specimen to monitor the risk of patients to develop EBV-related complications. RIC combined with in vivo T-cell depletion is a risk factor for the development of infection. EBV-specific CMI is a critical determinant in controlling the infection and consequently the EBV-related complications. Combined virological-immunological monitoring could improve the management of infection.

Made available in DSpace on 2019-03-29T23:14:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-12-21 / The goal of this work is to study the relationship between the body and the medical care in the subjectivities construction. For such, we undertook a bibliographical research, using as the main axle Michel Foucault s theoretical reference. According to his thought, the subject construction depends on the cultural characteristics, and therefore, it is transformed throughout the time. Initially, we delimited the conception of body used in the research. It is considered the biological body understood as organic substance. After that, we start to understand the subjective constitution by means of subjectivation to medical knowledge, which in Modernity is consolidated as the rationality that dominates the individuals truth. In this way, we saw that, with the rise of the anatomopathology Medicine, that has as an essential characteristic the reference to the death, the subjectivity was overlapped by the body. On a third moment, we treated with understanding the subjects construction by the dividing practice means unchained by the power relations in Medicine. On the last chapter, we ve dedicated ourselves to research for the subjectivation and the dividing practice by doctors knowledge means that predominates at the moment, which is, the Biomedicine. This new rationality conserves some aspects of the Medicine that preceded it, as considering the body in organism terms. However, it possesses characteristics that are peculiar to it, in which we would stand out the centre being no longer in death, but in life and health. In presence of this context, we evidence that, nowadays, the juxtaposition of the subjectivity to the body seems to be even more consolidated. We also conclude that the predominance of the biomedical knowledge in our society produced new subjectivation forms and dividing practice in the subjectivity processes. Key words: Body, subjectivity, medical care, Michel Foucault. / O objetivo deste trabalho é estudar a relação entre corpo e cuidados médicos na construção das subjetividades. Para tanto, empreendemos uma pesquisa bibliográfica, utilizando como eixo principal o referencial teórico de Michel Foucault. De acordo com seu pensamento, a construção dos sujeitos depende das características culturais, e, portanto, é transformada ao longo do tempo. Inicialmente, delimitamos a noção de corpo utilizada na pesquisa. Trata-se do corpo biológico compreendido como matéria orgânica. Em seguida, passamos a compreender a constituição subjetiva por meio do assujeitamento ao saber médico, que na Modernidade consolidou-se como a racionalidade que domina a verdade sobre os indivíduos. Deste modo, vimos que, com o nascimento da Medicina anatomopatológica, que tem como característica essencial a referência à morte, a subjetividade foi sobreposta ao corpo. No terceiro momento, tratamos de entender a construção dos sujeitos por meio das práticas divisórias desencadeadas pelas relações de poder da Medicina. No último capítulo, dedicamo-nos a pesquisar o assujeitamento e as práticas divisórias por meio do saber médico que predomina na atualidade, qual seja, a Biomedicina. Esta nova racionalidade conserva alguns aspectos da Medicina que a precedeu, como considerar o corpo em termos de organismo. Contudo, possui características que lhe são singulares, entre as quais destacaríamos o centramento não mais na morte, mas na vida e na saúde. Diante deste contexto, constatamos que, na contemporaneidade, a justaposição da subjetividade ao corpo parece estar ainda mais consolidada. Concluímos também que a predominância do saber biomédico na nossa sociedade engendrou novas formas de assujeitamento e novas práticas divisórias nos processos de subjetivação. Palavras-chave: Corpo, subjetividade, cuidados médicos, Michel Foucault.

Made available in DSpace on 2019-03-29T23:46:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-08-08 / The former work is dedicated to a discussion about identification and nomination on psychiatric clinic. Our problem is related to the growing way individuals present themselves as the classification given to them by the diagnosis. The research, exploratory by nature, used various authors who dedicate to the study of the epistemological and clinical bases of the diagnosis and the medical clinic. Regarding the psychoanalysis it is present as the base theory that allowed us to read our question, mainly in the aspects of the clinic, as we made an option to use scraps of clinical cases as a support to our discussions. The first chapter is dedicated to the study of the relations between diagnosis and classification, bringing up the effects that the medical discourse implies on the social field regarding the legitimacy and legality. On the second chapter we discuss the conceptions of identification and nomination on psychoanalysis, on Freud and Lacan, questioning the ways of representation that the significant takes for the subject in relation to the operations of nomination. The third chapter leans toward the questions between psychoanalysis and medicine, using the scraps of clinical cases to take up the discussion about subjective effects of classification. We consider this problem to be vast and we came to think about the contributions that psychoanalysis can offer to the medical field. Those contributions, on our point of view, lean towards the clinic, fundamentally on what concerns the consideration given to the demand and to the subject. Key-words: Diagnosis; Classification; Identification; Nomination; Psychiatric Clinic. / O presente trabalho trata de uma discussão acerca da identificação e da nomeação na clínica psiquiátrica. Nossa problemática diz respeito ao modo como os indivíduos cada vez mais passam a se apresentam a partir da classificação que lhes foi atribuída pelo diagnóstico. A pesquisa, que é de caráter exploratório, utilizou-se de diversos autores que se dedicam ao estudo das bases epistemológicas e clínicas do diagnóstico e da clínica médica. No que diz respeito à psicanálise esta aparece como teoria base que nos permitiu a leitura dedicada a nossa questão, sobretudo no que diz respeito à clínica, uma vez que optamos por também utilizar recortes de casos clínicos como suporte para nossa discussão. O primeiro capítulo é dedicado ao estudo às relações entre diagnóstico e classificação, pondo em pauta os efeitos que o discurso médico opera no campo social em termos de legitimidade e legalidade. No segundo capítulo tratamos dos conceitos de identificação e nomeação na psicanálise, em Freud e Lacan, questionando as formas de representação que o significante assume para o sujeito no que diz respeito às operações de nomeação. O terceiro capítulo trata das questões entre psicanálise e medicina, trazendo em seguida as vinhetas de casos clínicos para retomarmos a discussão sobre os efeitos subjetivos da classificação. Consideramos que esta problemática é vasta e nos leva sobretudo a pensar em que tipo de contribuição a psicanálise tem a oferecer para o campo médico. Estas contribuições, a nosso ver, dizem respeito à clínica, fundamentalmente no que à consideração concedida à demanda e ao sujeito. Palavras-chave: Diagnóstico; Classificação; Identificação; Nomeação; Clínica psiquiátrica.

Negli ultimi anni si è assistito ad un miglioramento della qualità di vita dei piccoli animali che, oltre ad aumentarne l'aspettativa di vita, ha determinato un aumento della frequenza di patologie associate all'età medio-avanzata, quali le patologie renali croniche. Il presente studio si fonda sulla necessità, sempre più sentita nella pratica clinica veterinaria, di poter fornire al proprietario del paziente affetto da CKD, una serie di parametri che, oltre a fungere da target terapeutico, possano aiutare a comprenderne la prognosi. Lo studio ha valutato una popolazione di cani affetti da CKD e ne ha seguito o ricostruito il follow-up, per tutto il periodo di sopravvivenza fino al momento dell’exitus. Di tali soggetti sono stati raccolti dati relativi ad anamnesi, esame clinico, misurazione della pressione arteriosa, diagnostica per immagini, esami ematochimici, analisi delle urine ed eventuale esame istologico renale. È stato possibile individuare alcuni importanti fattori prognostici per la sopravvivenza in pazienti con CKD. Oltre a fattori ben noti in letteratura, come ad esempio elevati valori di creatinina e fosforo, o la presenza di proteinuria, è stato possibile anche evidenziare il ruolo prognostico negativo di alcuni parametri meno noti, ed in particolare delle proteine di fase acuta positive e negative, e del rapporto albumina/globuline. Una possibile spiegazione del valore prognostico di tali parametri risiede nel ruolo prognostico negativo dell’infiammazione nel paziente con CKD: tale ruolo è stato suggerito e dimostrato nell’uomo e avrebbe alla base numerosi possibili meccanismi (sviluppo di anemia, complicazioni gastroenteriche, neoplasie, etc.), ma dati analoghi sono mancanti in medicina veterinaria. Una seconda possibile spiegazione risiede nel fatto che potenzialmente i livelli delle proteine di fase acuta possono essere influenzati dalla presenza di proteinuria nel paziente con CKD e di conseguenza potrebbero essere una conferma di come la proteinuria influenzi negativamente l'outcome. / In recent years there has been an improvement in the quality of life of small animals. In addition of increasing life expectancy, this has led to an increase in the frequency of diseases associated with elderly, such as chronic kidney disease. The present study is based on the need, in the veterinary practice, to be able to provide the owner of a patient with CKD some parameters which can help to understand the prognosis, besides being useful as a therapeutic target. The study evaluated a population of dogs with CKD and followed these dogs or rebuilt the follow-up, until the exitus. We collected data on medical history, clinical examination, blood pressure measurement, diagnostic imaging, blood tests, urinalysis and, when possible, renal histology. It was possible to identify important prognostic factors for survival in patients with CKD. The prognostic role of high levels of creatinine and phosphorus, or the presence of proteinuria is well known in the literature. It was also possible to emphasize the negative prognostic role of some less known parameters, such as acute phase proteins and albumin to globulin ratio. One possible explanation of the prognostic value of these parameters lies in the negative prognostic role of inflammation in patients with CKD: this role has been suggested and demonstrated in humans and has many possible underlying mechanisms (development of anemia, gastrointestinal complications, cancer, etc.), but similar data are missing in veterinary medicine. A second possible explanation lies in the fact that the levels of acute phase proteins may be influenced by the presence of proteinuria in the patient with CKD and therefore may be a confirmation of how proteinuria negatively affects the outcome.

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