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Masi G.,Scientific Institute of Child Neurology and Psychiatry | Perugi G.,University of Pisa | Perugi G.,Institute of Behavioral science | Millepiedi S.,Scientific Institute of Child Neurology and Psychiatry | And 7 more authors.
Psychiatry Research | Year: 2010

This study reports on the naturalistic pharmacotherapy of 266 youths with bipolar disorder (BP), manic or hypomanic episode (158 males and 108 females, 13.8 ± 2.8 years), first treated with monotherapy on valproic acid (VPA) (n=158, 59.4%), lithium (n=90, 33.8%) or atypical antipsychotics (n=18, 6.8%). Among the patients receiving mood stabilizers, 59.5% of those treated with VPA and 47.8% of those receiving lithium did not need other antimanic agents (mood stabilizers and/or atypical antipsychotics). Lower severity was associated with a greater persistence of both VPA and lithium monotherapy. Factors associated with greater persistence of VPA monotherapy were BP II and co-occurring generalized anxiety disorder, separation anxiety disorder and simple phobias. On the contrary, BP I and co-occurring psychotic symptoms and/or conduct disorder were associated with a lower persistence of VPA monotherapy. Factors associated with lower persistence of lithium monotherapy were younger age and the association with attention deficit hyper-activity disorder (ADHD). Type of BP and presence of psychotic symptoms and conduct disorder did not affect the lithium monotherapy. Overall, predictors of non-response (multiple stepwise logistic regression) in both VPA and lithium groups were baseline Clinical Global Impression (CGI) Severity score and comorbid conduct disorder; while psychotic symptoms and absence of comorbid generalized anxiety disorder were predictors of poorer treatment response only in the VPA group, and chronic course, comorbid ADHD and absence of comorbid panic disorder were predictors only in the lithium group. Such naturalistic data from an ordinary clinical setting have relevance to clinical practice. © 2009 Elsevier Ireland Ltd.


Halasz P.,Institute of Clinical Neuroscience | Bodizs R.,Institute of Behavioral Science | Parrino L.,University of Parma | Terzano M.,University of Parma
Sleep Medicine | Year: 2014

In this paper we reviewed results of sleep research that have changed the views about sleep slow wave homeostasis, which involve use-dependent and experience-dependent local aspects to understand more of the physiology of plastic changes during sleep. Apart from the traditional homeostatic slow-wave economy, we also overviewed research on the existence and role of reactive aspects of sleep slow waves. Based on the results from spontaneous and artificially evoked slow waves, we offer a new hypothesis on instant slow wave homeostatic regulation. This regulation compensates for any potentially sleep-disturbing events by providing instant "delta injections" to maintain the nightly delta level, thus protecting cognitive functions located in the frontal lobe. We suggest that this double (long-term /instant) homeostasis provides double security for the frontal lobes in order to protect cognitive functions. The incorporation of reactive slow wave activity (SWA) makes sleep regulation more dynamic and provides more room for the internalization of external influences during sleep. © 2014 Elsevier B.V. All rights reserved.


PubMed | University of Turku, King Abdulaziz University, Baylor College of Medicine, University of Helsinki and 27 more.
Type: Journal Article | Journal: The American journal of clinical nutrition | Year: 2015

Recent studies suggest that meat intake is associated with diabetes-related phenotypes. However, whether the associations of meat intake and glucose and insulin homeostasis are modified by genes related to glucose and insulin is unknown.We investigated the associations of meat intake and the interaction of meat with genotype on fasting glucose and insulin concentrations in Caucasians free of diabetes mellitus.Fourteen studies that are part of the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium participated in the analysis. Data were provided for up to 50,345 participants. Using linear regression within studies and a fixed-effects meta-analysis across studies, we examined 1) the associations of processed meat and unprocessed red meat intake with fasting glucose and insulin concentrations; and 2) the interactions of processed meat and unprocessed red meat with genetic risk score related to fasting glucose or insulin resistance on fasting glucose and insulin concentrations.Processed meat was associated with higher fasting glucose, and unprocessed red meat was associated with both higher fasting glucose and fasting insulin concentrations after adjustment for potential confounders [not including body mass index (BMI)]. For every additional 50-g serving of processed meat per day, fasting glucose was 0.021 mmol/L (95% CI: 0.011, 0.030 mmol/L) higher. Every additional 100-g serving of unprocessed red meat per day was associated with a 0.037-mmol/L (95% CI: 0.023, 0.051-mmol/L) higher fasting glucose concentration and a 0.049-ln-pmol/L (95% CI: 0.035, 0.063-ln-pmol/L) higher fasting insulin concentration. After additional adjustment for BMI, observed associations were attenuated and no longer statistically significant. The association of processed meat and fasting insulin did not reach statistical significance after correction for multiple comparisons. Observed associations were not modified by genetic loci known to influence fasting glucose or insulin resistance.The association of higher fasting glucose and insulin concentrations with meat consumption was not modified by an index of glucose- and insulin-related single-nucleotide polymorphisms. Six of the participating studies are registered at clinicaltrials.gov as NCT0000513 (Atherosclerosis Risk in Communities), NCT00149435 (Cardiovascular Health Study), NCT00005136 (Family Heart Study), NCT00005121 (Framingham Heart Study), NCT00083369 (Genetics of Lipid Lowering Drugs and Diet Network), and NCT00005487 (Multi-Ethnic Study of Atherosclerosis).


PubMed | Karolinska Institutet, Tufts University, University of Turku, University of Tartu and 29 more.
Type: Clinical Trial | Journal: Human molecular genetics | Year: 2015

Obesity is highly heritable. Genetic variants showing robust associations with obesity traits have been identified through genome-wide association studies. We investigated whether a composite score representing healthy diet modifies associations of these variants with obesity traits. Totally, 32 body mass index (BMI)- and 14 waist-hip ratio (WHR)-associated single nucleotide polymorphisms were genotyped, and genetic risk scores (GRS) were calculated in 18 cohorts of European ancestry (n = 68 317). Diet score was calculated based on self-reported intakes of whole grains, fish, fruits, vegetables, nuts/seeds (favorable) and red/processed meats, sweets, sugar-sweetened beverages and fried potatoes (unfavorable). Multivariable adjusted, linear regression within each cohort followed by inverse variance-weighted, fixed-effects meta-analysis was used to characterize: (a) associations of each GRS with BMI and BMI-adjusted WHRand (b) diet score modification of genetic associations with BMI and BMI-adjusted WHR. Nominally significant interactions (P = 0.006-0.04) were observed between the diet score and WHR-GRS (but not BMI-GRS), two WHR loci (GRB14 rs10195252; LYPLAL1 rs4846567) and two BMI loci (LRRN6C rs10968576; MTIF3 rs4771122), for the respective BMI-adjusted WHR or BMI outcomes. Although the magnitudes of these select interactions were small, our data indicated that associations between genetic predisposition and obesity traits were stronger with a healthier diet. Our findings generate interesting hypotheses; however, experimental and functional studies are needed to determine their clinical relevance.


Kurokawa J.,Asia Center for Air Pollution Research | Kurokawa J.,Japan National Institute of Environmental Studies | Ohara T.,Japan National Institute of Environmental Studies | Morikawa T.,Japan Automobile Research Institute | And 6 more authors.
Atmospheric Chemistry and Physics | Year: 2013

We have updated the Regional Emission inventory in ASia (REAS) as version 2.1. REAS 2.1 includes most major air pollutants and greenhouse gases from each year during 2000 and 2008 and following areas of Asia: East, Southeast, South, and Central Asia and the Asian part of Russia. Emissions are estimated for each country and region using updated activity data and parameters. Monthly gridded data with a 0.25 × 0.25 resolution are also provided. Asian emissions for each species in 2008 are as follows (with their growth rate from 2000 to 2008): 56.9 Tg (+34%) for SO2, 53.9 Tg (+54%) for NOx, 359.5 Tg (+34%) for CO, 68.5 Tg (+46%) for non-methane volatile organic compounds, 32.8 Tg (+17%) for NH3, 36.4 Tg (+45%) for PM10, 24.7 Tg (+42%) for PM 2.5, 3.03 Tg (+35%) for black carbon, 7.72 Tg (+21%) for organic carbon, 182.2 Tg (+32%) for CH4, 5.80 Tg (+18%) for N2O, and 16.0 Pg (+57%) for CO2. By country, China and India were respectively the largest and second largest contributors to Asian emissions. Both countries also had higher growth rates in emissions than others because of their continuous increases in energy consumption, industrial activities, and infrastructure development. In China, emission mitigation measures have been implemented gradually. Emissions of SO2 in China increased from 2000 to 2006 and then began to decrease as flue-gas desulphurization was installed to large power plants. On the other hand, emissions of air pollutants in total East Asia except for China decreased from 2000 to 2008 owing to lower economic growth rates and more effective emission regulations in Japan, South Korea, and Taiwan. Emissions from other regions generally increased from 2000 to 2008, although their relative shares of total Asian emissions are smaller than those of China and India. Tables of annual emissions by country and region broken down by sub-sector and fuel type, and monthly gridded emission data with a resolution of 0.25 × 0.25 for the major sectors are available from the following URL: http://www.nies.go.jp/REAS/. © 2013 Author(s).


Hunter L.M.,Institute of Behavioral Science | Strife S.,University of Colorado at Boulder | Twine W.,University of Witwatersrand
Society and Natural Resources | Year: 2010

The state of the local environment shapes the well-being of millions of rural residents in developing nations. Still, we know little of these individuals' environmental perceptions. This study analyzes survey data collected in an impoverished, rural region in northeast South Africa, to understand the factors that shape concern with local environmental issues. We use the "post-materialist thesis" to explore the different explanations for environmental concern in less developed regions of the world, with results revealing the importance of both cultural and physical context. In particular, gendered interaction with natural resources shapes perceptions, as does the local setting. Both theoretical and policy implications are discussed. © 2010 Taylor & Francis Group, LLC.


Maremmani I.,University of Pisa | Maremmani I.,Institute of Behavioral science | Gerra G.,Drug Prevention and Health Branch
American Journal on Addictions | Year: 2010

Maintenance therapy with methadone or buprenorphine-based regimens reduces opioid dependence and associated harms. The perception that methadone is more effective than buprenorphine for maintenance treatment has been based on low buprenorphine doses and excessively slow induction regimens used in early buprenorphine trials. Subsequent studies show that the efficacy of buprenorphine sublingual tablet (Subutex®) or buprenorphine/naloxone sublingual tablet (Suboxone®) is equivalent to that of methadone when sufficient buprenorphine doses, rapid induction, and flexible dosing are used. Although methadone remains an essential maintenance therapy option, buprenorphine-based regimens increase access to care and provide safer, more appropriate treatment than methadone for some patients. Copyright © 2010 American Academy of Addiction Psychiatry.


Vannucchi G.,University of Pisa | Toni C.,Institute of Behavioral science | Maremmani I.,University of Pisa | Maremmani I.,Institute of Behavioral science | And 2 more authors.
Journal of Affective Disorders | Year: 2014

Background Differential association of obesity in bipolar and unipolar Major Depressive Episode (MDE) has not been systematically studied. We explore the relationships between obesity and history of manic and hypomanic symptoms in a large national clinical sample of MDE patients. Method The sample comprised 571 consecutive patients with a DSM-IV diagnosis of MDE enrolled in a 7 months period. The study involved 30 psychiatric facilities for outpatients, distributed throughout Italy. Diagnosis was formulated by psychiatrists with extensive clinical experience in the diagnosis and treatment of mood disorders. In all patients height (meters) and weight (kilograms) were systematically measured at the moment of the clinical evaluation. The severity of depressive and anxious symptomatology was self-evaluated by the means of Zung's questionnaires for depression and anxiety. For the evaluation of lifetime manic or hypomanic features, Hypomania Check List-32 was also administered. Obese and Non-Obese subgroups were identified on the basis of a >30 BMI cut off point. Results BMI ≤30 was observed in 86 (15.1%) of our MDE patients. The Obese and Non-Obese subgroups did not report differences as regards to age and gender distribution. Obese patients reported a lower number of years of education in comparison with Non-Obese patients. As regards to marital status, Obese patients were more frequently married in comparison with the Non-Obese patients. Obese patients were more frequently belonging to the bipolar group than Non-Obese patients. Obese subjects also reported more frequently than Non-Obese an HCL total score >14. The effect of educational level, marital status and bipolar-unipolar distinction on the probability of Obese group membership was analyzed by stepwise logistic regression. Bipolar subtype resulted to be the strongest predictor of Obesity. Limitations Pharmacological treatments and co-morbidity with other psychiatric disorders are not explored and accounted for in our analyses. Conclusions Obesity in our national sample of patients with MDE is associated with bipolar subtype and (hypo)manic symptoms. These findings suggest the possibility that the presence of obesity in patients with MDE might be related to bipolarity. A common impulsive-addictive diathesis is proposed as mediating mechanism. Further longitudinal studies in clinical and non-clinical populations are necessary to better define the burden and the role of the association between obesity and bipolarity. © 2013 Elsevier B.V.

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