Does an emotion‐focused two‐chair dialogue add to the therapeutic effect of the empathic attunement to affect?

An increasing amount of research suggests that it is beneficial to work explicitly with emotions in psychotherapy. Emotion‐focused therapy (EFT) utilizes interventions that are thought to enhance the evocativeness of emotional processing and facilitate explorations of new meaning. The purpose of this study was to examine the effect of such an intervention on therapeutic outcome. The intervention, a two‐chair dialogue drawn from emotion‐focused therapy, was added to the treatment conditions that consisted of empathically following the clients' emotional processes. The treatment comprised 2 phases. Using a multiple baseline design, 21 self‐critical clients (15 women and 6 men) with clinically significant symptoms of depression and/or anxiety first received 5, 7, or 9 sessions of a baseline treatment focused on alliance building, empathic attunement to affect, and therapeutic presence and genuineness. A two‐chair dialogue intervention was then added for 5 sessions. The symptoms were measured before each session using Beck's Depression Inventory, Beck's Anxiety Index, and Forms of Self‐Criticizing/Attacking and Self‐Reassuring Scale. An analysis using Hierarchical Linear Modelling revealed that the phase with the two‐chair dialogue had a larger impact on symptoms of anxiety and depression when compared to the baseline phase. On BDI‐II, there was a greater impact on somatic‐affective components than cognitive components. Self‐criticism was reduced when we used time as a predictor for both phases but not significantly more after introducing the intervention. The results corroborate that the two‐chair dialogue intervention is associated with change beyond what is shown when relationship conditions alone are being provided. Implications and limitations are discussed.     

Asthma prevalence and exacerbations in children: is there an association with childhood vaccination?

Infections and vaccinations may have a potential role in the normal maturation of the immune system, in the development and balance of regulatory pathways, and in the development and exacerbations of asthma. Asthma exacerbations often result from respiratory viral infections, and, while vaccination towards common viral infections may reduce the occurrence of such exacerbations, there has been concern that vaccinations can increase the risk of asthma. Current studies show that childhood vaccines, including inactivated influenza vaccine, are generally safe. However, there is some concern regarding possible exacerbations in infants or children with frequent wheezing or persistent asthma who are given live-attenuated influenza vaccination. Although severe allergic adverse events attributable to vaccination are extremely rare, all serious allergic reactions should be further assessed to detect the likely causative vaccine component, such as egg protein or gelatin. The risks of not vaccinating children far outweigh the risks of allergy and asthma exacerbations. Therefore, childhood vaccination should remain an essential part of child health programs and should not be withheld, even from children with asthma or those predisposed to allergy.     

Do beta-amyloid (Abeta) deposits in patients with Alzheimer's disease and Down's syndrome grow according to the log-normal model?

The size frequency distributions of diffuse, primitive and classic beta-amyloid (Abeta) deposits were studied in single sections of cortical tissue from patients with Alzheimer's disease (AD) and Down's syndrome (DS) and compared with those predicted by the log-normal model. In a sample of brain regions, these size distributions were compared with those obtained by serial reconstruction through the tissue and the data used to adjust the size distributions obtained in single sections. The adjusted size distributions of the diffuse, primitive and classic deposits deviated significantly from a log-normal model in AD and DS, the greatest deviations from the model being observed in AD. More Abeta deposits were observed close to the mean and fewer in the larger size classes than predicted by the model. Hence, the growth of Abeta deposits in AD and DS does not strictly follow the log-normal model, deposits growing to within a more restricted size range than predicted. However, Abeta deposits grow to a larger size in DS compared with AD which may reflect differences in the mechanism of Abeta formation.     

Threshold levels in food challenge and specific IgE in patients with egg allergy: is there a relationship?

BACKGROUND: Previously published articles described a relationship between food-specific IgE and the outcome of food challenge in children with egg allergy. These investigations defined different levels of predictive values in different study populations and thus pointed toward the possibility of a certain level of specific IgE to egg white predicting a positive outcome in food challenge. OBJECTIVE: The purpose of this study was to determine the utility of specific IgE in estimating threshold level to predict a positive outcome in food challenge. METHODS: Fifty-six children were evaluated for egg allergy by titrated oral challenges. Sera were analyzed for specific IgE to egg white in 56 patients by using the Magic Lite test and 32 of 56 patients also by the CAP test. Values of specific IgE to egg white were compared to the outcome of challenges and the threshold level. RESULTS: The diagnostic level of specific IgE predicting clinical reactivity in this population with greater than 95% certainty was identified as 10.8 standardized units/mL (Magic Lite) and 1.5 kilounits of allergen-specific IgE/L (CAP), respectively. We found no significant relationship between the specific IgE concentration (egg white) and the challenge threshold level. CONCLUSION: Although the specific IgE concentration correlated to a positive outcome in food challenge, there was no significant relationship between the quantification of specific IgE and the challenge threshold level. Therefore the standardized food challenge still remains the gold standard in the diagnosis of food allergy.     

Clinical utility of calprotectin and lactoferrin in patients with inflammatory bowel disease: is there something new from the literature?

The identification of noninvasive biomarkers is still one of the major issue for gastroenterologists dealing with inflammatory bowel disease patients, due to the chronicity of these conditions and the early onset of symptoms in the majority of cases. Research attention has focused mainly on fecal proteins, especially calprotectin and lactoferrin, and most of the published data are reassuring about their applicability in the diagnosis and monitoring of these patients. However, there are still pending questions regarding the reliability of fecal proteins especially in the era of mucosal healing and biologics.     

What is the best way to change self‐efficacy to promote lifestyle and recreational physical activity? A systematic review with meta‐analysis

Purpose. Increasing self‐efficacy is an effective method to increase physical activity. Despite this, the evidence concerning the most effective techniques to increase self‐efficacy in physical activity interventions has not been systematically reviewed. The aim of the present research is to systematically gather, and meta‐analyse, intervention studies which aimed to increase self‐efficacy for physical activity; to estimate the association between intervention techniques used, and change in self‐efficacy achieved. Methods. A systematic database search was conducted for papers reporting lifestyle or recreational physical activity interventions. Published intervention studies explicitly targeting self‐efficacy in order to change physical activity behaviour in ‘healthy’ adults were eligible for inclusion. Results. The search strategy identified 27 unique physical activity intervention studies, with a total of 5,501 participants. A significant, yet small, relationship between the interventions and changes in self‐efficacy was found (mean d =0.16, p <.001). Owing to significant heterogeneity, moderator analyses were conducted, examining the association of changes in self‐efficacy with whether or not specific intervention techniques were used. Interventions that included feedback on past or others' performance produced the highest levels of self‐efficacy found in this review. Vicarious experience was also associated with higher levels of self‐efficacy. Persuasion, graded mastery, and barrier identification were associated with lower levels of self‐efficacy. Conclusions. This meta‐analysis forms an evidence base for which psychological techniques are most effective in increasing self‐efficacy for physical activity. The results are presented in terms of recommendations for those developing interventions and directions for future research.     

Decreased postural adaptation in patients with phobic postural vertigo—An effect of an “anxious” control of posture?

Postural adaptability and responses elicited by vibratory stimulation to the calf muscles recorded on a force platform with eyes open or closed were analyzed in 39 patients suffering from Postural Phobic Vertigo (PPV) (17 men and 22 women, mean age 49 years) and 24 healthy subjects (14 men, 10 women, mean age 38 years). The vibration induced increased body sway in both groups, but the adaptation pattern differed significantly. With eyes open the PPV patients decreased their induced body sway over time (−32%, p < 0.01), which the controls did not. With eyes closed the PPV patients reduced their induced body sway over time to a much lesser extent than the controls (PPV: −28%, p < 0.05, controls: −57%, p < 0.001). These new findings show that PPV patients adapt to proprioceptive perturbation to a lesser extent than normal subjects and that PPV patients do not use visual information as efficiently to modulate postural control. The results support the hypothesis that a cognitive set of posture, an “anxious control”, may underlie the symptoms of PPV, i.e. an increased readiness to react to any perturbation or deviation.     

Hydatidiform mole in the era of COVID‐19 pandemic. Is there an association?

Coronavirus disease 2019 (COVID‐19) is considered a worldwide pandemic. COVID‐19 patients had profound immune dysregulation so they could be susceptible for adverse pregnancy outcomes as hydatidiform mole. In this article, we tried to explain the link between hydatidiform mole and COVID‐19.     

Women's psychological profile and psychiatric diagnoses and the outcome of in vitro fertilization: is there an association?

The influence of psychological processes and psychiatric syndromes on the outcome of fertility treatments is not well understood. In this prospective study, we investigated the effect of baseline psychiatric diagnosis and situational psychiatric symptoms on several biological outcome factors of in vitro fertilization treatments (IVF). Women undergoing their first IVF treatment (n?=?108) were interviewed before treatment for the presence of a lifetime DSM-IV-TR disorder. Questionnaires measuring state depression (Center for Epidemiologic Studies Depression scale), anxiety (State Trait Anxiety Inventory), and psychiatric symptomatology (Brief Symptom Inventory) were administered at ovulation induction. Outcome variables were number of retrieved and fertilized oocytes, chemical pregnancy, and a take home baby. Situational anxiety, depression, or other psychiatric symptoms had no effect on any of the outcome measures. Women diagnosed with mood or anxiety disorder prior to the onset of the IVF treatment showed a higher, though not statistically significant, pregnancy success rate compared to women without a diagnosis (57?% compared to 38?%). We speculate that in women with such psychopathology, chronic stress results in biological effects that impede successful implantation, thus impairing fertility. Fertility treatment using the IVF paradigm may bypass this negative effect, resulting in high success rates. This hypothesis should be further explored.     

AIDS: is there an answer to the global pandemic? The immune system in HIV infection and control

HIV/AIDS continues to spread globally and remains a worldwide pandemic affecting about 40 million people. The prevention of infection remains paramount to vaccine studies. Although the best immune correlates for an efficacious HIV vaccine have not yet been discovered, progress has been made toward developing a vaccine. The identification of an effective antibody-binding site, targeted by a functional neutralizing antibody, and findings confirming that the Gag-specific responses are effective in protecting against disease progression are major advances in this field. This review highlights immunology-based developments in vaccine research and viral and host cell properties that could be employed to curb the spread of HIV.     

Can we assess an acute myocardial infarction in patients with acute coronary syndrome according to diagnostic accuracy of heat shock proteins?

Heat shock proteins (HSPs) have changed very little with evolution, suggesting that they play important role(s) in cellular survival. Specifically, HSPs protect cells from induced cell death. Their expression is triggered by heat or other stress, such as ischemia. HSPs provide protection against protein denaturation, although they slightly differ with respect to group affiliation. Release of HSPs from necrotic and ischemic cardiomyocytes into the intercellular space and plasma may correlate with the intensity of the pro-inflammatory response observed during and immediately after myocardial infarction. We hypothesized that the plasma concentration of particularly inducible forms of HSPs from different groups (HSP 90, HSP 70, HSP 60 and/or HSP 20) can be used as early specific markers for diagnosing myocardial infarction in patients with acute coronary syndrome. Our hypothesis is supported by the following data: (I) HSP expression occurs very early after acute coronary events; (II) HSP concentrations increase rapidly in the peripheral blood; (III) HSP concentrations correlate with markers of myocardial necrosis and pro-inflammatory biochemical parameters. The magnitude of the increase in plasma HSP concentrations over initial concentrations during the period of highest sensitivity and specificity of the assay could be important for early detection of myocardial infarction and distinguishing it from unstable angina. We suggest that these parameters, along with close observation of patients with chest pain, will assist providers who must differentiate between acute myocardial damage and other organ diseases.     

Change in hepatitis C virus genotype in hemodialysis patients after end‐of‐treatment response to interferon monotherapy—relapse or re‐infection?

Hepatitis C virus (HCV) infection remains common among hemodialysis patients and its occurrence is related mainly to nosocomial spread. Although dialysis patients with HCV infection respond well to interferon-based therapy, relapse is frequent. This study aimed at a selected group of hemodialysis patients infected with HCV infection undergoing interferon therapy who achieved end-of-treatment virological response but became HCV-RNA positive again 6 months after end-of-treatment. It was evaluated whether de novo HCV-RNA positivity in these non-sustained responders occurred due to lack of clearance of HCV after the initial response to interferon-alpha (relapse) or due to re-infection with a new strain (re-infection). Genotyping by Inno-LiPA and by phylogenetic tree analysis using partial HCV-NS5B sequences at two evaluation points: pre-treatment (T0) and 6 months after end-of-treatment (T18). Non-sustained responders (n = 15) carried subtypes 1a (8 patients), 1b (4 patients), 3a (2 patients), and 4a (1 patient) before treatment. Identical subtypes were detected in 10 patients at T18. Five patients changed genotypes at T18, suggesting nosocomial re-infection. This study emphasizes the importance of epidemiologic measures to control the re-exposure of hemodialysis patients treated previously for HCV infection.     

Are shame and self‐criticism the path to the pervasive effect of social stress reactivity on social functioning in psychosis?

It is widely known that stress reactivity and social functioning impairment are important difficulties in people with psychosis. However, the specific impact of stress reactivity on social functioning and its underlying mechanisms are still less explored. Social rank variables, such as shame and self‐criticism, have been pointed out as relevant in the development, maintenance of several types of psychosocial suffering and, specifically, in psychotic disorders. This study's aim was to explore the associations between external shame, self‐criticism, social stress reactivity, and social functioning difficulties and understand the mediator role of shame and self‐criticism in the relationship between social stress reactivity and social functioning. Seventy‐seven participants with a psychotic disorder filled in self‐reported measures of stress reactivity, shame, and self‐criticism and were clinically evaluated for social functioning. To study the associations between variables in the study, Spearman correlation coefficients were used. The PROCESS macro was used to test the sequential mediation analyses. All variables under study were associated with each other, and social stress reactivity predicted social functioning difficulties through external shame, whereas self‐criticism was not a significant mediator. The present study highlights the role of external shame in the pathway from stress reactivity to social impairment. These results inform recovery‐oriented interventions and reinforce the relevance of considering social competitive mentality when working with people with psychosis. Further research is needed to clarify the role of self‐to‐self relationship in social impairment and to identify other mechanisms aimed at dealing with shame used by people with psychosis.