Human Optimal Functioning: The Genetics of Positive Orientation Towards Self,Life, and the Future

Certain personality characteristics such as self-esteem, life satisfaction, and optimism are fundamental components of positive mental health status and well-being. There is consistent evidence that these traits tend to be substantially correlated in individuals. However, no previous studies have investigated the origin of such correlation. This research used the twin method to unravel the genetic and environmental architecture of self-esteem, life satisfaction, and optimism, along with their mutual interplay. The sample was derived from the population-based Italian Twin Register, and included 428 twin pairs, aged 23–24 years. Multivariate genetic modeling showed that genes influencing self-esteem, life satisfaction, and optimism are largely overlapping. Furthermore, results indicated that the environmental components of the traits may overlap only modestly, and suggested that a sizeable amount of variance in the traits may be explained by environmental effects specific to each of them. An erratum to this article can be found at     

Association of albuminuria with systolic and diastolic left ventricular dysfunction in type 2 diabetes: the Strong Heart Study

OBJECTIVES: We sought to compare systolic and diastolic function in American Indians with diabetes mellitus (DM) based on albuminuria status. BACKGROUND: Albuminuria has been shown to predict cardiovascular disease (CVD) in populations with DM. However, the mechanism of the association of albuminuria and CVD is unclear. METHODS: We compared echo-derived indices of left ventricular (LV) systolic and diastolic function in three groups of American Indians with DM based on albuminuria status: I = no albuminuria (<30 mg albumin/g creatinine); II = microalbuminuria (30 to 300 mg/g); and III = macroalbuminuria (>300 mg/g). RESULTS: Group II and III were slightly older than Group I with no significant gender difference between groups. Systolic blood pressure increased and body mass index decreased from Group I to Group III. Left ventricular systolic function was lower in the groups with albuminuria with step-wise decreases in ejection fraction and stress-corrected midwall shortening (MWS) from Group I to Group III. Similar findings were noted in diastolic LV filling with lower mitral E/A ratios and longer deceleration times in groups with albuminuria. The proportion of participants with abnormal MWS and abnormal LV diastolic relaxation showed step-wise increases from no albuminuria to macroalbuminuria. In multivariate analysis, albuminuria status remained independently associated with both systolic and diastolic dysfunction after adjusting for age, gender, body mass index, systolic blood pressure, duration of diabetes, coronary artery disease, and LV mass. CONCLUSIONS: Albuminuria is independently associated with LV systolic and diastolic dysfunction in type 2 DM; this may explain in part the relationship of albuminuria to increased cardiovascular (CV) events in the DM population. Screening for albuminuria identifies individuals with high CV risk and possible cardiac dysfunction.     

Novel types of polysaccharidic assemblies

New types of polysaccharidic assemblies based on chitosan and uncharged or charged derivatives of scleroglucan are presented. Macroscopic assemblies having a spherical skinlike shape were prepared by controlled mixing of two polyelectrolyte solutions. Hydrogels based exclusively on the above natural derivatized polysaccharides crosslinked via simple chemical processes, avoiding the use of extraneous reticulating agents and organic solvents, are also described. These biocompatible materials may, eventually, be used in drug release formulations or for the incapsulation of bioactive macromolecules. The interesting possibility exists to study the micelle formation of amphiphiles within the spherical skins.     

Exocrine pancreatic cancer,cigarette smoking,and diabetes mellitus: a case-control study in northern Italy

The role of cigarette smoking and diabetes mellitus as risk factors for exocrine pancreatic cancer (PC) was investigated in a hospital based case-control study. Current smokers were at increased risk for PC (OR = 2.36, 95% CI 1.53-3.63): the magnitude of the risk was related to the lifetime amount of smoking (chi2(trend) = 17.00; P < 0.0001). Among former smokers, after 15 years from ceasing smoking, the risk for PC dropped to the level of a lifetime non-smoker, whichever the lifetime smoking amount. Diabetes was associated with a 2.89-fold increased risk for PC (95% CI 1.71-4.86): the risk was 4.76 (95% CI 1.99-11.53) for diabetes diagnosed up to 2 years before the diagnosis of PC and dropped to 2.07 (95% CI 1.02-4.20) for diabetes diagnosed more than 5 years before PC. The risk for PC was estimated according to the treatment used to control diabetes: it was 6.49 (95% CI 2.28-18.48) for insulin treated diabetes and 2.12 (95% CI 1.16-3.87) for diabetes treated with oral hypoglycemic drugs. The risk of PC for diabetes treated for more than 5 years before the diagnosis of PC was 6.21 (95% CI 1.61-23.96) for patients treated with insulin and 1.21 (95% CI 0.50-2.92) for those treated with oral hypoglycemic drugs: the type of treatment needed to control the disease may discriminate between the diabetes that represents a consequence of cancer from the diabetes that could represent an etiological co-factor. More studies are needed to clarify whether long-lasting insulin-treated diabetes is an etiological co-factor in PC.     

Long-Term Follow-Up of a Donor versus No-Donor Comparison in Patients with Multiple Myeloma in First Relapse after Failing Autologous Transplantation

We report the long-term clinical outcomes of a retrospective multicenter study that enrolled 169 patients with multiple myeloma (MM) in first relapse after failing autologous stem cell transplantation (SCT). After HLA typing at relapse, 79 patients with a suitable donor, 72 (91%) of whom eventually underwent salvage allogeneic SCT (allo-SCT), were compared with 90 patients without a donor who were treated with multiple lines of salvage treatment with bortezomib and/or immunomodulatory agents. At a median follow-up of 30 months (range, 2-180 months) for all patients and 110 months (range, 38-180 months) for surviving patients, 7-year progression-free survival (PFS) was 18% in the donor group and 0% in the no-donor group (hazard ratio [HR], 2.495; 95% confidence interval [CI], 1.770-3.517; P?<?.0001). Seven-year overall survival (OS) was 31% in the donor group and 9% in the no-donor group (HR, 1.835; 95% CI, 1.306-2.577; P?<?.0001). By multivariate analysis, chemosensitivity to salvage treatments and presence of a suitable donor were significantly associated with better PFS and OS. The long-term follow-up of this study confirms the significant PFS benefit and provides new evidence of an OS advantage for patients with MM who have a suitable donor and undergo allo-SCT. Allo-SCT should be considered as a treatment option in young relapsed patients with high-risk disease features after first-line treatment.     

NK cells in autoimmune diseases: Linking innate and adaptive immune responses

The pathogenesis of autoimmunity remains to be fully elucidated, although the contribution of genetic and environmental factors is generally recognized. Despite autoimmune conditions are principally due to T and B lymphocytes, NK cells also appear to play a role in the promotion and/or maintenance of altered adaptive immune responses or in peripheral tolerance mechanisms.Although NK cells are components of the innate immune system, they shows characteristics of the adaptive immune system, such as the expansion of pathogen-specific cells, the generation of long-lasting “memory” cells able to persist upon cognate antigen encounter, and the possibility to induce an increased secondary recall response to re-challenge.Human NK cells are generally identified as CD56⁺ CD3^?, conversely CD56⁺ CD3⁺ cells represent a mixed population of NK-like T (NK T) cells and antigen-experienced T cells showing the up-regulation of several NK cell markers. CD56^dim constitute about 90% of NK cells in the peripheral blood, they are mature and involved in cytotoxicity responses; CD56^bright instead are more immature, mostly involved in cytokine production, having only a limited role in cytolytic responses, keen to leave the blood vessels as the principal population observed in lymph nodes. NK cells have been identified also in non-lymphoid tissues since, in pathologic conditions, they can quickly reach the target organs. A cross-talk between NK with dendritic cells and T cells is established throughout different receptor-ligand bindings.Several studies support the correlation between NK cell number and/or functional alterations, such as a defective cytotoxic activity and several autoimmune conditions. Among the different autoimmune pathologies and even within the same disease, NK cell function is significantly different either promoting or even protecting against the onset of the autoimmune condition.In this Review, we discuss recent literature supporting the role played by NK cells, as a bridge between innate and adaptive immunity, in the onset of autoimmune diseases.     

Sulphur Mineral Water and SPA Therapy in Osteoarthritis

Objective. Osteoarthritis (OA), the most common degenerative osteoarticular disease, is cause of pain and limitations in physical function with high disability that can conduct to a state of psycological stress, not always considered adequately, with negative impact on the quality of life. The mud and bath therapy can improve this aspect. However, these studies are insufficient. The objective of our research was to evaluate the impact of SPA therapy cycle on safety, efficacy and psychosocial disability in osteoarthritis. Materials and methods. The study was carried out on 99 subjects suffering from OA. The patients has treated for 12 days with applications of sulphurous mud-bath therapy from "Terme di Telese" (Benevento, Italy). At the beginning and at the end of the SPA therapy considered has assessed: 1) the adverse reactions; 2) the efficacy on the pain and functional limitations; c) the impact on the psychosocial function using the VAS scale, the SF-36 questionnaire, the WOMAC index and the SDS-Zung test. Statistical analysis of the data was performed by determining the mean ± SD. The results were compared with the Student "t" test or Wilcoxon test. A p value < 0.05 was considered significant. Results. In comparison to the basal values, this investigation has demonstrated that sulphurous mud and bath therapy has induced a significant (p < 0.01) improvement of overall quality of life with reduction of pain at rest (2.1 ± 1.5?→?1.2 ± 1.3) and during daily activities (2.3 ± 1.3?→?1.4 ± 1.3). This has facilitated the physical function and psychosocial disability as shown by the questionnaires SF-36, WOMAC and SDS Zung. Conclusions. In conclusion our data suggest that mud-bath therapy with sulphurous mineral water can be considered as an important phase of the therapeutic strategy in OA.     

Unsedated colonoscopy: A neverending story

Although sedation and analgesia for patients undergoing colonoscopy is the standard practice in Western countries, unsedated colonoscopy is still routinely provided in Europe and the Far East. This variation in sedation practice relies on the different cultural attitudes of both patients and endoscopists across these countries. Data from the literature consistently report that, in unsedated patients, the use of alternative techniques, such as warm water irrigation or carbon dioxide insufflation, can allow a high quality and well tolerated examination.