Health Care Professionals Attitudes Towards Mental Illness: Observational Study Performed at a Public Health Facility in Northern Italy

The United Nations Convention on the Rights of Persons with Disabilities Defines stigma as the process of social oppression barring persons with mental illness from enjoying social interaction through discrimination, exclusion and denial of human and social rights. Modern stereotypes still portray the mentally ill as guilty, unpredictable and violent. Observational studies report how healthcare professionals, including nurses, are often part of the stigma. Such phenomenon belittles the needs of people seeking mental care. The aim of this study is to describe attitudes held by psychiatric nurses and mental care professionals from different care settings of an Italian Healthcare Facility, towards the mentally ill and to identify any associated factors. Mental health care professionals were recruited for this observational study from 10 Italian different psychiatric care units. The Italian version of the Community Attitudes Mentally Ill inventory (CAMI-I) was validated and used for this study. 120 completed questionnaires were deemed valid. Optimal internal consistency (α = 0.856) was measured by calculating Cronbach's Alpha for the CAMI-I. Demographic variables were correlated to items grouped into three factors of the CAMI-I (authoritarian attitudes, benevolence, social restrictiveness). Parametric test (ANOVA) highlight significant differences between CAMI-I results for different demographic variables. Significant data were obtained by comparing responses for each factor of the CAMI-i per professional profile. All healthcare professionals studied show sensitivity and positive attitude towards mental illness. Positive approaches to mental illness contribute towards easing therapeutic care and recovery in patient-centred care. CAMI-I will be a useful tool to identifying discriminatory approaches and sensitize health professionals in Italy.     

Assessing the Reliability of Ultrasound Imaging to Examine Peripheral Nerve Excursion: A Systematic Literature Review

Ultrasound imaging (USI) is gaining popularity as a tool for assessing nerve excursion and is becoming an important tool for the assessment and management of entrapment neuropathies. This systematic review aimed to identify current methods and report on the reliability of using USI to examine nerve excursion and identify the level of evidence supporting the reliability of this technique. A systematic search of five electronic databases identified studies assessing the reliability of using USI to examine nerve excursion. Two independent reviewers critically appraised and assessed the methodological quality of the identified articles. Eighteen studies met the eligibility criteria. The majority of studies were of “moderate” or “high” methodological quality. The overall analysis indicated a “strong” level of evidence of moderate to high reliability of using USI to assess nerve excursion. Further reliability studies with consistency of reporting are required to further strengthen the level of evidence.     

The microcirculation in severe malaria

Severe malaria in humans and animals is initiated by interactions between malaria-infected cells, host blood cells (including monocytes, T cells and platelets) and endothelial cells of the microcirculation. Adhesion to vascular cells, and possible vascular obstruction in severe human disease, involves interaction between host receptors and parasite-derived proteins, such as the variant antigen Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1). Our understanding of how different PfEMP1 variants may target infected erythrocytes to specific sites, such as the placenta, is rapidly increasing. However, in most instances downstream immune-mediated inflammatory processes appear more central than parasite accumulation to development of severe malaria. Using genetically-manipulated animal models of severe malaria, key roles for CD8 T cells and mediators such as lymphotoxin in the pathogenesis of murine disease have been established. Experimental and human studies suggest vascular deposition of activated platelets may have a central role. Here, we review some recent advances in the understanding of severe malaria pathogenesis from human and animal studies, focusing on events at the level of the microcirculation, and highlight the role for activated host cells in initiating the pathology of the disease.     

A prospective, randomized trial to determine the early and late reactions after the use of iopamidol 340 (Niopam) and iobitridol 350 (Xenetix) in cardiac catheterization

BACKGROUND: Intravascular contrast agents presently used in modern digital catheter laboratories during cardiac catheterization are superior to older agents as regards patient tolerance. There are, however, significant differences between these agents. PURPOSE: The aim of this study was to determine the incidence of early (< 24 hours) and late (> 24 hours to 7 days) reactions to 2 contrast agents currently used during cardiac catheterization: iopamidol 340 (Niopam) and iobitridol 350 (Xenetix). METHODS: This was a prospective, randomized, double-blinded trial. Two thousand and nineteen patients undergoing cardiac catheterization received one of the following contrast agents: iopamidol 340 (Niopam) and iobitridol 350 (Xenetix). Reactions that were possibly related to the contrast agents were recorded during hospital admission (early reaction) and after discharge (late reaction) by means of a questionnaire. RESULTS: The baseline characteristics were matched in both the groups. There was no significant difference in the incidence of heat sensation experienced between the 2 groups, (p = 0.1). Early non-heat reactions occurred in 3.2% of patients receiving iopamidol 340 (Niopam) and 3.6% of those receiving iobitridol 350 (Xenetix), (p = 0.65). Electrocardiographic changes were recorded in 0.7% of patients who received iopamidol 340 (Niopam), and 2.6% of those who received iobitridol 350 (Xenetix), (p = < 0.01). Seven patients (0.8%) receiving iobitridol 350 suffered ventricular fibrillation requiring DC cardioversion compared with none in the iopamidol 340 group (p = < 0.01). Late reactions (post discharge symptoms) occurred in 13.9% of those receiving iopamidol 340 (Niopam) and 18.5% of those receiving iobitridol 350 (Xenetix) (p = 0.02). CONCLUSIONS: Iobitridol 350 (Xenetix) was associated with more ECG changes and, importantly, ventricular fibrillation, than iopamidol (Niopam). There were no features to suggest other benefits from iobitridol 350. These results suggest that iopamidol 340 is a preferable contrast agent in cardiac catheterization.     

Direct detection of proviral gag segment of human immunodeficiency virus in peripheral blood lymphocytes by colorimetric PCR assay as a clinical laboratory tool applied to different at-risk populations.

We used a colorimetric polymerase chain reaction (PCR)-based assay in kit form to detect directly human immunodeficiency virus type 1 (HIV-1) proviral gag sequences in peripheral blood cells from 68 healthy blood donors, 51 subjects at risk for HIV infection, 122 patients with HIV-1 infection, 11 patients with indeterminate Western blot (immunoblot) results, 4 blood donors HIV-1 positive by enzyme immunoassay, and 13 children born to HIV-1-seropositive mothers. The results obtained in the blood donors and HIV-1-infected patients demonstrated the high degree of diagnostic specificity and sensitivity of the PCR method. HIV-1 infection was excluded in 10 of the 11 patients with indeterminate Western blot results and in all four enzyme immunoassay-positive blood donors. A diagnosis of HIV infection was ruled out by negative PCR results in 5 of 13 children from seropositive mothers, which excluded vertical transmission of the infection in these cases; these children were younger than 3 months and had positive serological results. Two at-risk patients with negative serological results had positive PCR results. All results were confirmed by conventional PCR. In conclusion, colorimetric PCR, which is commercially available in kit form, is an easy and reliable technique that can be used to detect proviral HIV-1 genomes in blood cells, and despite the limitations owing to HIV genome variability, it is useful in the clinical setting for the diagnosis of HIV infection in selected categories of patients.