http://gruberpeplab.com/3131/Kreibig_2010.pdf

Autonomic nervous system activity in emotion: A review

The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease: A review

ContextBreast cancer screening in community practices may be different from
that in randomized controlled trials. New screening modalities are becoming
available.ObjectivesTo review breast cancer screening, especially in the community and to
examine evidence about new screening modalities.Data Sources and Study SelectionEnglish-language articles of randomized controlled trials assessing
effectiveness of breast cancer screening were reviewed, as well as meta-analyses,
systematic reviews, studies of breast cancer screening in the community, and
guidelines. Also, studies of newer screening modalities were assessed.Data SynthesisAll major US medical organizations recommend screening mammography for
women aged 40 years and older. Screening mammography reduces breast cancer
mortality by about 20% to 35% in women aged 50 to 69 years and slightly less
in women aged 40 to 49 years at 14 years of follow-up. Approximately 95% of
women with abnormalities on screening mammograms do not have breast cancer
with variability based on such factors as age of the woman and assessment
category assigned by the radiologist. Studies comparing full-field digital
mammography to screen film have not shown statistically significant differences
in cancer detection while the impact on recall rates (percentage of screening
mammograms considered to have positive results) was unclear. One study suggested
that computer-aided detection increases cancer detection rates and recall
rates while a second larger study did not find any significant differences.
Screening clinical breast examination detects some cancers missed by mammography,
but the sensitivity reported in the community is lower (28% to 36%) than in
randomized trials (about 54%). Breast self-examination has not been shown
to be effective in reducing breast cancer mortality, but it does increase
the number of breast biopsies performed because of false-positives. Magnetic
resonance imaging and ultrasound are being studied for screening women at
high risk for breast cancer but are not recommended for screening the general
population. Sensitivity of magnetic resonance imaging in high-risk women has
been found to be much higher than that of mammography but specificity is generally
lower. Effect of the magnetic resonance imaging on breast cancer mortality
is not known. A balanced discussion of possible benefits and harms of screening
should be undertaken with each woman.ConclusionsIn the community, mammography remains the main screening tool while
the effectiveness of clinical breast examination and self-examination are
less. New screening modalities are unlikely to replace mammography in the
near future for screening the general population.

https://jamanetwork.com/journals/jama/articlepdf/200479/JCR40026.pdf

Screening for Breast Cancer

Depressive symptoms and syndromes are common in the medically ill, although they are frequently unrecognized and untreated The authors review the epidemiology, differential diagnosis, clinical presentations, and response to treatment of this clinical problem They address such methodological issues in the current literature in this area as the advantages and limitations of standardized assessment measures and discuss treatment modalities for depression in the medically ill, including antidepressant medication and ECT This clinical problem warrants attention for a variety of reasons: its prevalence, associated morbidity, and treatability Elucidation of the mechanisms of depression in the medically ill may also contribute to a broader understanding of depression in other populations

Depression in the medically ill: An overview.

Background Cognitive behavioral treatment (CBT) of residual symptoms after successful pharmacotherapy yielded a substantially lower relapse rate than did clinical management in patients with primary major depressive disorders. The aim of this study was to test the effectiveness of this approach in patients with recurrent depression (≥3 episodes of depression). Methods Forty patients with recurrent major depression who had been successfully treated with antidepressant drugs were randomly assigned to either CBT of residual symptoms (supplemented by lifestyle modification and well-being therapy) or clinical management. In both groups, during the 20-week experiment, antidepressant drug administration was tapered and discontinued. Residual symptoms were measured with a modified version of the Paykel Clinical Interview for Depression. Two-year follow-up was undertaken, during which no antidepressant drugs were used unless a relapse ensued. Results The CBT group had a significantly lower level of residual symptoms after discontinuation of drug therapy compared with the clinical management group. At 2-year follow-up, CBT also resulted in a lower relapse rate (25%) than did clinical management (80%). This difference attained statistical significance by survival analysis. Conclusions These results challenge the assumption that long-term drug treatment is the only tool to prevent relapse in patients with recurrent depression. Although maintenance pharmacotherapy seems to be necessary in some patients, CBT offers a viable alternative for other patients. Amelioration of residual symptoms may reduce the risk of relapse in depressed patients by affecting the progression of residual symptoms to prodromes of relapse.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/204267/yoa7418.pdf

Prevention of Recurrent Depression With Cognitive Behavioral Therapy: Preliminary Findings

The effects of differentiation, novelty, and difficulty of ability tasks upon electrogastrographic activity of healthy subjects during digestion were investigated. Electrical recording of activity of the stomach by means of surface electrodes was performed in 40 healthy volunteers before and after easy or hard tasks. 20 subjects had to complete puzzles; the others had mental arithmetic. Both groups were matched in terms of scores on easy and difficult tasks. Baseline recordings were performed before each trial. The number of waves with peak amplitude > 100μv on electrogastrographic recording during each time span was measured, using a visual analysis. There was a significant decrease in number of waves/min. during task performance. A more pronounced decrease was produced by subjects working on puzzles than those working on mental calculation and by subjects working on easy tasks than those working on difficult tasks when the easy preceded the difficult ones. A larger decrease was obtained when the tasks o...

Effects of two tasks and two levels of difficulty upon surface electrogastrograms.

Gastrointestinal reactivity is a central concept in several psychosomatic approaches to peptic ulcer disease and irritable bowel disease. One potential limitation of many laboratory studies of gastrointestinal reactivity is their reliance on non-ecological tasks lacking components of social stressors which may better relate to day to day stress. Otherwise, the public speaking task is a well known stressful procedure and has a high degree of ecological validity. Stress reactions induced by preparation for public speaking are the result of both the cognitive demand of preparing a speech and social anxiety. The aim of this study was to observe the effect of the public speaking test on the electrogastric activity and the relationship between gastric myoelectrical activity and cardiac activity prior to and after the task. In particular, we hypothesized that public speaking would reduce the amplitude of the normal 3 c.p.m. band and that this decrease would be positively correlated with a reduction in respiratory sinus arrhythmia. As expected, the anticipation of public speaking triggered a decrease in respiratory sinus arrhythmia, an increase in heart rate, and higher skin conductance level compared to baseline. On the other hand, our measure of gastric myoelectrical activity was not affected by the public speaking task. Copyright © 2001 John Wiley & Sons, Ltd.

Giancarlo Trombini

Papers

Effects of two tasks and two levels of difficulty upon surface electrogastrograms.

Effect of public speaking on gastric myoelectrical reactivity and parasympathetic cardiac control

La sofferenza del bambino oncologico attraverso la tecnica delle 'storie disegnate'

Psicosomatica. L'equilibrio tra mente e corpo.

Course of gastric motility and the heart and respiratory rate of healthy subjects during the execution of performance tests