Introduction: In this study we estimated the rate and the trajectory of cognitive impairment in a naturalistic sample of outpatients with major depressive disorder (MDD) and bipolar disorder (BD) and its correlation with different variables. Materials and methods: An overall sample of 109 outpatients with MDD or BD was assessed for multiple clinical variables, including duration of untreated illness (DUI), and tested using the Montreal Cognitive Assessment (MoCA) during Major Depressive Episodes (MDE) and after remission. Correlations between MoCA scores and the clinical variables were then computed. Results: About 50% of patients with MDD and BD showed mild cognitive impairment during MDE. Improvement of cognitive function between depression and remission was significant, even though residual symptoms were observed especially in the most impaired patients. Of note, cognitive performance during depression was negatively associated with depression severity and DUI. Discussion: Present findings confirm available evidence about patterns of cognitive impairment in mood disorders, in terms of prevalence and persistence beyond remission in most severe cases. Moreover, a longer DUI was associated with worse cognitive performance during depression, and consequently with poorer outcome, underlining the importance of prompt treatment of these disorders also in light of a cognitive perspective.

A 35yearold man presented to the nephrology clinic for evaluation of microhematuria. After a positive dipstick test for blood in the urine, his family physician required an automated urine test, confirming the presence of 30 red blood cells (RBCs) per microscopic field. Family history was remarkable for the presence of kidney disease, including dialysis, on the maternal side. The physical examination was normal, with the exception of moderate hightone sensorineural hearing loss. A microscopic evaluation of the urinary sediment demonstrated the presence of dysmorphic RBCs. How should the finding of hematuria be addressed in this patient? How is hematuria defined and classified? Hematuria is the presence of RBCs (erythrocytes) in the urine. Hematuria can be broadly divided in two categories: aBSTracT The case of a 35yearold man presenting microscopic hematuria allows the following topics to be examined in depth: 1. How is hematuria defined and classified? 2. What are the causes of hematuria? 3. Hematuria is an important sign for the diagnosis of cancer of the urinary system. What are the risk factors for bladder carcinoma? 4. What is the role of the urinary dipstick test in the diagnosis of hematuria? 5. What is the role of the examination of urine sediment in the diagnosis of hematuria? 6. Once microscopic hematuria is confirmed, how can we proceed to reach a final diagnosis?