Semeiotica dell'articolazione temporo-mandibolare

Ha senso, nel 3° millennio ormai inoltrato, proporre un manuale di semeiotica clinica reumatologica? Negli ultimi due decenni la medicina si è avvalsa sempre più della tecnologia e i vantaggi che le sue applicazioni offrono a pazienti, clinici e ricercatori sono tutti ben evidenti. La Reumatologia non è rimasta impermeabile a questo nuovo corso, vedendo crescere in modo esponenziale il ruolo assunto dalla diagnostica per immagini. Chi ha vissuto la Reumatologia ai suoi albori si è adoperato per conferire alla disciplina autonomia accademica e nosografica dotandola, tra le altre cose, di un solido impianto clinico-semeiologico a supportare la convinzione che la Reumatologia sia una disciplina eminentemente clinica. Di questo lascito siamo debitori nei confronti di chi ci ha preceduto. Le nuove metodiche di imaging come l'ecografia e la risonanza magnetica (per citare le più diffuse) hanno aperto nuovi orizzonti su scenari prima sconosciuti o solo parzialmente esplorati e costretto le nuove generazioni di clinici ad una seria e critica revisione del loro patrimonio culturale in ambito clinico-semeiologico. In questo nuovo scenario alcune nozioni e pratiche semeiologiche storicamente sedimentate nel corso degli anni sono, oggi, da ritenersi troppo imprecise, se non addirittura superflue o desuete

BCG and Autoimmunity

The bacillus Calmette-Guérin (BCG) is a live, attenuated vaccine from Mycobacterium bovis obtained by Albert Calmette and Camille Guerin through 230 in vitro passages between 1908 and 1921. This chapter presents clinical applications of BCG such as tuberculosis, leprosy, asthma and other hypersensitivity diseases, Type 1 diabetes, multiple sclerosis, and cancer. BCG can be described as a “double-acting tool” because its own immunogenicity produces a preventive effect in a variety of diseases and may trigger a number of autoimmune phenomena. An acute inflammatory polyarthritis with skin maculopapular rash was reported in a healthy woman following intradermal BCG. Side effects such as granulomatous pneumonia and hepatitis are reported without sufficient data to support the possible link with intravesical BCG and the autoimmune mechanism. Even the kidney may be the target of hypersensitivity reaction to intravesical BCG, which can induce an interstitial nephritis with non-necrotizing, sterile granulomas responsive to steroid therapy

Gastronomic cultural EVOOlution of the virgin olive oil consumption model at the restaurant

Gastronomic experience can be a factor of motivation to improve the quality of extra virgin olive oil served at the restaurant. The “new” consumer is a very complex and demanding figure, who seeks in the consumption of food products not only a means to satisfy food needs, but experiences, emotions, feelings, service, nature, culture, etc. The quality requirements do not only concern the chemical-physical and organoleptic components of the product, but also the hedonostic ones, ie those related to the health aspects, the quality of the territory of origin, the typicality, the respect of the environment by the production processes used, respect for animal welfare, the ethical content of the product, etc. He is demanding in terms of information on the features of the product and requires greater guarantees on its characteristics and/or on the production processes used. All this seems to highlight the presence of potential unsatisfied needs around which it is possible to build paths of development of the offer able to satisfy them, especially at the restaurant, where cultural, emotional and multi-sensory satisfaction of food can be easily “discovered”. This is the right time to change the marketing of extra virgin olive oil at the restaurant, because extra virgin olive oil is an element that embodies the different aspects of the expected and perceptible quality of a food: taste, sensory, knowledge, sacredness, syncretism, health, history, naturalness and authenticity. Tasting a high quality oil, discovering the complexity of the aromas released by the contact with the warm dishes and the gustatory and kinesthetic perceptions that harmoniously interact by balancing the sensory profile of the other ingredients, is comparable to the emotion of a blind man when recovers his sight. From that moment, as the blind man will not be able to tolerate returning to the oblivion of darkness, the guests that tasted a high quality extra virgin olive oil can not tolerate returning to the banality of a fat that anoints without seasoning

Does the Introduction of Ultrasound in Extra-Virgin Olive Oil Extraction Process Improve the Income of the Olive Millers? The First Technology for the Simultaneous Increment of Yield and Quality of the Product

Olive oil is an important product of the European agro-alimentary sector. The current olive oil extraction process can be further improved in order to overcome the weaknesses of the actual system in terms of non-continuity, reduction of oil in waste, sustainability, and improvement of quality both in the healthy and sensory perspective. Many innovative approaches have been developed to improve the olive oil extraction process. However, not all the proposed innovations have the opportunity to effectively reach a technological level of readiness close to “ready for the market.” An innovator should simultaneously evaluate the aptitude of its invention to turn into a widely used commercial product both under the technological and the marketing perspectives. Under the technological point of view, an innovation should be effective, so, adequate to accomplish a purpose, and efficient, so, able to perform or functioning in the best possible manner with the least waste of time and effort. Under the marketing point of view, an innovation should be able to develop products that accurately and timely respond to customer needs, offering a valuable experience to the customer, exceeding his expectations. The innovative EVOO process based on ultrasound extraction has several advantages useful to improve olive miller income: higher yield extraction, higher polyphenols, and lower bitter and pungent taste than traditional EVOO samples

Olive sound: A sustainable radical innovation

Olive Sound is the acronym of a Horizon 2020 European Project aimed at the development of a high-flow oil extraction plant, the Sono-Heat-Exchanger, which combines ultrasound and heat exchange in order to break, through a radical innovation model in the oil mill, the historical paradigm that sees as inversely correlated the oil yield and the content of bio-phenols. These compounds are biologically active molecules that transform the product, extra virgin olive oil, from a mere condiment into a functional food. The primary objective of the project, financially supported by the European Union through the “Fast Track to Innovation” program, is the development of a product “ready for the market” (TRL 9) capable of making the involved companies more competitive while increasing the competitiveness of European extra virgin olive oil in the international context

Optimization of a Green Extraction of Polyphenols from Sweet Cherry (Prunus avium L.) Pulp

This work focused on the optimization of the ultrasound (US) extraction of polyphenols from sweet cherry pulp by monitoring cyanidin-3O-rutinoside, quercetin-3O-rutinoside, and trans-3-O-coumaroylquinic acid, representing the main anthocyanin, flavonol, and hydroxycinnamate, respectively, identified in the extracts through chromatographic analyses (HPLC-DAD), as output variables. The optimization was performed following a two-level central composite design and the influence of the selected independent variables (i.e., extraction time and solid to solvent ratio) was checked through the response surface methodology. The maximum recovery of the phenolic compounds was obtained at 3 min and 0.25 g/mL in water/ethanol (1:1, v/v) at a set temperature (25 °C), sonication power (100 W), and sonication frequency (37 kHz). Subsequent validation experiments proved the effectiveness and reliability of the gathered mathematical models in defining the best ultrasound-assisted extraction conditions

Severe alopecia complicating systemic sclerosis

Aims: To describe a case of systemic sclerosis (SSc) associated with severe alopecia areata (AA) responsive to topical and systemic treatments, including vasoactive and immunosuppressive drugs (mycophenolate mofetil). Presentation of the Case: A 56 year old woman, affected by SSc as from 5 years back, developed a rapid hair loss that progressively involved a large area of the scalp. AA was diagnosed, after the exclusion of an overlapping systemic lupus erythematosus or fungal infection. Treatment with topical steroids and minoxidil, plus mycophenolate mofetil that was introduced for interstitial lung disease, led to progressive improvement of alopecia up to a complete resolution within 4 months. Discussion: This is an interesting observation of SSc complicated by severe AA, which is often observed in patients affected by various autoimmune disorders. A possible common pathogenesis of AA and SSc is also discussed

Haematological Malignancies in Systemic Sclerosis Patients: Case Reports and Review of the World Literature

Background.The association of systemic sclerosis (SSc) and haematological cancers was reported in a large number of case reports and cohort studies, describing SSc patients with highly heterogeneous clinical pictures. Objective. We reviewed the literature to better describe SSc patients with haematological malignancies. Methods. SSc cases complicated by haematological malignancies described in the world literature were collected; other 2 cases referred to our centre were reported. Results. One hundred-thirty SSc subjects were collected from 1954 up to date. The mean age of patients at cancer diagnosis was 56.1 ± 16.7 years; 72% of patients were females. In 60% of cases, the diagnosis of haematological malignancy was described within 5 years of SSc diagnosis. In 7.8% of cases, coexistence of Sj¨ogren’s syndrome or other autoimmune disorders was cited. Sixty-six cases with lymphoma (in the majority of cases B-cell neoplasms), 28 with leukaemia (chronic lymphocytic form in 9), 14 with multiple myeloma plus one solitary IgM plasmocytoma, and 16 with myeloproliferative disorders were found. No specific SSc subsets seem to be related to haematological malignancies. Conclusions. We remarked the importance of clinical work-up in SSc, in order to early diagnose and treat eventual occult haematological malignancies, especially during the first years of the disease

Impegno cardiaco nella sclerosi sistemica

L'impegno cardiaco in corso di sclerosi sistemia consta di uno spettro variabile di manifestazioni cliniche conseguenti ad alterazioni di natura microangiopatica, elettrica e/o emodinamica. In danno ischemico e/o flogistico autoimmune del miocardio producono, in ultima analisi, il quadro istopatologico caratteristico della 'necrosi a bande' con deposizione di tessuto fibroso, responsabile della riduzione di elasticità e della capacità contrattile muscolare. ...