Rehabilitation in athletes with outcomes of Chronic Ankle Instability: literature analysis and specific treatment proposals depending on different sports.

openPer il trattamento della Chronic Ankle Instability sono stati studiati diversi percorsi riabilitativi che integrano più interventi specifici indirizzati su ROM, Rinforzo Muscolare, Propriocezione, Equilibrio, Funzione Senso-Motoria e Controllo Posturale. Nonostante la loro efficacia sia stata provata, questi percorsi hanno un’ottima efficacia per gran parte della popolazione, ma per quanto riguarda la popolazione sportiva? Negli sportivi abbiamo una diversa sollecitazione delle articolazioni: cambi di direzione, salti, atterraggi, contrasti e terreni dissestati mettono a dura prova le articolazioni degli arti inferiori e le caviglie in particolare. In seguito ad una distorsione di caviglia in uno sportivo c’è un’elevata percentuale di ricaduta, di recidive di infortuni, di return-to-play non ai livelli precedenti all’infortunio e addirittura in alcuni casi il ritiro dall’attività professionistica. L’obiettivo della tesi è quindi, partendo da una ricerca bibliografica nella letteratura e da un’analisi della biomeccanica dei movimenti che nei diversi sport possono causare infortuni alla caviglia, di arrivare a proporre delle proposte riabilitative più specifiche per il trattamento dell’instabilità cronica di caviglia negli sportivi, in particolare nei calciatori, cestisti e runners

Iatrogenic Rectal Perforation During Operative Colonoscopy: Closure With Endoluminal Clips

The risk of perforation during diagnostic or operative colonoscopy can be as high as 2%. Despite conservative treatment being acceptable, the closure of the perforation is usually mandatory, and surgery (either open or laparoscopic) is commonly advocated as rescue therapy. Currently, with the availability of the Endoclip, endoscopists are able to manage iatrogenic perforations avoiding surgery. Clip placement, if necessary, will not delay surgery and might help the surgeon find the site of perforation. However, data in the literature are scant, especially for the closure of large colonic defects. Endoscopic repair using Endoclip devices for a large high rectal perforation following polypectomy is described herein

Effect of season, late embryonic mortality and progesterone production on pregnancy rates in pluriparous buffaloes (Bubalus bubalis) after artificial insemination with sexed semen

The use of sexed semen technology in buffaloes is nowadays becoming more and more accepted by farmers, to overcome the burden of unwanted male calves with related costs and to more efficiently improve production and genetic gain. The aim of this study was to verify the coupling of some variables on the efficiency of pregnancy outcome after deposition of sexed semen through AI. Pluriparous buffaloes from two different farms (N = 152) were screened, selected, and subjected to Ovsynch protocol for AI using nonsexed and sexed semen from four tested bulls. AI was performed in two distinct periods of the year: September to October and January to February. Neither farms nor bulls had a significant effect on pregnancy rates pooled from the two periods. The process for sexing sperm cells did not affect pregnancy rates at 28 days after AI, for nonsexed and sexed semen, respectively 44/73 (60.2%) and 50/79 (63.2%), P = 0.70, and at 45 days after AI, for nonsexed and sexed semen, respectively 33/73 (45.2%) and 33/79 (49.3%), P = 0.60. Pregnancy rate at 28 days after AI during the transitional period of January to February was higher when compared with September to October, respectively 47/67 (70.1%) versus 47/85 (55.2%), P = 0.06. When the same pregnant animals were checked at Day 45 after AI, the difference disappeared between the two periods, because of a higher embryonic mortality, respectively 32/67 (47.7%) versus 40/85 (47.0%), P = 0.93. Hematic progesterone concentration at Day 10 after AI did not distinguish animals pregnant at Day 28 that would or would not maintain pregnancy until Day 45 (P = 0.21). On the contrary, when blood samples were taken at Day 20 after AI, the difference in progesterone concentration between pregnant animals that would maintain their pregnancy until Day 45 was significant for both pooled (P = 0.00) and nonsexed (P = 0.00) and sexed semen (P = 0.09). A similar trend was reported when blood samples were taken at Day 25, being highly significant for pooled, nonsexed, and sexed semen (P = 0.00). Hematic progesterone concentration between the two periods of the year was highly significant for pregnant animals at 28 days from AI when blood samples were taken at Day 20 after AI for pooled, nonsexed, and sexed semen, respectively P = 0.00, 0.00, and 0.06, and for pregnant animals at Day 45 for pooled, nonsexed, and sexed semen, respectively P = 0.00, 0.00, and 0.01. From these results, it can be stated that hematic progesterone concentration measurement since Day 20 after AI can be predictive of possible pregnancy maintenance until Day 45. Furthermore, the transitional period of January to February, although characterized by a higher pregnancy outcome when compared with September to October, suffers from a higher late embryonic mortality as evidenced by a significant different hematic progesterone concentration between the two periods at Day 20 after AI

Effect of photoperiod on follicular IGF-1 and oocyte quality independently of metabolic status in buffalo heifers

The aim of this study was to determine whether buffalo heifers maintained at a constant live weight (LW) and body condition score (BCS) by a restricted diet show changes in reproductive function in response to changes in day length. Heifers were fed a low energy diet (86% daily intake recommended for the species) throughout the study, which involved an 8-week period of decreasing day length and a 7-week period of increasing day length. Weekly, LW, BCS and ovarian follicular/oocyte population were assessed. Blood and follicular fluid samples were taken at the time of ovum pick-up for hormone analyses and at 30-day intervals to measure metabolic substrates. Buffalo heifers maintained LW and BCS throughout the study and blood concentrations of the main metabolic hormones, such as GH, insulin, IGF-1 and thyroid hormones were not influenced by photoperiod. Likewise, there were no differences in metabolic substrates such as glucose, NEFA, triglycerides and HDL cholesterol, suggesting that the metabolic condition remained essentially the same. During increasing day length periods, the number of total follicles (8.4 ± 0.5 vs. 11.9 ± 0.6; p < .01), cumulus-oocyte complexes (2.2 ± 0.3 vs 4.3 ± 0.5; p < .01) and superior quality Grade A + B COCs (0.2 ± 0.1 vs 1.1 ± 0.2; p < .01) decreased. These features were associated to reduced oestradiol levels both in plasma (3.9 ± 0.4 vs 9.2 ± 0.5 pg/mL; p < .01) and follicular fluid (49.7 ± 12.9 vs. 109.1 ± 25.8 ng/mL; p = .05), as well as to reduced intrafollicular IGF-1 levels (45.5 ± 4.0 vs. 58.5 ± 3.9 ng/mL; p < .05). These findings suggest that the ovarian function in buffalo heifers is influenced by photoperiod independent of nutritional and metabolic status.Highlights Metabolic profile, LW and BCS do not change in buffalo heifers on a restricted diet Photoperiod affects ovarian function in heifers regardless of metabolic status Follicular and oocyte population decrease in increasing day length periods Oestradiol and IGF-1 levels in follicular fluid are affected by photoperio

Use of QT intervals for a more accurate diagnose of syncope and evaluation of syncope severity.

Abstract BACKGROUND: This study aimed to evaluate the use of QT intervals, their diagnostic predictive value in patients with syncope and their relationship with syncope severity. METHODS: One hundred and forty nine patients with a diagnosis of syncope were admitted to Internal Medicine departments at the University of Palermo, Italy, between 2006 and 2012, and 140 control subjects hospitalised for other causes were enrolled. QT maximum, QT minimum, QTpeak, QT corrected, QT dispersion and Tpeak-to-Tend interval were compared between two groups. The paper medical records were used for scoring with San Francisco Syncope Rule (SFSR), Evaluation of Guidelines in SYncope Study (EGSYS) score and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk score. RESULTS: Mean QTc (p 424.8 ms (sensibility: 81.88 - specificity: 57.86) showed the greatest predictive value for diagnosis of syncope. On the EGSYS score and on the OESIL score, QTc was significantly prolonged in high-risk patients compared with low-risk patients. On the San Francisco Syncope Rule, QTc and QTdisp were significantly prolonged in high-risk patients compared with low-risk patients. CONCLUSION: Mean QTc, mean QTdisp, mean TpTe, mean QTmax and mean QTpeak were significantly longer in patients with syncope compared with control subjects. Furthermore, prolonged QTc and QTdisp were associated with major severe syncope according to San Francisco Syncope Rule, EGSYS and OESIL risk scores

Tumor induced osteomalacia: a systematic review and individual patient's data analysis

Context: Tumor induced osteomalacia (TIO) is a rare paraneoplastic syndrome, usually caused by small, benign and slow-growing phosphaturic mesenchymal tumors. Clinically, TIO is characterized by renal phosphate leak, causing hypophosphatemia and osteomalacia. This review was performed to assess the clinical characteristics of TIO patients described worldwide so far. Evidence acquisition: On 06/26/2021, a systematic search was performed in Medline, Google Scholar, Google book, and Cochrane Library using the terms: "tumor induced osteomalacia", "oncogenic osteomalacia", "hypophosphatemia". There were no language restrictions. This review was performed according to PRISMA criteria. Evidence results: Overall, 1725 TIO cases were collected. TIO was more frequent in adult men, who showed a higher incidence of fractures compared to TIO women. The TIO causing neoplasms were identified in 1493 patients. The somatostatin receptor-based imaging modalities have the highest sensitivity for the identification of TIO-causing neoplasms. TIO causing neoplasms were equally located in bone and soft tissues; these latter showed a higher prevalence of fractures and deformities. The surgery is the preferred TIO definitive treatment (successful in &gt;90% of patients). Promising non-surgical therapies are treatments with burosumab in TIO patients with elevated Fibroblast Growth Factor-23 levels, and with radiolabeled somatostatin analogs in patients with TIO-causing neoplasm identified by somatostatin receptor-based imaging techniques. Conclusion: TIO occurs preferentially in adult men. The TIO clinical expressiveness is more severe in men as well as in patients with TIO-causing neoplasms located to soft tissues. Treatments with burosumab and with radiolabeled somatostatin analogs are the most promising non-surgical therapies

Do Italian consumers value health claims on extra-virgin olive oil?

The present study aims to extend the existing literature on EVOO consumers by assessing the importance of health claims in selecting EVOO products by jointly accounting for consumer preferences for the many search, experience, and credence attributes potentially available on EVOO, as well as by accounting for attitudinal and psychographic individual characteristics which affect consumer decision to prefer products with health claims over conventional ones (i.e. subjective nutritional knowledge, nutritional knowledge, nutritional importance, attitudes towards using food as a medicine, general health interest). The latter characteristics play a pivotal role in individual decisions to consider health claims when purchasing food, as indicated in the general literature on consumers and health claims. Such individual related characteristics capture the individual attitude and interest in preventing health losses through food choices and diet (see for instance, Roininen et al. (1999), Van Trijp &amp; Van der Lans (2007) Dean et al. (2012)). To achieve our research goal, we employed a best-worst (BW) approach on a representative sample of Italian household members who are responsible for food shopping. Consumers tested competitively the multiple product attributes of EVOO. The share of consumers interested in health claims was detected by a latent class clustering model and characterized based on their socio-demographic, attitudinal, and psychographic features. Thus, this is the first study attempting to identify the features of consumers interested in health claims while purchasing EVOO using a large sample of household responsible of food purchases

DIAGNOSTIC ACCURACY OF BONE SCINTIGRAPHY IN THE EARLY PREDICTION OF MRONJ

Since Medication-Related Osteonecrosis of the Jaw (MRONJ) is challenging to treat, prevention and early detection are fundamental to limit progression. While some imaging techniques such as computed tomography (CT) scans are helpful to estimate the extent of osteonecrosis in clinically evident MRONJ, methods for early detection and identification of patients at risk for MRONJ need further investigations. The aim of our retrospective study was to evaluate the role of bone scintigraphy (BS) in the early prediction of MRONJ. BS of patients treated with antiangiogenic or antiresorptive therapy for bone metastases were evaluated for pathological tracer uptake of the jaws. Sensitivity, specificity, predictive values of BS for the prediction of MRONJ were investigated. Moreover, the latency from the first presence of pathological tracer uptake in BS to clinically evident MRONJ was determined. The significance of pathologic BS for MRONJ detection was calculated by Fisher's exact test and the odds ratio was determined.A total of 19 patients with representative BS were recruited from our Department database. Whole body BS in anterior and posterior positions were reviewed by a specialist in nuclear medicine, blinded to MRONJ diagnosis, for pathological tracer uptake of the jaws. Results were compared to development of clinically evident MRONJ. Sensitivity and specificity of BS for MRONJ prediction were respectively 90% and 82%. Positive and negative predictive values were 64% and 96%, respectively. Median time from the first presence of pathological tracer uptake in BS to clinically evident MRONJ was 20.3 months (range 7–41). Pathologic findings on BS were significantly (p < 0.001) more often observed in patients who developed MRONJ compared to patients who did not. The risk to develop MRONJ was 41.4-fold increased when BS was pathologic. According to our results, BS is an accurate method for the prediction of MRONJ

Study of the time and space distribution of beta+ emitters from 80 MeV/u carbon ion beam irradiation on PMMA

Proton and carbon ion therapy is an emerging technique used for the treatment of solid cancers. The monitoring of the dose delivered during such treatments and the on-line knowledge of the Bragg peak position is still a matter of research. A possible technique exploits the collinear 511\ \kilo\electronvolt photons produced by positrons annihilation from $\beta^+$ emitters created by the beam. This paper reports rate measurements of the 511\ \kilo\electronvolt photons emitted after the interactions of a 80\ \mega\electronvolt / u fully stripped carbon ion beam at the Laboratori Nazionali del Sud (LNS) of INFN, with a Poly-methyl methacrylate target. The time evolution of the $\beta^+$ rate was parametrized and the dominance of $^{11}C$ emitters over the other species ($^{13}N$, $^{15}O$, $^{14}O$) was observed, measuring the fraction of carbon ions activating $\beta^+$ emitters $A_0=(10.3\pm0.7)\cdot10^{-3}$. The average depth in the PMMA of the positron annihilation from $\beta^+$ emitters was also measured, D_{\beta^+}=5.3\pm1.1\ \milli\meter, to be compared to the expected Bragg peak depth D_{Bragg}=11.0\pm 0.5\ \milli\meter obtained from simulations

H9c2 Cardiomyocytes under Hypoxic Stress: Biological Effects Mediated by Sentinel Downstream Targets

The association between diabetes and cardiovascular diseases is well known. Related diabetes macro- and microangiopathies frequently induce hypoxia and consequently energy failure to satisfy the jeopardized myocardium basal needs. Additionally, it is widely accepted that diabetes impairs endothelial nitric oxide synthase (eNOS) activity, resulting in diminished nitric oxide (NO) bioavailability and consequent endothelial cell dysfunction. In this study, we analyzed the embryonic heart-derived H9c2 cell response to hypoxic stress after administration of a high glucose concentration to reproduce a condition often observed in diabetes. We observed that 24 h hypoxia exposure of H9c2 cells reduced cell viability compared to cells grown in normoxic conditions. Cytotoxicity and early apoptosis were increased after exposure to high glucose administration. In addition, hypoxia induced a RhoA upregulation and a Bcl-2 downregulation and lowered the ERK activation observed in normoxia at both glucose concentrations. Furthermore, a significant cell proliferation rate increases after the 1400W iNOS inhibitor administration was observed. Again, hypoxia increased the expression level of myogenin, a marker of skeletal muscle cell differentiation. The cardiomyocyte gene expression profiles and morphology changes observed in response to pathological stimuli, as hypoxia, could lead to improper ventricular remodeling responsible for heart failure. Therefore, understanding cell signaling events that regulate cardiac response to hypoxia could be useful for the discovery of novel therapeutic approaches able to prevent heart diseases