Vitamina D e artrite reumatoide

Recentemente si \ue8 osservato che la vitamina D svolge un ruolo importante nella regolazione della risposta immune. Molte cellule del sistema immunnitario esprimono i recettori della vitamina D. Studi in vitro e in vivo hanno mostrato che i metabolici della vitamina D modulano la proliferazione dei linfociti T e l\u2019attivit\ue0 delle cellule dendritiche. Inoltre dati epidemiologici mostrano che la carenza di vitamina D si associa ad un aumentato rischio di sviluppare malattie autoimmuni. La carenza di vitamina D \ue8 piuttosto frequente tra la popolazione anziana e si associa a sintomi muscoloscheletrici. Nell\u2019 artite reumatoide la sua carenza parrebbe associarsi ad un aumentato rischio di disabilit\ue0 e ad un aumentata attivit\ue0 di malattia. Abbiamo studiato 1191 pazienti affetti da AR (85% donne) provenienti da 22 Centri reumatologici italiani. Sono stati eseguiti dosaggi centralizzati della 25 OH vitamina D e del PTH, sono stati valutati i parametri di attivit\ue0 di malattia, lo stato funzionale di malattia, il tempo di esposizione al sole. Il 55% dei pazienti non assumevano supplementi di vitamina D, tra questi il 52% avevano livelli vitaminici D 0.000). The patients with the worse indices of disease activity were spending significantly less time at sunshine. The association between disease activity scores or functional sores and 25(OH)D levels remained statistically significant even adjusting 25(OH)D levels for both sun exposure time and BMI. In conclusion, in RA patients disease activity and disability scores are inversely related with 25(OH)D levels. The causality of these associations must be confirmed by longitudinal studies aimed at evaluating the clinical response of disease activity to large vitamin D supplementations

Indicadores de Biodiversidad : Informe preparado por el proyecto INTA PI 038. Evaluaion, monitoreo y manejo de la biodiversidad en sistemas agropecuarios y forestales

Se puede definir a la biodiversidad como “la variabilidad de organismos vivos de cualquier fuente, incluidos, entre otras cosas, los ecosistemas terrestres y marinos y otros ecosistemas acuáticos y los complejos ecológicos de los que forman parte; comprende la diversidad dentro de cada especie, entre las especies y de los ecosistemas.”. La biodiversidad es el sustento, en cada ecosistema, de su funcionamiento. Las funciones ecológicas, como el equilibrio y la resiliencia del sistema; la regulación de los ciclos biogeoquímicos, son a su vez la base de los servicios ecosistémicos. Entre ellos los servicios de provisión, como la producción de alimentos, medicinas, fibras, agua de bebida los de regulación y sostén, como la regulación de los flujos de agua, la purificación del agua y el aire, el hábitat para la fauna; o los servicios culturales, como las experiencias recreativas, espirituales y hasta aspectos de la identidad de los pueblo están ligados a la biodiversidad.Estación Experimental Agropecuaria BarilocheFil: Rusch, Veronica Elena. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Área Recursos Forestales. Grupo Ecología Forestal; ArgentinaFil: Natalia Fracassi. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Delta del Paraná; Argentin

Clinical and psychological characteristics associated with negative beliefs and concerns about treatment necessity in rheumatic diseases

Identifying factors that influence problematic beliefs and behaviors related to pharmacotherapy may be useful for clinicians to improve the patients' adherence. The study aims to assess patients' beliefs about the necessity and concerns regarding pharmacotherapy in rheumatic diseases and attitude styles, and to investigate the association between clinical factors and negative beliefs about medication. A sample of 712 patients affected by Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis was enrolled. They were assessed using the Beliefs about Medicines Questionnaires-Specific (BMQ), the Simplified Disease Activity Index (SDAI), the Visual Analogue Scale for pain (VAS), the Chalder Fatigue Scale (CFQ) and the Health Assessment Questionnaire-Disability Index (HAQ-DI). The balance between benefits and costs in the BMQ-Specific was positive in the 79.4% of patients, negative in the 12.1% and equal in the 8.6%. SDAI, taking more than 5 medications, taking anti interleukin 6 (Anti-IL6) or biological disease-modifying antirheumatic drugs (bDMARDs), or targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs), pain, and fatigue were significantly associated to higher Concerns. Having a longer disease duration was significantly associated with a higher Necessity, together with the current pharmacological treatments and the disability. The multivariate regression models estimated that higher pain and fatigue were associated to higher Concerns (p < 0.001), while a longer disease duration (p < 0.001) and all pharmacological treatments for a rheumatologic disease (p = 0.001) were associated to higher Necessity levels. A high length of disease, a low level of remission, a high number of total medications, the prescription of an Anti-IL6/bDMARDs/tsDMARDs drug, a high level of pain, fatigue and disability identified patients potentially less adherent to pharmacotherapy to be carefully looked after by clinicians

Inhaler technique knowledge and skills before and after an educational program in obstructive respiratory disease patients: A real-life pilot study

Patients present poor knowledge and skills about their respiratory disease and inhaler device. We aimed to: (1) evaluate COPD and asthmatic patients' ability to manage inhaled drugs (2) identify differences among devices and (3) correlate clinical data with patient ability.Patients (n=134) admitted for pulmonary rehabilitation (PR) were given an ad-hoc questionnaire covering 0% as the worst and 100% the best value of global ability (indicating the sum of knowledge and skills in managing inhaled drugs) at baseline (T0) and discharge (T1). Educational program was provided during PR. Setting of rehabilitation, age, sex, diagnosis, spirometry, CIRS score, level of autonomy to use medications, if naïve about PR, educational level, and number/type of prescribed inhaled drugs were recorded.Most patients used 1 drug while 37% used 2 drugs. DPIs were the main device prescribed. At baseline, patients' mean level of knowledge and skills were 73% and 58%, respectively. There was a significant difference in level of skills (p=0.046) among device families, DPIs resulting worst and pMDIs best. Global ability, skills and knowledge improved after educational support (p0.001) but did not reach the optimal level, 88%, 87% and 89%, respectively. Baseline global ability was positively correlated to female gender, younger age, previous PR access, outpatient status, higher education level and GOLD D class.At hospital admission, global ability was not optimal. Education may improve this, irrespective of the type of device used, in particular in male, elderly, naïve to PR, low educational level patients

Comparison and potential determinants of health-related quality of life among rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis: A cross-sectional study

Objectives: This study aimed to compare the health-related quality of life scores among rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis and to evaluate socio-demographic and clinical determinantes of quality of life across diseases. Methods: The sample comprised 490 patients with rheumatoid arthritis, 198 with psoriatic arthritis, and 119 with spondyloarthritis who completed a series of health examinations and self-reported questionnaires. Quality of life was evaluated using the Short-Form 36 Health Survey, disease activity by DAS28-CRP, DAPSA, and ASDAS-CRP (for rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis, respectively), depression and anxiety using the Hospital Anxiety and Depression Scale. ANOVA was used to compare the quality of life dimensions and their physical and mental summary measures among rheumatic diseases, and multivariate analysis was used to explore their potential determinants. Results: Rheumatoid arthritis had significantly worse scores than spondyloarthritis in the following dimensions: physical functioning, role limitation due to physical health, physical component score, and mental health. Psoriatic arthritis was not significantly different from the other two diseases. Multivariate analysis revealed that physical quality of life was mainly associated with disease activity across rheumatic diseases, rheumatological treatment and depression in rheumatoid arthritis and psoriatic arthritis. Mental quality of life is primarily associated with depression and anxiety across rheumatic diseases. Conclusion: There were differences in quality of life among patients with inflammatory rheumatic diseases, but overall, approximately uniform factors explained the variance in quality of life across diseases. Clinicians should develop general approaches and strategies for inflammatory rheumatic diseases to improve patients' quality of life

Depression is associated with increased disease activity and higher disability in a large Italian cohort of patients with rheumatoid arthritis

Depression is a quite common comorbidity in patients with rheumatoid arthritis (RA) and is thought to influence its severity. This study aims to estimate, in a large cohort of Italian patients with RA, the prevalence of depression and to investigate the clinical correlates of depression in terms of disease activity and disability

Fecal microbiota and inflammatory and antioxidant status of obese and lean dogs, and the effect of caloric restriction

Obesity is the most common nutritional disease in dogs, and is generally managed by caloric restriction. Gut microbiota alteration could represent a predisposing factor for obesity development, which has been associated with a low-grade inflammatory condition and an impaired antioxidant status. Besides, weight loss has been shown to influence the gut microbiota composition and reduce the inflammatory response and oxidative stress. However, these insights in canine obesity have not been fully elucidated. The aim of this study was to assess the differences in serum and inflammatory parameters, antioxidant status, fecal microbiota and bacterial metabolites in 16 obese and 15 lean client-owned dogs and how these parameters in obese may be influenced by caloric restriction. First, for 30 days, all dogs received a high-protein, high-fiber diet in amounts to maintain their body weight; later, obese dogs were fed for 180 days the same diet in restricted amounts to promote weight loss. Before the introduction of the experimental diet (T0), small differences in fecal microbial populations were detected between obese and lean dogs, but bacterial diversity and main bacterial metabolites did not differ. The fecal Dysbiosis Index (DI) was within the reference range (< 0) in most of dogs of both groups. Compared to lean dogs, obese dogs showed higher serum concentrations of acute-phase proteins, total thyroxine (TT4), and antioxidant capacity. Compared to T0, dietary treatment affected the fecal microbiota of obese dogs, decreasing the abundance of Firmicutes and increasing Bacteroides spp. However, these changes did not significantly affect the DI. The caloric restriction failed to exert significative changes on a large scale on bacterial populations. Consequently, the DI, bacterial diversity indices and metabolites were unaffected in obese dogs. Caloric restriction was not associated with a reduction of inflammatory markers or an improvement of the antioxidant status, while an increase of TT4 has been observed. In summary, the present results underline that canine obesity is associated with chronic inflammation. This study highlights that changes on fecal microbiota of obese dogs induced by the characteristics of the diet should be differentiated from those that are the consequence of the reduced energy intake

Primera aproximación a los daños por cotorras (Myiopsitta monachus) y su manejo en cultivos de pecán (Carya illinoinensis) en Argentina

Conocer las percepciones y experiencias sobre el daño por cotorras y su manejo en cultivos de pecán en nuestro país nos ayuda a orientar la investigación y el desarrollo de tecnologías de manejo adecuadas al contexto local de producción del cultivo.EEA ParanáFil: Canavelli, Sonia Beatriz. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Paraná; ArgentinaFil: Cuatrin, Alejandra. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Paraná; ArgentinaFil: D´Alessio, Mariana. Asociación Civil Regional. Cluster de la Nuez Pecán; ArgentinaFil: Fracassi, Natalia. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Delta del Paraná; ArgentinaFil: Goijman, Andrea Paula. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Recursos Biológicos; ArgentinaFil: Gonzalez, Adrian Claudio. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Delta del Paraná; ArgentinaFil: Grassi, Ana Laura. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Delta del Paraná; ArgentinaFil: Ferrer, José Luis. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Concepción del Uruguay. Agencia de Extensión Rural Villaguay; ArgentinaFil: Frusso, Enrique Alberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Recursos Biológicos; ArgentinaFil: Peyrou, Alejandro. Cámara Argentina de Productores de Pecán; ArgentinaFil: Poitevin, Adriana. Asociación Civil Regional. Cluster de la Nuez Pecán; ArgentinaFil: Zaccagnini, María Elena. Instituto Nacional de Tecnología Agropecuaria (INTA). Profesional Asociado; Argentin

Morphology of the toe flexor muscles in older people with toe deformities

Objective: Despite suggestions that atrophied, or weak toe flexor muscles are associated with the formation of toe deformities, there has been little evidence to support this theory. This study aimed to determine whether the size of the toe flexor muscles differed in older people with and without toe deformities. Methods: Forty-four older adults (&gt;60 years) were recruited for the study. Each participant had their feet assessed for the presence of hallux valgus or lesser toe deformities. Intrinsic and extrinsic toe flexor muscles were imaged with an ultrasound system using a standardised protocol. Assessor blinded muscle thickness and cross-sectional area was measured using Image J software. Results: Participants with lesser toe deformities (n=20) were found to have significantly smaller quadratus plantae (p=0.003), flexor digitorum brevis (p=0.013), abductor halluces (p=0.004) and flexor halluces brevis (p=0.005) muscles than the participants without any toe deformities (n=19). Female participants with hallux valgus (n=10) were found to have significantly smaller abductor hallucis (p=0.048) and flexor halluces brevis (p=0.013) muscles than the female participants without any toe deformities (n=10; p&lt;0.05). Conclusion: This is the first study to use ultrasound to investigate the size of the toe flexor muscles in older people with hallux valgus and lesser toe deformities compared to otherwise healthy older adults. The size of the abductor hallucis and flexor hallucis brevis muscles were decreased in participants with hallux valgus whereas the quadratus plantae, flexor digitorum brevis, abductor hallucis and flexor halluces brevis muscles were smaller in those participants with lesser toe deformities

Osteoporosis Treatment: When to Discontinue and When to Re-start

A number of effective therapies for the treatment of osteoporosis have become available in recent years. However, uncertainty exists regarding their long-term use and effectiveness. Bisphosphonate treatment, unlike hormone replacement, denosumab or teriparatide, is associated with benefits extended even after treatment discontinuation. The extended benefits are most apparent for alendronate (ALN) and zoledronate (ZOL). A drug holiday might be considered in patients at low-moderate risk and who have been fully compliant with treatment, and who have had a response to treatment. In patients at low-moderate risk of fractures the decision to consider a drug holiday should be balanced also with the safety profile of each treatment