Lenti ortocheratologiche e lenti morbide multifocali a confronto per il controllo della progressione miopica

- OBIETTIVO PRINCIPALE: Lo scopo di questo elaborato è paragonare le lenti a contatto ortocheratologiche e le lenti a contatto morbide multifocali per il controllo della progressione miopica. Nello specifico, capire le modalità in cui queste tipologie di lenti a contatto agiscono a livello oculare per rallentare la progressione miopica, e così rallentare l’evolversi di eventuali problemi gravi causati da un alto livello di miopia. - METODI DI RICERCA: In questo elaborato sono stati analizzati articoli scientifici raccolti su siti di divulgazione scientifica e banche dati online, sono stati consultati documenti reperiti online e dispense fornite da docenti. Ho inoltre analizzato un case report reale di un’applicazione di una lente ortocheratologica in soggetto miope. Le parole chiave utilizzate sono state: ortocheratologia, lenti a contatto multifocali, miopia, progressione miopica. - RISULTATI: Da un’attenta e accurata valutazione degli articoli scientifici, emerge che le lenti a contatto ortocheratologiche e multifocali sono efficaci per il trattamento della progressione miopica. Risultano essere i trattamenti contattologici reversibili più efficaci per la correzione dell’ametropia centrale e il controllo dello stato refrattivo periferico. Inoltre, a supporto dell’efficacia dell’ortocheratologia in termini di correzione della miopia, ho analizzato un case report reale, ottenendo un’ottima correzione della miopia associata ad astigmatismo con una lente a contatto ortocheratologica con zona ottica sferica. - CONCLUSIONI: Nelle ultime decadi abbiamo assistito ad un aumento significativo dell’incidenza della miopia e della progressione miopica. Sebbene i fattori che influiscono sullo sviluppo e sulla progressione siano noti dal panorama scientifico, si sta ancora cercando di definire una linea guida generale per trattare al meglio i soggetti che presentano una progressione miopica. Per meglio approfondire il comportamento delle lenti a contatto ortocheratologiche e lenti a contatto morbide multifocali per il controllo della progressione miopica, ho consultato numerosi articoli scientifici di interesse optometrico da me selezionati. Ho compreso che le lenti a contatto ortocheratologiche e le lenti a contatto morbide multifocali risultano essere efficaci per rallentare la progressione miopica, ma per poter definire delle linee guida univoche sul modo di agire in questo caso, come sottolineano diversi autori, bisognerà poter disporre di più studi randomizzati di maggior durata e con più partecipanti

The electoral behaviour of individuals with migration backgrounds at the 2015 and 2019 Swiss General Elections. Two completely different stories?

There is emerging understanding in the literature that voters who have a migration background across Western countries tend to vote for left leaning parties. Yet little is known about whether this implies different drivers of vote choice for citizens with migration background in comparison to natives. This article intends to respond to this question by studying the impact of specific policy issue considerations on the vote of citizens with both migration and non-migration background. To do so, we focus on the 2015 and 2019 Swiss National elections, relying on data from the SELECTS post-electoral studies. Our analyses show that, while Swiss natives' voting choices are consistently affected by key political issues (i.e., foreigners' job market integration and the environment respectively), non-native voters are generally less driven by the main topics discussed at each election, although relevant differences emerge across different migrant backgrounds

Centro de atendimento psicossocial de São Miguel do Oeste: avanços e desafios

Este artigo apresenta como temática central a saúde mental e objetiva analisar avanços e desafios que se impõem à assistência ao sofrimento mental no município de São Miguel do Oeste, Santa Catarina, a partir da implantação do Centro de Atendimento Psicossocial no ano de 2008. Trata-se do recorte de uma pesquisa realizada com profissionais da saúde que atuam no local; os dados foram coletados por meio da técnica da entrevista semiestruturada e de observações sistemáticas. A amostra contemplou quatro profissionais, equivalendo a 66% do universo. Entre os principais avanços destacaram-se: o trabalho multiprofissional realizado, a assistência e o apoio oferecidos aos familiares dos usuários, a referência e a contrarreferência envolvendo as equipes da Estratégia Saúde da Família. Como principais desafios foram apontados: a necessidade de maior visibilidade sobre o significado da doença e do sofrimento mental para a comunidade; a falta de local apropriado para os atendimentos necessários com melhoria da estrutura física do local, ampliação do número de leitos em alas psiquiátricas de hospitais gerais para a internação dos usuários em momentos de crise; e, as capacitações permanentes e especializações direcionadas aos profissionais que atuam na assistência e no cuidado da doença mental. Palavras-chave: Saúde mental. Política de saúde. Epidemiologia. Promoção da saúde

Validation of the Italian version of the educational needs assessment tool in rheumatoid arthritis patients and factors associated with educational needs

The educational needs assessment tool (ENAT) is a seven-domain questionnaire assessing the educational needs (EN) of patients with rheumatoid arthritis (RA). The aim of this study was to validate the Italian version of the ENAT and to identify factors associated with EN in people with RA. The original English ENAT version was translated into Italian according to Beaton's method and subjected to Rasch analysis for validity testing. Socio-demographic and clinical variables were tested for associations with the ENAT domain scores using a multivariable linear regression model. The ENAT translated well into Italian and retained its construct validity. Some adjustments were needed when pooling the Italian and English datasets. The overall score of the ENAT had a high median: 82.8 (interquartile range (IQR): 57.5 to 100) i.e., 72.4% of the maximum score. The highest score was observed in the domain "Arthritis process" and the lowest was in "Support systems". Only gender was independently associated with EN (females having higher EN than males). The Italian ENAT is feasible for the use in the clinical setting and may help the health care practitioners to tailor educational interventions for RA patients. The characteristics of the patients, particularly female gender, may be associated with higher EN

In Vitro Synovial Membrane 3D Model Developed by Volumetric Extrusion Bioprinting

Background: Synovial tissue plays a fundamental role in inflammatory processes. Therefore, understanding the mechanisms regulating healthy and diseased synovium functions, as in rheumatic diseases, is crucial to discovering more effective therapies to minimize or prevent pathological progress. The present study aimed at developing a bioartificial synovial tissue as an in vitro model for drug screening or personalized medicine applications using 3D bioprinting technology. (2) Methods: The volumetric extrusion technique has been used to fabricate cell-laden scaffolds. Gelatin Methacryloyl (GelMA), widely applied in regenerative medicine and tissue engineering, was selected as a bioink and combined with an immortalized cell line of fibroblast-like synoviocytes (K4IM). (3) Results: Three different GelMA formulations, 7.5–10–12.5% w/v, were tested for the fabrication of the scaffold with the desired morphology and internal architecture. GelMA 10% w/v was chosen and combined with K4IM cells to fabricate scaffolds that showed high cell viability and negligible cytotoxicity for up to 14 days tested by Live & Dead and lactate dehydrogenase assays. (4) Conclusions: We successfully 3D bioprinted synoviocytes-laden scaffolds as a proof-of-concept (PoC) towards the fabrication of a 3D synovial membrane model suitable for in vitro studies. However, further research is needed to reproduce the complexity of the synovial microenvironment to better mimic the physiological condition

Renewable polyol obtained by microwave-assisted alcoholysis of epoxidized soybean oil: Preparation, thermal properties and relaxation process

[EN] The soybean oil polyol (SOP) use as feedstock in the polyurethane industry has been recently emphasized due to its excellent resistance to hydrolysis, which is also applicable in coatings and thermal insulation. In this article, the SOP was obtained by a very fast microwave-assisted alcoholysis of epoxidized soybean oil (ESO). The preparation method, thermal properties, and relaxation process were evaluated. High yields as opening and consumption epoxy group and selectivity of 99.8 mol%, 985 mol%, and 71.2 mol% were obtained. Through titrations, nuclear magnetic resonance and gel permeation chromatography were identified parameters as 0.32 mg KOH.g(-1) acid number, 190 mg KOH.g(-1) hydroxyl number, 150 mg KOH.g(-1) saponification index, 0.17 wt% water content, 1463 g.mol(-1) molecular weight, 4.98 average functionality, 2.4 x 10(-5) mPa.s(-1) viscosity at 333 K and 1.00 g.cm(-3) density. The dielectric relaxation spectroscopy allowed identifying the alpha-relaxation process with a 193.5 K glass transition (T-g), 63.2 fragility index and 234.1 kJ mol(-1) activation energy associated with T-g from the dynamic fragility index. The ionic conductivity temperature dependence on SOP obeys Arrhenius behavior. In summary, the SOP structure and thermal relaxation parameters determination are fundamental for the understanding of the structure-properties relationship of renewable polyurethanes. (C) 2019 Published by Elsevier B.V.The authors thank the financial support from the Brazilian Agency Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) and Sindicato das Industrias de Material Plastic do Nordeste Gaucho (SIMPLAS) for the gratification received at Jovens Pesquisadores 2017, da University of Caxias do Sul (UCS). CAF and OB are National Council for Scientific and Technological Development (CNPq) fellows. CMG and MJS thank the Spanish Ministerio de Economia y Competitividad (MAT2015-63955-R) for partial financial help. The authors also thank Dr. Cesar H. Wanke for the suggestions. This work was supported by CNPq-Brazil (06086/2018-2).Favero, D.; Marcon, VR.; Barcellos, T.; Gomez-Clari, CM.; Sanchis Sánchez, MJ.; Carsí Rosique, M.; Figueroa, CA.... (2019). Renewable polyol obtained by microwave-assisted alcoholysis of epoxidized soybean oil: Preparation, thermal properties and relaxation process. Journal of Molecular Liquids. 285:136-145. https://doi.org/10.1016/j.molliq.2019.04.078S13614528

Del pensamiento tirano a vivir la emoción. Psicodrama en grupo con personas diagnosticadas de TOC

Este trabajo pretende aportar nuevas perspectivas e interrogantes sobre la práctica psicodramática, así como valorar la experiencia de la colaboración entre ambos métodos cognitivo conductual y psicodramático en pacientes diagnosticados con trastorno obsesivocompulsivo (TOC).info:eu-repo/semantics/publishedVersio

Inflammatory molecules produced by meniscus and synovium in early and end-stage osteoarthritis: a coculture study

The aim of this study was to identify the molecules and pathways involved in the cross-talk between meniscus and synovium that may play a critical role in osteoarthritis (OA) pathophysiology. Samples of synovium and meniscus were collected from patients with early and end-stage OA and cultured alone or cocultured. Cytokines, chemokines, metalloproteases, and their inhibitors were evaluated at the gene and protein levels. The extracellular matrix (ECM) changes were also investigated. In early OA cultures, higher levels of interleukin-6 (IL-6) and IL-8 messenger RNA were expressed by synovium and meniscus in coculture compared with meniscus cultured alone. RANTES release was significantly increased when the two tissues were cocultured compared with meniscus cultured alone. Increased levels of matrix metalloproteinase-3\ua0(MMP-3) and MMP-10 proteins, as well as increased release of glycosaminoglycans and aggrecan CS846 epitope, were observed when synovium was cocultured with meniscus. In end-stage OA cultures, increased levels of IL-8 and monocyte chemoattractant\ua0protein-1\ua0(MCP-1) proteins were released in cocultures compared with cultures of meniscus alone. Chemokine (C-C motif) ligand 21 (CCL21) protein release was higher in meniscus cultured alone and in coculture compared with synovium cultured alone. Increased levels of MMP-3 and 10 proteins were observed when tissues were cocultured compared with meniscus cultured alone. Aggrecan CS846 epitope release was increased in cocultures compared with cultures of either tissue cultured alone. Our study showed the production of inflammatory molecules by synovium and meniscus which could trigger inflammatory signals in early OA patients, and induce ECM loss in the progressive and final stages of OA pathology

Ultrastructural modifications of human meniscus under different conditions

Human meniscus presents two cell populations [1]. The main cell type present in its inner and middle part is the fibrochondrocyte, a round or oval shaped cell, while in outer zone fibroblast-like cells within a dense connective tissue [2] are mostly observable. The aim of this work is to study a variety of pathological conditions. We have analized samples of meniscus obtained from 3 multiorgan donors (63 median age, years), 5 patients with traumatic meniscal tear (40 median age, years) and from 3 patients undergoing total knee replacement for osteoartritis (OA) (73 median age, years). In elderly menisci we observed a progression of chromatin margination, and a partial cytoplasmic organelle conservation, but for the presence of occasional autophagic vacuoles. Both after trauma and in OA, an increasing chromatin condensation, organelle degeneration and cytoplasmic vacuolization appear. In OA, similarly to elderly, autophagic vacuoles, which probably represent a cellular self-protection mechanism, appeared in the cytoplasm. The most evident ultrastructural changes have been observed when intervention takes place long time after trauma. In this case a high chromatin condensation, a large cytoplasmic vacuolization with degeneration of organelles and several necrotic cells appear. Calcification areas occur in all conditions. In particular, specimens from traumatic menisci have a structure similar to OA ones, especially if trauma has not been surgically repaired at appropriate times. In all there is disorganization of collagen fibers, and their replacement with proteoglycans. We can conclude that trauma and OA induce an increasing meniscal degeneration, comparable to physiological aging. When surgery takes place long time after trauma we observed most evident menisci degeneration. In all pathological conditions apoptotic like features appeared [3]

Effect of an oral preparation containing hyaluronic acid, chondroitin sulfate, hydrolyzed collagen type II and hydrolyzed keratin on synovial fluid features and clinical indices in knee osteoarthritis. A pilot study.

The aim of this study was to evaluate the effect of an oral preparation containing a naturally occurring matrix of hydrolyzed collagen type II, chondroitin sulfate (CS), and hyaluronic acid (HA), and bioactive oligopeptides of natural hydrolyzed keratin (K) in patients affected by knee OA through the evaluation of synovial fluid (SF) and clinical changes before and after treatment. Thirty patients with knee OA and swollen joint were included in the study and submitted to arthrocentesis. Patients were randomized in two groups: 1) the treatment group (N.15) took a dietary supplement containing 120 mg HA, 240 mg CS and 300 mg K once a day for 4 weeks; 2) the control group (N.15) was only submitted to arthrocentesis. Patient symptoms were evaluated at the beginning and at the end of the study by the WOMAC self-assessment questionnaire, the Lequesne algofunctional index, and the VAS forms. SF changes were evaluated by measuring local inflammatory indices, cytokines IL-1β, IL-8, IL-6, IL-10 and GM-CSF. The group of patients treated with the oral supplement showed an improvement in the clinical indices WOMAC (p<0.01), Lequesne (p=0.014) and VAS pain (p<0.01). On the contrary, no significant changes were found in the control group. The SF collected from the treated group showed a reduction of IL-8 (p=0.015), IL-6 and IL-10 levels, while no changes in cytokines were observed in the control group. This pilot study suggests that an oral administration of a preparation containing a combination of HA, CS and K can improve some clinical parameters and affect cytokine concentrations in SF in patients with knee OA