Effetti Placebo, Nocebo e Fattori di Contesto: meccanismi che influenzano l’outcome fisioterapico e la risoluzione del dolore muscoloscheletrico. Una revisione narrativa della letteratura.

Negli ultimi anni la ricerca sugli effetti placebo, nocebo e sui fattori di contesto si è molto sviluppata, rivelando considerazioni importanti sul contesto psicosociale e sul peso che questo ha nell’influenzare gli outcome di trattamento. L’obiettivo di questa revisione narrativa è quello di ricercare uno schema generale dei fattori contestuali che possono influenzare gli esiti del trattamento fisioterapico per la risoluzione del dolore muscoloscheletrico. Si è condotta una ricerca sulle banche dati PubMed, CINAHL, PEDro e MEDLINE includendo tutti gli articoli che trattassero degli effetti placebo, nocebo e dei fattori di contesto in ambito fisioterapico e del loro utilizzo per la riduzione del dolore muscoloscheletrico. Sono stati esclusi studi che prendevano in esame persone con dolore non di origine muscoloscheletrica, con patologie reumatiche o oncologiche, con gravi disturbi d’ansia, depressione o patologie psichiche. Alla fine della ricerca sono stati inclusi 7 articoli. L’analisi di tali studi ha confermato la conoscenza superficiale dell’argomento sia da parte dei fisioterapisti specializzati in terapia manuale, che delle persone assistite. I risultati suggeriscono che un utilizzo etico ed appropriato dei fattori contestuali in clinica può innescare degli effetti placebo, migliorando così il dolore; mentre un utilizzo sbagliato o addirittura una negligenza nei confronti del contesto può sfociare nell’effetto nocebo, il quale incide negativamente sull’outcome, ottenendo risultati meno rilevanti, neutri o addirittura peggiorando le condizioni della persona. In conclusione, ritengo che l’obiettivo della mia ricerca abbia posto in evidenza un contesto molto rilevante nella pratica clinica, pur non avendo potuto trarre delle conclusioni sufficientemente supportate dalla letteratura, che spero si potrà dedicare con maggior attenzione a questo argomento

In-111 octreotide SPECT/CT in the early diagnosis of pulmonary sarcoidosis: A case report

Sarcoidosis is a granulomatous disease of unknown etiology. At present the best diagnostic imaging procedure to assess stage and activity of sarcoidosis is controversial. We report the case of a 50-year-old male admitted with a history of dyspnea and fatigue with past medical history negative for smoking, occupational and environmental risk factors. Physical examination, routine blood tests, and pulmonary function tests were normal except for hypercalciuria. A chest radiograph showed bilateral hilar lymphadenopathy. Single photon emission computed tomography and/or computed tomography (SPECT and/or CT) In-111 Octreotide (Octreoscan) scintigraphy confirmed morphologic involvement of bilateral hilar lymph nodes and a mediastinoscopy biopsy specimen provided diagnosis of pulmonary sarcoidosis (stage 0). This clinical case shows the effectiveness of In-111 Octreotide SPECT and/or CT in the early diagnosis of pulmonary sarcoidosis

Immunoregulatory Role of HLA-G in Allergic Diseases

Allergic diseases are sustained by a T-helper 2 polarization leading to interleukin-4 secretion, IgE-dependent inflammation, and mast cell and eosinophil activation. HLA-G molecules, both in membrane-bound and in soluble forms, play a central role in modulation of immune responses. Elevated levels of soluble HLA-G (sHLA-G) molecules are detected in serum of patients with allergic rhinitis to seasonal and perennial allergens and correlate with allergen-specific IgE levels, clinical severity, drug consumption, and response to allergen-specific immunotherapy. sHLA-G molecules are also found in airway epithelium of patients with allergic asthma and high levels of sHLA-G molecules are detectable in plasma and bronchoalveolar lavage of asthmatic patients correlating with allergen-specific IgE levels. Finally, HLA-G molecules are expressed by T cells, monocytes-macrophages, and Langerhans cells infiltrating the dermis of atopic dermatitis patients. Collectively, although at present it is difficult to completely define the role of HLA-G molecules in allergic diseases, it may be suggested that they are expressed and secreted by immune cells during the allergic reaction in an attempt to suppress allergic inflammation

Allergen-driven HLA-G expression and secretion in peripheral blood mononuclear cells from allergic rhinitis patients

It has been reported that soluble HLA-G serum levels are increased in patients with pollen-induced allergic rhinitis and decrease after immunotherapy. However, no functional study has been conducted so far. The aim of this study was to evaluate the membrane expression and secretion of HLA-G molecules in peripheral blood mononuclear cells from allergic rhinitis patients after in vitro incubation with the causal allergen

Beneficial effects of long-term treatment with bosentan on the development of pulmonary arterial hypertension in patients with systemic sclerosis

OBJECTIVE: To investigate the effects of long-term treatment with bosentan on pulmonary arterial hypertension (PAH) in patients with systemic sclerosis. METHODS: Patients with systemic sclerosis were followed between 2003 and 2014; those who developed digital ulcers were treated with standard regimens of bosentan. Patients were assessed at baseline and every 12\u2009months using transthoracic Doppler echocardiography, 6-min walking distance test, Borg dyspnoea index and monitoring of plasma levels of 76-amino-acid N-terminal probrain natriuretic peptide. Patients who developed PAH underwent right heart catheterization to confirm the diagnosis. RESULTS: Sixty-nine patients with systemic sclerosis were enrolled in the study. Of these, 25 developed digital ulcers and received treatment with bosentan; the remaining 44 comprised the control group. None of the patients treated with bosentan developed PAH during the follow-up period. Furthermore, in these patients the mean\u2009\ub1\u2009SD systolic pulmonary arterial pressure significantly decreased from 33.64\u2009\ub1\u20092.91\u2009mmHg at baseline to 26.20\u2009\ub1\u20091.78\u2009mmHg at the end of the follow-up period. In contrast, in the control group, seven patients developed PAH during the follow-up period, with the mean\u2009\ub1\u2009SD systolic pulmonary arterial pressure significantly increasing from 33.57\u2009\ub1\u20092.75\u2009mmHg at baseline to 39.41\u2009\ub1\u20094.11\u2009mmHg at the end of the follow-up period. CONCLUSION: Long-term treatment with bosentan reduces the risk of developing PAH in patients with systemic sclerosis

Pasta fortified with C-glycosides-rich carob (Ceratonia siliqua L.) seed germ flour: Inhibitory activity against carbohydrate digesting enzymes

Carob (Ceratonia siliqua L.) seed germ flour (SGF) is a by-product resulting from the extractionextraction of locust bean gum (E410), which is a texturing and thickening ingredient used for food, pharmaceutical and cosmetic preparations. SGF is a protein-rich edible matrix and contains relatively high amounts of apigenin 6,8-C-di- and poly-glycosylated derivatives. In this work, we prepared durum wheat pasta containing 5 and 10 % (w/w) of SGF and carried out inhibition assays against type-2 diabetes relevant carbohydrate hydrolysing enzymes, namely porcine pancreatic α-amylase and α-glycosidases from jejunal brush border membranes. Nearly 70–80% of the SGF flavonoids were retained in the pasta after cooking in boiling water. Extracts from cooked pasta fortified with 5 or 10% SGF inhibited either α-amylase by 53% and 74% or α-glycosidases by 62 and 69%, respectively. The release of reducing sugars from starch was delayed in SGF-containing pasta compared to the full-wheat counterpart, as assessed by simulated oral-gastric-duodenal digestion. By effect of starch degradation, the SGF flavonoids were discharged in the water phase of the chyme, supporting a possible inhibitory activity against both duodenal α-amylase and small intestinal α-glycosidases in vivo. SGF is a promising functional ingredient obtained from an industrial by-product for producing cereal-based foods with reduced glycaemic index.Fil: Siano, Francesco. Consiglio Nazionale delle Ricerche; ItaliaFil: Mamone, Gianfranco. Consiglio Nazionale delle Ricerche; ItaliaFil: Vasca, Ermanno. Universita di Salerno; ItaliaFil: Puppo, Maria Cecilia. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; ArgentinaFil: Picariello, Gianluca. Consiglio Nazionale delle Ricerche; Itali

expression of membrane bound human leucocyte antigen g in systemic sclerosis and systemic lupus erythematosus

Abstract Human leucocyte antigen-G (HLA-G) is a nonclassical class I major histocompatibility complex (MHC) molecule characterized by complex immunoregulatory and tolerogenic functions. Membrane-bound HLA-G is expressed on the surface of different cell populations in both physiological and pathological conditions. Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by widespread tissue fibrosis, vascular lesions and immunological alterations. Systemic lupus erythematosus is the prototypic systemic autoimmune disease affecting virtually any organ system, such as skin, joints, central nervous system, or kidneys. In SSc and SLE patients, the membrane expression of HLA-G on monocytes (0.88 ± 1.54 and 0.43 ± 0.75, respectively), CD4+ (0.42 ± 0.78 and 0.63 ± 0.48, respectively), CD8+ (2.65 ± 3.47 and 1.29 ± 1.34, respectively) and CD4+ CD8+ double-positive cells (13.87 ± 15.97 and 3.79 ± 3.11, respectively) was significantly higher than in healthy controls (0.12 ± 0.07; 0.01 ± 0.01; 0.14 ± 0.20 and 0.32 ± 0.38, respectively) (

Characterization of soluble and insoluble fibers in artichoke by-products by ATR-FTIR spectroscopy coupled with chemometrics

The objective of this study was to characterize the insoluble and soluble dietary fiber present in Argentine and Italian artichoke (Cynara scolymus) by-products by comparing chemical analysis and ATR-FTIR spectroscopy. Non-edible bracts of Argentine (AR) and Italian (Benevento (BN) and Sicily (SC)) artichoke cultivars were employed. The soluble and insoluble dietary fibers were extracted by physical procedures and determined by chemical, attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy, and chemometric analysis (principal components analysis, PCA). No differences in total dietary fiber content between AR and SC samples were observed, although they both showed higher values than BN. With respect to insoluble fiber, this fraction represents 82.5%, 63.5%, and 55.2% of the total dietary fiber for BN, SC and AR, respectively. Fibers from AR presented different compositions and structures, as determined by ATR-FTIR, compared to those of the Italian cultivars (BN and SC). Comparing the results of dietary fiber measured by ezymogravimetric assay with those obtained by ATR-FTIR and PCA, we conclude that it is possible to discriminate samples that contain different kinds of fiber using ATR-FTIR.Fil: Quintero Ruiz, Natalia Andrea. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; ArgentinaFil: Paolucci, M.. Consiglio Nazionale delle Ricerche; Italia. Università Degli Studi del Sannio; ItaliaFil: Siano, Francesco. Consiglio Nazionale delle Ricerche; ItaliaFil: Mamone, Gianfranco. Consiglio Nazionale delle Ricerche; ItaliaFil: Picariello, Gianluca. Consiglio Nazionale delle Ricerche; ItaliaFil: Puppo, Maria Cecilia. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; ArgentinaFil: Cascone, G.. Consiglio Nazionale delle Ricerche; ItaliaFil: Volpe, M. G.. Consiglio Nazionale delle Ricerche; Itali

Autoimmune central diabetes insipidus in a patient with ureaplasma urealyticum infection and review on new triggers of immune response

Diabetes insipidus is a disease in which large volumes of dilute urine (polyuria) are excreted due to vasopressin (AVP) deficiency [central diabetes insipidus (CDI)] or to AVP resistance (nephrogenic diabetes insipidus). In the majority of patients, the occurrence of CDI is related to the destruction or degeneration of neurons of the hypothalamic supraoptic and paraventricular nuclei. The most common and well recognized causes include local inflammatory or autoimmune diseases, vascular disorders, Langerhans cell histiocytosis (LCH), sarcoidosis, tumors such as germinoma/craniopharyngioma or metastases, traumatic brain injuries, intracranial surgery, and midline cerebral and cranial malformations. Here we have the opportunity to describe an unusual case of female patient who developed autoimmune CDI following ureaplasma urealyticum infection and to review the literature on this uncommon feature. Moreover, we also discussed the potential mechanisms by which ureaplasma urealyticum might favor the development of autoimmune CDI