The Effectiveness of Physical Exercise on Bone Density in Osteoporotic Patients

Physical exercise is considered an effective means to stimulate bone osteogenesis in osteoporotic patients. The authors reviewed the current literature to define the most appropriate features of exercise for increasing bone density in osteoporotic patients. Two types emerged: (1) weight-bearing aerobic exercises, i.e., walking, stair climbing, jogging, and Tai Chi. Walking alone did not appear to improve bone mass; however it is able to limit its progressive loss. In fact, in order for the weight-bearing exercises to be effective, they must reach the mechanical intensity useful to determine an important ground reaction force. (2) Strength and resistance exercises: these are carried out with loading (lifting weights) or without (swimming, cycling). For this type of exercise to be effective a joint reaction force superior to common daily activity with sensitive muscle strengthening must be determined. These exercises appear extremely site-specific, able to increase muscle mass and BMD only in the stimulated body regions. Other suggested protocols are multicomponent exercises and whole body vibration. Multicomponent exercises consist of a combination of different methods (aerobics, strengthening, progressive resistance, balancing, and dancing) aimed at increasing or preserving bone mass. These exercises seem particularly indicated in deteriorating elderly patients, often not able to perform exercises of pure reinforcement. However, for these protocols to be effective they must always contain a proportion of strengthening and resistance exercises. Given the variability of the protocols and outcome measures, the results of these methods are difficult to quantify. Training with whole body vibration (WBV): these exercises are performed with dedicated devices, and while it seems they have effect on enhancing muscle strength, controversial findings on improvement of BMD were reported. WBV seems to provide good results, especially in improving balance and reducing the risk of falling; in this, WBV appears more efficient than simply walking. Nevertheless, contraindications typical of senility should be taken into account

Increase of ribavirin dose improves sustained virological response in HCV-genotype 1 patients with a partial response to peg-interferon and ribavirin

Background and aim. In patients with chronic hepatitis C receiving Peg interferon/ribavirin (PEG-IFN/RBV) who do not achieve ≥ 2log-reduction in HCV-RNA at week 12 (null responders, NR) and in those with ≥ 2log-decrease but detectable at week 24 (partial responders, PR) the probability to achieve the sustained virological response (SVR) is almost null. The aim of this study was to investigate the efficacy of individualized schedule of progressively increased RBV doses in the setting of PEG-IFN/RBV treatment. Material and methods. PR or NR to PEG-IFN/RBV instead of discontinuing treatment were enrolled to receive increasing doses of RBV until a target theoretical concentration ([tRBV]) of ≥ 15 μmol/L (by pharmacokinetic formula based on glomerular filtration rate). HCV-RNA was assessed every 4 weeks and, if detectable, RBV dose was gradually increased until negativization. Twelve weeks later, patients with detectable HCV-RNA discontinued therapy while those with undetectable HCV-RNA continued for further 48 weeks. Results. Twenty genotype-1 patients (8 NR and 12 PR) were enrolled. After 12 weeks 9 (45%) were still HCV-RNA positive and were discontinued, while remaining 11 had undetectable HCV-RNA. One stopped treatment for side effects. Ten completed treatment. Five (all PR) achieved SVR. Side effects incidence was similar to that observed during PEG-IFN/RBV. Conclusions. In conclusion, RBV high doses, according to individualized schedule, increase SVR in PR on a similar extent to that of triple therapy but without increase of side effects. Such treatment should be considered in PR with no access or intolerant to protease inhibitors (PI)

Ricerca di anticorpi contro il virus dell\u2019epatite E in soggetti professionalmente esposti a contatto con suini

Il virus dell\u2019epatite E (HEV) \ue8 una causa frequente di epatite acuta nei Paesi in via di sviluppo, dove l\u2019infezione viene trasmessa principalmente per via orofecale attraverso acqua contaminata. Virus HEV-like sono stati identificati in diverse specie animali ed in particolare in quella suina. Negli ultimi anni, casi sporadici di malattia sono stati descritti anche in numerosi Paesi industrializzati, compresa l\u2019Italia, in persone senza un\u2019anamnesi di viaggi in zone considerate endemiche. L\u2019analisi nucleotidica dei virus associati a questi casi ha mostrato un elevato grado di omologia con ceppi di HEV isolati da suini e cinghiali, facendo ipotizzare un\u2019origine zoonosica di tali infezioni. Studi sperimentali hanno inoltre dimostrato la possibilit\ue0 di trasmissione interspecifica di ceppi umani al suino e di ceppi suini a primati non umani. Per tali motivi, la malattia \ue8 oggi considerata una zoonosi emergente. Alcune indagini condotte in USA, Grecia, Taiwan e Moldova hanno evidenziato un\u2019elevata prevalenza anticorpale anti-HEV in soggetti che lavorano a contatto con suini. Lo scopo del presente lavoro \ue8 stato quello di determinare, nel nostro Paese, la prevalenza di anticorpi anti-HEV in un gruppo di soggetti professionalmente esposti al contatto con suini. Nessuno degli 84 sieri esaminati \ue8 risultato positivo per HEV

Flow cytometry analysis of an in situ PCR for the detection of human immunodeficiency virus type-1 (HIV-1) proviral DNA

The polymerase chain reaction (PCR) (1,2) is extremely sensitive and flexible, and in theory, will detect a single copy of a specific DNA (or retrotranscribed RNA) sequence either in cell cultures or in clinical samples (3). PCR technology has, therefore, been applied to the diagnosis of a wide range of clinical conditions, in particular, infectious disease