Treatment of lesions of the rotator cuff

: The impingement syndrome and tendinopathy of the rotator cuff are the most common causes (complaints) of pain and disability of the shoulder. The aim of this study is to evaluate the efficacy of a specific rehabilitative protocol, integrated with the administration of a nutritional supplement, in the conservative rehabilitative treatment, as well as in post-surgery, of patients with lesions of the rotator cuff. Two groups with syndrome of the rotator cuff were formed to follow different therapeutic courses, in relation to the choice of each subject to undergo the conservative treatment (Arm A) or the surgical one (Arm B). In Arm A the study included the association of therapy with ESWT (shock waves) with the proprioceptive Multi Joint System, for rehabilitating joint movement and muscle strength of the shoulder, and a specific nutritional supplement to reduce the pain and conserve the cartilage tissue. Between February 2009 and June 2009, we enrolled 30 subjects (randomized into three homogenous groups A1, A2, A3), average age 45±10 years, with rotator cuff syndrome with calcification of the shoulder, diagnosed through clinical examination and investigative instruments (X-ray, echography or NMR). In Arm B, from September 2009 to January 2010, we enrolled 50 patients (randomized into two groups, B1 and B2), 24 male (average age 58.4: min 28 and max 78) and 26 females (average age 59.5: min 30 and max 80), who had undergone rotator cuff operations and acromionplasty for non-massive lesions without important gleno-humeral instability, with either open or arthroscopic procedures. The analysis of the results of Arm A highlights that in terms of reducing pain the main benefits were found in Group A1 where the supplement was given. From the analysis of the data of Arm B, in both groups an improvement of the first 4 items evaluated was evident. In Group B1, 84 percent of the patients declared to be satisfied and improved and 16 percent were dissatisfied; in Group B2, where the nutritional supplement was given, 92 percent were satisfied and 8 percent were dissatisfied. In conclusion, we retain that in cases of rotator cuff syndrome, an integrated rehabilitative approach, whether conservative or post-surgical, directed at taking total control of the patient, must observe particular attention to the optimization of the articular tissular metabolic balance in order to favour better functional recovery

Experimental infection of rock pigeons (Columba livia) with three West Nile virus lineage 1 strains isolated in Italy between 2009 and 2012

West Nile virus (WNV) circulation dynamics in the context of the urban environment is not yet elucidated. In this perspective, three groups of eight rock pigeons (Columbia livia) were inoculated with three WNV lineage 1 strains isolated in Italy between 2009 and 2012. The pigeons did not develop any clinical signs consistent with WNV acute infection. All animals seroconverted and shed virus up to 15 days post-infection by the oral or cloacal routes. In all infected groups viraemia lasted for 4 days post-infection. No WNV-specific gross or histological lesions were found in infected birds compared to control birds and immunohistochemistry remained constantly negative from all tissues. The reservoir competence index was also assessed and it ranged between 0·11 and 0·14. This study demonstrates that pigeons are competent reservoir hosts for Italian WNV lineage 1 circulating strains thus potentially posing a risk to the public health system

Consensus Conference Posture and Occlusion: Hypotesis of Correlation

Purpose: The goal of this meeting was an adjournment of that document with present state of the art evidence-based literature and experience. A thesis supporting a correlation between posture and occlusion was opposed to an oppositional position on the lack of a correlation (the pro and con positions). Results: After thorough review of the current literature, the committee developed a new document (consensus). The committee noted that current literature is poor both for quality and for quantity on this topic; nevertheless, it was observed, that conservative treatment might have a beneficial role in the treatment of postural and occlusal disorders. However, because of the lack of evidence in favor of any definitive treatment or evidence-based therapies, treatment cannot be invasive and should be limited to only conservative and reversible modalities. Conclusions: It was recognized by the committee that conservative, non-invasive, and reversible treatment may be beneficial for some patients, and treatment is not contraindicated, but no treatment can be provided unless a working diagnosis is arrived before instituting a treatment plan. For this reason, the updated document of this 2008 Consensus Symposium exhibits a significant improvement for guiding the clinicians while compared with 1997 position in that it suggests that there may be a rationale for conservative treatment for certain, well-defined conditions. The definition of posture in the new document encompasses the neurophysiological basis of posture and gait, and emphasizes that posture is now regarded as controlled by a dynamic, multifaceted system