Excitation of longitudinal coupled-bunch oscillations with the wide-band cavity in the CERN PS

Longitudinal coupled-bunch oscillations in the CERN Proton Synchrotron have been studied in the past years and they have been recognized as one of the major challenges to reach the high brightness beam required by the High Luminosity LHC project. In the frame of the LHC Injectors Upgrade project in 2014 a new wide-band Finemet cavity has been installed in the Proton Synchrotron as a part of the coupled-bunch feedback system. To explore the functionality of the Finemet cavity during 2015 a dedicated measurement campaign has been performed. Coupled-bunch oscillations have been excited with the cavity around each harmonic of the revolution frequency with both a uniform and nominal filling pattern. In the following the measurements procedure and results are presented

Measurements of the CERN PS longitudinal resistive coupling impedance

The longitudinal coupling impedance of the CERN PS has been studied in the past years in order to better understand collective effects which could produce beam intensity limitations for the LHC Injectors Upgrade project. By measuring the incoherent quadrupole synchrotron frequency vs beam intensity, the inductive impedance was evaluated and compared with the impedance model obtained by taking into account the contribution of the most important machine devices. In this paper, we present the results of the measurements performed during a dedicated campaign, of the real part of the longitudinal coupling impedance by means of the synchronous phase shift vs beam intensity. The phase shift has been measured by using two different techniques: in one case, we injected in the machine two bunches, one used as a reference with constant intensity, and the second one changing its intensity; in the second case, more conventional, we measured the bunch position with respect to the RF signal of the 40 MHz cavities. The obtained dependence of the synchrotron phase with intensity is then related to the loss factor and the resistive coupling impedance, which is compared to the real part of the PS impedance model

The effectiveness of intra-articular injectionc of Hyalubrix combined with exercise therapy in the tratment of hip osteoarthritis

Purpose. Osteoarthritis (OA) is the most common joint disorder in the elderly, causing significant pain which negatively affects mobility and quality ol liie. The aim of the study was to assess the effectiveness of ultrasound \ucdmage-guided intra-articular injections of Hyalubrix@ combined with exercise therapy in the treatment of hip osteoarthritis. Methods. This was a single site, prosp\ue8ctive, open-fabel, Investigator-initiated study. Forty patients rilere enrolled and received three ultrasound image.guided injections of Hyalubrix@, 45 days apart, combined with three sessions a week of phys\uedcal therapy (proprioceptive rehabilitation of the lower limbs; gait training; balance training) up to a total of 30 sessions (10 weeks), starting from one week after the first injection. Results. The primary obiective was to achieve a lasting reduction in OA symptoms related to pain during activity. During the course of the study the pain perceived by the patient during activity dropped from a mean value of 6.94 cm to a mean value of 1.46 cm and showed a statistically significant decrease from visit 1 compared to baseline (p < 0.05) which was confirmed at all the subsequent time points. Significant improvements were also observed in the evaluation of the secondary objectives: hip disability; OA-related pain at rest; daily functioning and NSAIDs intake. Conclusions. Results from this study including 40 patients for a total of 65 treated hips demonstrate a significant improvement in OA-related pain, hip disability, and patient's daily functioning as well as a reduction in NSAIDS intake. Patients suffering from hip OA s\ue8em to benefil from the treatment wiih Hyalubrix@ injections plus exercise therapy

Studio RIFRA: il rischio fratturativo in Italia

L'osteoporosi \ue8 un disordine scheletrico cronico-evolutivo, caratferizzato dalla perdita dell'equilibrio del metabolismo osseo con conseguente degenerazione quantitativa e qualitativa che compromette la resistenza dell'osso e predispone ad un aumentato rischio di fratture. Colpisce soprattutto il sesso femminile,conunaprevalenza del33%nelrange tra60eT0aacheaumentaconl'avanzaredell'et\ue0. Pu\uf2 rimanere clinicamente silente e successivamente manifestarsi con fratture (vertebrali 100.000 casi/anno, di polso 85.000 casi/anno e femorali 80.000 casi/anno). Le fratture da fragilit\ue0 comportano gravi conse gse\ueeze, sia a livello clinico individuale che sociale ed economico; rappresenrano pertanto una fonte di disabilit\ue0 complessa, che in quanto tale necessita di una presa in carico globale. Lo studio RIFRA nasce da un'idea del GISMO per rispondere alla necessit\ue0 primaria di quantificare il reale rischio fratturativo in Italia attraverso una specifica scheda e di valutare l'influenza delle comorbilit\ue0 e delle terapie corelate al rischio di frattura. L'obiettivo secondario analizzare \a percentuale di pazienti sottoposti a trattamento farmacologico in relazione ai valori densitometrici e alle pregresse fratture, nonch\ue9 valutare la prevalenza di fratture da fragilit\ue0 nella popol azione in studio

Synergistic Effect of Physical Therapy Plus Pharmacological Therapy with Eperisone in Tension-Type Cervicalgia

Background. This study assessed the effect of eperisone + physical therapy compared with physical therapy alone on the alleviation of pain and disability experienced by patients with tension-type cervicalgia. Methods. Patients with tension-type cervicalgia were randomized to eperisone + physical therapy (Group A) or physical therapy alone (Group B). Patients were assessed at baseline (T0), after 4-weeks’ treatment (T1), and at 2 months’ follow-up (T2). Outcome measures included the Numerical Rating Scale, the Italian version of the Neck Pain and Disability Scale, the Short Form-McGill Pain Questionnaire, and the Italian version of the Neck Disability Index. Results. Ninety-eight patients (50 patients in Group A and 48 patients in Group B) completed the study. Pain and disability scores for all outcome measures were significantly lower at both T1 and T2 for patients in Group A compared with Group B (all p<0.001). A small, improvement between T1 and T2 was observed in Group A patients but not in Group B patients, and significantly more Group B than Group A patients were worse at 2 months’ follow-up (all p<0.001). Conclusions. Eperisone in synergy with physical therapy can be a valuable tool in the therapeutic management of patients suffering from tension-type cervicalgia

A Systematic Review of Pharmacologic and Rehabilitative Treatment of Small Fiber Neuropathies

The aim of this systematic review is to guide the physician in defining the pharmacologicand rehabilitative therapeutic approaches for adopting the best strategies described in the currentliterature. The search was conducted in PubMed, EMBASE, Cochrane Library and Web of Scienceto identify the treatment of small fiber neuropathies. Two reviewers independently reviewed andcame to a consensus on which articles met inclusion/exclusion criteria. The authors excluded theduplicates, animal studies and included the English articles in which the treatment of patients withsmall fiber neuropathies was described. The search identified a total of 975 articles with the keywords“small fiber neuropathy” AND “rehabilitation” OR “therapy” OR “treatment”. Seventy-eight selectedfull-text were analyzed by the reviewers. Forty-two publications met the inclusion criteria and wereincluded in the systematic review to describe the rehabilitative and pharmacologic treatment of smallfiber neuropathies. Despite the range of different protocols of treatment for small fiber neuropathy,other robust trials are needed. In addition, always different therapeutic approaches are used; a uniqueprotocol could be important for the clinicians. More research is needed to build evidence for the beststrategy and to delineate a definitive therapeutic protocol

MOTOR DYSFUNCTION OF THE "NON AFFECTED" LOWER LIMB: A KINEMATIC COMPARATIVE STUDY BETWEEN HEMIPARETIC STROKE AND TOTAL KNEE PROSTHESIZED PATIENTS

In patients with hemispheric stroke, abnormal motor performances are described also in the ipsilateral limbs. They may be due to a cortical reorganization in the unaffected hemisphere; moreover, also peripheral mechanisms may play a role. To explore this hypothesis, we studied motor performances in 15 patients with hemispheric stroke and in 14 patients with total knee arthroplasty, which have a reduced motility in the prosthesized leg. Using the unaffected leg, they performed five superimposed circular trajectories in a prefixed pathway on a computerized footboard, while looking at a marker on the computer screen. The average trace error was significantly different between the groups of patients and healthy subjects [F ((2,25)) = 7.9; p = 0.003]; on the contrary, the test time execution did not vary significantly. In conclusion, both groups of patients showed abnormal motor performances of the unaffected leg; this result suggests a likely contribution of peripheral mechanisms

Case report: laser Nd:YAG e rieducazione funzionale nella sindrome del piriforme

La sindrome del piriforme \ue8 caratterizzata da una lombalgia con interessamento del gluteo e con possibile irradiazione all'arto inferiore; pu\uf2 essere definita come una patologia dovuta ad intrappolamento, compressione o irritazione del nervo sciatico a livello del muscolo piriforme con o senza deficit neurologici. In questo studio \ue8 stata valutata l'efficacia della sinergia terapeutica tra laser Neodimio:YAG e rieducazione funzionale nella riduzione del dolore e nel miglioramento dell'indipendenza funzionale in una paziente affetta da sindrome del piriforme

Physical Agent Modalities in Early Osteoarthritis: A Scoping Review

Early osteoarthritis (EOA) still represents a challenge for clinicians. Although there is no consensus on its definition and diagnosis, a prompt therapeutic intervention in the early stages can have a significant impact on function and quality of life. Exercise remains a core treatment for EOA; however, several physical modalities are commonly used in this population. The purpose of this paper is to investigate the role of physical agents in the treatment of EOA. A technical expert panel (TEP) of 8 medical specialists with expertise in physical agent modalities and musculoskeletal conditions performed the review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) model. The TEP searched for evidence of the following physical modalities in the management of EOA: “Electric Stimulation Therapy”, “Pulsed Electromagnetic field”, “Low-Level Light Therapy”, “Laser Therapy”, “Magnetic Field Therapy”, “Extracorporeal Shockwave Therapy”, “Hyperthermia, Induced”, “Cryotherapy”, “Vibration therapy”, “Whole Body Vibration”, “Physical Therapy Modalities”. We found preclinical and clinical data on transcutaneous electrical nerve stimulation (TENS), extracorporeal shockwave therapy (ESWT), low-intensity pulsed ultrasound (LIPUS), pulsed electromagnetic fields stimulation (PEMF), and whole-body vibration (WBV) for the treatment of knee EOA. We found two clinical studies about TENS and PEMF and six preclinical studies—three about ESWT, one about WBV, one about PEMF, and one about LIPUS. The preclinical studies demonstrated several biological effects on EOA of physical modalities, suggesting potential disease-modifying effects. However, this role should be better investigated in further clinical studies, considering the limited data on the use of these interventions for EOA patients

Prevalence of Vertebral Fractures in Osteoporotic HIP Fractured Patients: The Focus Study

Osteoporosis is a multifactorial systemic skeletal disease, characterized by low bone mass and microarchitectural modifications of bone tissue, with a consequent increase in fragility fractures. Vertebral fractures are the most prevalent osteoporotic fractures and osteoporotic hip fractures are the most serious complication of osteoporosis resulting in increased mortality and high socio-economic cost. The coexistence of these two pathological conditions in elderly patients has been previously described, leading to even worse functional outcomes than each one alone. To determine the prevalence of vertebral fractures in osteoporotic hip fractured women and to evaluate the relationship between prevalence of vertebral fractures and pre-existing factors such us autonomy in daily life activity, quality of walking, numbers of falls, cognitive aspects and comorbidities. 946 osteoporotic hip fractured women aged more than 60 years and with an X-ray evaluation of spine were consecutively enrolled in 25 Orthopaedic, Physical Medicine and geriatric centers in Italy. After spine X-ray morphometry patients were divided in two groups: previous vertebral fracture (F) and no previous fracture (NF). Moreover anamnestic, demographical and outcome related data (ADL, IADL, CIRS, SPMSQ, FAC and RANKIN scale) were collected. Prevalent vertebral fractures were present in 502 (54%) patients. 119 (13.7%) patients had at least one severe fracture. The F compared to NF group showed statistically significant worse scores regarding the pre hip fracture values of RANKIN, CIRS, SPMSQ, IADL and the overall number of falls (p<0.001). Moreover the F group showed statistically significant lower values of serif 25(OH)D than NF group (p<.0.001). Previous Vertebral fractures in hip fractured patients are a common issue and negatively influence several functional and cognitive outcome measures in these patients