L’aggiornamento delle “Linee di indirizzo sulla interruzione volontaria di gravidanza con mifepristone e prostaglandine”. L’ultima trincea dell’effettività del servizio di interruzione della gravidanza

A temporary reorganization of the SSN, required to face the Covid-19 pandemic, had consequences on other medical services such as access to the abortion service. In addition to such difficulties caused by the pandemic, the abortion service suffers from the historical weaknesses characterizing the law on abortion throughout the national territory, mainly due to the large number of conscientious objectors. The new guidelines of the Ministry of Health on medical abortion seem to aim at the implementation of the medical abortion procedure diffusion in order to solve old and new difficulties, through the most updated international scientific convictions, clinical practice and the choice of women

L’abbandono dei LEP alle Regioni. Il caso dell’interruzione volontaria di gravidanza

I dati raccolti dalla Relazione del Ministro della salute sull'attuazione della legge n. 194 del 1978 non diradano i dubbi circa la qualità del monitoraggio ministeriale avanzati dalla Commissione Affari sociali della Camera e dal Comitato dei diritti sociali del Consiglio d’Europa. E invece la questione della qualità dell’informazione dovrebbe preoccupare in ogni caso il Governo. Difatti, se rientra nella competenza legislativa statale la determinazione dei livelli essenziali delle prestazioni concernenti i diritti civili e sociali, ex art. 117 Cost., 2 co. lett. m) Cost., allora tanto più urgente e necessario - a fronte della conclamata incapacità delle Regioni e delle Province autonome di assicurare gli stessi livelli di protezione minimi su tutto il territorio nazionale - si rivela provvedere a verificare quelle situazioni che giustificano l’intervento sostitutivo statale ai sensi dell’art. 120 Cost

La Provincia futuribile

Gli interventi che hanno preceduto la legge n. 56 del 2014 appaiano slegati e indipendenti, salvo il comun denominatore del contenimento della spesa pubblica. Il riordino territoriale non è stato avvertito principalmente come l’occasione per sanare le aporie, denunciate da più parti, che affliggono da tempo le istituzioni territoriali, bensì come un second best. Da più parti, però, arrivano segnali che fanno intravedere che in futuro il legislatore dovrà riprendere nuovamente le fila del discorso sull’area vasta. A fronte di questo nuovo orizzonte di riforma ordinamentale appare utile recuperare le riflessioni sul merito e sul metodo di quanto si è fatto nella ristrutturazione istituzionale dell'ente provinciale

Short-Term Effect of a New Oral Sodium Hyaluronate Formulation on Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial

Objective: the aim of this pilot study was to test the short-term effect of oral supplementation with a sodium hyaluronate with a large spectrum of molecular weights (FS-HA®) on the symptoms and functionality of knee osteoarthritis (OA). Methods: 60 subjects affected by clinical and/or radiological diagnosis of symptomatic knee OA were consecutively enrolled in a randomized, double blind, placebo-controlled, clinical trial. At randomization visit, at day 28 (visit 2), and day 56 (visit 3), the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), the Lequesne Functional Index (LFI) and the Visual Analogue Scale (VAS) for pain (VAS-p) were administered to the enrolled patients. Then, patients were asked how many times they used rescue medications (non-steroidal antinflammatory drugs–NSAIDs and/or anti-pain drugs) during the previous 4 weeks. Finally, the range of knee joint motion (ROM) was also instrumentally measured. Results: In FS-HA® treated subjects, VAS-p, pain and total WOMAC score, LFI and ROM significantly improved compared to the baseline values (p < 0.05). At 60 days, the VAS-p and the pain WOMAC score were significantly lower after FS-HA® treatment when compared with placebo as well (p < 0.05). The FS-HA® treated subjects significantly reduced the weekly use of NSAIDs and/or antipain drugs when compared to the placebo-treated ones (p < 0.05). Conclusion: the oral supplementation with a FS-HA® characterized by a large spectrum of molecular weight was associated with a short-term improvement in symptomatology and functionality of osteoarthritis-affected knees, and associated with a reduction in the use of NSAIDS and anti-pain drugs

Three arms double-blind non-inferiority randomized clinical study testing the lipid-lowering effect of a novel dietary supplement containing red yeast rice and artichoke extracts compared to Armolipid Plus® and placebo

Introduction: There is growing interest in head-to-head comparison between different lipid-lowering nutraceuticals. The aim of our study was to test the lipid-lowering effect of dietary supplementation with low-dose monacolins from red yeast rice (2.8 mg per daily dose) combined with berberine (Armolipid Plus®) or highly standardized artichoke extract versus placebo. Material and methods: 60 overall healthy adult volunteers with polygenic hypercholesterolemia (baseline low-density lipoprotein cholesterol (LDL-C) = 160.2 ±9.2 mg/dl) were enrolled in a 3-arm, double-blind, non-inferiority, randomized, parallel-group clinical trial. After 4-week diet standardization, enrolled individuals were randomized to be treated for 8 weeks with red yeast rice and highly standardized artichoke extracts (ATC group), Armolipid Plus®, or placebo. Results: At the enrolment visit, LDL-C values were similar in the compared groups. After 8 weeks, all actively treated subjects experienced significant improvements in baseline total cholesterol (TC), LDL-C and apolipoprotein B (Apo-B) (all p &lt; 0.01) (ATC group: TC = -18.9%, LDL-C = -26.7% (placebo-corrected: -12.4%), Apo-B = -19.6%; Armolipid Plus®: TC = -18.4%, LDL-C = -25.8% (placebo-corrected: -12.1%), Apo-B = -23.2%; placebo: TC = -6.2%, LDL-C = -8%, Apo-B = -8.4%). Participants in the ATC group attained significantly lower body mass index (BMI) values (-2.1%), while individuals treated with Armolipid Plus® showed improvements in baseline high-density lipoprotein cholesterol (HDL-C) (+8.7%) and triglyceride (TG) (+17.5%) levels. Finally, baseline hepatic steatosis index (HSI) values significantly decreased in both actively treated groups (by -2.4% and -2.4% in ATC and in Armolipid Plus®, respectively). Conclusions: Patients with polygenic hypercholesterolemia experienced a significant improvement in several cardiovascular risk factors in both ATC and Armolipid Plus® groups

Who should be screened for secondary causes of hypertension?

The case of a 34-year-old patient with uncontrolled hypertension is described in this article, together with the diagnostic path followed in order to make the diagnosis, that finally reveals an arteriovenous fistula due to an old kidney biopsy. Uncontrolled or resistant hypertension may be caused by unrecognized secondary hypertension: we revise the clinical and laboratory criteria for selecting hypertensive patients in whom to look for secondary hypertension through the most appropriate diagnostic work up. A synthesis of the main causes of secondary hypertension is also provided in the discussion

Arterial stiffness, sugar-sweetened beverages and fruits intake in a rural population sample: Data from the brisighella heart study

Introduction: There is conflicting information linking fruit and fructose intake with cardio metabolic disorders. The main objective of our study was to evaluate the association between intake of fruits and sugar-sweetened beverages, and carotid-femoral pulse wave velocity (cfPWV), a non-invasive marker of arterial aging, in a large population sample. Methods: For this study, we selected four age and sex-matched subgroups from the last Brisighella Heart Study population survey, after exclusion of those in secondary prevention for cardiovascular diseases, affected by gout and moderate-to-severe chronic kidney disease (defined as eGFR &lt; 60 mL/min), and/or actively treated with direct vasodilating drugs (calcium-antagonists, alpha-blockers, nitrates). The remaining subjects were classified into four groups: (1) low fruit and low sugar-sweetened beverage intake (LFLB), (2) high fruit and low sugar-sweetened beverage intake (HFLB), (3) low fruit and high sugar-sweetened beverage intake (LFHB), (4) high fruit and high sugar-sweetened beverage intake (HFHB). Results: CfPWV was significantly elevated in subjects consuming a higher fructose load, particularly when it was derived from industrially sweetened beverages (pooled LFHB &amp; HFHB: 9.6 ± 2.3 m/s; pooled LFLB &amp; HFLB: 8.6 ± 2.3 m/s, p &lt; 0.001). Moreover, the main predictors of cfPWV values were serum uric acid (B = 0.391, 95%CI 0.321–0.486, p = 0.001), fructose load from both fruits and sugar-sweetened beverages (B = 0.310, 95%CI 0.099–0.522, p = 0.004), triglycerides (B = 0.228, 95%CI 0.117–0.389, p = 0.018), fasting plasma glucose (B = 0.015, 95%CI 0.008–0.022, p &lt; 0.001) and estimated Glomerular Filtration Rate (B = −0.043, 95%CI −0.052–−0.035, p &lt; 0.001). Conclusion: our data suggest that increased intake of fructose derived from industrial sweetened beverages, though not from fruits, is associated with higher pulse wave velocity

P2‐111: MESENCHYMAL STEM CELL‐DERIVED SECRETOME FULLY REPLICATE CELL‐MEDIATED NEURO‐REPARATIVE ACTIVITIES IN THE APP/PS1 MOUSE MODEL OF ALZHEIMER'S DISEASE

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Suicidal ideation in female individuals with fibromyalgia and comorbid obesity: prevalence and association with clinical, pain-related, and psychological factors

Objective Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity-a risk factor for suicidal ideation per se-could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation.Methods In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected.Results 3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation.Discussion The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation