Cranial osteopathic treatment and stress-related effects on autonomic nervous system measured by salivary markers: A pilot study.

BACKGROUND: Variations in the concentration of salivary alpha amylase (sAA) may indicate a change in the autonomic nervous system functionality. In osteopathic medicine it has long been stated that the osteopathic manipulative treatment (OMT) can modulate the autonomic nervous system. Studies carried out on the compression of the fourth ventricle (CV4) have shown a positive effect in reducing the sympathetic tone. The goal of this pilot study is measuring the physiological response of the sAA levels after CV4 technique. METHODS: 90 subjects were randomly assigned to a sham, a control or a CV4 group. Randomization accounted for sex and score in the STAI-2 (form Y) questionnaire. Each subject completed the STAI-1 (form Y) questionnaire to evaluate the anxiety of the moment. sAA activity and saliva flow rate were measured. Saliva was collected before, immediately after and 30 min after treatment. RESULTS: Within group analysis revealed that sAA activity increased significantly immediately after the technique application only in the CV4 group (p = 0,05). Between groups analysis show a significant difference of the sAA activity in the CV4 group respect the control group (p < 0,05), but no significant difference between CV4 and sham group (p > 0,05). The effect in the CV4 group after the intervention is highly variable and appeared to be related to the level of stress measured with the STAI-Y1 questionnaire (p = 0,002). CONCLUSIONS: This study shows a positive effect of the CV4 procedure on sAA activity even if not significantly different from the sham procedure, probably due to the confounding effect of stress variability between groups.

Italian Translation and Cross-Cultural Adaptation of a Back Pain Screening Questionnaire (Start Back Screening Tool).

BACKGROUND: Low back pain is a heterogeneous condition, from which most patients recover after a few months. However, a considerable proportion of patients develop chronic pain despite different types of treatment. Primary care evidence-based guidelines for non-specific back pain highlight the importance of identifying indicators of poor prognosis in order for treatment to be appropriately targeted. The Start Back Screening Tool Questionnaire (SBST) is a prognostic tool developed and validated to identify subgroups of patients and guide the decision-making process for the initial primary care of the acute back pain. AIMS: The aim of this project is the translation and the cross-cultural adaptation of an Italian SBST version. The development of a reliable and validated questionnaire would be useful for different health professionals in the management of low back pain. METHODS: The translation and validation of this tool was divided in different steps, following the guidance of questionnaire translation: contact with the SBST developers, translation from English to Italian, synthesis, retranslation from Italian to English, expert committee review, test of the pre-final version on 30 individuals with LBP, and the final version being approved by the original Author. RESULTS: For the linguistic translation it was necessary to make some semantic variations. The interviewed participants reported a good general understanding of the questions. However, 6 subjects (14%) wondered if two questions were related to back pain or general health. After discussion within the expert committee and with the SBST developer, the wording was modified to add a reference to back pain in these two questions. The Italian version of STST is now ready for validation.

Inefficient skeletal muscle oxidative function flanks impaired motor neuron recruitment in Amyotrophic Lateral Sclerosis during exercise.

This study aimed to evaluate muscle oxidative function during exercise in amyotrophic lateral sclerosis patients (pALS) with non-invasive methods in order to assess if determinants of reduced exercise tolerance might match ALS clinical heterogeneity. 17 pALS, who were followed for 4 months, were compared with 13 healthy controls (CTRL). Exercise tolerance was assessed by an incremental exercise test on cycle ergometer measuring peak O2 uptake ([Formula: see text]O2peak), vastus lateralis oxidative function by near infrared spectroscopy (NIRS) and breathing pattern ([Formula: see text]E peak). pALS displayed: (1) 44% lower [Formula: see text]O2peak vs. CTRL (p < 0.0001), paralleled by a 43% decreased peak skeletal muscle oxidative function (p < 0.01), with a linear regression between these two variables (r2 = 0.64, p < 0.0001); (2) 46% reduced [Formula: see text]Epeak vs. CTRL (p < 0.0001), achieved by using an inefficient breathing pattern (increasing respiratory frequency) from the onset until the end of exercise. Inefficient skeletal muscle O2 function, when flanking the impaired motor units recruitment, is a major determinant of pALS clinical heterogeneity and working capacity exercise tolerance. CPET and NIRS are useful tools for detecting early stages of oxidative deficiency in skeletal muscles, disclosing individual impairments in the O2 transport and utilization chain.

1H and 13C chemical shifts for some 6,6a-dihydrochromeno(3,4-b)chromene derivatives.

The 1H and 13C NMR resonances of five 6,6a-dihydrochromeno(3,4-b)chromene derivatives were assigned completely with certainty using a concerted application of one- and two-dimensional experiments (DEPT, gs-COSY, gs-HMQC and gs-HMBC).