The role of biophysical stimulation with pemfs in fracture healing: from bench to bedside.

Clinical biophysics investigates the relationship between non-ionizing physical energy and the human body. This narrative review aims to summarize the current evidence on the efficacy of PEMF-therapy in the promotion of fracture healing. The effectiveness of PEMFs has been deeply investigated in preclinical in vitro ed in vivo studies and level-I clinical studies. All these studies depicted only PEMF-devices with specific physical wave features - i.e. pulse shape, frequency and amplitude- could significantly promote bone repair. Moreover, the dose-response relationship was also defined in preclinical studies, thus providing the minimum exposure time needed in PEMF-therapy. PEMFs are currently employed in the management several bone injuries, including acute fractures at non-union risk, non-unions, osteotomies, stress fractures and osteonecrosis. Moreover, several ongoing studies are investigating the effectiveness of PEMFs on emerging clinical conditions, thus the indications to PEMF-therapy could potentially raise in future years.

Extremely long decay time optical cavity.

We report on the resonant Fabry Perot cavity of the PVLAS (Polarization of the Vacuum with LASer) experiment operating at λ = 1064 nm with a record decay time of 2.7 ms, a factor more than two larger than any previously reported optical resonator. This corresponds to a coherence length of 8.1 · 10(5) m. The cavity length is 3.303 m, and the resulting finesse is 770,000.

Continuity and discontinuity of attachment patterns: a short-term longitudinal pilot study using a sample of late-adopted children and their adoptive mothers.

This study analysed the attachment patterns of 28 late-adopted children (placed when they were between four and seven years of age) and their adoptive mothers. The change in the children's internal working models (IWMs) within seven to eight months of their placement was evaluated. In addition, we wanted to observe the influence of a secure-autonomous maternal state of mind in facilitating the change in the children's IWMs and the possible associations between the maternal IWMs and the children's IWMs in the adoptive dyads. The separation-reunion procedure (SRP) was used for the late-adopted children in order to assess their attachment behavioural patterns, and the Manchester Child Attachment Story Task (MCAST) was used to evaluate their attachment narrative patterns. The adoptive mothers completed the Adult Attachment Interview (AAI) in order to classify their state of mind with regard to attachment. The results showed a significant change in the attachment behavioural patterns of late-adopted children, from insecure to secure (p = .002). Furthermore, the children who presented this change were predominantly placed with secure-autonomous adoptive mothers (p = .047), although the link between the adoptive mothers' representations of their attachment history and their adopted children's completed narratives was not significant. In conclusion, it seems possible to revise the attachment behaviour of late-adopted children but, for about one-third of children, the adverse history will persist at a narrative/representational level.

'Adoption and attachment theory' the attachment models of adoptive mothers and the revision of attachment patterns of their late-adopted children.

OBJECTIVE: This study examined the attachment patterns of late-adopted children (aged 4-7) and their adoptive mothers during the first 7- to 8-month period after adoption and aimed to evaluate the effect of adoptive mothers' attachment security on the revision of the attachment patterns of their late-adopted children. DESIGN: We assessed attachment patterns in 20 adoptive dyads and 12 genetically related dyads at two different times: T1 (time 1) within 2 months of adoption and T2 (time 2) 6 months after T1. METHODS: The children's behavioural attachment patterns were assessed using the Separation-Reunion Procedure and the children's representational (verbal) attachment patterns using the Manchester Child Attachment Story Task. The attachment models of the adoptive mothers were classified using the Adult Attachment Interview. RESULTS: We found that there was a significant enhancement of the late-adopted children's attachment security across the time period considered (P= 0.008). Moreover, all the late-adopted children who showed a change from insecurity to security had adoptive mothers with secure attachment models (P= 0.044). However, the matching between maternal attachment models and late-adopted children's attachment patterns (behaviours and representations) was not significant. CONCLUSIONS: Our data suggest that revision of the attachment patterns in the late-adopted children is possible but gradual, and that the adoptive mothers' attachment security makes it more likely to occur.

[Efficacy study in vitro: assessment of the properties of resveratrol and resveratrol + N-acetyl-cysteine on proliferation and inhibition of collagen activity]. / Studio d'efficacia in vitro: valutazione dell'influenza de resveratrolo e resveratrolo + N-acetil-cisteina sulla proliferazione cellulare e sull'inibizione della collagenasi.

During and after menopause the skin shows up clearly how the lack of estrogen affects tissues, and menopause can in fact be considered a "multisystemic" disorder of connective tissue. The low menopausal estrogen levels combined with age-related skin changes, accelerating skin aging. This affects both the epidermis and the dermis: fibroblasts not only become fewer, but they produce 30% less collagen, reflecting its metabolic decline. Estrogens act on collagen synthesis by directly stimulating fibroblasts. However, hormone replacement can prevent the postmenopausal loss of collagen--or eliminate it once it has started. The results of the Women's Health Initiative study drastically changed Italian gynecologists' prescribing habits. Natural products with estrogen-like activity are increasingly accepted, since they have good effects on collagen synthesis and/or inhibit collagenase activity, with a reassuring safety profile. This was confirmed by an in vitro study that assessed the tonic-trophic properties of two treatments on cultured skin fibroblasts. Cells were treated with resveratrol either alone or combined with NAC 10-100-1000 µM. There was a dose-related increase in the rate of cell proliferation and in inhibition of collagenase activity.

Experimental observation of optical rotation generated in vacuum by a magnetic field.

We report the experimental observation of a light polarization rotation in vacuum in the presence of a transverse magnetic field. Assuming that data distribution is Gaussian, the average measured rotation is (3.9 +/- 0.5) x 10(-12) rad/pass, at 5 T with 44 000 passes through a 1 m long magnet, with lambda = 1064 nm. The relevance of this result in terms of the existence of a light, neutral, spin-zero particle is discussed.

Use of a fast EM algorithm for 3D image reconstruction with the YAP-PET tomograph.

OBJECTIVE: We would like to improve the image reconstructions for both signal-to-noise ratio (SNR) and spatial resolution characteristics for the small animal positron emission tomograph YAP-PET, built at the Department of Physics of Ferrara University. The three-dimensional (3D) filtered backprojection (FBP) algorithm, usually used for image reconstruction, has a limited angle restriction due to the tomograph geometry, which causes a serious loss in sensitivity. METHODS: We implemented a 3D iterative reconstruction program using the symmetry and sparse properties of the 'probability matrix', which correlates the emission from each voxel to the detector within a coincidence tube. A fraction only of matrix elements are calculated before the reconstruction and stored on disk: this allows us to avoid on-line computation. A depth dependent function differentiates the voxels in a coincidence tube. Three experimental phantoms with no background were reconstructed by using the program, in comparison with traditionally used FBP. RESULTS: The adopted method allowed us to reduce the computation time significantly. Furthermore, the simple depth dependent function improved the spatial resolution. With 64 x 64 x 20 voxels of 0.625 x 0.625 x 2.0 mm(3) in the field of view, the computation time was less than 4 min per iteration on a Sparc Ultra 450 Workstation, and less than 6 min per iteration on a Mac-PPC G3 300 MHz: the spatial resolution measured with a 0.8 mm diameter 18F-FDG filled capillary reconstructed in this way was 2.0 mm FWHM. By decreasing the voxel size to 0.3125 x 0.3125 x 2.0 mm(3) per voxel the transaxial FWHM was 1.7 mm with a computation time of 15 min per iteration on a Sparc Ultra 450. By using all the acquired data, the SNR improves from 1.3 to 6.0 in the worst measured case, a pair of 0.8mm diameter 18F-FDG filled capillaries, which are 2.5 mm apart each other. CONCLUSION: The adoption of iterative reconstruction allowed us to overcome the loss in sensitivity of previously used FBP: this improved the SNR. The studies of symmetry and sparse properties avoided a severe increase of the reconstruction time and of storing space on disk. This fast EM Algorithm is now routinely used for the image reconstruction with the YAP-PET tomograph.

Quality of life in chronic diseases of the aged: the importance of cognitive deterioration.

The interference of a chronic disease on the aging process reduces patients efficiency in confronting everyday life events and their Quality of Life (QOL). The purpose of this study was to examine the interaction between cognitive problems and emotional difficulties as related to several chronic diseases commonly present among aged patients in contributing to their QOL reduction. Diseases considered were: chronic cerebro-vascular disorders non-insulin dependent diabetes mellitus and hypertension. Memory characteristics and subjective evaluation of several areas of daily living where problems could be present were assessed. Severity of cognitive and behavioral deterioration emerged as a major component independent from type of disease, contributing to reduction of QOL. Disease type determined the different risk of presence of an objective reduction of memory efficiency. The QOL of aged patients was identified as a multidimensional array of different components among which cognitive deterioration assumes a primary role. These results, together with analogous findings from previous studies, underline the importance of considering cognitive efficiency in aged patients even with chronic diseases not directly affecting CNS in order to evaluate their needs.

[Tiaprofenic acid: levels in plasma and upper airway tissues]. / Acido tiaprofenico: livelli plasmatici e tissutali nelle vie aeree superiori.

Inflammatory processes of the upper airways can be successfully improved by using non steroid anti-inflammatory drugs, alone or in association with antibiotics. Recent clinical reports suggest that tiaprofenic acid (TA) is particularly suited for this purpose. This fact can be explained on the basis of the drug's pharmacokinetics and by the high concentration TA can achieve in the respiratory tract mucous membranes. In order to confirm this hypothesis TA levels were studied in the plasma as well as in tonsillar and turbinal tissue. Patients admitted for tonsillectomy or turbinectomy were given two tablets (600 mg) of TA from one and a half to five hours before surgery. In all cases blood and tissue samples were taken at the same time during surgery and drug levels determined by HPLC. Plasma levels ranged from 12 to 26 to 32.2 microgram/ml; tissue levels ranged from 3.9 to 5.4 to 4.9 micrograms/g, respectively, depending on time of administration. There was no significant difference between tonsillar and turbinal tissue. These results suggest a good penetration of nasal and airway mucosa by TA and are in agreement with the clinical data on the efficacy of TA in dealing with upper airway inflammatory conditions.

Ambroxol inhibits airway hyperresponsiveness induced by ozone in dogs.

To follow up previous observations that airway hyperresponsiveness induced by ozone is linked to airway inflammation and particularly to the release of arachidonic acid metabolites, we investigated the effect of ambroxol (a mucoactive and surfactant-stimulating drug that has recently been discovered to inhibit the release of arachidonic acid from cell membrane phospholipids) on airway hyperresponsiveness and bronchoalveolar neutrophilia induced by ozone in dogs. One group of 5 dogs was studied before treatment with nebulized saline and then after exposure to ozone (3 ppm, 1 h); another group of 6 dogs was studied before treatment with ambroxol (100 breaths of a 1% solution) and after exposure to ozone. On each occasion, we measured airway responsiveness to acetylcholine and counted the number of cells in bronchoalveolar lavage fluid. When the dogs were given the saline placebo, ozone induced a marked increase in airway responsiveness to acetylcholine and a marked influx of neutrophils in the airways. When the dogs were given ambroxol, ozone induced the same increase in the number of neutrophils in bronchoalveolar lavage, but did not increase the degree of airway responsiveness to acetylcholine. We conclude that ambroxol inhibits ozone-induced airway hyperresponsiveness in dogs, probably by inhibiting the formation and release of oxygenation products of arachidonic acid from neutrophils.

Ambroxol for the prevention of chronic bronchitis exacerbations: long-term multicenter trial. Protective effect of ambroxol against winter semester exacerbations: a double-blind study versus placebo.

In a 6-month, double-blind multicenter trial conducted over the winter, the effects of daily administration of ambroxol retard (75 mg) were compared with those of placebo in preventing exacerbations and improving symptoms and clinical signs in chronic bronchitis patients. The trial was completed by 110 patients in the ambroxol group and by 104 in the placebo group. Initially, there were no significant differences between the groups. By the end of the 2nd month of treatment, 67.2% of the ambroxol group had had no exacerbations compared to 50.4% in the placebo group. At the end of the 6-month trial, 45.5% of the treatment group had had no exacerbations, compared to only 14.4% of the control group. These differences were statistically significant. Patients in the treatment group lost significantly fewer days through illness (442) and had fewer days when they needed antibiotic therapy (371) compared to the placebo group patients (837 and 781). Ambroxol also produced statistically significant symptomatic improvement, measured as difficulty in expectoration, coughing, presence of dyspnea and the auscultatory signs as compared to controls. Since ambroxol was well tolerated and compliance was good, it appears like a drug of choice for pharmacological prophylaxis of chronic bronchitis.

An alternative to steroids for prevention of respiratory distress syndrome (RDS): multicenter controlled study to compare ambroxol and betamethasone.

The results are reported of a multicenter randomized study of the effectiveness of maternal administration of betamethasone versus ambroxol, a substance of the group of the benzylamines, for prevention of RDS in preterm infants. Women of 27 to 34 weeks gestation with threatened premature delivery or planned premature delivery were admitted to the trial. Between September 1981 and November 1984 a total of 288 randomized patients delivered 315 neonates. The incidence of RDS was assessed in 169 viable neonates born before the 37th week. Of these 86 were born of 76 mothers treated with beta-methasone and 83 of 76 mothers treated with ambroxol. The overall incidence of RDS was significantly (P less than 0.05) higher in the betamethasone group (31%) than the ambroxol group (13%). Ambroxol was significantly more effective than betamethasone in twin births, in infants born before the 31st week, when ROM to delivery time was more than 48 hours, when treatment to delivery time was between 2 and 7 days and in female infants. The neonatal infection rate was significantly higher (P less than 0.05) in the group of betamethasone treated infants (18% with four fatalities) than in the group of ambroxol treated infants (9% with one fatality). These results suggest that ambroxol may be a valid alternative to steroids for prevention of RDS.

Multicenter study on the treatment of secretory otitis media with ambroxol. Importance of a surface-tension-lowering substance.

Animal studies showed the presence of a surfactant substance in the Eustachian tube. On the premise that alteration of surfactant-like substance might cause pathology of the middle ear in man, a multicenter (24 ENT hospitals) double-blind trial versus placebo was carried out in 435 adults and children with secretory otitis media. Treatment was ambroxol, a drug that changes the bronchial secretions and promotes surfactant synthesis. The dosage regimen was as follows: adults--one 30-mg tablet of ambroxol 3 times/day; children--9 mg of ambroxol syrup, 4 times daily. The treatment lasted 15 days. The clinical signs and symptoms (hypoacusis, conduction deafness) and the otoscopic and rhinoscopic findings of treated patients improved. The differences in these parameters between patients given ambroxol and the controls were statistically significant (p less than 0.05). The symptomatological amelioration was supported by improvement in tympanometric findings and hearing threshold. Drug tolerance was excellent.

A study of cellular immunity in newborns after prevention of respiratory distress syndrome (RDS).

Cellular immune responsiveness against infections was evaluated in four groups of newborns. The first group was composed of preterm newborns whose mothers had received betamethasone for prevention of RDS, the second group of preterm newborns whose mothers had received ambroxol for prevention of RDS, the third group of preterm newborns whose mothers had not received any drug enhancing surfactant production, and the fourth group were healthy-term infants. A reduction of OKT4+ cells and functional deficits of neutrophils were found in preterm infants born to mothers treated with steroids, whereas no functional abnormalities of immune-competent cells were observed in preterm infants born to mothers treated with ambroxol.

Possibility of interaction among antibiotics and mucolytics in children.

A controlled clinical trial in children with acute infections of the lower respiratory tract was carried out to see whether or not treatment with ambroxol could bring about faster and better results. One hundred twenty children with acute lower respiratory tract infections were all given antibiotics plus, at random, either ambroxol (1.5-2.0 mg/kg body weight orally) or a placebo. The duration of the trial was ten days. All the patients in both groups were cured clinically. However, remission of the cough, of the chest pathological signs, as well as the improvement of the lung radiographical pictures were significantly more rapid in children treated with ambroxol than in those who received the antibiotic alone. Ambroxol was tolerated perfectly by all the children.

Correlation between newborn gastric aspirate microviscosity and gestational age.

Fluorescence polarization (FP) values were determined in 59 samples of amniotic fluid and in 56 samples of newborn gastric aspirate, collected from the 28th to 41st week of gestation. Both amniotic fluid and gastric aspirate FP values showed a significant correlation respectively with gestational age (r = 0.77; p less than 0.01 and r = 0.50; p less than 0.01). The two regression lines were parallel (F = 0.052; p = 0.8046). Mean FP of gastric aspirate were about 0.05 lower than those of amniotic fluid. One infant whose gastric aspirate FP value was 0.342 developed RDS.