Inflammation and physical activity in multiple sclerosis patients. A systematic review and meta-analysis.

OBJECTIVES: Due to the inflammatory nature of multiple sclerosis (MS), the most widely used therapeutic approach targets the immune response but can comprise side effects (e.g. secondary immunosuppression). For these reasons, among non-pharmaceutical interventions without known side effects, physical activity (PA) gained importance because it is feasible, safe and a supportive complementary treatment strategy to alleviate symptoms in MS subjects. Consequently, the main aim of this systematic review is to analyze the effect of PA protocols, as a complementary therapy, on inflammatory status in MS patients. METHODS: Four electronic databases (PubMed, Embase, CINAHL, and Cochrane CENTRAL) were systematically searched up to 01 June 2023 (Prospero Protocol ID=CRD42021244418). The refined search strategy was based on three concepts: "MULTIPLE SCLEROSIS" AND "PHYSICAL ACTIVITY" AND "INFLAMMATION". RESULTS: three main findings emerged: 1) untrained subjects showed a negative modulation of inflammatory biomarkers concentrations when compared to trained people (-0.74, 95 %C.I.-1.16, -0.32); 2) training modulated positively inflammatory biomarkers (+0.47, 95 %C.I. 0.24,0.71); 3) Aerobic PA protocol enhance higher positive influence on inflammation. CONCLUSIONS: Persistent, low-grade inflammation in MS could be upregulated by non-pharmacological complementary therapies, in particular by regular aerobic PA that could reduce and positively modulate inflammation.

Daily music listening to reduce work-related stress: a randomized controlled pilot trial.

BACKGROUND: Literature shows that music can reduce stress conditions. This pilot study investigated the effects of music listening on work-related stress and well-being in healthcare professionals. METHOD: A total of 45 subjects were randomly assigned to three treatment groups: No Music, Individualized Music and Melomics-Health Listening. Music groups experienced a daily 30-min-playlist listening for 3 weeks at home. The Maugeri Stress Index-Revised (MASI-R) and the Psychological General Well-Being Index (PGWBI) were administered at baseline, after 3 weeks and after 7 weeks (follow-up). Longitudinal data were analyzed by means of a nested ANOVA model, testing the main effects of time and treatment and the interaction between them. RESULTS: MASI-R scores showed a positive trend in music groups and a worsening in the control group. Only the interaction time/treatment emerged as supporting a trend toward statistical significance (P = 0.07). PGWBI showed a stability in music groups and a clear decline in controls, without significant effects. CONCLUSIONS: Results from the study support the need for a larger clinical trial: it is suggested that daily music listening could be implemented to reduce work-related stress and that the effects may be related, not only to individual musical preferences and familiarity, but also to specific music structures and parameters.

A medical device containing purified bovine colostrum (Monurelle Biogel) in the treatment of vulvovaginal atrophy in postmenopausal women: Retrospective analysis of urinary symptoms, sexual function, and quality of life.

OBJECTIVE: This study assessed the effectiveness and safety of a medical device containing purified bovine colostrum (Monurelle Biogel; Zambon, Bresso, Italy) in improving vulvovaginal atrophy (VVA), sexual function, urinary symptoms, and quality of life (QoL) in postmenopausal women. METHODS: In all, 172 postmenopausal women with VVA were included in the study. All women were treated with vaginal Monurelle Biogel daily for 12 weeks. Patients underwent clinical examinations, completed a 3-day voiding diary, and had VVA graded using the Vaginal Health Index (VHI) at baseline and 12 weeks. Patients also completed the Female Sexual Function Index (FSFI), overactive bladder questionnaire (OAB-Q), and the Urogenital Distress Inventory (UDI-6), among others. RESULTS: After 12 weeks, there were significant increases in mean (± SD) VHI (12.53 ± 3.67 vs. 19.31 ± 3.49; P < .0001), the number of patients engaging in regular sexual activity 102 (59.3%) vs. 144 (83.7%), and in the total FSFI score (21.64 ± 2.99 vs. 28.16 ± 1.93; P < .0001) compared with baseline. In addition, there were significant reductions in the mean number of 24-hour voids (9.57 ± 2.12 vs. 7.13 ± 1.22; P < .0001), urgent micturition episodes per 24 hours (1.75 ± 0.76 vs. 1.14 ± 0.87; P = .001), nocturia episodes (1.58 ± 0.85 vs. 0.97 ± 1.18; P = .0002), and urinary incontinence episodes per 24 hours (0.74 ± 0.59 vs. 0.28 ± 0.52; P = .003). Finally, after 12 weeks treatment, there were significant differences in UDI-6 (7.85 ± 0.81 vs. 5.56 ± 1.40), OAB-Q symptom (53.60 ± 12.57 vs. 22.08 ± 9.63), and OAB-Q health-related QoL (21.75 ± 8.51 vs. 69.34 ± 14.59) scores compared with baseline (P < .0001 for all). The Patient Impression of Global Improvement scale revealed global improvement in 143 women (83.14%). CONCLUSIONS: Monurelle Biogel is an effective treatment for VVA in postmenopausal women, improving sexual life, urinary symptoms, and QoL.

Beet pulp intake and hairball faecal excretion in mixed-breed shorthaired cats.

Hairball formation may induce vomiting and intestinal obstruction in predisposed cats. Some insoluble fibres as sugarcane fibre and cellulose can prevent hairball formation. The aim of this study was to evaluate the effect of beet pulp consumption, a moderate soluble and fermentable fibre source, on faecal trichobezoars excretion in adult shorthaired cats fed kibble diets. Eighteen mixed-breed shorthaired cats and three extruded diets were used as follows: a basal diet without added fibre source (PB0-8.8% dietary fibre); BP8-8% inclusion of beet pulp (17.5% of dietary fibre); BP16-16% inclusion of beet pulp (23.8% of dietary fibre). The cats were fed during 31 days and faeces quantitatively collected during three periods of 3 days each (from days 3-5; 15-17; 26-28). Gastrointestinal transit time was determined in the last 3 days of study (from days 29-31). The trichobezoars were separated from faeces, collected, dried and washed in ether for complete removal of all faecal material. The results were submitted to repeated-measure analysis of variance and means evaluated by polynomial contrast (p < 0.05). Beet pulp increased faecal production (p < 0.001) and reduced gastrointestinal transit time (p = 0.003). No alterations were found on trichobezoar faecal excretion, both as considered in number per cat per day of mg per cat per day (p > 0.05). Beet pulp intake did not reduce the number or the size of hairballs eliminated via faeces of shorthaired cats.

ß-Boswellic acid, a bioactive substance used in food supplements, inhibits protein synthesis by targeting the ribosomal machinery.

The Boswellia gum resin extracts have been used in traditional medicines because of their remarkable anti-inflammatory properties. Nowadays, these extracts are on the market as food supplements. ß-Boswellic acid (ßBA) is one of the main pentacyclic triterpene components, among the family of BAs, of the Boswellia gum resins. BAs have been broadly studied and are well known for their wide anti-inflammatory and potential anticancer properties. In this paper, a mass spectrometry-based chemoproteomic approach has been applied to characterize the whole ßBA interacting profile. Among the large numbers of proteins fished out, proteasome, 14-3-3 and some ribosomal proteins were considered the most interesting targets strictly connected to the modulation of the cancer progression. In particular, because of their recent assessment as innovative chemotherapeutic targets, the ribosomal proteins were considered the most attractive ßBA partners, and the biological role of their interaction with the natural compound has been evaluated. Copyright © 2016 John Wiley & Sons, Ltd.

[Pilonidal sinus. Outpatient treatment with local anesthesia]. / Sinus pilonidalis. Trattamento ambulatoriale in anestesia locale.

The authors describe their surgical technique for pilonidal sinus outpatient total excision with local anaesthesia and primary repair of surgical wound. The results for recurrences and off work short time are good. Fewer complications and recurrences are observed in comparison to patients treated with general anaesthesia. For decreasing recurrence rate, the Authors stress the importance of body weight control and correct local hygiene. Local anaesthesia is safe e cost-effectiveness for outpatient treatment of the pilonidal sinus.

[Advantages and limits of tumescent anesthesia in outpatient surgery]. / Vantaggi e limiti dell'anestesia per tumescenza in chirurgia ambulatoriale.

The Authors report the results of the tumescent anesthesia in 187 patients submitted to various outpatient surgical procedures comparing with those in patients submitted to local anesthesia by direct infiltration.

Soy isoflavones, lactobacilli, Magnolia bark extract, vitamin D3 and calcium. Controlled clinical study in menopause.

AIM: Affective and behavioural disorders possibly concomitant to the vasomotor menopausal symptoms worsen quality of life. A rational formulation containing soy isoflavones (60 mg), lactobacilli (500 millions spores), calcium (141 mg) and vitamin D3 (5 microg) was added of Magnolia bark extract (60 mg) and magnesium (50 mg) (Estromineral serena, ES). The Magnolia extract active principles interact with GABA system and exhibit a sedative central action. Magnesium intervenes in enzymatic reactions of the energetic metabolism and protects the bone integrity. Aim of this controlled study was to compare the clinical activity and safety of ES versus calcium+vitamin D3 (Ca+D) in menopause. METHODS: A controlled, randomised, multicentre study was carried out in symptomatic menopausal women with sleep or mood alterations. Women received 1 tablet/day of ES or Ca+D for 24 weeks. Symptoms during the treatment and final judgements on efficacy and acceptability were evaluated. RESULTS: Eighty-nine women (44 ES and 45 Ca+D, mean age 53.8 years, in menopause since 56.6 months) participated to the study. Flushing, nocturnal sweating, palpitations, insomnia, asthenia, anxiety, mood depression, irritability, vaginal dryness, dyspareunia, and libido loss, significantly decreased in severity and frequency during ES versus Ca+D treatment even since the fourth week. Woman wellbeing (good/very good 66.7% vs 20%) judgement on efficacy (72.7% vs 17.1%) and acceptability (93.9% vs 31.4%) were significantly better for ES. CONCLUSIONS: The controlled study showed the efficacy of Magnolia extract and magnesium on psycho-affective and sleep disturbances in menopause, in addition to the effects of isoflavones on vasomotor symptoms. A global natural approach to menopause with ES evidenced its therapeutic usefulness and safety.

[Hypophosphatemia and refeeding syndrome: a severe and underdiagnosed adverse effect]. / Hypophosphatémie et renutrition: un effet secondaire grave méconnu.

A 68-year-old woman was hospitalised because of generalised weakness and development of confusional state, related to severe hyponatremia, probably due to an eating disorder with malnutrition. During the first days of hospitalisation the patient eats surprising large amounts of food. The worsening of the confusional state in spite of normalisation of natremia, and the progressive development of anemia and thrombocytopenia, leads to the discovery of a new onset severe hypophosphatemia. The rapid fall in plasma levels of phosphorus, magnesium and potassium are the main futures of the refeeding syndrome. Its clinical manifestations are neurological, muscular, haematological and renal. The development of this syndrome is associated with a high mortality. The refeeding syndrome is seen when carbohydrates are introduced after a period of malnutrition. Identification of patients at risk for the refeeding syndrome (anorexia nervosa, chronic alcoholism, chronic malnutrition, elderly patients, oncology patients), the introduction of cautious progressive nutrition and the careful monitoring of vital signs, electrolytes levels and fluid balance, allows to prevent morbidity and mortality of this syndrome.

[Plasma-cell granuloma of the sigmoid colon concomitant with adenocarcinoma of the cecum. Viewpoint for debate, literature review on pseudotumors, idiopathic colitis and cancer]. / Concomitanza di granuloma plasmacellulare del sigma e adenocarcinoma del cieco. Spunto per una discussione ed una revisione della letteratura in tema di pseudotumori, coliti idiopatiche e cancro.

A case of colonic pseudotumor, causing intestinal occlusion, concomitant with a caecum neoplasia is reported. A male 69 years old was referred to our Institution for colic abdominal pain: colonoscopy aborted because of an insuperable sigma stenosis; diagnostic enema confirmed the sigmoid stenosis, originally advised as neoplastic. As operation, the sigmoid tumor appeared accompanied with enlarged draining lymph nodes and peritoneal sac was disseminated of miliary-like whity granules. Hystological examination showed a plasma-cell granuloma with nodular and peritoneal chronic inflammatory reaction. A pancolonoscopy, performed fourty days later, discovered an unsuspected adenocarcinoma neoplasia of the caecum, that was resected with a second operation. Regional nodes were not involved. The authors make a review of international literature about of plasma-cell granuloma, pseudotumor and inflammatory chronic bowel diseases in order to identify possible correlations between pseudotumor and neoplasms. The extremely low incidence of plasma-cell granulomas in the alimentary tract (17 case since 1970 to 1994) and the reported association with concomitant neoplasms (29%) suggest to consider extremely useful an accurate study of patients with intestinal pseudotumors in order to identify neoplasms of the gastrointestinal tract as well as of other organs.

Serum levels of procollagen type I carboxyterminal extension peptide in cancer patients with bone metastases.

Serum levels of procollagen type I carboxy-terminal extension peptide (PICP) reflect the synthesis of type I collagen. As PICP is produced by osteoblasts and is not incorporated into bone matrix, serum PICP levels have been suggested as a marker of bone formation. In 37 cancer patients (21 men and 16 women; age: 72.4 +/- 8.6 (mean +/- SD) years) with bone metastases and 23 women (age: 77.3 +/- 6.64 years) as controls, the following biochemical variables were measured: serum PICP, calcium (Ca), phosphorus, alkaline phosphatase (AP) and tartrate-resistant acid phosphatase (TRAP), and urinary hydroxyproline and calcium corrected for creatinine excretion. Higher serum levels of PICP were observed in cancer patients than in control (245 +/- 177 micrograms/l vs 121.7 +/- 36 micrograms/l, p < 0.01). Cancer patients also had higher AP levels than controls (704 +/- 755 U/l vs 216.5 +/- 56 U/l, p < 0.01). Abnormal PICP and AP serum concentrations (above the mean + 2SD of controls) were found in 46% and 51% of patients, respectively. Moreover, patients showed significantly lower serum calcium concentrations (p < 0.001), and higher TRAP and hydroxyproline levels although statistical significance was not reached. In the patients, PICP was correlated directly with AP (r = 0.50, p < 0.01) and TRAP (r = 0.34, p < 0.05). In conclusion, patients with bone metastases have increased bone turnover as shown by serum markers. Serum PICP may be used as an adjunctive, non-invasive index to assess bone metabolism. However, the clinical usefulness of PICP in cancer patients needs further evaluations.

Caffeine stimulates in vivo platelet reactivity.

The effect of coffee drinking on platelet reactivity was studied in 12 healthy subjects. Plasma beta-thromboglobulin concentration was determined before and one hour after administration of 100 mg of caffeine, corresponding to one cup of coffee. Mean values were 47.0 +/- 19.3 and 179.3 +/- 85.5 ng/ml before and after caffeine administration respectively. The increase, 298 +/- 150%, is highly significant (p less than 0.001).

Plasma lipoproteins, liver function and glucose metabolism in haemodialysis patients: lack of effect of L-carnitine supplementation.

The effects of L-carnitine administration (2 g i.v. three times weekly for 6 weeks) were studied in a double blind trial comprising 2 X 14 patients on regular haemodialysis treatment. The initial plasma carnitine concentrations were normal in the male, but slightly lowered in the female participants and rose more than ten-fold in the patients receiving active treatment. The majority (15/28) of patients had moderate hypertriglyceridaemia, whereas plasma HDL cholesterol levels were normal. Activities of hepatic and lipoprotein lipase were decreased and fat tolerance impaired. The S-triiodothyronine and/or thyroxine levels were subnormal in 11 patients. Four patients had fasting hyperinsulinemia, and 6 demonstrated abnormal B-glucose patterns after a peroral glucose load. The galactose elimination rate demonstrated moderately impaired hepatocyte function in four patients. No effects of carnitine treatment on any of the variables could be detected.

[Pyrosis in major diseases of the upper digestive tract. Computerized analysis of symptoms in 700 cases subjected to gastroduodenoscopy]. / La pirosi nelle principali malattie del tratto superiore dell'apparato digerente. Analisi computerizzata del sintomo in 700 casi sottoposti a gastroduodenoscopia.

The prevalence of the symptom pyrosis was investigated in 700 cases subjected to gastroduodenoscopy. The incidence of pyrosis was considered in relation to sex, age, "vices" (consumption of coffee, alcohol, cigarettes), character traits, family and pathological medical histories and the diagnosis formed during endoscopy. The incidence of pyrosis proved to be identical for both sexes and slightly higher in the first decades of life. There was no correlation between familial gastroduodenal or intestinal diseases and pyrosis. There seems to be no connection between cigarette smoking and alcohol consumption (assessed quantitatively) and a higher incidence of pyrosis; the consumption of coffee, however, does appear to increase the incidence of pyrosis. When interpreting these data, it should be remembered that many subjects may have modified their habits as a result of pyrosis. The incidence of pyrosis was always found in cases of oesophagitis, current bulbar ulcers, the initial stage of gastric tumours (not advanced cases) and, although with less certainty, in pyloric stenosis and duodenitis. A low incidence was recorded for cases of hypotrophic gastropathies, and cicatricial gastric or duodenal ulcers, for males with oesophageal varices or with a history of chronic hepatopathies. To conclude, pyrosis does not seem to show any characteristics of specificity or sensitivity.

[Dyspepsia among the principal diseases of the upper tract of the digestive apparatus. Analysis of the symptom in 700 cases subjected to gastroduodenoscopy]. / La dispepsia nelle principali malattie del tratto superiore dell'apparato digerente. Analisi del sintomo in 700 casi sottoposti a gastroduodenoscopia.

700 cases subjected to endoscopic examination were investigated to find the relationship between dyspepsia and personal characteristics, lifestyle, family and pathological history and formulated diagnosis. Dyspepsia is taken to represent: epigastric heaviness following meals, prolonged and difficult digestion accompanied by the sensation of slow gastric emptying and fullness. Dyspepsia occurs with equal frequency in both series and is more common during the first decades of life. Dyspepsia is not affected by whether or not the patient lives in the town or the country, smokes, drinks significant amounts of alcohol or coffee. Neither a family history of gastroduodenal or intestinal complaints or gall bladder stones or chronic liver diseases have many bearing on dyspepsia. An attempt to connect endoscopic diagnosis with dyspepsia had no positive result. Dyspepsia was observed with the same frequency in subjects free from upper digestive tract diseases, subjects with organic disease and subjects with functional diseases.

The effect of D,L-carnitine supplementation on muscle metabolism, neuropathy, cardiac and hepatic function in hemodialysis patients. A pilot study.

Three patients on regular hemodialysis treatment were perorally supplemented with D.L-carnitine, 900 mg/d, during four weeks. Before treatment, muscle carnitine concentrations were low and the patients showed signs of hypometabolism in skeletal muscle, cardiomyopathy, impaired hepatic function and a moderate hyperlipoproteinemia. After treatment, the skeletal muscle metabolism normalized. The results further indicate improvement of the cardiac and hepatic function and of the neuropathy on the sensory side. No improvement was found, however, in plasma lipoprotein pattern or in variables reflecting plasma lipid transport (lipoprotein lipase activity and intravenous fat tolerance).