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Giuseppe Ventriglia,1 Fabrizio Gervasoni,2 Massimiliano Franco,1 Alberto Magni,1 Giorgio Panico,2 Giovanni Iolascon3 1SIMG (Italian College of General Practitioners and Primary Care), Florence, Italy; 2Rehabilitation Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy; 3Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, ItalyCorrespondence: Fabrizio Gervasoni, Rehabilitation Unit, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, Via G.B. Grassi 74, Milan, 20157, Italy, Tel +39 02 39041, Email fabrizio.gervasoni@asst-fbf-sacco.itPurpose: In Italy, musculoskeletal (MSK) disorders are pervasive with one-third of adults seeking medical consultation for a MSK issue in the past year. MSK pain is often treated with local heat applications (LHAs) which can be integrated into MSK care by different specialists and in different settings. Compared to analgesia and physical exercise, LHAs have been less evaluated, and the quality of randomized clinical trials is generally low. The aim of the survey is to assess the knowledge, attitude, perception/practices of general practitioners (GPs), physiatrists and sports medicine doctors towards thermotherapy as delivered by superficial heat pads or wraps.Patients and Methods: The survey was conducted between June and September 2022 in Italy. An online questionnaire with 22 multiple-choice questions was administered to explore the demographics and prescribing habits of the participants; the clinical profile of MSK patients; and physicians’ attitude and beliefs about the use of thermotherapy/superficial heat applications in MSK pain management.Results: GPs are at the forefront of the MSK patient journey and preferentially select NSAIDs as first-line option in arthrosis, muscle stiffness, and strain while prescribing heat wraps as preferred choice in presence of muscle spasm/contracture. Similar pattern of prescribing habits was found among specialists who, in contrast to GPs, adopted more frequently ice/cold therapy to relieve pain due to muscle strain and limited paracetamol use. Generally, survey participants agreed on the benefits of thermotherapy in MSK care management, namely increased blood flow and local tissue metabolism as well as connective tissue elasticity and pain relief which all may be of help in attaining pain control and improvement of function.Conclusion: Our findings provided the basis for further investigations aimed at optimizing the MSK patient journey while building up additional evidence supporting the benefit of using superficial heat applications to effectively manage patients with MSK disorders.Keywords: musculoskeletal disorder, superficial heat therapy, general practitioner, heat pads, heat wraps

Bacteria are the most common causative agents of ocular infections. Treatment with topical broad-spectrum antibiotics is recommended in severe cases. However, antibiotic resistance has become a major concern in recent years, although antibiotics are generally effective in treating ocular infections. Antibacterial compound screening is performed to identify alternative therapeutic options to antibiotics. The aim of this study was to assess the in vitro antimicrobial activity of an ophthalmic solution containing ozonated oil. Strains of bacterial species with a multidrug resistance profile, which are responsible for a large proportion of ocular infections, were isolated and selected from different biological samples. The bacterial isolates were cultured, and ozonated oil was used to evaluate the inhibition zones at different time points. The treatment exhibited antibacterial activity against all the tested species. The effect was lower against the strains of Pseudomonas aeruginosa and more evident against Staphylococcus and Streptococcus spp. Our results suggest that the administration of ozonated oil may be a candidate agent to treat some infections of the ocular surface with a potential role in antimicrobial prophylaxis.

First order phase transitions in the early universe may have left a variety of experimentally accessible imprints. The dynamics of such transitions is governed by the density perturbations caused by the propagation of the bubble wall in the false vacuum plasma, conveniently described by a Boltzmann equation. The determination of the bubble wall expansion velocity is crucial to determine the experimental signatures of the transition. We report on the first full (numerical) solution to the Boltzmann equation. Differently from traditional ones, our approach does not rely on any ansatz. The results significantly differ from the ones obtained within the fluid approximation and large differences for the friction acting on the bubble wall are found. The wall velocity is calculated in a singlet extension of the Standard Model, including out-of-equilibrium contributions from both the top quark and the electroweak gauge bosons.

La sialometaplasia necrotizante (SN) es una patología estadísticamente infrecuente, benigna, inflamatoria, autolimitante, que afecta predominantemente a las glándulas salivales menores. Su etiología no está clara, la mayoría de los autores sugieren que una lesión química, física o biológica de los vasos sanguíneos produciría cambios isquémicos, que desencadenaría infarto del tejido glandular con necrosis, inflamación e intento de reparación. Su aspecto clínico e histológico tiene apariencia de malignidad, pudiendo inducir a un diagnóstico erróneo de neoplasia maligna de origen anexial, considerando que la SN se trata de una patología autoresolutiva, es fundamental realizar un correcto diagnóstico clínico e histopatológico para evitar tratamientos quirúrgicos innecesarios. Se presenta el caso clínico de una paciente de sexo femenino que fue derivada al Servicio de Otorrinolaringología (ORL) de la Clínica Universitaria Reina Fabiola con diagnóstico de SN, sus características clínicas, histopatológicas y la evolución de la lesión.

Los épulis son lesiones bien conocidas que muestran predilección por las encías (mucosa gingival o alveolar), de crecimiento lento y a veces muestra un crecimiento rápido; suelen aparecer como un nódulo solitario localizado con una base sésil o pediculada y color que varía de rojo, violáceo o rosa, según la vascularización de la lesión. Este crecimiento se considera de naturaleza no neoplasica (psuedotumor benigno hiperplásico), que se presenta en la cavidad oral en diversas formas clínicas e histológicas. Debido a su aparición especialmente en la encía, este artículo presenta un caso clínico de un épulis fibroso o hiperplasia gingival fibrosa circunscripta, su manejo clínico, como revisión en la literatura.

El metotrexato es un fármaco usado en el tratamiento de muchas enfermedades autoinmunes y auto inflamatorias. Sin embargo, ciertos eventos adversos se relacionaron con su administración, entre ellos la afectación mucocutánea. Presentamos el caso de un paciente con manifestaciones de toxicidad dermatológica secundaria a la ingesta de metotrexato en forma diaria, sin indicación médica. Las lesiones respondieron a la suspensión de la droga y al tratamiento sintomático. El paciente no presentó compromiso sistémico severo.

El liquen plano oral (LPO) es una enfermedad mucocutánea crónica, de carácter inflamatorio, etiología desconocida y naturaleza autoinmune, en la que se produce una agresión por parte de los linfocitos T dirigida frente a las células basales del epitelio de la mucosa oral. El diagnóstico del LPO debe basarse en la observación clínica y confirmarse con la descripción de las características histopatológicas. Se presenta caso clínico de paciente femenina de 39 años de edad que acudió a consulta odontológica al Servicio de Estomatología de la Escuela de Odontología, de la Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, por presentar múltiples lesiones blancas en la cavidad bucal de 1 año de evolución. La paciente manifiesta episodios de stress. Se realizó biopsia de tipo incisional y se envió a anatomía patológica donde se confirmó el diagnóstico de Liquen Plano Oral.

First order phase transitions in the early universe naturally lead to the production of a stochastic background of gravitational waves and to the generation of a matter-antimatter asymmetry. The dynamics of the phase transition is affected by the density perturbations in the hot plasma. We address this topic by providing, for the first time, a full numerical solution to the linearized Boltzmann equation for the top quark species coupled to the Higgs field during a first order phase transition at the electroweak scale. Differently from the traditional approaches, our results do not depend on any ansatz and can fully describe the non-equilibrium distribution functions of the particle species in the plasma.

Annalisa Panico,1 Giovanni Messina,2,3 Gelsy Arianna Lupoli,1 Roberta Lupoli,1 Marianna Cacciapuoti,1 Fiorenzo Moscatelli,2 Teresa Esposito,3 Ines Villano,3 Anna Valenzano,2 Vincenzo Monda,3 Antonietta Messina,3 Francesco Precenzano,4 Giuseppe Cibelli,2 Marcellino Monda,3 Giovanni Lupoli1 1Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy; 2Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; 3Department of Experimental Medicine, Second University of Naples, Naples, Italy; 4Department of Mental and Physical Health, and Preventive Medicine, Child and Adolescent Neuropsychiatry Unit, Second University of Naples, Naples, Italy Objective: Polycystic ovary syndrome (PCOS) is characterized by phenotypic heterogeneity and has a wide variety of consequences. Approximately half of women with PCOS are overweight or obese, and their obesity may be a contributing factor to PCOS pathogenesis through different mechanisms. The aim of this study was to evaluate if PCOS alone affects the patients’ quality of life and to what extent obesity contributes to worsen this disease. Design: To evaluate the impact of PCOS on health-related quality-of-life (HRQoL), 100 Mediterranean women with PCOS (group A), 50 with a body mass index (BMI) >25 kg/m2 (group A1) and 50 with BMI 25 (A1) showed a significant and more marked reduction in scores, suggesting a lower quality of life, compared with controls (B) and with normal-weight PCOS patients (A2). Conclusion: PCOS is a complex disease that alone determines a deterioration of HRQoL. The innovative use of these psychometric questionnaires in this study, in particular the PCOS questionnaire, has highlighted that obesity has a negative effect on HRQoL. It follows that a weight decrease is associated to phenotypic spectrum improvement and relative decrement in psychological distress. Keywords: polycystic ovary syndrome, obesity, normal-weight, health-related quality-of-life, psychological disturbances

TRAAK, TREK-1, and TREK-2 are mechanosensitive two-pore domain K+ (K2P) channels that contribute to action potential propagation, sensory transduction, and muscle contraction. While structural and functional studies have led to models that explain their mechanosensitivity, we lack a quantitative understanding of channel activation by membrane tension. Here, we define the tension response of mechanosensitive K2Ps using patch-clamp recording and imaging. All are low-threshold mechanosensitive channels (T10%/50% 0.6-2.7 / 4.4-6.4 mN/m) with distinct response profiles. TRAAK is most sensitive, TREK-1 intermediate, and TREK-2 least sensitive. TRAAK and TREK-1 are activated broadly over a range encompassing nearly all physiologically relevant tensions. TREK-2, in contrast, activates over a narrower range like mechanosensitive channels Piezo1, MscS, and MscL. We further show that low-frequency, low-intensity focused ultrasound increases membrane tension to activate TRAAK and MscS. This work provides insight into tension gating of mechanosensitive K2Ps relevant to understanding their physiological roles and potential applications for ultrasonic neuromodulation.

Introduction: A relevant role is now emerging for nutraceuticals and specific functional foods in the treatment of dyslipidemia. The aim of this study was to evaluate the efficacy of a nutraceutical multi-target approach in subjects with moderate cardiovascular risk and to compare it with red yeast rice (RYR) treatment alone. Materials and Methods: Sixty patients with a first diagnosis of moderate dyslipidemia were included in a 6-week open-label, randomized, parallel-group controlled clinical trial and were treated with a nutraceutical supplement of Red Yeast Rice (RYR) extract containing 10 mg of monacolin k or its combination with 48 mg of an improved form of highly bioavailable resveratrol. The dosage of RYR was selected on the basis of its expected efficacy in reducing low-density lipoprotein- cholesterol also approved by the EFSA panel. All differences were assessed by Student’s t test with P values .05 are considered as statistically significant. Statistical analysis was performed by using Excel. Results: Treatment with RYR (10 mg monacolin K) led to a reduction of total cholesterol (20%) and low-density lipoprotein- cholesterol (21%). The combination with resveratrol however, compared to RYR alone significantly reduced triglyceride (-18 %) levels, systolic blood pressure (-2 %) and HOMA index (-17 %). Discussion: These results indicate that the nutraceutical supplementation of RYR associated with resveratrol not only shows lipid-lowering activity but compared to RYR treatment alone significantly also ameliorates other metabolic parameters. Thus, may represent a valid and safe approach, especially in people with moderate cardiovascular risk, in which a pharmacologic intervention may not be appropriate.

Introduzione: la vaccinazione antinfluenzale (VA) rappresenta uno degli interventi raccomandati per proteggere non solo operatori sanitari e pazienti ad alto rischio, ma la popolazione tutta. Lo scopo dello studio è stato valutare l’adesione alla VA da parte del personale infermieristico dedicato all’assistenza dei pazienti immunocompromessi presso l’A.O.U. “Federico II” di Napoli negli ultimi cinque anni. Ulteriori obiettivi sono stati: rilevare il fabbisogno formativo e comprendere i motivi della mancata adesione alla VA. Metodo: lo studio osservazionale è stato condotto da giugno a settembre 2015; è stato somministrato un questionario rivolto agli infermieri utilizzando un modulo di analisi on-line creato con la piattaforma G-Drive di Google. Risultati: sono stati somministrati un totale di 227 questionari con un tasso di adesione del 67.8%. Il 61.3% del campione creda nelle vaccinazioni quali strumenti importanti per la riduzione/eliminazione delle malattie. Nell’anno 2014-15, l’89% del campione non ha praticato la vaccinazione antinfluenzale. Negli ultimi 5 anni il 20.8% dichiara di essersi vaccinato soltanto una volta, l’11% due o più volte, mentre il 68.2% non si è mai vaccinato. Un ulteriore bisogno di informazioni è emerso nell’80% del campione. Conclusioni: l’assenza di un protocollo aziendale e le misconception sulla VA sembrano essere i principali elementi che hanno determinato i risultati. Vi è la necessità di attuare interventi capaci di stimolare gli operatori a comprendere l’importanza della VA, sviluppando una maggiore l’adesione.

La Medicina Bucal, como toda actividad humana, puede ser abordada desde dos sistemas de razonamiento, conocidos como Sistemas Cognitivos. El Sistema 1 es intuitivo, económico y rápido, mientras que el Sistema 2 es analítico, lento, costoso en esfuerzo, pero más confiable. Ambos sistemas interactúan entre sí, de manera que nuestra actividad de diagnóstico emplea a uno y otro. Los errores de diagnóstico en Medicina Bucal pueden basarse en falta de aplicación de reglas sistemáticas del sistema 2, o en errores cognitivos al utilizar exclusivamente el sistema 1. Estos errores derivan generalmente en considerar falso un diagnóstico verdadero, o en considerar verdadero un diagnóstico falso. Existen estrategias para reducir estos errores cognitivos, pero el paso fundamental es conocer cómo pensamos y cuáles son los errores que podemos cometer. El análisis reflexivo de los errores cognitivos de diagnóstico (metacognición) permitiría transformarlos en oportunidades de crecimiento profesional y en una mejor atención para nuestros pacientes.