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Mingrone VM, Paduano S, Venturelli F, Marchesi I, Valeriani F, Bassi MC, Borella P, Bargellini A. Effectiveness of mud-therapy in rheumatic and dermatologic diseases: a systematic review. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Thermal mud therapy alone or in combination with thermal water baths is widely used in clinical practice for the management of rheumatic and dermatologic diseases in many countries. Despite its long history and tradition, its biological action and its clinical effectiveness are still not clear. The aim of this systematic review is to synthetize the current evidence on the mud therapy effects on pain, function and quality of life in patients with rheumatic and dermatologic diseases.
Methods
PubMed/Medline, Embase, and Cochrane Library were searched for articles about the comparative effectiveness of mud therapy alone or combined with other therapies on pain, function and quality of life in adults with rheumatic or dermatological diseases without any restrictions of severity. Studies were searched up to 15 October 2019. We included randomized and non-randomized trials and comparative cohort studies, as well as non-comparative case series and case reports only for safety outcomes. The following outcomes were considered: pain assessed by validated scales or through painkillers drugs consumption, function (i.e. muscle tone, joint motility and stiffness) assessed by validated scores, quality of life and autonomy assessed by validated scales and adverse events. Laboratory inflammation parameters were investigated as secondary outcomes.
Results
A total of 2,455 articles were retrieved through database search, remaining 1,914 records after duplicates removed. The selection by title and abstract led to include 140 studies for full-text evaluation. The screening of full-text is still being carried out. The majority of 140 records assess the effects of mud therapy in patients with osteoarthritis (51 articles), osteoarthrosis (12) and psoriasis (10).
Conclusions
Our results will provide a synthesis of the current evidence on the mud therapy effectiveness, useful to evaluate its inclusion within clinical protocols for the treatment of rheumatic and dermatologic diseases.
Key messages
The majority of studies report the treatment with mud for rheumatic diseases. The synthesis of the evidence is useful to evaluate the mud therapy as treatment for rheumatic and dermatologic diseases.
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Affiliation(s)
- V M Mingrone
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - S Paduano
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - F Venturelli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - I Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - F Valeriani
- Department of Movement, Human and Health Sciences, University of Rome ‘Foro Italico’, Rome, Italy
| | - M C Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - P Borella
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - A Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Bertolini V, Palmieri A, Bassi MC, Bertolini M, Trojani V, Piccagli V, Fioroni F, Cavuto S, Guberti M, Versari A, Cola S. CT protocol optimisation in PET/CT: a systematic review. EJNMMI Phys 2020; 7:17. [PMID: 32180029 PMCID: PMC7076098 DOI: 10.1186/s40658-020-00287-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/10/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose Currently, no consistent guidelines for CT scans used within PET/CT examinations are available. This systematic review provides an up-to-date overview of studies to answer the following questions: What are the specific CT protocols used in PET/CT? What are the possible purposes of requiring a CT study within a PET/CT scan? Is the CT protocol obtained from a dosimetric optimisation study? Materials and method PubMed/MEDLINE, Cochrane Library, Embase and Scopus were systematically searched for relevant studies in accordance with the PRISMA statement. The literature search was conducted from January 2007 until June 2019. Data derived from studies were standardized in order to reduce possible biases, and they were divided into clinically homogeneous subgroups (adult, child or phantom). Subsequently, we divided the CT protocol intents into 3 types (anatomic localization only, attenuation correction only and diagnostic purpose). A narrative approach was used to summarise datasets and to investigate their heterogeneity (due to medical prescription methodology) and their combination in multiseries CT protocols. When weighted computed tomography dose index (CTDIw) was available, we calculated the volumetric computed tomography dose index (CTDIvol) using the pitch value to make the results uniform. Eventually, the correlation between protocol intents and CTDIvol values was obtained using a Kruskal–Wallis one-way ANOVA statistical test. Result Starting from a total of 1440 retrieved records, twenty-four studies were eligible for inclusion in addition to two large multicentric works that we used to compare the results. We analyzed 87 CT protocols. There was a considerable range of variation in the acquisition parameters: tube current–time product revealed to have the most variable range, which was 10–300 mAs for adults and 10–80 mAs for paediatric patients. Seventy percent of datasets presented scans acquired with tube current modulation, 9% used fixed tube current and in 21% of them, this information was not available. Dependence between mean CTDIvol values and protocol intent was statistically significant (p = 0.002). As expected, in diagnostic protocols, there was a statistically significant difference between CTDIvol values of with and without contrast acquisitions (11.68 mGy vs 7.99 mGy, p = 0.009). In 13 out of 87 studies, the optimisation aim was not reported; in 2 papers, a clinical protocol was used; and in 11 works, a dose optimisation protocol was applied. Conclusions According to this review, the dose optimisation in PET/CT exams depends heavily on the correct implementation of the CT protocol. In addition to this, considering the latest technology advances (i.e. iterative algorithms development), we suggest a periodic quality control audit to stay updated on new clinical utility modalities and to achieve a shared standardisation of clinical protocols. In conclusion, this study pointed out the necessity to better identify the specific CT protocol use within PET/CT scans, taking into account the continuous development of new technologies.
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Affiliation(s)
- V Bertolini
- Medical Physics Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - A Palmieri
- Nuclear Medicine Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - M C Bassi
- Medical Library, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - M Bertolini
- Medical Physics Unit, Azienda USL-IRCCS, Reggio Emilia, Italy.
| | - V Trojani
- Medical Physics Unit, Azienda USL-IRCCS, Reggio Emilia, Italy.,Medical Physics Specialization School, Università degli Studi di Bologna, Bologna, Italy
| | - V Piccagli
- Medical Physics Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - F Fioroni
- Medical Physics Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - S Cavuto
- Research and Statistics Infrastructure, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - M Guberti
- Health Care Professionals Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - A Versari
- Nuclear Medicine Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - S Cola
- Nuclear Medicine Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
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Díaz Crescitelli ME, Ghirotto L, Sisson H, Sarli L, Artioli G, Bassi MC, Appicciutoli G, Hayter M. A meta-synthesis study of the key elements involved in childhood vaccine hesitancy. Public Health 2019; 180:38-45. [PMID: 31838344 DOI: 10.1016/j.puhe.2019.10.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/26/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Immunization is one of the most successful and cost-effective interventions to improve health outcomes. However, internationally, the phenomenon of parental vaccine hesitancy is increasing and presents a growing challenge for health professionals. This article summarizes the evidence surrounding childhood vaccine hesitancy from the perspective of parents. STUDY DESIGN We conducted a systematic review and meta-synthesis of qualitative studies. METHODS We searched for qualitative research articles in electronic databases from inception to March 2018. In addition, a manual search of the retrieved articles and their references was conducted to identify other potential articles. We used the Critical Appraisal Skills Programme to examine study validity, adequacy and potential applicability of the results. No articles were excluded for reasons of quality. By performing a meta-synthesis, we identified descriptive themes and, subsequently, the conceptual elements of vaccine hesitancy. RESULTS The review included 27 studies involving a total of 1557 parents who were hesitant about vaccinating their child. Five overarching categories were identified: (1) risk conceptualization; (2) mistrust towards vaccine-related institutions, pharmaceutical companies, researchers, health professionals and the information from media; (3) parental alternative health beliefs about childhood immunity, vaccine scheduling and the perceived toxicity of vaccinations; (4) philosophical views on parental responsibility; and (5) parents' information levels about vaccination. CONCLUSIONS Healthcare providers need to approach this difficult situation considering that parents desire to do what they feel right for the child. Understanding the core elements of hesitancy will allow health professionals to adopt effective communication and behavioural strategies.
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Affiliation(s)
| | - L Ghirotto
- Azienda USL - IRCCS di Reggio Emilia, Italy
| | - H Sisson
- Faculty of Health Sciences, University of Hull, UK
| | - L Sarli
- Department of Medicine and Surgery, University of Parma, Italy
| | - G Artioli
- Azienda USL - IRCCS di Reggio Emilia, Italy
| | - M C Bassi
- Azienda USL - IRCCS di Reggio Emilia, Italy
| | | | - M Hayter
- Faculty of Health Sciences, University of Hull, UK
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Bortesi M, Martino V, Marchetti M, Cavazza A, Gardini G, Zanetti E, Bassi MC, Ghirotto L, Costantini M, Piana S. Pathologist’s assistant (PathA) and his/her role in the surgical pathology department: a systematic review and a narrative synthesis. Virchows Arch 2018; 472:1041-1054. [DOI: 10.1007/s00428-018-2300-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 12/28/2017] [Accepted: 01/15/2018] [Indexed: 12/01/2022]
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Celani MG, Bassi MC, Bignamini A, Candelaresi P, Carlini M, Cecconi M, Congedo M, Cusi C, Cuzzubbo S, Guerra D, Macone S, Melis M, Motto C, Nardi K, Oppo V, Papetti R, Piersanti C, Piras V, Serafini A, Sgoifo AL, Susani E, Tremolizzo L, Cantisani TA. Do outcome measures used in neurological clinical research realistically represent the needs and the expectations of patients and their care givers? Trials 2015. [PMCID: PMC4460782 DOI: 10.1186/1745-6215-16-s1-p8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
Chromatin architecture plays a decisive role in many aspects of transcription regulation. We have tested the role of specific chromatin structures in c-fos gene regulation, using a gene transfer system based on episomes derived from the Epstein-Barr virus (EBV). This system reproduces in several respects the chromatin structure and regulation of the chromosomal c-fos gene. Using this approach, we first demonstrate that the pausing of RNA polymerase II downstream of the transcriptional start site does not require precisely positioned nucleosomes. Indeed, changing the pattern of MNase hypersensitive sites along the transcribed sequence does not perturb RNA polymerase II pausing or the regulation of the c-fos gene. Next, we show that a putative nucleosome positioned between the SIE/SRE elements (-300) and the CRE/TATA elements (-36) is not necessary for activation by a variety of inducers. Accordingly, total or partial deletion of the putative nucleosome sequence does not disturb c-fos regulation while the two regulatory sites flanking the nucleosome sequence remain hypersensitive to MNase. As described in this paper, EBV episomes are useful vectors to critically examine the role of the chromatin structure in gene transcription for human cells.
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Affiliation(s)
- J Fivaz
- Swiss Institute for Experimental Cancer Research (ISREC), Chemin des Boveresses 155, CH-1066, Epalinges, Switzerland
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Abstract
Transcription elongation regulates c-fos expression in mouse and human cells. In the inactive state of the gene, RNA polymerases are engaged only in the promoter-proximal region. Upon activation, RNA polymerases move efficiently along the complete gene. We have used Epstein-Barr virus (EBV) episomes as a gene transfer system to study the role of promoter-proximal pausing and transcript elongation in c-fos expression. We find that the sequence located immediately downstream of the transcriptional start site specifies pausing of RNA polymerases, dependent on both its orientation and position relative to the promoter. This sequence is, however, not necessary to maintain repression in the absence of a stimulus. As promoter-proximal pausing is therefore not a repression mechanism for the c-fos gene, the promoter and enhancer sequences are the main determinants of RNA polymerase elongation competence. Surprisingly, we find that promoter-proximal pausing further increases transcriptional levels from a variety of promoters. These observations lead us to hypothesize that promoter-proximal pausing of RNA polymerase II augments c-fos expression by allowing more efficient phosphorylation of the C-terminal domain of the large subunit.
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Affiliation(s)
- J Fivaz
- Swiss Institute for Experimental Cancer Research (ISREC), Chemin des Boveresses 155, CH-1066, Epalinges, Switzerland
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