Effectiveness of intra-articular infiltration of platelet concentrates for the treatment of painful joint disorders in the temporomandibular joint: a systematic review.

BACKGROUND: The role of Platelet-rich Plasma injections as a complementary therapy, together with other minimally invasive procedures, has been analyzed previously, however, there are no articles that evaluate the effects of intra-articular infiltration in the Temporomandibular Joint by itself. The aim of this article is to evaluate the effectiveness of intra-articular infiltration with Platelet-rich Plasma, as a single procedure, to both reduce pain and improve clinical parameters in painful joint disorders. MATERIAL AND METHODS: A systematic search was performed using the terms "Temporomandibular Joint Disorders" and "Platelet-rich plasma" in May 2021. Only the Clinical Trials found in the Pubmed/Medline, Embase, Cochrane Library/Cochrane CENTRAL, Google Scholar, and LILACS databases were selected. RESULTS: Only four articles were selected for full-text review. Statistically significant differences were found in pain reduction Platelet-rich Plasma-based interventions with respect to preoperative measurements up to six months. Only two studies found significant intergroup differences favoring Platelet-rich Plasma over other interventions. In relation to maximum mouth opening, three studies reported an increase compared to the preoperative measurements. CONCLUSIONS: Platelet-rich Plasma might potentially be effective in reducing pain levels and improving clinical parameters such as interincisal distance. However, studies with better methodological quality, larger sample sizes, and lower risk of bias are required to assess the real value of this intervention in the management of painful joint disorders.

Gut-oriented interventions in patients with multiple sclerosis: fact or fiction?

OBJECTIVE: Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating, disimmune disease of the central nervous system whose etiology and pathogenesis remain poorly understood, due to its complex and multifactorial nature. Evidence of a bidirectional connection linking the gut microbiome with the intestinal barrier and the immune system (the gut-brain axis) may have implications for the pathogenesis of inflammatory demyelinating diseases such as MS. This narrative review summarizes the evidence for the gut-brain axis involvement in the pathogenesis of MS and examines the role of gut-oriented interventions in MS. PATIENTS AND METHODS: We reviewed all available studies in PubMed concerning gut-directed interventions and MS. This research was conducted using different combinations of pertinent keywords (multiple sclerosis, immune-mediated inflammatory diseases, autoimmune diseases, first demyelinating event, neurocognition, neurological disorders, neurology practice, risk factors, taxonomic biomarkers, nutrition, diet, dietary additives, complementary treatment, gut bacteria, gut microbiome, microbiome, gut-brain axis, epidemiology, alpha-linolenic acid, fermentative metabolites, fat, saturated fat, monounsaturated fat, polyunsaturated fat, omega-3 fatty acids, calorie restricted diet, fasting, fecal microbiome, fecal microbiota transplantation, animal testing). RESULTS: There is an emerging evidence that alterations in the gut microbiome and increased intestinal permeability may be causative factors in the complex interplay between nutrition, metabolic status and the immune-inflammatory response in patients with MS. This suggests the possibility that modification of lifestyle and the microbiome, for example by specific diets or fecal microbiota transplantation, supplementation with bile acids and intestinal barrier enhancers, may positively influence the pathogenesis of MS. CONCLUSIONS: Although the role of nutritional factors in the pathogenesis of MS remains to be established, there is evidence that appropriate gut-directed interventions such as diet, nutritional supplementation or fecal transplantation may modulate the inflammatory response and improve the course of MS as a complementary treatment in the disease.

[Inflammatory pseudotumor of the lung]. / Lo pseudotumore infiammatorio del polmone.

An inflammatory pseudotumour of the lung was occasionally observed at radiology and is reported. Such lesions account for 1% of all lung tumours and are frequently asymptomatic; the findings on physical and laboratory examinations are usually nonspecific. Radiographic findings and invasive diagnostic procedures--including bronchoscopy and transthoracic fine needle biopsy--may be not sufficient for histological diagnosis. Surgery is then important for both diagnostic and therapeutic reasons; the treatment of choice is complete but non extensive excision. Radiotherapy should be considered in patients who had incomplete surgical resection or postoperative recurrences and in patients non resectable due to associated medical conditions.

[Primary non-Hodgkin's lymphomas of the colon: apropos of a case with double localization]. / I linfomi primitivi non-Hodgkin del colon: a proposito di un caso a duplice localizzazione.

A case of non-Hodgkin's lymphoma involving the caecum and the rectum was resected. The disease occurs in 1-4% of gastrointestinal neoplasms and comprises 0.2-0.65% of colorectal tumours. The caecum is frequently involved while primary malignant lymphoma localized to the caecum and the rectum is more uncommon. The most representative histological types are histiocytic or lymphocytic tumours. The disease commonly presents as a painful abdominal mass and is associated with weight loss and diarrhoea. Barium enema and pancolonoscopy are sufficient for diagnosis, but echotomography and Tc scan are useful for staging. Surgery is the treatment of choice and overall 5-years survival is 30-40%. The role of adjuvant therapy has not yet been clearly defined, although data from some studies indicate increased survival in those patients given adjuvant therapy compared with patients treated with surgical resection alone.

[Peritoneal mesothelioma as a rare case of acute abdomen. Review of the literature]. / Il mesotelioma peritoneale come raro caso di addome acuto. Revisione della letteratura.

Peritoneal mesothelioma is a rare neoplasm with generic and non-specific symptoms. In some cases it is associated with various and particular clinical syndromes. These findings make it so insidious that the diagnosis is rarely make the preoperative course. Usually, there has been previous exposure to asbestos, during even if other causes are reported. Rarely, a peritoneal mesothelioma appears with signs and symptoms suggestive of acute abdomen, such as the present case. On admission the patient presented clinical features apparently requiring emergency surgery. In fact, at laparotomy, the tumour, arising from the mesenterium, had perforated the peritoneal cavity and communicated with the digiunal lumen, causing a septic hemoperitoneum. A radical resection was performed and the continuity of the intestinal tract was restored through an end-to-end entero-anastomosis. The patient, with a history of exposure to asbestos, was alive four years later. But over the last twelve months diffuse metastasis has occurred in the lung and liver, and there was no response to systemic chemotherapy. This case may be considered singular of the clinical syndrome, the long-term survival and the circumscribed aspect of the tumour. Through a review of the literature, the features of the present diagnostic procedure are underlined and the importance of multidisciplinary treatment as the best approach to peritoneal mesothelioma is emphasized.

[Spontaneous perforations of the large intestine]. / Le perforazioni spontanee del grosso intestino.

Spontaneous perforation of colon is a rare disease and physiopathologic basis are actually unknown. Surgical treatment is standardized and post-operative survival is over 60%, morbidity and mortality rate depends on peritoneal contamination. In 1984 J.A. Berry classified spontaneous perforations into "stercoral" and "idiopathic" perforations on the basis of etiopathogenetical causes of lesions. Anatomopathologically stercoral and idiopathic perforations present different characteristics. Macroscopically stercoral perforation origines from an ulcerative lesion often situated on the sigmoid colon or rectum. Microscopical characteristic is represented by a superficial ischemic necrosis of mucosa (caused by fecalomas) followed by an extension to sub-mucosa and muscular tissues of the colonic wall. On the contrary, "idiopathic perforation", frequently situated on the sigma, is a linear laceration of anti-mesenteric side of the colon without pathologic modifications of the colon. Physiopathologic basis of spontaneous perforations of the colon were also discussed. Stercoral perforation is often a consequence of chronic constipation. Instead, two hypoteses are advanced as regards idiopathic perforations. S.V. Kessing e coll. (1962) hypotized a parietal suffering caused by ischemia of anti-mesenteric side of the colon, depending on ipoperfusion of colonic tissues; they also hypotized a constitutional weakness of colonic wall as a cause of idiopathic perforation. Others hypotized an intraluminal hypertension caused by intestinal hernias (J.W. Eadie, 1955; K. Cronin, 1959), rectal prolapse or abnormal depth of Douglas cavity (D.C. Lyon, 1969). In these cases, lesion is caused by contraction of abdominal muscles during defecation, which presses colonic wall during distension.(ABSTRACT TRUNCATED AT 250 WORDS)

[Bronchoesophageal fistulae: apropos a case rarely seen]. / Le fistole bronco-esofagee: a proposito di un caso di rara osservazione.

One case of acquired oesophago-bronchial fistula is reported. Diagnostic images are presented. Pathogenesis, clinical and therapeutics features are discussed.

[Acute alithiasic cholecystitis (pathogenetic and clinical considerations)]. / Le colecistiti acute alitiasiche (considerazioni patogenetiche e cliniche).

The authors address the topic of acute acalculous cholecystitis and examine the related aetiopathogenetic and clinical problems, taking as their starting point two cases of the disease observed in their department.