Behavior of rats treated with Rhus toxicodendron 200cH

One of the main pathogenetic characteristics of Rhus toxicodendron (Rhus-t) is the presence of articular pain and aggravation on standing, which improve only by motion. The present study proposes an experimental model to evaluate the action of Rhus-t 200cH. Rats were divided into 3 groups according to treatment received (Rhus-t, diazepam and water); each group was further divided into two sub-groups according to the initial pattern of behavior (hyperactive and hypoactive) as assessed by open-field procedure. A second evaluation of behavior performed 24 hours later pointed out to the effects of the medications under study. Results were analyzed through Kruskal-Wallis/Dunn’s test, with a level of significance p=0.05. Keywords: Rhus toxicodendron; Animal behavior; Open-field; Idiosyncrasy.  Conduta de ratos tratados com Rhus toxicodendron 200cH Resumo Uma das características patogenéticas principais de Rhus toxicodendron (Rhus-t) é a presença de dor articular e agravação em pé, melhorando exclusivamente com o movimento. O presente estudo propõe um modelo experimental para avaliar a ação de Rhus-t 200cH. Ratos foram divididos em 3 grupos de tratamento (Rhus-t, diazepam e água); cada grupo doi subdividido em 2 subgrupos de acordo com o padrão inicial de conduta (hiper e hipoativos) em procedimento de campo aberto. Uma segunda avaliação da conduta, realizada 24 horas após, indicou o efeito dos medicamentos sob estudo. Os resultados foram analisados pelo teste de Kruskal-Ealis/Dunn com nível de significância p=0,05. Palavras-chave: Rhus toxicodendron; comportamento animal; Campo aberto; idiossincrasia.  Conducta da ratones tratados con Rhus toxicodendron 200cH Resumen Una de las principales características patogenéticas de Rhus toxicodendron (Rhus-t) es la presencia de dolor articular y agravación de pie, que mejora exclusivamente por el movimiento. Este estudio propone un modelo experimental para evaluar la acción de Rhus-t 200cH. Ratones fueron divididos en 3 grupos de tratamiento (Rhus-t, diazepam y agua); cada grupo fue subdividido en 2 subgrupos según el padrón inicial de conducta (hiper e hipoactivos) en procedimiento de campo abierto. Una segunda evaluación de la conducta, realizada 24 horas después, indicó el efecto de los medicamentos en estudio. Los resultados fueron analizados por el test de Kruskal-Wallis/Dunn con nivel de significancia p=0,05. Palabras-clave: Rhus toxicodendron; Comportamiento animal; campo abierto; Idiosincrasia.  Correspondence author: Leoni Villano Bonamin; Universidade Paulista, Brazil; [email protected] How to cite this article: Rocha MPS, Soares FM, Martini LC, Bonamin LV. Behavior of rats treated with Rhus toxicodendron 200cH. Int J High Dilution Res [online]. 2008 [cited YYYY Mmm DD]; 7(22): 3-6. Available from: http://journal.giri-society.org/index.php/ijhdr/article/view/265/333. ÂÂÂ

A Challenge of COVID—19: Associated Infective Endocarditis with Streptococcus gordonii in a Young Immunocompetent Patient

The COVID-19 pandemic is a new challenge for the diagnosis and treatment of infective endocarditis (IE). Fever and other unspecific symptoms of coronaviral infection could be misleading or masking its manifestations. We present the case of a young patient admitted for persistent fever, profuse sweating, headache, articular pain, myalgias, and weight loss. She reported regression taste and smell disorders compared to a month earlier when diagnosed with moderate COVID-19 pneumonia. While the RT-PCR SARS-COV-2 test was positive, she was admitted to a COVID-19 ward. Investigations of febrile syndrome revealed two positive blood cultures with Streptococcus gordonii and the presence of vegetations on the aortic valve, supporting a certain diagnosis of IE. After six weeks of antibiotic treatment, the patient had clinical and biologic favorable outcomes. Streptococcus gordonii is a common commensal related to the dental biofilm, although there were no caries in our patient. The influence of COVID-19 infection on the human microbiome by modifying the virulence of some commensal germs may be a risk factor for IE pathogenesis on native valves and requires the vigilance of clinicians for suspicion of this disease.

Application of nutraceuticals in managing osteoarthritis and osteoporosis

Background: Several health problems, especially musculoskeletal disorders, are caused by dif-ferences in work cultures and human lifestyles around the world. While the conventional ap-proach to treating such conditions emphasizes a balanced work-life balance and daily exercise, nutraceuticals have proven to be successful. Nutraceuticals are dietary compounds that help sus-tain cartilage metabolism homeostasis, reducing articular pain. Dietary intake of a variety of nutraceuticals is thought to be essential for controlling and, more specifically, preventing osteoar-thritis and osteoporosis. Objective: The current article offers a succinct overview in which data was gathered and searched using specific key-terms related to nutraceuticals, osteoarthritis, and osteoporosis that were available in public domains for analysis and evaluation. Method: The current write-up offers a concise summary of disease and its relevance as to how nutraceuticals are helpful, based on the defined findings and their interpretation. The present re-view also discusses the existing literature, patents, and current studies in the era of nutraceuticals for osteoarthritis and osteoporosis treatment, offering a rational basis for further investigation and research. Result: This article discusses a wide variety of nutraceuticals with possible uses for osteoarthritis and osteoporosis patients. An analysis revealed that nutraceuticals' efficacy has been established. However, further study and investigation are needed to determine their protection. Conclusion: As a result of this analysis, it was concluded that more innovation and technology transfer were required. It was also concluded that greater industry-academic collaboration was required to begin more effective research in the treatment of osteoarthritis and osteoporosis with nutraceuticals.

Functional Evaluation of a “Lingual Ring” Oral Device Applied on Patients Affected by Temporo-Mandibular Disorders TMDs: A Comparative Clinical Trial

This study aims to evaluate the functional variations of the electromyographic response and clinical symptomatology in TMD patients. This study has been performed and compared before and after the application of a therapeutic protocol based on the use of an oral device working on the proper mandibular repositioning through the proprioceptive-based lingual re-education called “Lingual Ring”. Between January to December 2016, 32 TMD patients have been recruited out of a series of 321 individuals recruited at the Neurosensorial and Motorial Surgery Department, in Palermo (Italy). All the patients underwent the Surface Electromyography (sEMG) of Masseter and Temporal muscles, with different registrations at T0, T1, T2, and T3; to evaluate the variations of the Electromyographic values, it was assigned the application of the Lingual Ring as the only therapy. The study demonstrated a neat rebalancing of the EMG tracks and important improvements with the TMD related issues. The clinical responses, due to the treatment at the end of the therapeutic protocol, were: absence or reduction of muscular or articular pain; absence or reduction of articular noises; absence or reduction of the cephalalgia. Hence, significant results, both clinical and in terms of instrumental EMG, were assessed. We can affirm that the adopted methodology allowed the monitoring of the Electromyographic variation and clinical symptoms. Moreover, the usage of the “Lingual Ring device” allowed to carry out a simple and immediate therapeutic protocol that is minimally invasive, ensuring a clear rebalancing of the EMG tracks as well as the TMD related pain.

P266 The impact of vedolizumab and ustekinumab on arthropathy and arthralgia in IBD patients: a real-life multicentric cohort study

Background Extra-intestinal manifestations (EIM) are frequently reported in inflammatory bowel diseases (IBD). Although the efficacy of TNF inhibitors is well documented, data regarding the effect of vedolizumab (VDZ) and ustekinumab (UST) are limited. Theoretically, the advantage of VDZ, i.e. gut-selectivity, may reduce the efficacy on EIM while the systemic effect of UST may be of benefit. Therefore, we evaluated the differences in new onset and evolution of EIM during both treatments. Methods An international multicentric retrospective study was performed on IBD patients who started VDZ or UST between May 2010 and December 2020. EIM were assessed at baseline and during follow-up. Arthropathy was defined as joint inflammation (arthritis/sacroiliitis) and arthralgia as articular pain without confirmed inflammation. Skin EIM included erythema nodosum (EN), pyoderma gangrenosum (PG) and Sweet syndrome. Ocular EIM included (epi)scleritis and uveitis. Uni- and multivariate analyses were performed. Results In total 856 patients were included: 528 treated with VDZ and 328 with UST. At baseline, arthropathy was more prevalent in UST treated patients (12.2% vs 7.2%; p=0.037; Table 1). No differences in rates of new onset (Fig 1) or evolution of pre-existing arthropathies could be identified between VDZ and UST. In multivariate analyses new onset arthropathy was not associated with smoking, IBD type, sex nor studied biological. In 5 out of 48 (10.4%) VDZ patients and 2 of 46 (4.3%) UST patients with either pre-existing or new arthropathy, treatment was stopped due to articular disease (difference not significant). In contrast, new arthralgia onset within 1 year of follow-up was significantly associated with VDZ treatment (OR 2.1 (1.1–4.0); p=0.022; Fig 1). Arthralgia was the reason to stop treatment in 2 of 87 (2.3%) VDZ patients and never in UST patients. Beside joint EIM, 2 patients developed EN, 1 PG and 1 episcleritis during VDZ treatment. Under UST treatment 1 patient developed EN. No patients developed new Sweet syndrome, scleritis nor uveitis. Conclusion No differences in the rate of new arthropathy onset were observed between VDZ and UST. In contrast, VDZ treatment did increase the risk of new onset arthralgia.

Rosai-Dorfman-Destombes (RDD) disease presenting as palindromic rheumatism

Background Rosai-Dorfman-Destombes (RDD) disease, is a rare proliferative and inflammatory disorder of non-Langerhans cell histiocytes. Case presentation We report a 35-year-old woman, who originally presented with recurrent episodes of lower extremity joint/bone pain and chronic nasal stuffiness and congestion. Her worsening nasal congestion was due to an obstructing nasal cavity lesion which was subsequently biopsied. Pathology was consistent with RDD. 18F-FDG PET images demonstrated intense uptake in the paranasal sinuses and a large pelvic lymph node. Focal osseous lesions with intense 18F-FDG uptake were also observed in the lower extremity, corresponding to areas of peri-articular pain. Rheumatologic work-up was consistent with palindromic rheumatism. She was diagnosed with immune-related disseminated RDD, presenting as palindromic rheumatism. Conclusions This is the first case of RDD presenting as palindromic rheumatism. RDD should be considered as a possible but rare diagnosis in young patients with sinus-related symptoms and lymphadenopathy. The disease can on rare occasions be disseminated and can also present as immune-related RDD, such as in this patient.

Case Report of Osteopoikilosis: Sparse Cause of Bone Pain and Mimicker of Metastasis on Radiographs

Introduction: Osteopoikilosis (OPK) is an extremely rare benign condition with autosomal dominant inheritance characterized by sclerosing bony dysplasia with multiple benign enostoses. It is characterized by symmetrically distributed numerous, small, well-defined, homogenous circular or ovoid radiodensities clustered in epiphysis and metaphysis of long bones in periarticular region, and in some cases diffusely present throughout axial and appendicular skeleton. There is no age and sex predilection; age at the time of diagnosis ranges from 15 to 60 years. It is usually asymptomatic but rarely in 15–20% patients slight juxta-articular pain and joint effusions can be seen. These are incidental radiological findings in most of the cases, also sometimes confused as bony metastasis. There are no specific clinical features; histological features are similar to bony island and it may be associated with connective tissue disorders, synovial osteochondromatosis, and a rare bone condition melorheostosis. Case Report: We present a case of OPK in a 32-year-old male with bilateral hip and shoulder pain, based on the available literature and focus on clinical significance, due to its mimicking capability of other more severe conditions such as bone metastases and an extremely uncommon cause of bone pain. Conclusion: OPK is an uncommon hereditary condition involving juxta-articular region of long bones with intricate etiopathogenesis, often discovered incidentally on radiographs. It is characterized by multiple, symmetrical ovoid radiodensities, and in most instances confused with osteoblastic metastasis. This concludes that OPK is a condition that should be kept in mind to avoid misdiagnosis, in particular osteoblastic metastasis and undue distress to both the patients and doctors. Keywords: Osteopoikilosis, melorheostosis, bone metastases

Assessment of widespread and extra-articular pain in psoriatic arthritis: a case-control study

Objective A remarkable lack of detailed knowledge on pain areas in Psoriatic Arthritis (PsA) is present, and their clinical relevance is quite unknown. The main aim of the study was to explore pain areas in PsA, comparing them with those involved in Fibromyalgia (FM) patients. In addition, to investigate any possible association between pain areas and outcome measures in PsA. Methods Case-control study on PsA patients satisfying CASPAR criteria and FM. In all PsA and FM patients a body chart filled in by the patient in 80 body locations was performed. The Widespread Pain Index (WPI) was performed in all PsA and FM patients. In all PsA patients, an assessment of disease activity, treatment target, function, and impact of disease were carried out. Results 50 PsA patients and 50 FM controls with FM were evaluated. A significantly higher number of pain areas at body chart and WPI score were found in FM patients when compared to PsA patients. In PsA, the number of areas reported at body chart significantly correlated with DAPSA, HAQ-DI and PsAID. Patients who were not in remission/MDA or have a greater impact of disease or reduced function showed a significant high number of extra-articular pain areas involved. Conclusion The main results showed that widespread and extra-articular pain was present in PsA patients, showing that this non-articular pain had an impact on important disease domains. The present study could contribute to an important aspect of this challenging and multifaceted disease, such as the assessment of widespread pain.

Predictive factors of response in radial Extracorporeal Shock-waves Therapy for Myofascial and Articular Pain: A retrospective cohort study

BACKGROUND: Myofascial Pain Syndrome causes disability in daily life activities and despite all efforts, it continues to be a challenge, perpetuating suffering, overloading services and costs. New treatment options need to be tested. OBJECTIVE: We aimed to quantify the rESWT short-term analgesic effect and identify the success predictors through results comparisons achieved in MPS and Articular Pain (AP). METHOD: Retrospective cohort study of 1,580 patients with Myofascial Pain Syndrome or Articular Pain underwent two weekly radial Extracorporeal Shock-wave Therapy sessions. The pain intensity was measured by Visual Analog Scale before and one week after the end of the treatment (3 weeks). RESULTS: The therapy decreases pain by 62.50% (p< 0.0001), with a high success rate (91.59%) and a low worsening rate (2.1%). The best recommendation is for patients with intense myofascial pain (Visual Analog Scale ⩾ 70 mm), using high shock-wave frequency (⩾ 15 Hz). CONCLUSIONS: Two rESWT sessions promote pain relief, with a high success rate and low rates of treatment abandonment and worsening. The best results are obtained in myofascial pain patients with high pain intensity, treated with high-frequency dosage.

Importance of Patient Education for At-home Yoga Practice in Women With Hormonal Therapy-induced Pain During Adjuvant Breast Cancer Treatment: A Feasibility Study

Background Osteo-articular pain (OAP) is experienced by approximately 50% of women under hormonal therapy (HT) for breast cancer (BC), which increases the risk for therapy discontinuation. This study was aimed to assess benefits of yoga practice combined with patient education (PE) for at-home practice by evaluating feasibility among BC patients under HT and measuring OAP, flexibility and satisfaction. Methods Feasibility was evaluated by patient adherence as accomplishment of at least 4 out of 6 supervised yoga-PE sessions along with 70% or more at-home yoga sessions. Intervention (12 weeks) included two 6-weeks periods: P1 comprising one 90-minutes supervised yoga-PE session/week and 15-minutes daily at-home yoga and P2, daily autonomous at-home yoga sessions. Evaluations (at inclusion and by the end of each period) consisted in assessment of OAP on Visual Analog Scale (VAS), forward flexibility (cm) and patient satisfaction on Likert (0-10 points) scale. Results Between September 2018 and May 2019 we included 24 patients of median 53 years (range 36-72). Feasibility was validated by 83% successful adherence rate. Pain was significantly reduced from median VAS of 6 [range 4-10] to 4 [range 0-7] at the end of both P1 and P2 ( p < 0.01), albeit with no difference between P1 and P2. Forward flexibility improved by a median gain of 8 cm (end of P2) and median satisfaction score of 10/10 [range 8-10]. Conclusion Combined physiotherapy-yoga-PE intervention is a feasible strategy to increase at-home yoga practice with potential benefit on pain, flexibility, and satisfaction, thus prompting further evaluations in larger randomized multicenter trials. ClinicalTrials.gov NCT04001751