A low fermentable oligo-di-mono saccharides and polyols (FODMAP) diet reduced pain and improved daily life in fibromyalgia patients

Fibromyalgia (FM) is a chronic, rheumatic disease characterized by widespread myofascial pain, of unknown aetiology, having a major impact on quality of life (QOL). Available pharmacotherapy for FM is marginally effective. FM is associated with co-morbidities of gastrointestinal (GI) disorders and Irritable Bowel Syndrome (IBS). There is growing evidence that diets low in FODMAPs, “fermentable oligo-, di- or mono-saccharides and polyols” [Low FODMAP Diet (LFD)], are effective in treating IBS. The aim of this pilot study was to examine the effects of LFDs on symptoms of FM, especially with regard to pain, QOL and GI disorders. Methods A longitudinal study using LFD intervention was performed on 38, 51 ± 10 year-old, female patients diagnosed with FM for an average of 10 years, based on ACR (American College of Rheumatology) 2010 criteria. The study was conducted from January through May, 2015, using a four-week, repeated-assessment model, as follows: Moment 0 – introduction of the protocol to participants; Moment 1 – first assessment and delivery of individual LFD dietary plans; Moment 2 – second assessment and reintroduction of FODMAPs; Moment 3 – last assessment and final nutritional counselling. Assessment tools used were the following: RFIQ (Revised Fibromyalgia Impact Questionnaire), FSQ (Fibromyalgia Survey Questionnaire), IBS-SSS (Severity Score System), EQ-5D (Euro-QOL quality of life instrument), and VAS (Visual Analogue Scale). Daily consumption of FODMAPs was quantified based on published food content analyses. Statistical analyses included ANOVA, non-parametric Friedman, t-student and Chi-square tests, using SPSS 22 software. Results The mean scores of the 38 participants at the beginning of the study were: FSQ (severity of FM, 0–31) – 22 ± 4.4; RFIQ (0–100) – 65 ± 17; IBS-SSS (0–500) – 275 ± 101; and EQ-5D (0–100) – 48 ± 19. Mean adherence to dietary regimens was 86%, confirmed by significant difference in FODMAP intakes (25 g/day vs. 2.5 g/day; p < 0.01). Comparisons between the three moments of assessment showed significant (p < 0.01) declines in scores in VAS, FSQ, and RFIQ scores, in all domains measured. An important improvement was observed with a reduction in the severity of GI symptoms, with 50% reduction in IBS scores to 138 ± 117, following LFD therapy. A significant correlation (r = 0.36; p < 0.05) was found between improvements in FM impact (declined scores) and gastrointestinal scores. There was also a significant correlation (r = 0.65; p < 0.01) between “satisfaction with improvement” after introduction of LFDs and “diet adherence”, with satisfaction of the diet achieving 77% among participants. A significant difference was observed between patients who improved as compared to those that did not improve (Chi-square χ2 = 6.16; p < .05), showing that the probability of improvement, depends on the severity of the RFIQ score. Conclusions Implementation of diet therapy involving FODMAP restrictions, in this cohort of FM patients, resulted in a significant reduction in GI disorders and FM symptoms, including pain scores. These results need to be extended in future larger studies on dietary therapy for treatment of FM. Implications According to current scientific knowledge, these are the first relevant results found in an intervention with LFD therapy in FM and must be reproduced looking for a future dietetic approach in FM.

Does an In-Season Detraining Period Affect the Shoulder Rotator Cuff Strength and Balance of Young Swimmers?

Aims: To compare the physical activity, sedentary activity and health-related quality of life (HRQoL) in institutionalized vs. non-institutionalized elderly, and to establish a pattern of relationship and prediction of physical and sedentary activity with physical and mental components of HRQoL. Methods: The sample consisted of 383 elderly with ≥ 75 years old (n=187 institutionalized and n=196 non-institutionalized). Were administered the International Physical Activity Questionnaire (IPAQ) and Short Form 36 Health Survey (SF-36) for evaluated the physical and sedentary activity and HRQoL. Also was used the Mini Mental State Examination (MMSE) as exclusion criteria for cognitive problems in the elderly. Results: Differences between institutionalized and non-institutionalized elderly were found in moderate-intensity activities and walking, a favour of non-institutionalized. The institutionalized elderly remain more minutes in sedentary activity. Also, were observed differences between both groups in physical component of HRQoL, a favour of non-institutionalized elderly. The mental component remained unchanged. The multivariate regression analyses showed that physical activity predicted the physical (8 to 12%) and mental (5 to 8%) components of HRQoL for institutionalized and non-institutionalized elderly. Conclusions: Non-institutionalized elderly were more physically active, spent less time in sedentary activity and showed better perception physical component of HRQoL that institutionalized elderly. An important and encouraging result of this study was that physical activity is a predictor of improved physical and mental component of HRQoL for institutionalized and non-institutionalized elderly.

Un commento a Lucrezio, De rerum natura 6.703-1089

La tesi consiste in un commento scientifico ai versi 703-1089 del VI libro di Lucrezio, dove sono discussi vari mirabilia della natura (le piene estive del Nilo, i luoghi Averni, l’escursione termica dei pozzi, alcune fonti prodigiose e il magnete). Nell’introduzione, si traccia una rapida panoramica del VI libro per contestualizzare al suo interno il passo oggetto del commento; ci si concentra, poi, sul significato della meraviglia e del meraviglioso nell’opera, anche a confronto con la tradizione paradossografica. Seguono il testo, corredato di un sintetico apparato critico, e la traduzione. Nel commento, che intende valorizzare il côté letterario, filosofico e scientifico dell’opera, sono affrontati i più rilevanti problemi testuali ed esegetici, oltre a questioni di ordine grammaticale, linguistico, stilistico e metrico. Chiudono il lavoro due appendici di natura critico-testuale.

Integración de sistemas para la documentación, gestión y puesta en valor del patrimonio arquitectónico: el parque arqueológico de las tumbas de la Vía Latina en Roma

En la civilización de la antigua Roma, tres de los aspectos más importantes de la vida cotidiana estaban vinculados a la arquitectura: las termas, los acueductos y las tumbas. Esta investigación propone el estudio de la integración de sistemas avanzados para la documentación, gestión y valorización del patrimonio arquitectónico funerario de la Vie Latina y la Appia Antica, en estrecha relación con el tema del Paisaje Cultural. De hecho, el Parque de las Tumbas Latinas alberga uno de los complejos funerarios más importantes, que en la actualidad conserva el aspecto tradicional del antiguo paisaje romano. A lo largo de una vía empedrada, como todas las vías consulares, la Vía Latina (al igual que la Vía Appia Antica), que, como recordaba Tito Livio, conectaba en su día las ciudades de Roma con Capua, sigue manteniendo "congelado" el antiguo trazado urbano/paisajístico. El sistema multiforme del Ager Romanus y del sitio cultural Via Latina/Appia Antica estudiado en esta investigación es, por tanto, comparable a una estructura viva y dinámica y, como tal, debe ser analizada. Por lo tanto, para diseñar una herramienta de protección y gestión tan "potente" y adecuada para un sitio histórico de enorme importancia, fue necesario utilizar las técnicas de levantamiento arquitectónico más avanzadas que se utilizan actualmente (como el escaneo láser y la fotogrametría, junto con un software de análisis específico), acompañadas de un estudio en profundidad de las técnicas de construcción antiguas. El último aspecto clave que pretende abordar la investigación es la catalogación. De hecho, los sitios y monumentos históricos no se pueden mantener sólo mediante su uso y utilización pasiva, sino activando todas las operaciones de protección y conservación mediante intervenciones directas (mantenimiento/restauración) e indirectas, como la catalogación constante de las obras históricas y la consiguiente "catalogación dinámica".