Definitivo Brochure 2014_20 02 2014
Transcription
Definitivo Brochure 2014_20 02 2014
2014 Anniver sario FoRST “10 anni a sostegno della ricerca scientifica termale” Il 2013 ha segnato il decimo anniversario della nascita della Fondazione. Motivo di orgoglio per la Federterme che l’ha istituita nel 2003 e per tutte le aziende termali italiane che attraverso il proprio contributo finanziano la ricerca in ambito termale Molti gli obiettivi raggiunti in questo decennio, forse impensabili nel lontano 2003, ma sicuramente molto resta ancora da fare. Riassumendo brevemente, possiamo ricordare che la Fondazione ha raccolto sino ad oggi circa 6 milioni di euro di contributi dalle aziende termali, per investirne quasi altrettanti per iniziative di ricerca. I bandi lanciati sino ad oggi sono stati 16, per un totale di 67 progetti co-finanziati e una somma complessiva di 2.150 mila euro erogati agli enti di ricerca, per un totale di fondi impegnati a favore della ricerca pari a 5 milioni di euro. L’ultimo bando in ordine di tempo, è quello dedicato al tema della riabilitazione in ambito termale, che evidenzia il collegamento tra l’impegno di FoRST ed il Piano nazionale per la riabilitazione termale, fortemente voluto dal Ministero della Salute, che insieme all’INAIL, ha costituito un gruppo tecnico di lavoro finalizzato a redigere i criteri per l’avvio presso gli stabilimenti termali di una sperimentazione clinica, per il trattamento dei pazienti in fase post-acuzie. Ben 35 le pubblicazioni su riviste scientifiche impattate, che oltre a coprire la quasi totalità degli ambiti scientifici di riferimento, si sono arricchite di risultati superiori alle aspettative, come recentemente avvenuto sui progetti di ricerca sui solfuri portati avanti da gruppi di ricerca italiani e statunitensi. Nello specifico i risultati ottenuti dall’Università di Modena evidenzierebbero l’importanza dell’idrogeno solforato nel rallentare la progressione dei processi neurodegenerativi indotti dall’Alzheimer. L’equipe del prof. Robert Gallo, dell’Università di Baltimora si è invece dedicata allo studio del ruolo del solfuro di idrogeno negli stati acuti dei processi infiammatori e la prevenzione della loro cronicizzazione. L’interesse suscitato nei ricercatori dai risultati preliminari degli studi, li ha convinti ad approfondirne il significato; siamo pertanto in attesa di conoscere quali saranno gli esiti delle nuove sperimentazioni cliniche che partiranno a breve. Di pari passo con le iniziative scientifiche, e rispondendo anche ad una logica di “servizio” alle Aziende, FoRST ha avviato nell’ultimo triennio una linea specifica di promozione dei risultati delle ricerche finanziate, ma anche in senso più generale sull’efficacia delle cure termali. Negli incontri organizzati con la stampa specializzata i ricercatori delle università co-finanziate hanno illustrato i risultati pubblicati delle ricerche effettuate in tema di patologie, reumatiche, otorinolaringoiatriche, gastroenterologiche ecc. Ha, attivamente collaborato alla campagna radiofonica realizzata da Federterme “occupando” spazi specifici dedicati alle patologie più comunemente curate alle Terme con dei “focus” particolari, come quelli dedicati ai bambini. Le malattie respiratorie in età pediatrica hanno altresì costituito uno dei leit-motiv guida del sito della Fondazione, che oltre a proporsi quale utile banca dati per gli addetti al settore, ha inteso proporsi anche quale strumento di dialogo con i medici di base, le Scuole di Specializzazione in Medicina termale, nonché i Direttori sanitari degli stabilimenti termali, al fine di creare un circolo virtuoso, che comprenda tutte le fase dell’erogazione delle prestazioni termali, a partire dalla prescrizione del medico di famiglia. E proprio ai medici di famiglia sono state rivolte le iniziative sul territorio realizzate lungo tutto il 2013, finalizzate ad integrarne la formazione con le nuove conoscenze che si stanno acquisendo sul tema della ricerca in ambito termale. Registriamo, infine, grande soddisfazione per il documento Wold Health Organization Traditional Medicine Strategy 2014-2023, presentato dall’Organizzazione Mondiale Sanità lo scorso novembre e che ha riconosciuto il pieno ruolo delle terapie termali nell’ambito delle medicine tradizionali e complementari. Una novità assoluta resa possibile dai risultati degli studi realizzati da un gruppo di lavoro composto da rappresentanti della FEMTEC (Federazione Mondiale Termalismo e Climatismo) e della nostra Fondazione, con la supervisione tecnica dell’Organizzazione Mondiale della Sanità. L’auspicio è quello di poter fornire un supporto appropriato alla richiesta che sarà inviata alla Commissione Europea, di inserire la Medicina Termale fra le materie oggetto di programmazione in tema di ricerca scientifica, con la conseguente allocazione di risorse dedicate. Ma sul tema della ricerca scientifica, vogliamo spingerci ancora oltre. Sono infatti in corso contatti con i poli tecnologici di alcuni istituti universitari, al fine di individuare un progetto di comune interesse nel campo dell’innovazione tecnologica, o nell’ambito delle modificazioni biotecnologiche dei principi attivi delle acque o sul tema dello sviluppo di nuove tecnologie per la somministrazione delle cure. Come dicevamo all’inizio tanto resta ancora da fare, ma in un’Italia segnata dalla fuga dei ricercatori in altri Paesi, ci sentiamo orgogliosi del nostro sistema di imprese, che continua a finanziare con i propri mezzi la ricerca scientifica. Il Presidente Filippo Fernè LA RICERCA SCIENTIFICA TERMALE L’impostazione metodologica della Fondazione per la Ricerca Scientifica Termale (FoRST) è destinata a generare un significativo impulso alla ricerca scientifica di qualità nel settore termalistico. L’adozione di criteri internazionalmente riconosciuti di giudizio scientifico sui progetti presentati (elenco pubblicazioni, impact factor e altri elementi bibliometrici della produzione scientifica dei proponenti) e la revisione dei progetti esclusivamente da parte di esperti stranieri sono i cardini del recente adeguamento di Fondazione agli standard scientifici internazionalmente riconosciuti per le agenzie di granting della ricerca. Parallelamente, FoRST ha intrapreso un confronto con realtà termali di altri Paesi europei per stabilire criteri comuni (ad esempio, le parole chiave per rendere omogenei i motori di ricerca sulla materia termale) e si propone un ampliamento su scala non solo europea di questo confronto scientifico tramite organizzazioni internazionali di massimo livello per poter giungere nell’arco dei prossimi 2-3 anni a linee guida condivise sui metodi, indicazioni e trattamenti nell’ambito della medicina termale basati sulle evidenze. Razionale allocazione dei fondi finalizzata alla ricerca scientifica di qualità ed internazionalizzazione sono le metodologie di FoRST destinate a creare la piattaforma su cui Federterme desidera proseguire il dialogo con le Istituzioni preposte alla tutela della salute, alla prevenzione ed alla formazione sanitaria. Una analisi più specifica della ricerca che FoRST ha finanziato in questi anni (analisi ovviamente retrospettiva) rivela come la produzione scientifica sia stata comunque di buon livello. In particolare è da segnalare che, in parallelo a studi clinici atti a dimostrare il beneficio tangibile dell’approccio termale in varie patologie, siano finalmente stati implementati con ottimi risultati studi di scienze di base, in cui l’acqua termale è stata sostituita nei saggi in vitro su cellule umane con il principio attivo delle stesse (sali, donatori chimici di sostanze gassose): i risultati sono stati pubblicati su riviste scientifiche di qualità, e la strada per una valutazione scientifica seria basata sulla sperimentazione controllata in vitro è stata tracciata. Un altro aspetto da sottolineare è il finanziamento che la FoRST ha assegnato, in collaborazione con AIRC all’Istituto Nazionale Tumori di Milano per studiare l’azione termale su una ampia e ben controllata popolazione di fumatori al fine di prevenire almeno in parte gli effetti cronici del fumo sulla mucosa bronchiale. Questo progetto, basato su un rigoroso approccio sperimentale, ha come punto di forza la popolazione dello studio ben controllata e statisticamente assai significativa (diverse migliaia di soggetti) e implica la verifica della valenza preventiva dell’acqua termale sulla precancerosi bronchiale. Il punto di incontro fra una delle branche della medicina in cui tradizionalmente l’uso delle acque termali ha avuto un suo preciso spazio e queste tematiche di grande valenza riguardo alla prevenzione (con ovvie implicazioni sulla salute pubblica) rappresenta il vero e nuovo punto di partenza della medicina termale moderna. Prof. Marco Vitale Coordinatore del Comitato Scientifico FoRST I PROGETTI E LE RISORSE Sulla base di un Accordo sottoscritto fra Federterme, il Ministero della Salute e le Regioni, a partire dall’anno 2000 le Aziende termali italiane hanno iniziato ad accantonare lo 0,30% (0,40% nel solo 2004) del fatturato SSN lordo ticket presso un Fondo, appositamente costituito presso Federterme, per la realizzazione di iniziative di ricerca scientifica in campo termale. Nel gennaio 2003, al fine di consentire una più corretta operatività nella gestione dei fondi raccolti, è stata istituita da Federterme, con l’assenso del Ministero della Salute e delle Regioni, la “Fondazione per la Ricerca Scientifica Termale” - FoRST cui è stata riconosciuta personalità giuridica nel settembre 2003. Dall’anno 2000 e sino al 31.12.2013, la Fondazione ha raccolto circa 5,8 milioni di euro, impegnando in progetti di ricerca più di 5 milioni di euro. La Fondazione, amministrata da un CdA misto pubblico-privato, ha lanciato dal 2004 ad oggi ben sedici bandi di ricerca, mettendo in moto 73 progetti e cofinanziandone 61, di cui 35 pubblicati su riviste impattate, 4 in corso di pubblicazione e 40 conclusi. A far data dal 1° gennaio 2010, così come previsto dall’Accordo Nazionale per il rinnovo delle tariffe per le prestazioni termali a valere sul biennio 2008-2009, le Aziende Termali versano lo 0,30% di loro spettanza direttamente alla FoRST. Nell’ambito dell’Accordo sopra citato Federterme e le Regioni si sono impegnate a definire, in tempi prefissati, una “scheda sanitaria” sulla base di quella progettata dall’Istituto Superiore di Sanità e realizzata con il contributo economico della Fondazione, con l’obiettivo di procedere alla sistematica rilevazione dei dati clinici e sociali relativi ai soggetti in cura termale e con possibilità di ricavare su basi statisticamente significative elementi epidemiologicamente utili sia ai fini della valutazione degli effetti della terapia termale effettuata, sia ai fini di carattere sanitario generale, in ordine alla prevenzione e alla cura delle malattie, nonché alla riabilitazione. Gli ambiti nosologici di riferimento dei bandi sono i seguenti: Reumatologia-Ortopedia Otorinolaringoiatria Broncopneumologia Patologie dermatologiche Patologie dell’apparato digerente e urinario Sistema cardiovascolare Terapia della riabilitazione con mezzo termale Igiene e Microbiologia nelle strutture termali Farmacoeconomia Innovazione tecnologica FoRST IN CIFRE € 5.800.000 i fondi raccolti 67 dal 2000 al 2013 € 5.000.000 il totale dei fondi 40 impegnati a favore della ricerca 16 i bandi lanciati dall’inizio dell’attività 35 i progetti di ricerca cofinanziati i progetti di ricerca conclusi i progetti di ricerca pubblicati su riviste impattate PROGETTI PU B B LIC ATI I E II B A N D O [ANNI 2005-2006] Progetti pervenuti: 98 Progetti cofinanziati: 29 Stanziati: € 1.400.000 Valore dei progetti: € 2.501.225 Importo dei cofinanziamenti: € 1.076.750 Erogati: € 487.428,11 SCIENZA DI BASE € 2.600.000 – – € 2.400.000 – – € 2.200.000 – – € 2.000.000 – – € 1.800.000 – – € 1.600.000 – – € 1.400.000 – – € 1.200.000 – – € 1.000.000 – – € 800.000 – – € 600.000 – – € 400.000 – – € 200.000 – – Stanziati Valore dei progetti Importo dei cofinanziamenti Erogati Tutti i progetti sono stati conclusi N. 12 lavori pubblicati - (abstract in calce) N. 8 revocati SCIENZA DI BASE Hydrogen sulfide prevents apoptosis of Exogenous Hydrogen Sulfide Induces human PMN via inhibition of p38 and Functional Inhibition and Cell Death of Cytotoxic Lymphocytes Subsets. caspase 3. Laura Rinaldi1 , Giuliana Gobbi1 , Maurizia Pambianco2 , Cristina Micheloni1 , Prisco Mirandola1 and Marco Vitale1,3 1 Department of Anatomy, Pharmacology & Forensic Medicine, Human Anatomy Section, University of Parma, Ospedale Maggiore, Parma, Italy; 2 Terme di Sirmione, Cell Biology Laboratory, Terme di Sirmione, Brescia, Italy 3 ITOI-CNR, Bologna Unit, c/o Research Institute ‘CodivillaPutti’, IOR, Bologna, Italy Hydrogen sulfide, together with carbon monoxide and nitric oxide, is now considered a gasotransmitter able to induce specific cellular responses. As hydrogen sulfide is a component of several natural compounds known to be effective in many inflammatory pathologies, particularly of the respiratory tract, we studied its effects in vitro on the survival and bactericidal activity of purified human neutrophils. We found that (1) HS_ ions promote the survival of granulocytes, but not that of lymphocytes or eosinophils, cultured in serumfree medium; (2) the pro-survival effect of HS_ is due to inhibition of caspase-3 cleavage and p38 MAP kinase phosphorylation; (3) the bactericidal activity of neutrophils is not impaired by hydrogen sulfide. We conclude that HS_ promotes the short-term survival of neutrophils potentially accelerating the resolution of inflammatory processes and preventing the occurrence of new ones. Laboratory Investigation (2006) 86, 391-397 © 2006 USCAP, Inc All rights reserved 0023-6837/06 $30.00 www.laboratoryinvestigation.org Prisco Mirandola1 , Giuliana Gobbi1 , Ivonne Sponzilli1 , Antonio Maurizia Pambianco2 , Chiara Malinverno1 , Cacchioli3 , Giuseppe De Panfilis4 , and Marco Vitale1 1 Department of Anatomy, Pharmacology & Forensic Medicine, Human Anatomy Section, University of Parma, Ospedale Maggiore, via Gramsci, Parma, Italy; 2 Terme di Sirmione, Cell Biology Laboratory, Terme di Sirmione, Brescia, Italy; 3 Department of Animal Health, University of Parma, Italy; 4 Department of Surgery, Section of Dermatology, University of Parma, Italy The toxic effects of exogenous hydrogen sulfide on peripheral blood lymphocytes have been investigated in detail. Hydrogen sulfide is now considered as a gasotransmitter with specific functional roles in different cell types, like neurons and vascular smooth muscle. Here we show that exogenous hydrogen sulfide induces a caspase-independent cell death of peripheral blood lymphocytes that depends on their intracellular glutathion levels, with a physiologically relevant subset specificity for CD8+ cells and NK cells. Although lymphocyte activation does not modify their sensitivity to HS-, after 24 h exposure to hydrogen sulfide surviving lymphocyte subsets show a dramatically decreased proliferation in response to mitogens and a reduced IL-2 production. Overall, our data demonstrate that HS- reduces the cellular cytotoxic response of peripheral blood lymphocytes as well as their production of IL-2, therefore deactivating the major players of local inflammatory responses, adding new basic knowledge to the clinically well known antiinflammatory effects of sulfur compounds. J. Cell. Physiol. 213: 826–833, 2007. 2007 Wiley-Liss, Inc. ORIGINAL ARTICLE 826 Journal of Cellular Physiology O TO R I N O L A R I N G O I AT R I C A O TO R I N O L A R I N G O I AT R I C A Effects of sulfurous, salty, bromic, iodic thermal water nasal irrigations in nonallergic chronic rhinosinusitis: a prospective, randomized, double-blind, clinical, and cytological study Effectiveness of Ischia thermal water nasal aerosol in children with seasonal allergic rhinitis: a randomized and controlled study Ottaviano G, Marioni G, Staffieri C, Giacomelli L, MarcheseRagona R, Bertolin A, Staffieri A. Otolaryngology Section, Department of Medical and Surgical Specialties, University of Padova, Padova, Italy. OBJECTIVES: Nasal irrigations are mentioned among the adjunctive measures for treating several sinonasal conditions. Hyperchromatic supranuclear stria (HSS) in the ciliated cells (CCs) has recently been suggested as a potential cytological marker of the anatomofunctional integrity of nasal mucosa. The aim of this study was to compare the effects of nasal irrigations with sulfurous, salty, bromic, iodic (SSBI) thermal water or isotonic sodium chloride solution (ISCS) in patients with nonallergic chronic rhinosinusitis, considering the endoscopic, functional, microbiological, and cytological evidence (including the ratio of HSS-positive CCs to total CCs [the HSS+ rate]). METHODS: In a prospective, randomized, double-blind setting, 80 patients were recruited for nasal irrigations with SSBI water or ISCS for 1 month. RESULTS: An endoscopically assessed significant clinical improvement was seen after both SSBI thermal water and ISCS irrigations. Before treatment, Staphylococcus aureus was isolated in 5 patients in the SSBI thermal water group and 4 in the ISCS group. After the nasal irrigations, there was no sign of the bacteria in either group. Only the SSBI water irrigations significantly reduced total nasal resistance, as determined by rhinomanometry. Mild nasal irritation (6 cases) and episodes of extremely limited epistaxis (5 cases) were only reported after SSBI thermal water irrigations. Neither type of nasal irrigation significantly increased the mean HSS+ rate at cytological control after 1 month. CONCLUSIONS: Both types of nasal irrigation improved the endoscopic and microbiological features of patients with nonallergic chronic rhinosinusitis, whereas only SSBI irrigations significantly reduced total nasal resistance. Further investigations are needed based on longer treatments and follow-up periods to establish whether the HSS+ rate is useful for monitoring clinical improvements in chronic rhinosinusitis treated with nasal irrigations. Am J Otolaryngol. 2010 May 25. Copyright © 2010. Published by Elsevier Inc. PMID: 20537762 [PubMed - as supplied by publisher M. Miraglia Del Giudice1, F. Decimo1, N. Maiello1, S. Leonardi2, G. Parisi3, M.Golluccio2, M. Capasso1, U. Balestrieri1, A. Rocco1, L. Perrone1 and G. Ciprandi4 1 Pediatric Department “F.Fede”, II University of Naples, Naples; 2 Pediatric Department, University of Catania; 3 UOC Pediatrics and Neonatology, ASL Na-2, PO “Anna Rizzoli”, Lacco Ameno; 4 Azienda Ospedaliera Universitaria San Martino, Genova, Italy Allergic rhinitis is characterized by local inflammation. Nasal lavage may be a useful treatment, however, there are few studies on this topic. This study aims to evaluate the effects of Ischia thermal water nasal irrigation on allergic rhinitis symptoms and airway inflammation during the period of natural exposure to Parietaria pollen in children with allergic rhinitis and intermittent asthma. Forty allergic children were randomly divided into two groups: the first group (Group 1) practiced crenotherapy with thermal water aerosol for 15 days per month, for three consecutive months, the control group (Group 2) was treated with 0.9% NaCl (isotonic) solution. In addition, all children were treated with cetirizine (0.5 gtt./kg/day once daily). Nasal symptom assessment, including Total Symptom Score (TSS), spirometry, and exhaled nitric oxide (FeNO) were considered before the treatment (T0), at the end of the treatment (T1) and again 2 weeks after the end of the treatment (T2). The study was registered in the Clinical Trials.gov (NCT01326247). Thermal water significantly reduced both TSS and FeNO levels and there was a significant relationship between reduction of nasal symptoms and FeNO values at the end of treatment with thermal water. In conclusion, this study shows that nasal crenotherapy with the hypermineral chloride-sodium water of Ischia was effective in children with seasonal allergic rhinitis based on the sensitivity to Parietaria. These results demonstrate that this natural treatment may be effective in a common and debilitating disease such as the allergic rhinitis. Keywords: thermal water, nasal lavage, Ischia, allergic rhinitis, children Received April 14, 2011 – Accepted October 10, 2011 International Journal of Immunopathology and Pharmacology Vol. 24, no. 4, 0-0 (2011) Copyright © by BIOLIFE, s.a.s. O TO R I N O L A R I N G O I AT R I C A O TO R I N O L A R I N G O I AT R I C A Smoking and chronic rhinitis: effects of nasal irrigations with sulfurous-arsenicalferruginous thermal water: A prospective, randomized, double-blind study Crenotherapy modulates the expression of proinflammatory cytokines and immunoregulatory peptides in nasal secretions of children with chronic rhinosinusitis Giancarlo Ottaviano, MD,PhDa, Gino Marioni, MDa, Luciano Giacomelli, MDb, Fabio Biagio La Torre, MDa. Claudia Staffieri, MDc, Rosario Marchese-Ragona, MDa, Alberto Staffieri, MDa a) Department of Neurosciences, Otalaryngology Section, Padova University, Padova, Italy b) Department of Medicine Anatomic Pathology Section, Padova University, Padova, Italy c) Department of Neurosciences, Otalaryngology Section, Treviso Branch, Padova University, Treviso, Italy ABSTRACT PURPOSE: Smoking is a self-destructive behavior that is known to induce remodeling of the lower airways, leading to squamous metaplasia, but little is known about its effects on the nose and paranasal sinuses. Nasal irrigations are often mentioned as measures for treating sinonasal inflammations. The purpose of our study was to compare the effects of nasal irrigations with sulfurousarsenical-ferruginous thermal water or isotonic sodium chloride solution in smokers with nonallergic chronic rhinosinusitis, based on clinical and olfactory evidence. MATERIALS AND METHODS: The present study was a prospective, randomized, double-blind study performed in a tertiary academic referral center. Seventy smokers with nonallergic chronic rhinitis were enrolled. Nasal endoscopy, rhinomanometry, nasal cytology, and odor threshold measurements were performed in subjects randomized to daily nasal irrigations with either thermal water or isotonic sodium chloride solution for 1 month. RESULTS: Immediately after the treatment, the thermal water irrigations revealed a positive pharmacologic action, judging from a tendency toward lower nasal resistances (P = .07) and larger numbers of ciliated cells in the patients treated (P = .003). Endoscopic findings in the thermal water group were still better than in the control group a further 2 months later (P = .03). CONCLUSIONS: Our results indicate that nasal irrigations with thermal water had a good effect on endoscopic objective signs, nasal resistances, and epithelial trophism. Received 7 February 2012 - Epub 2012 Apr 20. Am J Otolaryngol. 2012 Nov-Dec;33(6):657-62. 10.1016/j.amjoto.2012.03.002. © 2012 Elsevier Inc. All rights reserved doi: Annalisa Passariello, MD, PhD, Margherita Di Costanzo, MD, Gianluca Terrin, MD, PhD, Antonio Iannotti, MD, Pietro Buono, MD, PhD, Umberto Balestrieri, MD, Gianni Balestrieri, MD, Enrico Ascione, MD, Monica Pedata, MD, Francesco Berni Canani, MD, and Roberto Berni Canani, MD, PhD Abstract Background: The effect of crenotherapy on major mucosal markers of inflammation, TNF alpha, human beta-defensins 2 (hBD-2), and calprotectin, are largely unexplored in pediatric chronic rhinosinusitis (CRS). The aim of this study was to investigate the effects of crenotherapy with sulfate-sodiumchloride water on mucosal markers of inflammation in children with CRS. Methods: Children with CRS received 15-day crenotherapy consisting of sulfate-sodium-chloride thermal water inhalations by nasal aerosol (15 minutes/day). Concentrations of nasal mucosal markers of inflammation (TNF alpha, hBD-2, and calprotectin) were measured before and after crenotherapy. Presence of specific symptoms (nasal obstruction, nasal discharge, facial pain, sense of smell, and cough), value of symptoms score sino-nasal 5 (SN5), quality of life (QoL) score (1 [worse] to 10 [optimal]) were also assessed. Results: After crenotherapy a significant reduction was observed in TNF alpha (from 0.14 ± 0.02 to 0.08 ± 0.01; p < 0.001), calprotectin (from 2.9 ± 1.0 to 1.9 ± 0.5; p < 9.001); and hBD-2 (from 2.0 ± 0.1 to 0.9 ± 0.6; p < 0.001) concentrations. A significant (p < 0.05) reduction in number of subjects presenting symptoms of nasal obstruction (100% versus 40%), nasal discharge (33% versus 13%), facial pain (30% versus 10%), and sense of smell (60% versus 20%) was observed. A significant improvement of SN5 (from 3.07 ± 0.76 to 2.08 ± 0.42; p < 0.001) was observed after the crenotherapy. QoL also improved after crenotherapy (from 4.2 ± 1.1 to 6.6 ± 1.0; p < 0.001). Conclusion: Crenotherapy induced a down-regulation of nasal mucosal inflammatory mediators in children with CRS. Am J Rhinol Allergy. 2012 Jan-Feb;26(1):e15-9. doi: 10.2500/ajra.2012.26.3733. D E R M ATO L O G I C A GASTROENTEROLOGICA Hydrogen sulfide impairs keratinocyte cell growth and adhesion inhibiting mitogen-activated protein kinase signaling. Functional and Histologic Assessment of Rat Gastric Mucosa after Chronic Treatment with Sulphurous Thermal Water Giuliana Gobbi1,2,Francesca Ricci1, Chiara Malinverno1, Ceciloa Carubbi1, Maurizia Pambianco3, Giuseppe de Panfilis4, Marco Vitale1,2 and Prisco Mirandola Gabriella Coruzzia, Maristella Adamia, Cristina Pozzolia, Elvira Solenghib, Daniela Grandib 1) Department of Anatomy, Pharmacology and Forensic Medicine, University of Parma, Parma, Italy; 2) Center for Morphology and Body Composition (CMBC), University of Parma, Parma, Italy; 3) Terme di Sirmione, Cell Biology Laboratory, Terme di Sirmione, Brescia, Italy; 4) Department of Surgery, Dermatology Division, University of Parma, Parma, Italy. The effects of exogenous hydrogen sulfide (H2S) on normal skin-derived immortalized human keratinocytes have been investigated in detail. We show in vitro that exogenous hydrogen sulfide reduces clonal growth, cell proliferation and cell adhesion of human keratinocytes. H2S, in fact, decreases the frequency of the putative keratinocyte stem cell subpopulation in culture, consequently affecting clonal growth, and impairs cell proliferation and adhesion of mature cells. As a mechanistic explanation of these effects, we show at the molecular level that (i) H2S reduces the Raf/MAPK kinase/ERK signaling pathway; (ii) the reduced adhesion of sulfur-treated cells is associated to the downregulation of the expression of b4, a2 and a6 integrins that are necessary to promote cell adhesion as well as anti-apoptotic and proliferative signaling in normal keratinocytes. One specific interest of the effects of sulfurs on keratinocytes derives from the potential applications of the results, as sulfur is able to penetrate the skin and a sulfur-rich balneotherapy has been known for long to be effective in the treatment of psoriasis. Thus, the relevance of our findings to the pathophysiology of psoriasis was tested in vivo by treating psoriatic lesions with sulfurs at a concentration comparable to that most commonly found in sulfurous natural springs. In agreement with the in vitro observations, the immunohistochemical analysis of patient biopsies showed a specific downregulation of ERK activation levels, the key molecular event in the sulfur-induced effects on keratinocytes. KEYWORDS: flow cytometry; western blot; MAPK; skin; NaHS. Laboratory Investigation (2009), 1-13 © 2009 USCAP, Inc. All Rights Reserved 0023-6837/09 $32,00 Sections of aPharmacology and bAnatomy, Department of Human Anatomy, Pharmacology and Forensic Medicine, University of Parma, Parma, Italy Key Words • Sulphurous thermal water • Gastric acid secretion • Sulphurous muscosal defense • Ethanol • Indomethacin The effect of a chronic (4 weeks) administration of sulphurous thermal water on gastric acid secretion and mucosal defense was investigated in rats. Animals were randomized to receive daily intake of tap water or of thermal water obtained from a local spa center (Tabiano, Parma, Italy). Rats were followed for one month as for water and food consumption, body weight and general conditions. At the end of the watering period, the following study protocols were carried out: (a) study of basal and stimulated gastric acid secretion under general anesthesia, and (b) study of the gastric mucosal resistance against the damage induced by ethanol and indomethacin in conscious rats. Basal acid secretion and the acid response to pentagastrin or to histamine were similar in rats assuming ordinary drinking water or thermal water. As for resistance to gastric damage, histological, but not macroscopic, evaluation revealed that rats which assumed thermal water were slightly more resistant to the gastrolesive effect of ethanol (either absolute or diluted). Again, when indomethacin was used as a noxious stimulus, no difference was noted between the two groups as for macroscopic damage; only a nonsignificant reduction of damage was observed histologically in stomachs of rats assuming thermal water. In conclusion, these results indicate that chronic treatment of rats with thermal water, rich in sulphur compounds, may have only minimal effects on the rat gastric mucosa and did not significantly affect mucosal defense mechanisms. The observed tendency to gastroprotection would possibly need further investigation with longer periods of administration. Pharmacology 2010; 85:146-152 (DOI: 10.1159/000280603) Copyright © 2010 S. Karger AG, Basel GASTROENTEROLOGICA Beneficial effect of sulphate-bicarbonate -calcium water on gallstone risk and weight control Stefano Ginanni Corradini1, Flaminia Ferri1, Michela Mordenti1, Luigi Iuliano2, Maria Siciliano1, Maria Antonella Burza1, Bruno Sordi3, Barbara Caciotti3, Maria Pacini3, Edoardo Poli1, Adriano De Santis1, Aldo Roda4, Carolina Colliva4, Patrizia Simoni5, Adolfo Francesco Attili1 1) Gastroenterology Division, Department of Clinical Medicine, Sapienza University of Rome, Viale dell’Università 37, Rome 00185, Italy 2) Department of Medical Sciences and Biotechnology, Vascular Medicine and Atherothrombosis Laboratory, Sapienza University of Rome, Corso della Repubblica 79, Latina 04100, Italy 3) Direzione Sanitaria Terme di Chianciano, Via delle Rose 12, Chianciano Terme Siena 53042, Italy 4) Department of Pharmaceutical Science, Alma MaterUniversity of Bologna, Via Belmeloro 6, Bologna 40126, Italy 5) Department of Clinical Medicine, Alma Mater-University of Bologna, Via Massarenti 9 Bologna 40138, Italy Author contributions: Ginanni Corradini S, Attili AF and De Santis A designed research; Ginanni Corradini S, Ferri F, Mordenti M, Siciliano M, Burza MA, Sordi B, Caciotti B, Pacini M, Poli E and Iuliano L performed research; Roda A, Colliva C, Simoni P contributed analytic tools; Ginanni Corradini S, Ferri F, Mordenti M analyzed data and wrote the paper. Supported by The Italian Thermal Scientific Research Foundation and the Italian Ministery of Instruction University and Research Stefano Ginanni Corradini, MD, PhD, Gastroenterology Division, Department of Clinical Medicine, Sapienza University of Rome, Viale dell’ Università 37, Rome 00185, Italy. E-mail: [email protected] +39-6-49972086 Fax: +39-6-4453319 Abstract AIM: To investigate the effect of drinking sulphate-bicarbonatecalcium thermal water (TW) on risk factors for atherosclerosis and cholesterol gallstone disease. METHODS: Postmenopausal women with functional dyspepsia and/or constipation underwent a 12 d cycle of thermal (n = 20) or tap (n = 20) water controlled drinking. Gallbladder fasting volume at ultrasound, blood vitamin E, oxysteroys (7-ß-hydroxycholesterol and 7-ketocholesterol), bile acid (BA), triglycerides, total/low density lipoprotein and high density lipoprotein cholesterol were measured at baseline and at the end of the study. Food consumption, stool frequency and body weight were recorded daily. RESULTS: Blood lipids, oxysterols and vitamin E were not affected by either thermal or tap water consumption. Fasting gallbladder volume was significantly (P < 0.005) smaller at the end of the study than at baseline in the TW (15.7 ± 1.1 mL vs 20.1 ± 1.7 mL) but not in the tap water group (19.0 ± 1.4 mL vs 19.4 ± 1.5 mL). Total serum BA concentration was significantly (P < 0.05) higher at the end of the study than at baseline in the TW (5.83 ± 1.24 µmol) but not in the tap water group (3.41 ± 0.46 µmol vs 2.91 ± 0.56 µmol). The increased BA concentration after TW consumption was mainly accounted for by glycochenodeoxycholic acid. The number of pasta (P < 0.001), meat (P < 0.001) and vegetable (P < 0.005) portions consumed during the study and of bowel movements per day (P < 0.05) were significantly higher in the TW than in the tap water group. Body weight did not change at the end of the study as compared to baseline in both groups. CONCLUSION: Sulphate-bicarbonate-calcium water consumption has a positive effect on lithogenic risk and intestinal transit and allows maintenance of a stable body weight despite a high food intake. Keywords: thermal water, gallstones, oxidative stress, body weight, bile acid Received: June 24, 2011 - Revised: September 9, 2011Accepted: December 31, 2011 Published online 2012 March 7. doi: 10.3748/wjg.v18.i9.930 World J Gastroenterol. 2012 March 7; 18(9): 930–937. © 2012 Baishideng. All rights reserved. R E U M ATO L O G I C A R E U M ATO L O G I C A Short- and long-term effects of spa therapy Short and long-term effects of mud-bath in knee osteoarthritis treatment on hand osteoarthritis: a randomized clinical trial Fioravanti A, Iacoponi F, Bellisai B, Cantarini L, Galeazzi M. Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy. OBJECTIVE: To assess both the short- and long-term effectiveness of spa therapy in patients with primary knee osteoarthritis in a prospective, randomized, single-blinded, controlled trial. DESIGN: Eighty outpatients were enrolled in this study; 40 patients were treated with a combination of daily local mud packs and bicarbonate-sulfate mineral bath water from the spa center of Rapolano Terme (Siena, Italy) for 2 wks, and 40 patients continued regular, routine ambulatory care. Patients were assessed at baseline time; after 2 wks; after 3, 6, and 9 mos after the beginning of the study and were evaluated by Visual Analog Scale for spontaneous pain, Lequesne index, Western Ontario and McMaster Universities Index for gonarthrosis, Arthritis Impact Measurement Scale-1, and symptomatic drug consumption. RESULTS: We observed a significant improvement of all evaluated parameters at the end of the cycle of spa therapy, which persisted throughout the whole of the follow-up period, whereas in the control group no significant differences were noted. This symptomatic effect was confirmed by the significant reduction of symptomatic drug consumption. Tolerability of spa therapy seemed to be good, with light and transitory side effects. CONCLUSIONS: The results from our study confirm that the beneficial effects of spa therapy in patients with knee osteoarthritis lasts over time, with positive effects on the painful symptomatology and a significant improvement on functional capacities. Spa therapy can represent a useful backup to pharmacologic treatment of knee osteoarthritis or a valid alternative for patients who do not tolerate pharmacologic treatments. Am J Phys Med Rehabil. 2010 Feb;89(2):125-32. Antonella Fioravanti1, Sara Tenti1, Chiara Giannitti1, Nicola Angelo Fortunati2, Mauro Galeazzi1 1) Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Viale Bracci,1, 53100, Siena, Italy, e- mail: [email protected] 2) Spa Centre of Fonteverde Natural Spa Resort San Casciano Terme, Siena, Italy Abstract The aim of this study was to evaluate both the short-term and the long-term effectiveness of spa therapy in patients with primary hand osteoarthritis (OA). This was a prospective randomized, single blind controlled trial. Sixty outpatients with primary bilateral hand OA were included in the study and randomized to one of two groups. One group (n = 30) was treated with 12 daily local mud packs and generalized thermal baths with a sulfate-calcium-magnesium-fluorides mineral water added to usual treatment. The control group (n = 30) continued regular outpatient care routine (exercise, NSAIDs and/or analgesics). Each patient was examined at baseline, after 2 weeks, and after 3, 6, 9 and 12 months. Primary outcome measures were global spontaneous hand pain on a visual analogue scale (VAS) and the functional index for hand osteoarthritis (FIHOA) score; secondary outcomes were health assessment questionnaire (HAQ), duration of morning stiffness, medical outcomes study 36-item short form (SF-36) and symptomatic drugs consumption. Our results demonstrated that the efficacy of spa therapy was significant in all the assessed parameters, both at the end of therapy and after 3 months; the values of FIHOA, HAQ and drugs consumption continued to be significantly better after 6 months in comparison with baseline. There were no significant modifications of the parameters throughout the follow-up in the control group. Differences between the two groups were significant for all parameters at the 15th day and at 3 months follow-up; regarding FIHOA, HAQ, and symptomatic drugs consumption, the difference between the two groups persisted and was significant at 6month follow-up. Tolerability of spa therapy seemed to be good. In conclusion, our results confirm that the beneficial effects of spa therapy in patients with hand OA last over time. Keywords: mud-bath treatment, spa therapy, hand osteoarthritis, randomized clinical trial Received: 16 October 2012 – Revised: 19 December 2012 Accepted: 20 December 2012 Published online: 14 January 2013 Int J Biometeorol. DOI 10.1007/s00484-012-0627-6 © ISB 2013 R E S P I R ATO R I A Effects of Inhalation of Thermal Water on Exhaled Breath Condensate in Chronic Obstructive Pulmonary Disease Gabriella Guarnieria, Silvia Ferrazzonia, Maria Cristina Scarpaa, Alberto Lallib, Piero Maestrellia a) Department of Environmental Medicine and Public Health, University of Padova b) Centro Studi Termali Pietro d’Abano, Montegrotto TermeAbano Terme, Padova, Italy Key Words Lung function _ Normal saline _ Aerosol therapy _Leukotriene B 4 _ ulmonary inflammation Inhalation of thermal water (TW) is traditionally used as part of the treatment of chronic obstructive pulmonary disease (COPD), but its benefit and mechanisms are controversial.We previously observed a reduced proportion of neutrophils in induced sputum after treatment with TW. The aim of this study was to determine whether inhalation of TW in COPD patients is associated with biochemical changes of airway lining fluid, including a reduction in the neutrophil chemoattractant leukotriene B 4 (LTB 4). Thirteen COPD patients were randomly assigned to receive a 2-week course of TW and normal saline inhalation in a cross-over, single-blind study design. Exhaled breath condensate (EBC) was collected before and after treatments. LTB 4 concentrations in EBC were determined by ELISA, and EBC pH was measured before and after argon deaeration. No significant differences in LTB 4 concentrations in EBC were detected with either treatment. A significant decrease in pH of non- eaerated EBC was observed after a standard course of TW (median 7.45, interquartile range 6.93–7.66, vs. median 6.99, interquartile range 6.57–7.19; p = 0.05), which disappeared after argon deaeration. In conclusion, there is no evidence that TW treatment affects LTB 4 concentration in EBC. The results of EBC pH measurements suggest that TW inhalation induces an imbalance of volatile components of the buffer system in airway lining fluid. Clinical Investigations Respiration DOI: 10.1159/000227801 Copyright © 2009 S. Karger AG, Basel III B A N D O [ A N N O 2 0 1 0 ] Progetti pervenuti: 25 Progetti cofinanziati: 13 Stanziati: € 1.500.000 Valore dei progetti: € 2.686.000,00 Importo dei cofinanziamenti: € 1.195.000,00 Erogati: € 876.527,60 VA S C O L A R E € 2.800.000 – – € 2.600.000 – – € 2.400.000 – – € 2.200.000 – – € 2.000.000 – – € 1.800.000 – – € 1.600.000 – – € 1.400.000 – – € 1.200.000 – – € 1.000.000 – – € 800.000 – – € 600.000 – – € 400.000 – – € 200.000 – – Stanziati Valore dei progetti Importo dei cofinanziamenti Erogati N. 10 lavori pubblicati - (abstract in calce) N. 3 revocati VA S C O L A R E Hydrogen sulfide is an endogenous Hydrogen sulfide down-regulates the inhibitor of phosphodiesterase activity expression and release of osteoprotegerin (OPG) by vascular endothelial cells Mariarosaria Bucci, Andreas Papapetropoulos, Valentina Vellecco, Zongmin Zhou, Anastasia Pyriochou, Charis Roussos, Fiorentina Roviezzo, Vincenzo Brancaleone, Giuseppe Cirino From the Department of Experimental Pharmacology, Faculty of Pharmacy, University of Naples–Federico II, Naples, Italy (M.B., V.V., F.R., V.B., G.C.); the Laboratory for Molecular Pharmacology, Department of Pharmacy, University of Patras, Greece (A. Papapetropoulos, A. Pyriochou), and the “G. P. Livanos” Laboratory, Department of Critical Care and Pulmonary Services, University of Athens, Greece (Z.Z., C.R.). Erika Rimondi 1, Maria Grazia di Iasio 1, Arianna Gonelli 1, Claudio Celeghini 2, Paola Secchiero 1, Giorgio Zauli 2,3 1 Department of Morphology and Embryology and LTTA Centre, University of Ferrara, Ferrara, Italy 2 Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy 3 Department of Morphology and Embryology, Human Anatomy Section, University of Ferrara OBJECTIVE: Recent studies have demonstrated that hydrogen sulfide (H(2)S) is produced within the vessel wall from L-cysteine regulating several aspects of vascular homeostasis. H(2)S generated from cystathione γ-lyase (CSE) contributes to vascular tone; however, the molecular mechanisms underlying the vasorelaxing effects of H(2)S are still under investigation. METHODS AND RESULTS: Using isolated aortic rings, we observed that addition of L-cysteine led to a concentrationdependent relaxation that was prevented by the CSE inhibitors DL-propargylglyicine (PAG) and β-cyano-l-alanine (BCA). Moreover, incubation with PAG or BCA resulted in a rightward shift in sodium nitroprusside-and isoproterenol-induced relaxation. Aortic tissues exposed to PAG or BCA contained lower levels of cGMP, exposure of cells to exogenous H(2)S or overexpression of CSE raised cGMP concentration. RNA silencing of CSE expression reduced intracellular cGMP levels confirming a positive role for endogenous H(2)S on cGMP accumulation. The ability of H(2)S to enhance cGMP levels was greatly reduced by the nonselective phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine. Finally, addition of H(2)S to a cellfree system inhibited both cGMP and cAMP breakdown. CONCLUSIONS: These findings provide direct evidence that H(2)S acts as an endogenous inhibitor of phosphodiesterase activity and reinforce the notion that this gasotransmitter could be therapeutically exploited. Keywords: endothelium - hypertension - signal transduction - vascular muscle - vasodilation - cystathione γ-lyase hydrogen sulfide - cAMP - cGMP - phosphodiesterase. Osteoprotegerin (OPG) is a soluble member of the tumor necrosis factor (TNF) receptor family, initially characterized for its ability to inhibit the receptor activator of NfkB ligand (RANKL)stimulated formation of osteoclasts. OPG also interacts with TNF-related apoptosis inducing ligand (TRAIL), a different member of the TNF super-family whose extracellular domain shares a 35% homology with RANKL. Several studies have demonstrated that OPG is elevated in the serum/plasma of patients affected by different types of cancer, but the potential role of OPG with respect to cancer development/progression is unknown. Among different potential cellular sources of circulating OPG, endothelial cells represent a major source of OPG under basal conditions as well as in response to inflammatory stimuli. Hydrogen sulfide (H2S)-known for decades as a toxic gas—is endogenously generated from cysteine, in reactions catalyzed by cystathionine β-synthase(CBS) and cystathionine y-lyase (CSE). Mounting data on endogenously generated H2S have now included this gas in the family of gasotransmitters, together with nitric oxide (NO) and carbon monoxide (CO), and its effects are intensively investigated both at the cellular and molecular level. On these bases, the aim of the present study was to investigate in vitro the effect of H2S on the expression and release of OPG by human vascular endothelial cells in the absence or presence of the pro-inflammatory cytokine TNF-α Published online July 15, 2010 Arterioscler Thromb Vasc Biol DOI: 10.1161/ATVBAHA.110.209783 Print ISSN: 1079-5642. Online ISSN: 1524-4636 Copyright © 2010 American Heart Association. All rights reserved. Received: 9 April 2011 - Accepted: 19 April 2011 Published online 04 May 2011 Invest New Drugs DOI 10.1007/S10637-011-9675-8 © Springer Science+Business Media, LLC 2011 MICROBIOLOGICA MICROBIOLOGICA Hydrogen sulfide in thermal spring Molecular enrichment for detection of S. waters and its action on bacteria of aureus in recreational waters human origin a a a b S. Giampaolia , F. Valeriani , G. Gianfranceschi , M. Vitali , M. Delfini c, M.R. Festa c, E. Bottari c, V. Romano Spica a a) Unit of Public Health, University of Rome “Foro Italico”, P.zza L. De Bosis, 6, 00135 Roma, Italy b) Department of Public Health and Infectious Diseases, “Sapienza” University, P.le Aldo Moro, 5, 00185, Rome, Italy c) Department of Chemistry, “Sapienza” University, P.le Aldo Moro, 5, 00185, Rome, Italy Abstract Hydrogen sulfide (H2S) is a molecule dissolved in many thermal spring waters at variable concentration. The H2S effects of thermal waters treatments have long been studied, for dermatological and clinical treatments, but its role in recreational waters was never investigated. The use of sulfur spring waters in pools raises concerns related to disinfection by oxidants. The aim of this work is to evaluate the survival rate of microbial species in waters with different titers of H2S. Four selected thermal waters collected from Italian springs, belonging to different chemical categories, have been tested in comparison to Tyrrhenian sea water and natural mineral bottled water. Results show inhibition properties on bacterial proliferation that seem related to H2S concentrations. To further asses this phenomenon H2S was added to thermal and natural mineral waters. The results strongly support a bactericidal role of H2S in thermal spring waters used for recreational purposes. These observations open up new perspectives for a disinfectant role of H2S in pool treatment and management. Keywords: hydrogen sulphide, thermal spring water, pools, bacteria, disinfection, hygiene Received 19 October 2012 - Accepted 29 October 2012 Microchemical Journal. ©2012 Elsevier B.V. All rights reserved F. Valeriani, S. Giampaoli, L. Buggiotti, G. Gianfranceschi and V. Romano Spica University of Rome ‘Foro Italico’, P.zza L. De Bosis, 6, 00135 Roma, Italy E-mail: [email protected] Abstract The identification of rapid methods for the control of recreational water and of aquatic environments with similar characteristics is necessary to provide adequate levels of health safety for users. Molecular techniques have been proposed in recent years as a viable alternative to traditional microbiological methods, as they offer various advantages and are less time consuming than traditional tests. An innovative protocol based on molecular enrichment that allows the identification of low concentrations of Staphylococcus aureus in recreational water has been developed. The method is based on the specific amplification of prokaryotic genomic DNA by the usage of universal primers for 23S rDNA; subsequently, a second amplification step is performed with specific real-time polymerase chain reaction (PCR) primers and probe. This approach shows sensitivity levels similar to those observed with microbiological tests, with the additional benefits of the specificity typical of nucleic acids techniques. This methodology is easily applicable also to other microbiological parameters, representing an important milestone in hygiene monitoring by the detection of specific pollution indicators. Keywords: molecular enrichment, real-time PCR, recreational water, staphylococcus aureus, 23S rDNA Water Sci Technol. 2012;66(11):2305-10. doi: 10.2166/wst.2012.435 D E R M ATO L O G I C A URINARIA Hydrogen sulfide modulates the release Dietary habits in women with recurrent of nitric oxide and VEGF in human idiopathic calcium nephrolithiasis keratinocytes 1 1 1 Stefania Merighi, Stefania Gessi, Katia Varani, Debora Fazzi, Pier Andrea Borea Department of Clinical and Experimental Medicine, Pharmacology Section and Interdisciplinary Center for the Study of Inflammation, University of Ferrara, Via Fossato di Mortara, 17/19, 44100 Ferrara, Italy. Abstract Hydrogen sulfide (H2S) is a novel signaling molecule with both pro- or anti-inflammatory effect. The present study aimed to: (i) characterize the in vitro effects of H2S on human keratinocyte's proliferation and death; (ii) investigate the ability of H2S to modulate VEGF and NO production; (iii) examine the intracellular signaling pathways involved in VEGF and NO modulatory effect. We found that exogenous application of H2S (NaHS and GYY4137 as H2S donors) significantly enhances NO through increase of iNOS, in a manner Aktdependent. The increment in NO down-regulates ERK1/2 activation thereby resulting in the decrease of VEGF release. We suggest that H2S -releasing agents may be promising therapeutics for chronic inflammatory disorders of the skin, i.e. psoriasis, in which NO increases as well as anti-VEGF treatments have been suggested to be novel effective approaches. Keywords: Akt, ERK ½, hydrogen sulphide, keratinocytes, nitric oxide,VEGF Pharmacol Res. 2012 Nov;66(5):428-36. doi: 10.1016/j.phrs.2012.07.002. Received 11 May 2012 - Received in revised form 9 July 2012 - Accepted 9 July 2012 - Epub 2012 Jul 27. Copyright © 2012 Elsevier Ltd. All rights reserved. Tiziana Meschi , Antonio Nouvenne , Andrea Ticinesi , Beatrice Prati 1, Angela Guerra 1, Franca Allegri 1, Federica Pigna 1, Laura Soldati 2, Giuseppe Vezzoli 3, Giovanni Gambaro 4 , Fulvio Lauretani 5, Marcello Maggio 6 and Loris Borghi 1 1) Department of Clinical Sciences, University of Parma, Via A. Gramsci 14, 43126 Parma, Italy 2) Department of Medicine, Surgery and Dentistry, University of Milan, Milan, Italy 3) Nephrology Unit, S. Raffaele Hospital, Milan, Italy 4) Department of Internal Medicine and Medical Specialties, Renal Program, Columbus-Gemelli University Hospital, Catholic University, Rome, Italy 5) Geriatric Unit, Parma University Hospital, Parma, Italy 6) Department of Internal Medicine and Biomedical Sciences, University of Parma, Parma, Italy Abstract Background: Nutrition has been widely recognized to influence the risk of kidney stone formation. Therefore the aim of our study was to assess: a) whether usual diet of women with idiopathic calcium nephrolithiasis (ICN) living in Parma (Northern-Italy) is different compared to healthy controls, b) how their diet differs from Italian National guidelines and c) whether it is related to nephrolithiasis clinical course. Methods: 143 women with recurrent ICN (mean age 43 ± 13 ys) and 170 healthy women (mean age 42 ± 11 ys) were enrolled. All women completed a food frequency questionnaire for the last 60-days and a 3-day dietary diary analysed with a dedicated software. Results: Stone formers showed a higher consumption of sausages, ham, meat and sweets than healthy controls (43.1% vs 11.1%, 29.4% vs 13.9%, 21.6% vs 4.2%, 66.7% vs 18.1%, p < 0.001). The 3-day diary analysis showed an intake of calories, carbohydrates, lipids and non-discretionary sodium about 10% higher than healthy controls (p < 0.001). Finally, after dividing the population into 3 age groups (≤30, 31-40, > 40 years), the differences described above were amplified in the class ≤30 years, where nephrolithiasis presented a more serious course (shorter recurrence interval, greater stonerate). In this age group the intake of fruit and vegetables was notably lower than guideline recommendations. Conclusions: We conclude that the usual diet of women with recurrent ICN is different from controls and characterized by low intake of fruits and vegetables and higher consumption of simple sugars and foods with high protein and salt content. This dietary imbalance could play a role in the ICN pathogenesis, especially in younger women. This work was financed by grants from Italian Ministry of University and Research as part of a larger project about the prevention of kidney stones (PRIN 2005063822) and by Fondazione per la Ricerca Scientifica Termale (FoRST). No potential conflict of interest relevant to this paper was reported. Keywords: Idiopathic calcium nephrolithiasis, Diet, Kidney stones, Food frequency Journal of Translational Medicine 2012, 10:63 doi:10.1186/1479-5876-10-63 URINARIA Lifestyle Recommendations to Reduce the Risk of Kidney Stones Tiziana Meschi, MD, Antonio Nouvenne, MD, PhD, Loris Borghi, MD* Internal Medicine and Subacute Critical Care Clinic, Department of Clinical Sciences, University of Parma, Via A. Gramsci 14, 43126 Parma Italy *Corresponding author. E-mail address: [email protected] Kidney stones are a disorder that could be termed social because of its vast diffusion and growing incidence in wealthy industrialized countries.1 Many international studies have shown that this condition affects just less than 10% of the population, constituting an expense of approximately 2 billion dollars a year in hospital admissions in the United States alone.2 In some cases, it is the consequence of specific hereditary or acquired diseases, such as cystinuria, primary hyperoxaluria, medullary sponge kidney, primary hyperparathyroidism, and infections or anatomic malformations of the kidneys and urinary tract. However, the most common form is idiopathic calcium nephrolithiasis (ICN), with the formation of calcium oxalate stones, sometimes mixed with calcium phosphate and with a prevalence of approximately 80%. The distribution by sex shows the frequency to be slightly higher in men.3 The pathogenesis of ICN includes genetic and acquired factors that interact to cause biochemical urinary abnormalities that lead to the formation of kidney stones. A high rate of supersaturations of calcium oxalate and/or calcium phosphate leads to the formation of crystalline nests that can grow and join together to form a stone. The urinary elements and compounds, both inhibitors and activators, involved in the crystallization process are known as lithogenic urinary risk factors. For calcium oxalate, the lithogenic urinary risk factors are low urinary volume (<2 L/d), hypercalciuria (>250 mg/d), hyperoxaluria (>40 mg/d), hyperuricosuria (>600 mg/d), hypocitraturia (<320 mg/d), and hypomagnesuria (<50 mg/d). For calcium phosphate, in addition to the above, the most important factors are hyperphosphaturia (>1000 mg/d) and urinary pH. A pH more than 7 favors the formation of kidney stones primarily comprising phosphates, whereas a pH between 6 and 7 associated with a urinary volume of less than 1 L/d can dangerously increase the supersaturation of calcium phosphate and lead to the formation of mixed Ca-oxalate and Ca-phosphate stones. Last, in the case of uric acid–induced stone disease, another common form with a frequency of 10% to 15%, the factors involved are hyperuricosuria and pH less than 5.5. Of the various lithogenic urinary risk factors, the most commonly observed in patients with ICN is hypercalciuria, with a prevalence of approximately 50%. Regarding the age of onset, there are 2 peaks: between 20 and 30 years and between 50 and 60 years.4 The presence of a genetic substrate does not, however, detract from the role of lifestyle: dietary habits and lifestyle have a direct effect on the lithogenic urinary risk factors and the pathogenesis of this condition. This article examines the role of lifestyle in the prevention and treatment of calcium and uric acid kidney stones. This article specifically analyzes the relationship between (1) kidney stones and dietary habits, (2) kidney stones and body weight, (3) kidney stones and exercise, (4) kidney stones and stressful life events, and (5) particular causes. This work was supported by Fondazione per la Ricerca Scientifica Termale (FoRST) grants.The authors have nothing to disclose. Keywords: idiopathic calcium nephrolithiasis, lifestyle, diet, prevention, kidney stones Urol Clin N Am 38 (2011) 313-320 doi: 10.1016/j.ucl.2011.04.002 0094-0143/11/$ - see front matter ©2011 Elsevier Inc. All rights reserved. NEUROLOGICA SCIENZA DI BASE Hydrogen sulfide slows down progression of experimental Alzheimer's disease by targeting multiple pathophysiological mechanisms Sulphurous thermal water increases the release of the anti-inflammatory cytokine IL-10 and modulates antioxidant enzyme activity Giuliani D, Ottani A, Zaffe D, Galantucci M, Strinati F, Lodi R, Guarini S. Prandelli C, Parola C, Buizza L, Delbarba A, Marziano M, Salvi V, Zacchi V, Memo M, Sozzani S, Calza S, Uberti D, Bosisio D. Department of Biomedical, Metabolic and Neural Sciences, Section of Pharmacology and Molecular Medicine, University of Modena and Reggio Emilia, Modena, Italy Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy. Abstract It has been previously reported that brain hydrogen sulfide (H2S) synthesis is severely decreased in Alzheimer's disease (AD) patients, and plasma H2S levels are negatively correlated with the severity of AD. Here we extensively investigated whether treatment with a H2S donor and spa-waters rich in H2S induces neuroprotection and slows down progression of AD. Studies with sodium hydrosulfide (a H2S donor) and Tabiano's spa-water were carried out in three experimental models of AD. Short-term and long-term treatments with sodium hydrosulfide and/or Tabiano's spa-water significantly protected against impairment in learning and memory in rat models of AD induced by brain injection of β-amyloid1-40 (Aβ) or streptozotocin, and in an AD mouse model harboring human transgenes APPSwe, PS1M146V and tauP301L (3xTg-AD mice). The improvement in behavioral performance was associated with hippocampus was size of Aβ plaques and preservation of the morphological picture, as found in AD rats. Further, lowered concentration/phosphorylation levels of proteins thought to be the central events in AD pathophysiology, namely amyloid precursor protein, presenilin1, Aβ1-42 and tau phosphorylated at Thr181, Ser396 and Ser202, were detected in 3xTg-AD mice treated with spawater. The excitotoxicity-triggered oxidative and nitrosative stress was counteracted in 3xTg-AD mice, as indicated by the decreased levels of malondialdehyde and nitrites in the cerebral cortex. Hippocampus reduced activity of c-jun Nterminal kinases, extracellular signal-regulated kinases and p38, which have an established role not only in phosphorylation of tau protein but also in inflammation and apoptosis, was also found. Consistently, decrease in tumor necrosis factor-α level, up-regulation of Bcl-2, and downregulation of BAX and the downstream executioner caspase-3, also occurred in the hippocampus of 3xTg-AD mice after treatment with Tabiano's spa-water, thus suggesting that it is also able to modulate inflammation and apoptosis. Our findings indicate that appropriate treatments with H2S donors and Tabiano’s spa-waters, and may be other spa-waters rich in H2S content, might represent an innovative approach to slow down AD progression in humans by targeting multiple pathophysiological mechanisms. Ricerca pubblicata su: Neurobiology of Learning and Memory 2013 Titolo originale: Hydrogen sulfide slows down progression of experimental Alzheimer's disease by targeting multiple pathophysiological mechanisms Data di pubblicazione: 2013 Abstract The beneficial effects of hot springs have been known for centuries and treatments with sulphurous thermal waters are recommended in a number of chronic pathologies as well as acute recurrent infections. However, the positive effects of the therapy are often evaluated in terms of subjective sense of wellbeing and symptomatic clinical improvements. Here, the effects of an S-based compound (NaSH) and of a specific sulphurous thermal water characterized by additional ions such as sodium chloride, bromine and iodine (STW) were investigated in terms of cytokine release and anti-oxidant enzyme activity in primary human monocytes and in saliva from 50 airway disease patients subjected to thermal treatments. In vitro, NaSH efficiently blocked the induction of pro-inflammatory cytokines and counterbalanced the formation of ROS. Despite STW not recapitulating these results, possibly due to the low concentration of S-based compounds reached at the minimum non-toxic dilution, we found that it enhanced the release of IL-10, a potent anti-inflammatory cytokine. Notably, higher levels of IL-10 were also observed in patients’ saliva following STW treatment and this increase correlated positively with salivary catalase activity (r2 = 0.19, *p less than 0.01). To our knowledge, these results represent the first evidence suggesting that S-based compounds and STW may prove useful in facing chronic inflammatory and age-related illness due to combined anti-inflammatory and anti-oxidant properties. Ricerca pubblicata su: International Journal Of Immunopathology And Pharmacology Titolo originale: Sulphurous thermal water increases the release of the anti-inflammatory cytokine IL-10 and modulates antioxidant enzyme activity Data di pubblicazione: 2013 R E U M ATO L O G I C A A multidisciplinary approach to study the effects of balneotherapy and mudbath therapy treatments on fibromyalgia Bazzichi L. 1, Da Valle Y. 2, Rossi A. 1, Giacomelli C. 1, Sernissi F. 1, Giannaccini G. 2, Betti L. 2, Ciregia F. 2, Giusti L. 2, Scarpellini P. 3, Dell'Osso L. 3, Marazziti D. 3, Bombardieri S. 1, Lucacchini A. 2 1) Department of Clinical and Experimental Medicine, Division of Rheumatology 2) Department of Pharmacy, and 3) Department of Clinical and Experimental Medicine, Division of Psychiatry, University of Pisa, Pisa, Italy Abstract OBJECTIVES: To study the effects of both balneotherapy and mud-bath therapy treatments in patients affected by primary fibromyalgia (FM) using rheumatological, psychiatric, biochemical and proteomic approaches. METHODS: Forty-one FM patients (39 females, 2 males), who fulfilled the American College of Rheumatology criteria received a 2-week thermal therapy programme consisting of therapy once daily for 6 days/week. Twenty-one patients received mud-bath treatment, while the other twenty balneotherapy. Pain, symptoms, and quality of life were assessed. Oxytocin, brainderived neurotrophic factor (BDNF), ATP and serotonin transporter levels during therapy were assayed. Comparative whole saliva (WS) proteomic analysis was performed using a combination of two-dimensional electrophoresis (2DE) and mass spectrometry techniques. RESULTS: We observed a reduction in pain, FIQ values and improvement of SF36 in both groups of patients treated with mud-bath or balneotherapy. The improvement of the outcome measures occurred with different timing and duration in the two spa treatments. A significant decrease in BDNF concentrations was observed either after balneotherapy or mud-bath therapy when assayed after twelve weeks, while no significant change in oxytocin levels, ATP levels and serotonin transporter were detected. Significant differences were observed for phosphoglycerate mutase1 (PGAM1) and zinc alpha-2glycoprotein 1 (AZGP1) protein expression. CONCLUSIONS: Our results showed that the thermal treatment might have a beneficial effect on the specific symptoms of the disease. In particular, while balneotherapy gives results that in most patients occur after the end of the treatment but which are no longer noticeable after 3 months, the mud-bath treatment gives longer lasting results. Ricerca pubblicata su: Clinical and Experimental rheumatology Titolo originale: A multidisciplinary approach to study the effects of balneotherapy and mud-bath therapy treatments on fibromyalgia Data di pubblicazione: 2013 IV B A N D O [ A N N O 2 0 1 2 ] B a n d o i n Me di ci na Te r m ale Riabilitativa o Otorinolaringoiatrica € 1.000.000 – Progetti pervenuti: 10 € 900.000 – € 800.000 – € 700.000 – Progetti cofinanziati: 6 € 600.000 – € 500.000 – Stanziati: € 500.000 € 400.000 – € 300.000 – Valore dei progetti: € 923.000,00 € 200.000 – € 100.000 – Importo dei cofinanziamenti: € 499.550,00 Stanziati Valore dei progetti Erogati: € 87.760,00 Importo dei cofinanziamenti Erogati N. 1 revocato Ateneo Titolo Ricerca Area Durata (in mesi) _______________________________________________________________________________________________________________________________________________________________ Università di Milano - Bicocca Lymphopoiesis in secondary lymphoid tissue. Ear, nose & throat 24 _______________________________________________________________________________________________________________________________________________________________ Università di Padova The effects of thermal balneokinesitherapy in obese patients with knee osteoarthritis. Rehabilitation 24 _______________________________________________________________________________________________________________________________________________________________ IRCCS San Raffaele Pisana Effectiveness of thermal water nasal inhalation and irrigation in rhinopharyngitis and sinusitis. Ear, nose & throat 24 _______________________________________________________________________________________________________________________________________________________________ Università di Bari Thermal water inhalationin chronic upper respiratory tract infections in elderly. Ear, nose & throat 12 _______________________________________________________________________________________________________________________________________________________________ Università di Napoli Federico II Effects of crenotherapy+ exercise rehabilitation in patients with PAOD stage II b. Rehabilitation 24 _______________________________________________________________________________________________________________________________________________________________ Università di Cagliari Randomized controlled trial of a thermal rehabilitation program in axial spondyloarthritis. Rehabilitation 24 _______________________________________________________________________________________________________________________________________________________________ I progetti di ricerca hanno preso avvio nel mese di luglio 2013 Conclusione prevista luglio 2015 BANDI PREMIO 2007 - 2012 A partire dal 2007 FoRST ha bandito annualmente un premio per la ricerca medico-scientifica a favore delle migliori pubblicazioni bio-mediche di interesse per il settore termalistico. I lavori scientifici proposti devono essere pubblicati su riviste a diffusione internazionale indicizzate (impact factor), in data non antecedente ai due anni precedenti il bando. Emanati a partire da febbraio 2008 Stanziati: € 55.000,00 Lavori pervenuti: 31 Lavori premiati: 18 E M ATO L O G I C A Thermal balneotherapy induces changes of the platelet serotonin transporter in healthy subjects Donatella Marazziti a, Stefano Baroni a, Gino Giannaccini a, Mario Catena Dell’Osso a, Giorgio Consoli a, Michela Picchetti a, Marina Carlini a, Gabriele Massimetti a, Serafina Provenzano b, Antonio Galassi b a Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Italy b Medical Direction, Montecatini spa, Italy Il lavoro mette in evidenza come la sensazione di benessere soggettivo di pazienti sottoposti a trattamento balneotermale ozonizzato sia correlato all’incremento di serotonina, neuromodulatore implicato in funzioni fisiologiche della psiche. Sono stati studiati 18 soggetti sani, uomini e donne, di età fra 25-50 anni sottoposti a balneoterapia termale ozonizzata a cui si sono misurati prima e dopo il trattamento i parametri ematici piastrinici del Sert. Il trasportatore (Sert) della serotonina (5HT) è una proteina localizzata a livello dei terminali presinaptici serotoninergici e rappresenta il principale meccanismo che regola la concentrazione sinaptica d 5-HT attraverso un meccanismo attivo di ricaptazione. La nostra ricerca ha verificato modificazioni del SERT, attraverso la valutazione dei parametri (Bmax e Kd) del binding della 3H-paroxetina in membrane piastriniche di 18 soggetti sani prima (t0) e dopo (t1) trattamento balneoterapico in acqua termale. I risultati ottenuti evidenziano un aumento dell’affinità (l’inverso della costante di dissociazione, Kd) del radioligando 3H-paroxetina per il SERT, in tutti i soggetti dopo il trattamento (t1), che si incrementava ulteriormente in quelli dopo una settimana (t2). Queste modificazioni del SERT potrebbero giustificare la sensazione soggettiva di benessere dopo la balneoterapia in acqua termale, rilevata in tutto il campione in esame. I risultati ottenuti nel nostro studio evidenziano modificazione del SERT (trasportatore della serotonina, neuromediatore maggiormente correlato alla sensazione di benessere soggettivo) successiva ad un trattamento di balneoterapia ozonizzata in acqua termale ipotonica salso-solfato- alcalina di Montecatini, utilizzata per la cura delle vasculopatie periferiche. L’aumento del Sert, indotto dal trattamento termale, sembra responsabile della sensazione di benessere manifestata dai pazienti inseriti nello studio. Lo studio, eseguito in doppio cieco, avvalora l’importanza dell’ambiente e del mezzo termale nei pazienti sottoposti a crenoterapia aprendo nuovi orizzonti a trattamenti balneoterapici che coinvolgono l’organismo sia nel soma che nella psiche. Progress in Neuro-Psycopharmacology & Psychiatry 31 (2007) 1436 –1439 ELSEVIER Biological R E S P I R ATO R I A R E S P I R ATO R I A Control of Legionella Pneumophila Contamination in a Respiratory Hydrotherapy System with Sulfurous Spa Water Free radical-scavenging activity of sulfurous water investigated by electron paramagnetic resonance (EPR) spectroscopy. E. Leoni, MD, R. Sacchetti, MSc, F. Zanetti, MD, and P. P. Legnani, MD Pier Carlo Braga, Monica Dal Sasso, Maria Culici, Mario Falchi, Alessandra Spallino, and Giuseppe Nappi Department of Medicine and Public Health, Division of Hygiene, University of Bologna, Italy (all authors) Center of Respiratory Pharmacology, Department of Pharmacology, School of Medicine, University of Milan, Milan, Italy Objective: To evaluate the effectiveness of different disinfection treatments in a spa water system contaminated by Legionella pneumophila and associated with a case of Legionella pneumonia. Design: During an 18-month period, the spa water was analyzed by taking samples from the well, the recirculation line, and the final distribution devices (nebulizers and nasal irrigators). Various attempts were made to eradicate Legionella organisms by chemical and thermal shock. The final protocol consisted of heat shock treatment at 70° C – 75° C for 3 hours, 2 nights per week, followed by a lowering of the water temperature to 30° C + 1° C for the use in the plant. In addition, 3 times a week superheated steam (at a pressure of 1 atmosphere) was introduced for 1 hour into the nebulization machines. Setting: A spa at which sulfurous water was used for hydrotherapy by means of aerosol and nasal irrigation. Patient: A 74-year-old woman with legionnaires disease. Results. After the case of infection occurred, L. pneumophila was isolated from the recirculation line at a concentration of 400,000 cfu/ L and from the nebulizers and nasal irrigators at levels ranging from 3,300 to 1,800,000 cfu/L. The colonizing organisms consisted of a mixture of L. pneumophila serogroup 1 (12%) and serogroup 5 (88%). The shock treatment with chlorine dioxide and peracetic acid resulted in the eradication of Legionella organisms from the recirculation line but not from the water generated from the final distribution devices. After the restructuring of the plant and the application of thermal shock protocol, an evaluation after 12 months revealed no evidence of Legionella contamination. Conclusion: To prevent Legionella colonization, disinfection treatment is effective if associated with carefully selected materials, good circuit design, and good maintenance practices. Infection Control and Hospital Epidemiology July 2006, Vol. 27, No. 7 Abstract The aim of the study was to explore the antiradical activity of sulfurous water, used for inhalatory therapy (characterized by the presence of sulfhydryl [HS]) by means of electron paramagnetic resonance (EPR) spectroscopy. The effects of sulfurous water corresponding to the concentrations from 16 down to 0.25 μg/mL of HS were tested by means of Fenton reaction (HO•), KO2–crown ether system (O2−•), and EPR of Tempol and of Fremy's salt radical. All of these assays were made using natural sulfurous water or degassed sulfurous water (no detectable HS) or reconstituted sulfurous water (degassed plus NaHS). The free radicals were significantly inhibited by natural water with HS concentrations ranging from 16 to 1 μg/mL for HO•, Tempol, and Fremy's salt, and O2−• was significantly inhibited from 16 and 2 μg/mL. The tests of degassed water did not reveal any significant differences from baseline values. The tests of reconstituted water led to significant results overlapping those obtained using natural water, thus confirming the importance of the presence of HS group (reductive activity). The positive effects of the activity of sulfurous thermal water is partially based on the patients’ subjective sense of well-being and partially on symptomatic (or general) clinical improvements that are sometimes difficult to quantify. These findings indicate that, in addition to their known mucolytic activity and trophic effects on respiratory mucosa, the HS groups in sulfurous water also have antioxidant activity that contributes to the water's therapeutic effects on upper and lower airway inflammatory diseases. Keywords: antixodant activity, electron paramagnetic resonance (EPR), spectroscopy, HS group, sulforous thermal water. Epub 2011 Dec 20. Exp Lung Res. 2012 Mar;38(2):67-74.doi: 10.3109/01902148.2011.641668. © Informa Healthcare USA, Inc. R E U M ATO L O G I C A R E U M ATO L O G I C A Polyphasic characterization of a thermo - Combination treatment with etanercept tolerant filamentous cyanobacterium and an intensive spa rehabilitation isolated from the Euganean thermal muds program in active ankylosing spondylitis (Padua, Italy) 1 1 1 1 1 Isabella Moro , Nicoletta Rascio , Nicoletta La Rocca , Katia Sciuto 1, Patrizia Albertano 2, Laura Bruno 2 and Carlo Andreoli 1 1) Department of Biology; University of Padua, Via Ugo Bassi 58/B, 35131Padua, Italy 2) Department of Biology; University of Roma “Tor Vergata”, Via della ricerca scientifica, 00133 Roma, Italy Abstract In this paper we report a morphological, ultrastructural, biochemical and molecular (16S rRNA, 16S–23S ITS, rbcL and rpoC1 gene sequencing) survey on a very thin, nonheterocystous, filamentous cyanobacterium, isolated from mats covering several mud maturation tanks of the Euganean Thermal District, at temperatures ranging from 26 to 59°C. Denaturing gradient gel electrophoresis results, obtained using cyanobacterial primers targeting the 16S rRNA gene, confirmed that this cyanobacterium is one of the commonest taxa growing in the mud tanks. Comparison with Geitlerinema sp. PCC 8501 (=Phormidium laminosum Gomont ex Gomont strain OH-1-p Cl 1), a thin thermobiotic species isolated from hot springs of Oregon and morphologically similar to our isolate, led us to hypothesize that the Euganean and PCC 8501 strains are either very similar sister species or ecotypes of the same species in a yet to be defined clade, clearly distinct within the paraphyletic Leptolyngbya group. Keywords: cyanobacteria, morphology, pigment composition, thermal springs, ultrastructure, 16S rRNA, 16S–23S ITS, rbcL, rpoC1 Received 12 February 2009 - Revised 30 October 2009 Accepted 6 November 2009 Eur. J. Phicol. DOI:10.1080/09670260903564391 M. Colina, G. Ciancio, R. Garavini , M Conti , F. Trotta and M. Govoni 1 Presidio di Medicina Fisica e Riabilitazione delle Terme di Castrocaro, Italy The aim of this study is to determine the effects of a combination treatment with etanercept and spa rehabilitation versus etanercept alone on function, disability and quality of life in a group of patients with active ankylosing spondylitis (AS). Sixty patients with AS underwent etanercept as suggested by ASAS/EULAR recommendations. As the clinical and laboratory conditions improved, 30 patients accepted the proposal of coupling the medical therapy with a 7-day rehabilitation program in a thermal baths centre; the remaining 30 subjects continued to take the biologic agent alone. The comparisons between the 2 groups were made after 3 and 6 months. The primary outcome was an improvement in BASFI. The secondary outcome was an improvement in the visual analogic scale of EuroQol (EQ-5Dvas). After 6 months a statistically significant improvement in BASFI (p < 0.05) and EQ-5DVAS (p < 0.05) scores was observed in both groups. The mean change in EQ-5DVAS value showed a statistically significant difference in favour of the combination therapy group versus the monotherapy group (22 vs 32, p < 0.05). A therapeutic regimen combining etanercept with an intensive rehabilitation program contributes to disability reduction and ameliorates quality of life for AS patients. Keywords: ankylosing spondylitis, rehabilitation, etanercept, BASFI, quality of life. Received May 8, 2009 – Accepted September 24, 2009 International Journal of Immunopathoogy and Pharmacology Vol. 22 no. 4, 1125-1129 (2009) Copyright © by BIOLIFE, s.a.s. R E U M ATO L O G I C A R E U M ATO L O G I C A The in-vitro percutaneous migration of Effects of Spa therapy on serum leptin chemical elements from a thermal mud and adiponectin levels in patients with for healing use knee osteoarthritis F. Tateo a, A. Ravaglioli b, C. Andreoli c, F. Bonina d, V. Coiro e, S. Degetto f, A. Giaretta a, A. Menconi Orsini g, C. Puglia d, V. Summa h a Istituto di Geoscienze e Georisorse, CNR, Padova, Italy b Istituto di Scienza e Tecnologia dei Materiali Ceramici, CNR, Faenza, RA, Italy c Dipartimento di Biologia, University of Padova, Padova, Italy d Dipartimento di Scienze Farmaceutiche, University of Catania, Catania, Italy e Dipartimento di Medicina Interna e Scienze Biomediche, University of Parma, Parma, Italy f Istituto di Chimica Inorganica e delle Superfici, CNR, Padova, Italy g Circuito Termale Emilia-Romagna (COTER), Castel S.Pietro Terme, BO, Italy h Istituto di Metodologie di Analisi Ambientale, CNR, Potenza, Italy In-vitro experiments have been developed to ascertain whether pelotherapy applications involve the transfer of chemical elements from the healing mud to the human body, across the skin. All the materials used for therapy (raw clay, mineral water and healing mud obtained after maturation) have been characterised from different points of view (mineralogy, chemistry, exchange properties, radioactivity, grain size and microbiology) in order to get an accurate knowledge of the natural media used for therapy and to follow the development of maturation in the spa centre. A polymineralic silty clay with rather a common mineralogical and chemical composition is used; the mud is matured in a very saline mineral water, of marine origin, for 5 months. Under these conditions the maturation process increases the dispersion of clay particles and allows cation exchange between clays and water, whereas neither microbiological nor mineralogical changes are detectable. In absence of the biologic indicators of mud maturity, the equilibration of clay with mineral water represents an objective quantitative criterion. Invitro tests have been carried out by using the Franz-type diffusion cells, which show that the transfer of chemical elements across the skin is very well-developed, and also involving many essential or possibly essential elements. The amounts of chemical elements transferred were compared with toxicological guidelines and with world-wide daily requirement models. No concerns appear from the data, whereas a significant supply of some elements results from a typical application of thermal mud (20 min, full body). The elements which have been considered in order to represent a significant supply are Li, Sr, B, I, Rb, Br, Ba, Na, Cl, Se and Ca, some of these are essential nutrients. The biological effects of the main elements are briefly discussed. Keywords: Pelotherapy Essential elements Percutaneous absorption Applied Clay Science 44:83-94, 2009 © 2009 Elsevier B.V. All rights reserved. Antonella Fioravanti 1, Luca Cantarini 1, Maria Romana Bacarelli 1, Arianna de Lalla 2, Linda Ceccatelli 2, Patrizia Blardi 2 1 Rheumatology Unit, Department of Medicine and Immunological Sciences, University of Siena, Viale Bracci, 1, 53100 Siena, Italy e-mail: [email protected] 2 Center of Clinical Pharmacology, University of Siena, Siena, Italy Abstract Adipocytokine, including leptin and adiponectin, may play an important role in the pathophysiology of osteoarthritis (OA). Spa therapy is one of the most commonly used nonpharmacological approaches for OA, but its mechanisms of action are not completely known. The aim ofthe present study was to assess whether spa therapy modified plasma levels of leptin and adiponectin in thirty patients with knee OA treated with a cycle of a combination of daily locally applied mud-packs and bicarbonate–sulphate mineral bath water. Leptin and adiponectin plasma levels were assessed at baseline and after 2 weeks, upon completion of the spa treatment period. The concentrations of leptin and adiponectin were measured by ELISA. At basal time, plasma leptin levels were significantly correlated with body mass index (BMI) and gender, but no significant correlation was found with patient age, duration of disease, radiographic severity of knee OA, VAS score or Lequesne index. There was no correlation between plasma adiponectin level and BMI, gender and age, duration of the disease, radiographic severity of knee OA and VAS score. A significant correlation of plasma adiponectin levels was found only with the Lequesne index. At the end of the mud-bath therapy cycle, serum leptin levels showed a slight but not significant increase, while a significant decrease (P\0.05) in serum adiponectin levels was found. However, leptin and adiponectin concentrations after treatment were not correlated with other clinical parameters. In conclusion, our data show that spa therapy can modify plasma levels of the adipocytokines leptin and adiponectin, important mediators of cartilage metabolism. Whether this effect may play a potential role in OA needs further investigations. Keywords Osteoarthritis _ Leptin _ Adiponectin _Spa therapy Received: 13 October 2009 / Accepted: 27 February 2010 /Published online: 18 March 2010 Rheumatol Int DOI 10.1007/s00296-010-1401-x © Springer-Verlag 2010 R E U M ATO L O G I C A R E U M ATO L O G I C A Biomarkers of oxidation, inflammation and cartilage degradation in ostearthritis patients undergoing sulfur-based spa therapies A study on the efficacy of treatment with mud packs and baths with Sillene mineral water (Chianciano Spa Italy) in patients suffering from knee osteoarthritis. Serena Benedetti a*, Claudia Canino a, Gaetana Tonti a, Virginia Medda a, Piergiorgio Calcaterra b, Giuseppe Nappi c, Fausto Salaffi d, Franco Canestrari a Antonio Fraioli a, Angelo Serio b, Gioacchino Mennuni a, Fulvia Ceccarelli c, Luisa Petraccia a, Mario Fontana a, Marcello Grassi a, Guido Valesini a a Department of Biomolecular Sciences, Section of Clinical Biochemistry, University of Urbino “Carlo Bo,” Urbino, Italy b Thermal Center of Saturnia, Grosseto, Italy c Study and Research Center of Thermal Medicine, University of Milan, Milan, Italy d Department of Rheumatology, Polytechnic University of Marche, Ancona, Italy a) Dipartimento di Clinica e Terapia Medica, UOC Medicina Interna E, Terapia Medica e Medicina Termale, Scuola di Specializzazione in Idrologia Medica, Sapienza Università di Roma, Azienda Policlinico Umberto I, V.le del Policlinico 155, 00161 Rome, Italy e-mail: [email protected] b) Università Campus Bio-Medico di Roma, Rome, Italy c) Dipartimento di Clinica e Terapia Medica, UOC Reumatologia, Scuola di Specializzazione in Reumatologia, Sapienza Università di Roma, Azienda Policlinico Umberto I, V.le del Policlinico 155, 00161 Rome, Italy Objectives: To investigate the effects of sulfur-based spa therapies on oxidation, inflammation and cartilage degradation biomarkers in osteoarthritis (OA) patients. Design and methods: Analyses were performed before therapy (T0), after therapy (T1) and 1 month after its suspension (T2), in OA subjects undergoing mud bath treatments in combination (group A) or not (group B) with hydropinotherapy, and compared with those of patients not subjected to spa therapies (group C). Results: No modifications in plasma/serum biomarker concentrations were observed throughout the study in nontreated patients, while a significant reduction in oxidation, inflammation and cartilage degradation parameters was evidenced in patients of group A. Group B presented a favorable biochemical profile at T1 but not at T2. Conclusions: To ensure the long term preservation of the chondroprotective effects of sulfur-based therapies, standard mud bath treatments should be associated with hydropinotherapy in order to maintain reduced oxidative, inflammatory and degradative stimuli longer. Keywords: Osteoarthritis, Oxidative stress, Spa therapy, Sulfurous water, Antioxidant protection Received 9 February 2010 – Received in revised form 3 May 2010 – Accepted 6 May 2010 – Available online 20 May 2010 Clinical Biochemistry 43 (2010) 973-978 DOI: 10.1016/j.clinbiochem.2010.05.004 © 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved. Abstract Mud-bath therapy plays a primary role in the treatment and prevention of osteoarthritis that has been recognised since antiquity. Numerous studies have demonstrated its clinical benefits and its effects on inflammatory mediators (interleukins), the immune system, cenesthesic factors (endorphins), and the diencephalic–pituitary–adrenal axis. This study was conducted to assess the efficacy of mud-bath therapy with mineral water from the Sillene Spring at Italy’s Chianciano Spa in patients with osteoarthritis of the knee. Patients (n = 61) were divided into two groups. Group A underwent three cycles of mud-based spa therapy over a year’s time, whereas group B did not. Clinical conditions, visual analogue scale pain ratings, and Lequesne indexes of the two groups were compared. We also compared these same parameters in the patients of the two groups that were following the therapy with drugs and in the patients of the group A before and after spa treatment. The percentage of patients with no symptoms or mild symptoms was higher in group A than in group B. Within group A, this percentage was higher after treatment than before spa therapy. Even in the comparison between the patients of the two groups that were following the therapy with drug, the results was that in group A the percentage of patients with no symptoms or mild symptoms was higher than in group B. Statistical analyses based on various tests revealed that almost all these differences were highly significant. No adverse effects were observed in any of the patients in group A. In conclusion, the mud-bath therapy performed at Chianciano Spa with Sillene Spring water remarkably improved the clinical conditions of patients with knee arthritis and significantly reduces the frequency and severity of symptoms and the disability they cause. Keywords: spa therapy, mud-bath therapy, osteoarthritis, knee osteoarthrits Rheumatol Int (2011) 31:1333-1340 DOI 10.1007/s00296-010-1475-5 Received 21 November 2009 - Accepted 27 March 2010 Published online 14 April 2010 © Springer-Verlag 2010 R E U M ATO L O G I C A R E U M ATO L O G I C A Mechanisms of action of spa therapies in Short-term and long-term maturation of rheumatic diseases: what scientific different clays for pelotherapy in an evidence is there? alkaline-sulphate mineral water (Rapolla, Italy) Antonella Fioravanti, Luca Cantarini, Giacomo Maria Guidelli, Mauro Galeazzi Rheumatology Unit, Department of Clinical Medicine and Immunology, University of Siena, Viale Bracci 1, 53100 Siena, Italy. e-mail: [email protected] Abstract Spa therapy represents a popular treatment for many rheumatic diseases. The mechanisms by which immersion in mineral or thermal water or the application of mud alleviates suffering in rheumatic diseases are not fully understood. The net benefit is probably the result of a combination of factors, with mechanical, thermal and chemical effects among the most prominent ones. Buoyancy, immersion, resistance and temperature all play important roles. According to the gate theory, pain relief may be due to the pressure and temperature of the water on skin; hot stimuli may influence muscle tone and pain intensity, helping to reduce muscle spasm and to increase the pain threshold. Mud-bath therapy increases plasma β-endorphin levels and secretion of corticotrophin, cortisol, growth hormone and prolactin. It has recently been demonstrated that thermal mud-pack therapy induces a reduction in the circulating levels of prostaglandin E2 (PGE2), leukotriene B4 (LTB4), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α), important mediators of inflammation and pain. Spa therapy has been found to cause an increase in insulin-like growth factor-1 (IGF1), which stimulates cartilage metabolism, and transforming growth factor-β (TGF-β). There is also evidence of the positive action of mud-packs and thermal baths on the oxidant/antioxidant system, with a reduction in the release of reactive oxygen (ROS) and nitrogen (RNS) species. Overall, thermal stress has an immunosuppressive effect. Many other non-specific factors may also contribute to the beneficial effects observed after spa therapy in some rheumatic diseases, including effects on cardiovascular risk factors, and changes in the environment, pleasant surroundings and the absence of work duties. Keywords: spa therapy, balneotherapy, mud-packs, rheumatic diseases, mechanisms of action Received: 7 April 2010 – Accepted: 13 November 2010 Published online 1 december 2010 Rheumatol Int (2011) 31:1-8 DOI 10.1007/s00296-010-1628-6 © Springer –Verlag 2010. F. Tateo a, C. Agnini b, A. Carraro a, M.L. Giannossi c, S. Margiotta c, L. Medici c, F.E. Finizio c, V. Summa c a) Istituto di Geoscienze e Georisorse, Consiglio Nazionale delle Ricerche (CNR) Padova, c/o Dipartimento di Geoscienze, Università di Padova, Via Giotto 1, I-35137 Padova, Italy b) Dipartimento di Geoscienze, Università di Padova, Via Giotto 1, I-35137 Padova, Italy c) Lab. Environmental and Medical Geology of IMAA-CNR C.da Santa Loja, Tito scalo (Pz), Italy Abstract This study investigated in detail the mineralogical changes within 8 little maturation ponds filled with different clay materials placed in a spa center in southern Italy and kept under the traditional environmental conditions used by the spa itself. Both short- and long-term maturation periods were investigated. Several changes were observed in all the samples during the first month of maturation and also in the following 2 months. A significant increase in soluble Na occurred in all the samples. No significant variations in the initial mineral assemblage were detectable either in the bulk material and or in the clay fraction except for the crystallization of neoformed Na-minerals. The amount and the type of silicate minerals did not change in time, but the position and the width of the basal reflection of expansible minerals changed due to a gradual incorporation of new ions into the interlayer space. During the first month a variation in the grain-size distribution as well as a decrease in calcareous nannofossils can be observed. A slight increase in Corg was also recorded during the maturation. Some of the parameters which were more sensitive to short maturation continued to adjust also during a fairly longer time such as 15 months. The spacing and the FWHM of the basal reflection of smectite and mixed layers minerals and the crystallization of soluble salts were good monitors of long-term maturation. There were two tracks in the maturation period and were related to particular indicators. Typical indicators of this “first track”, mainly between months 1 and 2 of maturation were the grain size, the calcareous nannofossils and the amount and the type of exchangeable cations. The salt crystallization can be considered a suitable indication of the “second track” of maturation within 6–9 months. Keywords: maturation, pelotherapy, sulfate-alkaline water, calcareous nannofossils, clay Received 24 June 2010 Received in revised form 31 August 2010 Accepted: 2 October 2010 - Available online 12 October 2010 Applied Clay Science, Volume 50, Issue 4, December 2010, Pages 503–511 © Published by Elsevier B.V. O TO R I N O L A R I N G O I AT R I C A O TO R I N O L A R I N G O I AT R I C A The effects of sulfurous-arsenical- Antioxidant Effect of Sulphurous ferruginous thermal water nasal Thermal Water on Human Neutrophil irrigation in wound healing after Bursts: Chemiluminescence Evaluation functional endoscopic sinus surgery Pier Carlo Braga a, Giuseppe Sambataro b, Monica Dal Sasso a, forchronic rhinosinusitis: a prospective Maria Culici a, Marina Alfieri a, Giuseppe Nappi c randomized study a b Alberto Staffieri, MD ,* Filippo Marino, MD , Claudia Staffieri, MD a, Luciano Giacomelli, BD b, Emiliano D'Alessandro, MD b, Silvia Maria Ferraro, MD a, Umberto Fedrazzoni, MD c, Gino Marioni, MD a a Department of Medical and Surgical Specialties, Section of Otolaryngology, University of Padova, Padua, Italy b Department of Medical/Diagnostic Sciences and Special Therapies, Section of Anatomic Pathology, University of Padova, Padua, Italy c Levico Spa, Levico Terme, Trento, Italy Purpose: Although several publications reported the benefits of nasal irrigation in the managementof chronic rhinosinusitis and in sinonasal postoperative care, the available data are poorly controlled. The aim of this prospective randomized study was to compare the effects of sulfurous-arsenicalferruginous thermal water nasal irrigation vs isotonic sodium chloride solution nasal irrigation after functional endoscopic sinus surgery (FESS) for chronic sinonasal disease considering the histomorphological characteristics of mucosal repair after sinus surgery. Materials and Methods: Eighty patients who consecutively underwent FESS were randomly assigned (1:1) to postoperative nasal irrigation with sulfurous-arsenicalferruginous thermal water or isotonic sodium chloride solution for 6 months. Intraoperative and postoperative (1, 3, and 6 months) mean counts of lymphocytes, neutrophils, eosinophils, plasma cells, histiocytes, and mast cells in ethmoid biopsies were blindly determined by a pathologist. Results: Fifty-six patients underwent at least 2 postoperative biopsies. A statistically significant reduction of eosinophil count was disclosed 6 months postoperatively only after sulfurousarsenicalferruginous solution nasal irrigation (P = .04). After isotonic sodium chloride solution nasal irrigation, the mean eosinophil count in 6-month postoperative biopsies did not decrease. After both irrigation modalities, the mean mast cell counts in 6-month postoperative biopsies were significantly lower than in intraoperative biopsies (P b .05). Neutrophils, lymphocytes, histiocytes, and plasma cell counts were not significantly different between intraoperative vs 6-month postoperative biopsies independently from irrigation modality. Conclusions: Considering the important role of eosinophils in allergic response, we should suggest sulfurousarsenicalferruginous solution nasal irrigation in particular, which significantly reduces local eosinophil count, for allergic patients after FESS for chronic rhinosinusitis. Received 31 January 2007 American Journal of Otolaryngology–Head and Neck Medicine and Surgery 29 (2008) 223–229 © 2008 Elsevier Inc. All rights reserved. a Center of Respiratory Pharmacology, Department of Pharmacology, School of Medicine, University of Milan, b Department of Otolaryngology, School of Medicine, University of Milan, c Center of SPA Thermal Medicine, School of Medicine, University of Milan, Italy. The activities of the HS (sulfhydryl or thiolic) group in the cysteine of glutathione or various low-weight soluble molecules (thiolic drugs), such as N-acethylcysteine, mesna, thiopronine and dithiotreitol or stepronine and erdosteine (prodrugs), include its antioxidant activity in the airways during the release of reactive oxygen or nitrogen species (ROS,RNS) by neutrophils (PMNs) activated in response to exogenous or endogenous stimuli. In addition to being administered by means of thiolic molecules, the HS group can also be given by means of the inhalation of sulphurous thermal water. The aim of this luminol-amplified chemiluminescence (LACL) study was to investigate the effect of sulphurous thermal water on the release of ROS and RNS during the bursts of human PMNs. The water significantly reduced the LACL of fMLP- and PMAactivated PMNs on average from 0.94μg/ml to 15.5μg/ml of HS, even after the addition of L-Arg, a nitric oxide (NO) donor. Similar findings have also been obtained in a cellfree system, thus confirming the importance of the presence of HS group (reductive activity). The positive effects of the activity of sulphurous thermal waters has been partially based on the patients’ subjective sense of wellbeing and partially on not always easy to quantify symptomatic (or general) clinical improvements. Our findings indicate that, in addition to their known mucolytic activity and trophic effects on respiratory mucosa, the HS groups present in the sulfureous thermal water of this spring also have antioxidant activity that contributes to the therapeutic effects of the water in upper and lower airway inflammatory diseases. Key words: Sulphurous thermal water; HS group; Antioxidant activity; PMN; LACL; Cell-free system. Respiration 2008;75:193-201 (DOI: 10.1159/000107976) Copyright © 2007 S. Karger AG, Basel INFIAMMAZIONE GASTROENTEROLOGICA Antioxidative effects of sulfurous Possible antioxidant role of SPA therapy mineral water: protection against lipid with chlorine-sulphur-bicarbonate mineral and protein oxidation water S Benedetti 1, F Benvenuti 1, G Nappi 2, NA Fortunati 3, L Marino 3, T Aureli 3, S De Luca 2, S Pagliarani 1 and F Canestrari 1 1 Istituto di Istologia e Analisi di Laboratorio, Università di Urbino ‘Carlo Bo’, Urbino, Italy; 2 Centro di Studi e Ricerche in Medicina Termale, Università di Milano, Milano, Italy 3 Terme di Saturnia, Grosseto, Italy Objectives: To investigate the antioxidative properties of sulfurous drinking water after a standard hydropinic treatment (500 ml day-1 for 2 weeks). Subjects/Methods: Forty apparently healthy adults, 18 men and 22 women, age 41–55 years old. The antioxidant profile and the oxidative condition were evaluated in healthy subjects supplemented for 2 weeks with (study group) or without (controls) sulfurous mineral water both before (T0) and after (T1) treatment. Results: At T1, a significant decrease (P<0.05) in both lipid and protein oxidation products, namely malondialdehyde, carbonyls and AOPP, was found in plasma samples from subjects drinking sulfurous water with respect to controls. Concomitantly, a significant increment (P<0.05) of the total antioxidant capacity of plasma as well as of total plasmatic thiol levels was evidenced. Tocopherols, carotenoids and retinol remained almost unchanged before and after treatment in both groups. Conclusions: The improved body redox status in healthy volunteers undergoing a cycle of hydropinic therapy suggests major benefits from sulfurous water consumption in reducing biomolecule oxidation, possibly furnishing valid protection against oxidative damage commonly associated with aging and age-related degenerative diseases. Keywords: hydropinic treatment; sulfurous mineral water; hydrogen sulfide; thiols; oxidative markers; antioxidant profile European Journal of Clinical Nutrition (2009) 63, 106–112; doi:10.1038/sj.ejcn.1602892; published online 22 August 2007 M. Costantino 1,2 G. Giuberti 3, M. Caraglia 3, A. Lombardi 3, G. Misso 3, A. Abbruzzese 3, F. Ciani 4, E. Lampa 2 1 CE.RI.S.T. Center of Thermal Researches and Studies Srl, Naples, Italy; 2 Department of Experimental Medicine Pharmacological Division II, University of Naples, Naples, Italy; 3 Department of Biochemistry and Biophysics “F. Cedrangolo” II, University of Naples, Naples, Italy; 4 Department of Veterinary, University “Federico II”, Naples, Italy The aim of our research was to analyze the antioxidant role and efficacy of thermal or salus per aquam (spa) therapy with chlorine-sulphur-bicarbonate mineral water. The study has been performed on 30 rats. The animals were randomized in three groups, each of them composed by ten animals, denominated A, B and C. The A group was the control group and was not subjected to any specific treatment (placebo); the B group has been treated with a standard cycle of hydropinics treatment with mineral water of Therme of Stabia in Castellammare (Naples, Italy) denominated STABIA; the C group was treated with a standard cycle of hydropinics treatment with mineral water of Therme of Stabia Castellammare (Naples, Italy) denominated SULFUREA. After two weeks of treatment all the rats were sacrificed and blood was collected for the plasmatic determination of reactive oxygen species (ROS). The results demonstrated a significant (P<0.05) reduction of ROS in B (374 Carr. U + 73) and C group (399 Carr. U + 62) treated with mineral waters if compared with control group (571 + 69 Carr. U). In conclusion this study suggests a possible antioxidant effect of chlorine-sulphurbicarbonate spa hydropinic treatment with a consequent suitable intestinal physiology, with reduction of the functional and organic modifications that can lead to pathological disorders of the gastroenteric diseases in whole pathogenesis the oxidative stress can develop an important role. Keyword Spa therapy – Sulphur mineral water – Reactive radicals of the oxygen – Free radicals –Oxidative stress Polyamines Amino Acids (2009) 36: 161 – 165 DOI 10.1007/s00726-0080032-y SCIENZA DI BASE URINARIA Has time come for a re-assessement of Effects of a low-salt diet on idiopathic spa therapy? The NAIADE survey in Italy hypercalciuria in calcium-oxalate stone formers: a 3-mo randomized controlled S. Coccheri 1, G. Gasbarrini 2, M. Valenti 3, G. Nappi 4, F. Di Orio 5 trial1–3 1 Cardiovascular Department, University of Bologna, Via Ugo Bassi, 13 - 40121 Bologna, Italy e-mail: [email protected] 2 Department of Internal Medicine, Catholic University, Rome, Italy 3 Unit of Epidemiology, University of L’Aquila, L’Aquila, Italy 4 Postgraduate School of Hydrology and Thermal Medicine, University of Milan, Milan, Italy 5 Department of Medical Statistics and Public Health, University of L’Aquila, L’Aquila, Italy Abstract Goal of this study was to investigate whether appropriately applied spa therapy in several indications could be associated with a subsequent fall in the need for costly health services and missed working days due to sick-leave. The Naiade project was a multicenter observational, longitudinal, questionnaire-based study comparing an “entry” inquiry addressed to patients before an entry thermal cycle, and a “return” inquiry after 1 year. Routine statistical methods were used for comparisons. The study was carried out in 297 of the 340 certified Italian spa centers. Inquiries were managed by the spa doctor(s), with the collaboration of family doctors, and when necessary, hospitals, other health services, labour offices and employers. After exclusion of regular customers and of patients with acute disease phases or severe health conditions, 39,943 patients divided into eight diseases subgroups (rheumatic, respiratory, dermatologic, gynaecologic, otorhynologic, urinary, vascular and gastroenteric) underwent entry inquiry and appropriate spa treatment. Patients who returned for treatment after 1 year (“index year”) were 23,680 (59.2%) and received return inquiry. Outcomes considered were: frequency and duration of hospitalisation periods; missed working days; regular use of disease-specific drugs; and resort to “non-spa” rehabilitation therapies. The data collected at return inquiry were compared with those of entry inquiry. All the considered outcomes appeared to be significantly reduced in the index year in seven of the eight disease subgroups in comparison with the previous year. In conclusion, disease-appropriate spa treatments were followed by a reduction in the need of subsequent health interventions in most disease subgroups. The health promoting value of spa treatments should therefore undergo more rigorous assessment with randomised controlled studies. Keywords Spa treatments * Health resources * Hospital admissions * Sick-leave * Drug consumption Received: 4 July 2006/Revised: 18 June 2007/Accepted: 1 August 2007/Published online: 6 September 2007 Int J Biometeorol (2008) 52:231-237 DOI 10.1007/s00484-007-0117-4 © ISB 2007 Antonio Nouvenne, Tiziana Meschi, Beatrice Prati, Angela Guerra, Franca Allegri, Giuseppe Vezzoli, Laura Soldati, Giovanni Gambaro, Umberto Maggiore, and Loris Borghi From the Departments of Clinical Sciences (AN TM BP AG FA and LB) AND Clinical Medicine, Nephrology and Prevention Sciences (UM), University of Parma, Parma, Italy; the Nephrology Unit, San Raffaele Hospital, Milan, Italy (GV); the Department of Sciences and Biomedical Technologies, University of Milan, Milan, Italy (LS); and the Division of Nephrology, Columbus-Gemelli Hospital, Catholic University, Rome, Italy (GG). ABSTRACT Background: A direct relation exists between sodium and calcium excretion, but randomized studies evaluating the sustained effect of a low-salt diet on idiopathic hypercalciuria, one of the main risk factors for calcium-oxalate stone formation, are still lacking. Objective: Our goal was to evaluate the effect of a low-salt diet on urinary calcium excretion in patients affected by idiopathic calcium nephrolithiasis. Design: Patients affected by idiopathic calcium stone disease and hypercalciuria (.300 mg Ca/d in men and .250 mg Ca/d in women) were randomly assigned to receive either water therapy alone (control diet) or water therapy and a low-salt diet (low-sodium diet) for 3 mo. Twenty-four-hour urine samples were obtained twice from all patients: one sample at baseline on a free diet and one sample after 3 mo of treatment. Results: A total of 210 patients were randomly assigned to receive a control diet (n = 102) or a low-sodium diet (n = 108); 13 patients (2 on the control diet, 11 on the low-sodium diet) withdrew from the trial. At the follow-up visit, patients on the low-sodium diet had lower urinary sodium (mean ± SD: 86 ± 43 mmol/d at 3 mo compared with 228 ± 57 mmol/d at baseline; P < 0.001). Concomitant with this change, they showed lower urinary calcium (271 ± 86 mg/d at 3 mo compared with 361 ± 129 mg/d on the control diet, P = 0.001) and lower oxalate excretion (28 ± 8 mg/d at 3 mo compared with 32 ± 10 mg/d on the control diet, P = 0.001). Urinary calcium was within the normal range in 61.9% of the patients on the low-salt diet and in 34.0% of those on the control diet (difference: +27.9%; 95% CI: +14.4%, +41.3%; P < 0.001). Conclusion: A low-salt diet can reduce calcium excretion in hypercalciuric stone formers. This trial was registered at clinicaltrials.gov as NCT01005082 Received September 3, 2009 - Accepted December 4, 2009 Published online December 30, 2009 Am J Clin Nutr 2010;91:565–70. DOI: 10.3945/ajcn.2009.28614. Printed in USA. © 2010 American Society for Nutrition VA S C O L A R E Effect of immersion in CO2-enriched water on free radical release and total antioxidant status in peripheral arterial occlusive disease G. Dogliotti 1, E. Galliera 1, E. Iorio 2, M. De Bernardi Di Valserra 3, U. Solimene 1,4, M. M. Corsi 1,5 1 Department of Human Morphology and Biomedical Sciences “Città Studi”, University of Milan, Italy 2 International Observatory for Oxidative Stress, Salerno, Italy 3 Rabbi Fonti, Trento, Italy 4 Bioclimatology Study Center, University of Milan, Milan, Italy 5 Operative Unit of Clinical Pathology, IRCCS Policlinico San Donato, Milan, Italy Aim. The aim of this paper was to investigate the release of oxygen free radicals in patients with peripheral occlusive arterial disease and the effects of immersion of the legs and feet in carbon dioxide (CO2)-enriched water. Methods. Twenty-five patients with peripheral occlusive arterial disease (Fontaine stage II) and 15 healthy controls were treated by immersing the lower legs in either CO2 enriched or normal spa water. Blood samples were collected in heparinized tubes and total antioxidant status (TAS) and reactive oxygen metabolites (ROMs) were measured after five treatments a week for two weeks. Results. d-ROM plasma levels decreased in patients with peripheral occlusive disease after immersion in CO2-enriched water (P<0.001), and in healthy controls (P<0.01), in line with a significant increase in TAS (P<0.001). Conclusion. CO2 -enriched water immersion had a positive effect, reducing free radical plasma levels and raising the levels of antioxidants, suggesting an improvement in the microcirculation. Key words: Free radicals - Reactive oxygen species - Arterial occlusive diseases Received October 5, 2009 – Accepted April 9, 2010 Int Angiol 2011;30:12-17 PREMIO 2013 On. MASSIMO VANNUCCI A partire dall’anno 2013, FoRST ha inteso dedicare all’On. Massimo Vannucci, fautore della legge di riordino del settore termale e promotore dell’Associazione parlamentare «Amici del Termalismo» il premio previsto per le migliori pubblicazioni scientifiche per la ricerca medico-scientifica in ambito termalistico “Premio Massimo Vannucci 2013” per la ricerca medico-scientifica in ambito termalistico Il 17 dicembre 2013, presso la Sala Berlinguer della Camera dei Deputati, Filippo Maria FERNE’, Presidente della Fondazione FoRST e Costanzo JANNOTTI PECCI, Presidente di Federterme, hanno avuto il piacere di consegnare i premi ai ricercatori vincitori del premio 2013: dott.ssa K. Sciuto, dott.ssa A. Fioravanti, prof. M.M. Corsi, prof.ssa A. Faga. Sono intervenuti alla cerimonia: Nadia Vannucci, sorella On. Massimo Vannucci Luciano Arcangeli, Sindaco di Macerata Feltria Marco Vitale, Coordinatore scientifico FoRST Conclusione e saluti finali a cura dell’On. Stefano Fassina del Partito Democratico Pubblicazioni che si sono aggiudicate il premio On. Massimo Vannucci 2013 R E U M ATO L O G I C A R E U M ATO L O G I C A Polyphasic approach and typification Efficacy of balneotherapy on pain, of selected Phormidium strains function and quality of life in patients (Cyanobacteria) with osteoarthritis of the knee Katia Sciuto, Carlo Andreoli, Nicoletta Rascio, Nicoletta La Rocca, Isabella Moro Department of Biology, University of Padova, Italy Abstract Cyanobacteria (phylum Cyanophyta/Cyanobacteria, class Cyanophyceae) are among the most widespread organisms and are able to adapt themselves to different extreme environments. These micro-organisms have an important ecological role, given their ability to perform oxygenic photosynthesis, and are employed in different fields based on their ability to produce several bioactive compounds. Their prokaryotic nature, the presence of many cryptic species, and the coexistence of different nomenclature systems make the taxonomic identification of cyanobacteria particularly difficult. Moreover, for several species, the original reference strains (holotypes) are lacking. Increasingly, authors are using a polyphasic approach to characterize cyanobacteria, while typification is a recent trend that is being used to solve the problem of missing holotypes in other micro-organisms. Here we focus on a filamentous cyanobacterium, isolated from the Euganean Thermal District (Padova, Italy) and temporarily named strain ETS-02, using a polyphasic approach that includes morphological, ultrastructural, biochemical (pigment and fatty acid content), physiological (nitrogen fixation), and genetic (16S rRNA, 16S–23S ITS, cpcB-IGS-cpcA, rpoC1, gyrB, rbcL, nifD loci) analyses. The description of Phormidium cf. irriguum CCALA 759 as the epitype of Phormidium irriguum was also used to complete the characterization of strain ETS02. Ricerca pubblicata su: Cladisticts Titolo originale: Polyphasic approach and typification of selected Phormidium strains (Cyanobacteria) Data di pubblicazione: 2012 Fioravanti A, Giannitti C, Bellisai B, Iacoponi F, Galeazzi M. Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy. [email protected] Abstract The aims of this study were to evaluate whether balneotherapy with mineral sulphate-bicarbonate-calcium water could determine substantial symptomatic improvement, and to detect any changes in the quality of life (QoL) of patients with symptomatic knee osteoarthritis (OA). This was a prospective randomized, single blind controlled trial. Sixty outpatients with primary bilateral knee OA, according to ACR criteria, were included in the study and randomized to one of two groups: group I (30 patients) was treated with a daily sulphatebicarbonate-calcium mineral water bath; group II (30 patients), the control group, continued their regular outpatient care routine. At baseline, after 15 days and after 12 weeks, patients were evaluated by Visual Analogue Scale (VAS) for spontaneous pain, Lequesne and Womac Index for gonarthrosis, SF-36, Arthritis Impact Measurement Scale (AIMS) and symptomatic drugs consumption. We observed a significant improvement of all parameters at the end of the cycle of balneotherapy which persisted throughout the follow-up period, whereas in the control group no significant differences were noted. This symptomatic effect was confirmed by the significant reduction of symptomatic drugs consumption. The differences between the two groups were significant for all considered parameters already from the 15th day and persisted during follow-up. Tolerability of balneotherapy seemed to be good, with light and transitory side effects. Our results confirm that the beneficial effects of balneotherapy in patients with knee OA last over time, with positive effects on the painful symptomatology, a significant improvement on functional capacities and QoL. Balneotherapy can represent a useful backup to pharmacological treatment of knee OA or a valid alternative for patients who do not tolerate pharmacological treatments. Ricerca pubblicata su: Int J Biometeorol 2012 Titolo originale: Efficacy of balneotherapy on pain, function and quality of life in patients with osteoarthritis of the knee Data di pubblicazione: 2012 D E R M ATO L O G I C A O TO R I N O L A R I N G O I AT R I C A Effects of thermal water on skin Carbon dioxide-enriched water regeneration inhalation in patients with allergic rhinitis and its relationship with nasal Faga A, Nicoletti G, Gregotti C, Finotti V, Nitto A, Gioglio L. fluid cytokine/chemokine release. Department of Plastic Surgery, University of Pavia - IRCCS Fondazione S. Maugeri, Pavia, Italy Abstract An experimental study was carried out in an animal (New Zealand white rabbit) wound model to evaluate any effects of a hypotonic, bicarbonate-calcium-magnesium mineral water (Comano thermal water) on skin regeneration, comparing the healing rate of split-thickness skin graft donor sites treated with the thermal water wet dressing versus a standard petrolatum gauze dressing versus a saline solution wet dressing. The study was performed in two steps; an overall of 22 animals were enrolled in the study. The wound healing progress was evaluated both by the surgeons and by the histologists. Sixtyfour punch biopsies were examined in all. The histological samples were examined after staining with haematoxylin and eosin, Masson's and orcein staining and under a transmission electron microscope. The data were statistically analysed. The Comano thermal water proved to improve skin regeneration, not only by increasing keratinocyte proliferation and migration but also favourably modulating the regenerated collagen and elastic fibres in the dermis. We propose that the results of the topical treatment with the thermal water could be due to the favourable combination of a local wet environment with an antiinflammatory action and that the regenerative properties of Comano thermal water observed in rabbits could also be applied for human use. Ricerca pubblicata su: International Journal Of Molecular Medicine 2012 Titolo originale: Effects of thermal water on skin regeneration Data di pubblicazione: 2012 Pagani D, Galliera E, Dogliotti G, De Bernardi di Valserra M, Torretta S, Solimene U, Corsi MM, Pignataro L. Department of Special Surgical Sciences, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, University of Milan, Italy Abstract Background and aims: Allergic rhinitis is characterized by eosinophil infiltration and accumulation in the nasal mucosa mainly due to IL-3, IL-5, and eotaxin activities. We undertook this study to investigate a possible in vivo effect of carbon dioxide-enriched water inhalation in patients with allergic rhinitis. Methods: Twenty five consecutive patients inhaled carbon dioxide-enriched water at Fonti di Rabbi Spa Centre (Trento, Italy). Symptom scores for nasal obstruction, itching and sneezing were obtained before and after treatment. Nasal lavage was collected, and IL-3, IL-5, and eotaxin levels were assessed using the quantitative sandwich enzyme immunoassay technique. Cytometric analysis was performed on samples to measure total cell count, CD45+ cells, and percentages of polymorphonucleates and lymphocytes. Results: There were statistically significant differences in chemokine levels and in cell populations between patients and healthy controls before treatment. After carbon dioxideenriched water inhalation, we observed statistically significant improvements in symptom scores, chemokine levels, and percentages of cell populations. Conclusions: Our results seem to confirm the role of IL-3, IL5, and eotaxin in the pathophysiology of allergy and the beneficial effect of carbon dioxide-enriched water inhalation in patients affected by allergic rhinitis. Received for publication February 14,2011; accepted June 20,2011 (ARCHMED-D-1100081) Ricerca pubblicata su: Elsevier Inc. Titolo originale: Carbon dioxide-enriched water inhalation in patients with allergic rhinitis and its relationship with nasal fluid cytokine/chemokine release. Data di pubblicazione: 2011 B A N D O CONGIUNTO Anni 2009-2013 A.I.R.C. Associazione Italiana per la Ricerca sul Cancro FoRST Fondazione per la Ricerca Scientifica Termale Hanno emesso un bando congiunto per uno stanziamento complessivo di 900 mila euro per il finanziamento del progetto: “Efficacy of thermal treatment for respiratory airways in heavy smokers” Ente di ricerca: Istituto Tumori di Milano Principal Investigator: prof. Ugo Pastorino finalizzato a valutare l’eventuale valenza terapeutica delle acque termali nel prevenire l’insorgenza dei fattori di rischio nelle neoplasie polmonari Progetto concluso – si attende la pubblicazione COLLABORAZIONI CON ENTI DI RICERCA INTERNAZIONALI “Analysis of the effects of H2S as a major component of the thermal waters on endothelial functions during Mycoplasma infection” Dipartimento di Virologia Umana, dell’Università del Maryland equipe del prof.Robert Gallo Progetto di ricerca di base sugli effetti del solfuro di idrogeno (H2S) sugli stati acuti dei processi infiammatori e la prevenzione della loro cronicizzazione Progetto concluso e in fase di pubblicazione - prevista una II fase dello studio www.fondazioneforst.it Contatti I Mappa del sito Fondazione per la Ricerca Scientifica Termale Chi siamo News ed Eventi FoRST per i Medici Come curarsi alle Terme La nostra Ricerca 5 per mille Link LA FONDAZIONE La Fondazione per la Ricerca Scientifica Termale ( FORST) promuove e sostiene l’attività di ricerca medico- scientifica in ambito termale. I progetti di ricerca finanziati dalla Fondazione sono orientati a certificare gli effettivi benefici che l’utilizzo delle acque termali e delle risorse del termalismo terapeutico sono in grado di assicurare. [segue] AREA PUBBLICO AREA MEDICI AREA RICERCATORI Come curarsi alle terme FoRST per i medici [Entra] [Entra] Possibilità di partecipazione ai bandi per la ricerca online [Entra] AT T I V I T À E P R O G R A M M I P E R I L 2 0 1 4 • Progetto di ricerca con Campus Biomedico di Roma: “Effetto dell’assunzione di acqua ad alto potere tampone e bassa tensione di CO2 sul profilo pH-impedenzometrico e sullo score dei sintomi in pazienti affetti da malattia da reflusso gastroesofageo non erosiva e da dispepsia” • V bando in materia di innovazione tecnologica Stanziamento 300 mila euro Ambiti di riferimento: - Modificazioni biotecnologiche dei principi attivi delle acque - Sviluppo di nuove tecnologie per la somministrazione delle cure. Sono in corso contatti con poli tecnologici universitari per l’individuazione di un progetto di comune interesse. • Progetto Hydroglobe: Femtec/FoRST/Oms “Definition of a global framework for hydrotherapy” Presentazione risultati • Prosecuzione attività di comunicazione sui risultati delle ricerche co-finanziate • Consolidamento rapporti con enti ed istituzioni europee ed internazionali per il rafforzamento del sistema termale nazionale ed europeo • Bando Premio 2014 On. Massimo Vannucci per uno stanziamento di 40 mila euro ! "#$%!& ! "#$%!& !"# !"# $%& '(" $%& '(" &)*+,!-. &)*+,!-. ++ , &!+ ++ , &!+ + # + # ' ' ( ( E S T R AT TO D E L L O S TAT U TO D I F o R S T Articolo 2 SCOPI 2.1 La Fondazione prosegue le attività già svolte dal Fondo per la ricerca scientifica termale e si propone lo scopo di promuovere e sostenere l’attività di ricerca medico-scientifica in ambito termale, anche sulla scorta di quanto previsto dalla Legge n. 323/2000. In particolare si propone di confermare nel tempo, in rapporto all’evoluzione epidemiologica, l’appropriatezza delle cure termali erogate con oneri a carico del SSN, ai sensi dell’art. 4 comma 1 della Legge n. 323/2000. 2.2 Ai fini del comma precedente, la Fondazione, nei limiti e in conformità alle norme di legge applicabili, può promuovere lo svolgimento di convegni, conferenze, programmi di studio e ricerca, intraprendere e promuovere l’attuazione di iniziative di carattere scientifico nel campo della progettazione e promozione della realizzazione delle Opere dell’ingegno, assumere direttamente la gestione di iniziative nel campo della elaborazione di studi progettuali e/o della promozione della realizzazione delle Opere dell’ingegno, sollecitare e sostenere specifici progetti di ricerca di interesse del settore termale, intraprendere qualsiasi altra attività necessaria o utile ai fini del perseguimento dei propri scopi istituzionali. 2.3 Rientrano, altresì, tra gli scopi della Fondazione la stampa e la diffusione, mediante qualsiasi mezzo di comunicazione, anche di massa, ritenuto utile allo scopo, di lavori, pubblicazioni e informazioni medico-scientifiche in materia termale anche finalizzate alla maggiore conoscenza delle terapie termali e della loro efficacia. 2.4 La Fondazione potrà prestare la propria collaborazione con Enti o Istituzioni, sia pubblici che privati, per il conseguimento degli scopi predetti ed effettuare ogni altra attività necessaria o utile ai fini del perseguimento dei propri scopi istituzionali. 2.5 La presentazione dei progetti di ricerca, finanziabili attraverso il patrimonio della Fondazione, dovrà avvenire da parte dei soggetti indicati e secondo le modalità stabilite dal Regolamento. 2.6 Le finalità della Fondazione sono espletate su tutto il territorio della Comunità Europea. 2.7 Non possono far parte della Fondazione, né possono essere nominati Sostenitori, e se già nominati sono esclusi di diritto, coloro che si trovino in conflitto d’interessi o in situazione d’incompatibilità con la Fondazione. L’esclusione viene dichiarata con deliberazione del Consiglio di Amministrazione. E S T R AT TO D E L R E G O L A M E N TO D I F o R S T OMISSIS Articolo 6 - SOGGETTI LEGITTIMATI A PRESENTARE E REALIZZARE PROGETTI DI RICERCA Articolo 8 - MODALITÀ DI FINANZIAMENTO 8.1 La Fondazione, secondo le procedure di cui al seguente art. 10, co-finanzierà una quota che in nessun caso potrà eccedere il 60% dell’intero importo previsto per la realizzazione Sono soggetti legittimati a presentare e realizzare progetti di del progetto di ricerca e comunque fino alla concorrenza di un ricerca scientifica finanziabili dalla Fondazione: importo massimo di cofinanziamento non superiore ad euro a) Enti di Ricerca nazionali ed internazionali sia pubblici che 90.000,00 (novantamila) come da delibera del Comitato ese- privati, le Università e le Aziende Sanitarie e Ospedaliere; cutivo del 7 luglio 2011. La percentuale e l’importo massimo b) gli IRCCS; di cofinanziamento di cui sopra sono comprensivi dell’even- c) le Regioni; tuale ulteriore contributo per la pubblicazione dei risultati della d) il Ministero della Salute; ricerca su riviste scientifiche con fattore d’impatto citate in e) l’Istituto Superiore di Sanità; ISI/PubMed, il cui ammontare non potrà superare il 30% del- f) l’INPS; l’importo co-finanziato, di cui all’art.12, punto 2. g) l’INAIL. 8.2 Fondazione stipulerà apposita Convenzione con gli Enti Art. 7 - CRITERI DI INAMMISSIBILITÀ E DI VALUTAZIONE DEI PROGETTI beneficiari del co-finanziamento. Fondazione è abilitata al versamento delle somme oggetto del co-finanziamento unicamente nei confronti dei Soggetti firma- 7.1 Non verranno ritenuti ammissibili: tari della Convenzione, i quali sono tenuti all’analitica rendi- a) progetti la cui durata prevista sia superiore a quella indicata contazione delle spese sostenute per la realizzazione del in ogni singolo Bando; progetto di ricerca, secondo i criteri riportati in ciascun bando b) progetti che non prevedano un piano almeno annuale di e allegati alla Convenzione di cui al comma precedente. stato di avanzamento dei lavori; 8.3 In tutti i casi in cui venga erogato il finanziamento, i lavori c) progetti di ricerca già avviati; scientifici pubblicati ed i relativi risultati rimarranno nella libera d) progetti di ricerca la cui conduzione scientifica risulti affidata disponibilità della Fondazione. a soggetti diversi da quelli indicati all’art.6, lett. a), b), c), d), 8.4 Nel caso in cui, in riferimento ad un medesimo Bando, ven- e), f), g); gano ritenuti idonei al finanziamento più progetti, di norma si 7.2 La valutazione dei progetti sarà effettuata secondo le se- procederà all’erogazione della quota prevista partendo dal pro- guenti modalità: getto che avrà ottenuto il punteggio più elevato fino a concor- Il Comitato Esecutivo della Fondazione per la Ricerca Scien- renza dell’importo destinato al singolo Bando. tifica Termale è incaricato dell’istruttoria, ed opera una prima analisi dei progetti di ricerca per valutarne l’ idoneità formale. OMISSIS I progetti di ricerca dichiarati ammissibili verranno sottoposti al parere di esperti internazionali di cui al successivo art.10, che dovranno proporre per iscritto un punteggio sulla base dei Articolo 12 - PROCEDURE DI EROGAZIONE DEL CONTRIBUTO criteri riportati nel bando. Il Comitato Esecutivo, acquisiti i pareri del Comitato Scientifico 12.1 Il 70% del contributo complessivo che FoRST erogherà e verificata la congruità del finanziamento richiesto, propone all’Ente aggiudicatario sarà versato con le seguenti modalità: la graduatoria finale alla valutazione del Consiglio di Ammini- a. il 20% del contributo, ad avvenuta comunicazione di inizio strazione. attività ed in concomitanza alla sottoscrizione della Convenzione; 7.3 Sulla base dei risultati dell'istruttoria preliminare e della b. il 30% del contributo dopo 12 mesi dalla comunicazione di valutazione successiva circa gli aspetti di ordine tecnico – inizio attività e previa presentazione di una relazione scientifica scientifico e finanziario, il Consiglio di Amministrazione della dettagliata dello stato di avanzamento del progetto nonché Fondazione per la Ricerca Scientifica Termale approva con della rendicontazione contabile delle spese sostenute; propria delibera la graduatoria finale dei progetti, specificando c. Il residuo 20% del contributo alla presentazione dei risultati l’entità del finanziamento riconosciuto nonché le modalità e le conclusivi della ricerca (relazione conclusiva) e della rendicon- procedure per l’erogazione dello stesso. tazione analitica delle spese sostenute, secondo i criteri ripor- 7.4 Le verifiche in itinere ed ex post vengono operate dal Co- tati nell’allegato modello di rendicontazione (Allegato A). mitato scientifico e dalla Commissione di rendicontazione. 12.2 Il 30% della cifra complessivamente riconosciuta verrà infine erogato alla pubblicazione dei risultati della ricerca su riviste scientifiche con fattore d’impatto citate in ISI/PubMed. I F I N A N Z I ATO R I D E L L A R I C E R C A ABRUZZO LOMBARDIA 1 2 1 2 3 4 5 6 7 8 9 CARAMANICO POPOLI TOT. VERSATO € 115.478,31 BASILICATA 1 2 LUCANE RAPOLLA TOT. VERSATO € 46.611,13 BOARIO BORMIO FRANCIACORTA MIRADOLO RIVANAZZANO SALICE SIRMIONE TRESCORE BALNEARIO VALLIO TOT. VERSATO € 493.436,47 9 10 11 12 13 14 15 16 17 SAN CASCIANO SAN FILIPPO SAN GIOVANNI ELBA S. GIOVANNI RAPOLANO S. GIULIANO SATURNIA SANT'ELENA VENTURINA SALUTE AMBIENTE (BAGNI DI PETRIOLO) TOT. VERSATO € 442.986,36 CALABRIA 1 2 ANTONIMINA LOCRI SIBARITE TOT. VERSATO € 212.014,68 CAMPANIA 1 2 3 4 ASS.NE ISCHIA CAPPETTA TELESE VESUVIANE TOT. VERSATO € 792.935,71 BRISIGHELLA CASTEL SAN PIETRO DELL'EMILIA CERVAREZZA FRATTA ISTITUTO E. BAISTROCCHI CASTROCARO CERVIA EUROTERME FELSINEE MONTICELLI PORRETTA PUNTA MARINA RIMINITERME RICCIONE RIOLO ROSEO SANT’ANDREA SALSOMAGGIORE SALVAROLA SANT'AGNESE TABIANO 1 2 3 € 162.273,43 ACQUE ALBULE ALBA ALBERGO CIORRA CARACCIOLO COTILIA NUOVA SUIO Srl POMPEO SANTAMARIA SANT'EGIDIO VESCINE VITERBO PAPI € 363.677,54 € 151.420,06 MARGHERITA DI SAVOIA SANTA CESAREA TORRE CANNE TOT. VERSATO € 363.642,80 SARDEGNA 1 2 AURORA SARDARA TOT. VERSATO € 51.511,58 SICILIA 1 2 3 4 5 6 ACQUAPIA FINTUR GERMANI MARINO GORGA GRANATA CASSIBILE GRAND HOTEL DELLE TERME (I.G.A.R.) SEGESTANE STEA TOT. VERSATO FONTECCHIO € 36.730,01 VALLE D'AOSTA PUGLIA 1 2 3 € 122.065,98 UMBRIA TOT. VERSATO ACQUI FONS SALUTIS VALDIERI TOT. VERSATO MERANO COMANO LEVICO TOT. VERSATO PIEMONTE 7 8 LAZIO TOT. VERSATO 1 2 3 ACQUASANTA RAFFAELLO SAN VITTORE SARNANO TOLENTINO 1 TOT. VERSATO € 1.453.803,12 1 2 3 4 5 6 7 8 9 10 11 TRENTINO 1 2 3 4 5 TOT. VERSATO EMILIA-ROMAGNA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 MARCHE 1 TERME DI SAINT VINCENT TOT. VERSATO € 5.451,57 VENETO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 ASS.NE ABANO BIBIONE GRAN TORINO HOTEL SMERALDO HOTEL TERME ASTORIA HOTEL TERME BELLAVISTA HOTEL TERME BELVEDERE HOTEL TERME DELLE NAZIONI HOTEL TERME DELTA HOTEL TERME DOLOMITI HOTEL TERME ELISEO HOTEL TERME INTERNAZIONALE HOTEL TERME MARCONI HOTEL TERME PRINCIPE HOTEL TERME VERDI MIRAMONTI PARK HOTEL RECOARO SALZANO TOT. VERSATO € 790.355,16 € 161.186,91 TOSCANA 1 2 3 4 5 6 7 8 ANTICA QUERCIOLAIA BAGNI DI LUCCA CASCIANA CHIANCIANO EQUI - G.A.T.T. GROTTA GIUSTI MONTECATINI MONTEPULCIANO Totale complessivo regionale 5.765.580,82 IL CONSIGLIO DI AMMINISTRAZIONE Presidente Filippo Fernè * Tesoriere Rosanna Turchi * Consiglieri d’Amministrazione Enzo Baretella Paolo Bonini * Amato De Paulis Aldo Ferruzzi Leonardo Punzi Marco Tagliaferri Claudio Zucchi Coordinatore del Comitato Scientifico Marco Vitale COLLEGIO DEI REVISORI DEI CONTI Presidente Bruno Mambriani Sindaci Mario Crosato Alessandro Mollica Segretario Cristina Frezza * Membri Comitato Esecutivo Via Po, 22 00198 Roma 06.85300966 www.fondazioneforst.it