Crohn's disease (CD) and ulcerative colitis (UC), two chronic and relapsing inflammatory bowel diseases (IBD), are supposed to develop in genetically-predisposed individuals as a result of an excessive immune mucosal response directed against normal components of the gut microbiota. There is also evidence that defects in counter-regulatory mechanisms play a major role in the pathogenesis of IBD. One such a defect involves TGF-β1, a cytokine produced by multiple cells types and able to inhibit pathogenic responses in the gut. In both CD and UC, TGF-β1 is highly produced but unable to signal through the TGF-β receptor-associated Smad pathway and suppress production of inflammatory molecules. Abrogation of TGF-β1 activity has been related to Smad7, an intracellular protein that binds to TGF-β receptor and inhibits TGF-β1-driven Smad-dependent signalling. Indeed, silencing of Smad7 with a specific antisense oligonucleotide restores TGF-β1/Smad signalling, thereby down-regulating inflammatory cytokine production and ameliorating experimental colitis in mice. Altogether these observations led to the development of an oral pharmaceutical compound containing the specific Smad7 antisense oligonucleotide (herein termed GED0301), which seems to be safe and well tolerated in CD patients. In this article we summarize the data supporting the pathogenic role of Smad7 in IBD and discuss the recent results of the use of GED0301 in CD.

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Background Intra-articular hip injections for osteoarthritis represent a useful instrument to reduce pain and disability in the common clinical practice. Several medications can be injected locally with different level of evidence-based efficacy. Objective The objective of this systematic review is to investigate the effectiveness of intra-articular injections of different medications or substances for the pain treatment and the management of disability in subjects affected by hip osteoarthritis. Methods Two reviewers selected independently randomised controlled trials published in the last 10 years, using PubMed and Scopus databases. The risk of bias was evaluated with Cochrane library assessment tool. Results 12 randomised controlled trials have been selected. We found 8 papers comparing hyaluronic acid with platelet rich plasma, with corticosteroids and with saline solution; 1 paper compares two types of hyaluronic acid with different molecular weights; 3 papers study the effects of corticosteroids alone or compared to ketorolac or saline solution. Conclusions The studies reviewed were heterogeneous regarding sample size, level of osteoarthritis, evaluated with Kellegren-Lawrence score, medications used and follow up timings. However, we have observed that intra-articular injections of platelet-rich plasma seem to decrease pain at short term and disability at long term, in patients affected by hip osteoarthritis better than hyaluronic acid. The association of hyaluronic acid and corticosteroids could give better results compared to hyaluronic acid alone, while the use of intra-articular ketorolac and saline solution requires more studies.

Trigger finger (TF) disorder is a sudden release or locking of a finger during flexion or extension. Treatments for this disease are conservative and surgical, including NSAIDs, hand splints, corticosteroid injections, physical therapies and percutaneous or open surgery. However, the effectiveness about the optimal treatment of TF is still in lack of evidence. The aim of this study is to investigate the effectiveness of physical therapies as conservative treatment for trigger finger. A comprehensive literature search of the MEDLINE (via PubMed), Cochrane Library Databases and PEDro databases has been conducted without limits because few papers were published about this argument. The literature search identified four papers in PubMed. Two types of physical therapies were used in the conservative management of trigger finger: external shock wave therapy (ESWT) in three papers, and ultrasound therapy (UST) in one paper. ESWT is an effective and safe therapy for the conservative management of TF. It seems to reduce pain and trigger severity and to improve functional level and quality of life. UST has proven to be useful to prevent the recurrence of TF symptoms. Even if the results suggest the effectiveness of ESWT and UST for TF, future studies are necessary to understand the characteristics of the optimal treatment protocol for trigger finger.

Background: Postural instability has a major impact on the mobility and daily life activities of Parkinson’s disease (PD) patients as it often leads to reduced mobility, insecure stance and falls. The aim of this study was to evaluate the effect of focal vibration on the static and dynamic balance of a group of Parkinson’s disease patients. Methods: Twenty-three idiopathic PD patients (14 M; 9 F), Hoehn and Yahr (HeY) stage II–III, underwent three weeks of focal muscle vibration applied to the quadriceps, soles of the feet and trapezius muscles bilaterally in addition to conventional physiotherapy. The static and dynamic balance was assessed at baseline (T0), after 3 weeks of treatment (T1) and after 1 month from the last treatment (T2) with the Tinetti scale and stabilometry evaluations. Results: There was a statistically significant improvement in the mean Tinetti score at T1, and in the Romberg area (CE/OE) of oscillation and oscillation velocity on the x-axis with the eyes closed at T2. Conclusions: Focal muscle vibration in conjunction with physiotherapy is a useful tool in the rehabilitation of gait and balance disorders of patients with Parkinson’s disease HeY stage II–III.