Salute

Restless legs syndrome: what it is and how to relieve symptoms

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While restless legs syndrome can be hereditary, according to Stahl, a number of medical conditions, such as iron deficiency, kidney failure, pregnancy, and multiple sclerosis, can contribute to symptoms. Sometimes RLS can exist on its own with no link to genetics or underlying health problems.

Staying active is extremely important when trying to combat restless leg symptoms.

“We recommend getting regular exercise to help reduce symptoms,” Stahl says. Since restless leg symptoms usually occur after periods of inactivity, moderate exercise can help reduce these sensations.

Include theaerobic activity and leg stretches in the daily routine it can help support important muscle movements. A 2016 study published onAsian Journal of Sports Medicine found that people suffering from RLS saw a decrease in symptoms after eight weeks stretching constant.

One regular stretching can help increase elasticity and reduce body stiffness. Doing any kind of quadriceps, calf, and hamstring stretches shifts the focus to your lower half and could help relieve leg tension. Creating a short stretching routine that you can do before bed can help alleviate the sensations that come with RLS.

Also some lifestyle changes can help relieve the symptoms of RLS.

“Sleep is very important – sleep deprivation is a big aggravating factor,” says Stahl. “Seven or eight hours of sleep every night is essential for getting your body back on track.”

The diet it can affect many aspects of your life, including restless legs. In some cases, nutrient deficiencies can make symptoms worse. Stahl says having a correct and balanced diet is important and that some nutrients, such as ferro when its levels are low, they are associated with RLS.

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The first step towards personalized medicine

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What does systemic medicine mean? Systemic medicine is the first step on the path to personalized medicine. Systems medicine is based on computer models, in which large amounts of clinical data are used to analyze the health of individual patients. Systemic medicine allows to deepen our understanding of disease mechanisms, to increase the effectiveness of treatments and to reduce the costs of health care.

There is no average patient

Ultimately, these trends towards a more personalized approach can radically change the interaction between patients, doctors and other healthcare professionals. There is no average patient, today people are living longer and there are more patients with three or more chronic diseases. In patients with more than one disease, treatment guidelines can even be contradictoryIndeed, the guidelines are often based on clinical trials of patients who are likely to be very different from the patients in the doctor’s office. No single patient ever exactly the same as the average patient for which guidelines have been written and that is why, drugs administered in the context of current treatment regimens rarely have 100% of the expected result. How do you do systemic medicine? With a multidisciplinary, data-driven approach. And the medicine becomes personalized.

* Member of Digital Health Working Group, European Public Health Alliance (WG-DH EPHA); CIRM medical director

21 September 2020 (modified on 21 September 2020 | 19:30)

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Weather forecast for Tuesday 22 September: yellow warning for rain in six regions of the Center-North

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The rapid descent of a cyclonic vortex from the British Isles will also bring bad weather to the Mediterranean areas. The depression will bring southern winds to Italy which will push perturbations over our country, fueled by the fresh North Atlantic air. The phenomena will be distributed in an irregular way, but may be of strong intensity at the local level. Civil protection: yellow alert in Lombardy, Veneto, Friuli-Venezia Giulia, Tuscany, Umbria and Lazio.

IlMeteo.it forecasts

North

Rains and scattered thunderstorms will affect all regions, moderate / heavy rainfall is expected in Lombardy, Friuli-Venezia Giulia and in the Veneto between the plain and the coast. Temperature in calo with maximums not exceeding 25 degrees. The Civil Protection has issued a yellow alert for Lombardy, Veneto and Friuli-Venezia Giulia

Center and Sardinia

Unstable weather with rains and local thunderstorms on all central regions. Temperatures of 24 degrees in Rome and Florence, 21 in Perugia. Yellow alert of the Civil Protection for southern Tuscany, Lazio and Umbria.

South and Sicily

More unstable weather on Sicily where clouds can cause some rain. Compact clouds in the Tyrrhenian area, sun elsewhere. Temperatures below 30 degrees.

21 September 2020 (modified on 21 September 2020 | 16:58)

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New column of the Health channel, with the doctors’ answers to our readers

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I have to go in Emergency room if I have a significant rise in blood pressure? What if I have sudden back pain? And how do I do an intramuscular or subcutaneous injection? These are just three of the issues that will be addressed in a new online column from today on Corriere.it. An initiative created to try to answer the questions that readers of Health Courier have posed more often in recent years. The aim is not to pursue novelty, but to provide useful information, of service, in line with the philosophy that has always inspired Health Courier and the Health section of the Corriere della Sera, but this time it will be declined in an even more direct, explicit and courageous way. The “magazine” chosen, “Doctor explain to me»Is the manifesto. Because the experts will be the ones to respond directly to the requests that have reached our e-mail boxes.

A series of new initiatives

In some cases the topics will be treated with video interviews, in others through real practical demonstrations, or by resorting to web-app with decision-making algorithms, or even with real written answers prepared by professionals who already converse online on Corriere.it/salute: over one hundred of the most qualified specialists in the country, who manage more than 60 forums, and range from cardiology, to pediatrics, neuroscience, oncology, nutrition, just to name a few areas. “Doctor, explain to me” is just the first of a series of new initiatives that will enrich the Health section of Corriere.it, which is already divided into 14 thematic channels and which, among other things, will host all the meetings of «The Time of Health», Scheduled in Milan, at the Museum of Science and Technology from 13 to 15 November, which this year will have “To remember», In the etymological sense of« bringing back to the heart », that is to say at the center of our attention, not only our well-being, but also that of others and the environment.

18 September 2020 (change September 18, 2020 | 08:39)

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The new Salute is born: the Italian home of wellbeing

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We will be online on September 22nd, on newsstands on the 24. And we will be the largest and richest container of information about us and our body in Italian. The only means of health information that has the ambition to answer the questions that we all ask ourselves when faced with discomfort, disease, risks. And that we will therefore build from the readers’ questions. Here, this is it Health. Feeling good according to science, which you can find at newsstands and online with The Republic, The Press, The XIX Century and all 13 newspapers and websites of the Gedi News Network. Millions of people, so different that they recognize themselves in 16 different newspapers, from Rome to Turin, from Livorno to Trieste passing through Modena, Mantua Pordenone…. To which we introduce ourselves with Borders. The Festival of Health: online from 22 to 27 September: a succession of talk shows, video inquiries, great scientists who explain what happens inside us: from Anthony Fauci, the commander in chief of the American war against Covid-19 to Jules Hoffman, Nobel Prize for medicine for having discovered, look a bit, the mechanisms of immunity; Alberto Mantovani, Giacomo Rizzolatti, Walter Ricciardi, Michele Maio, Piergiuseppe Pelicci, Roberto Burioni, Giorgio Scagliotti and many other big names in the Italian medcina. But Health will not be just medicine, it will look for answers in the meanders of the mind and feelings; with psychiatrists, artists, writers; that the festival will not fail to open other doors on our health: Vittorio Lingiardi, Sergio Rubini, Melania Mazzucco, Helena Janeczek, among others.

Online on September 22nd

In short, starting from 22 September we will be the portal to Italian health. Why are we going to ask scientists for the right and useful answers to what you asked yourselves just yesterday, or this morning: what is that stain on my son’s back? Why does this cough not go away? Do I need this diagnostic test or am I wasting money and time? What should I eat, how much should I sleep. I can jog after a bypass, sunbathe with dermatitis, make love with arrhythmia. Or, paraphrasing the title of the first cover story of our monthly: are we ready for the autumn pandemic? Does my doctor know what to do? What vaccines should my family get, including grandfather?

READ Frontiere the digital festival that talks about medicine

The schedule

Covid and our bewilderment

The bewilderment in the face of Covid-19, the uncertainties that have surrounded our every choice in recent months, the incessant question of the truth about what the pandemic was doing to ourselves, to our world, and to our idea of ​​society, have revealed that many, certainly too many, questions remain unanswered. Or they get confused and stammering answers. Covid 19 has amplified, but how many question marks and uncertainties are there when we think about our health? But there is always an answer, as long as we convince ourselves that medicine does not give certainties, it gives precise indications based on concrete evidence. Covid-19 has made us understand that the illusions of being able to overcome disease, the utopia of a gay and endless life, the greatness of medicine, the eternal struggle between mankind and death, has become a supermarket (more governed by marketing than science). And he revealed the new need to understand, above all to understand what we can ask those who care for us.

We can ask what to do to stay healthy, prevent the big killers of our time (from heart disease to neurological diseases that disturb us so much, to tumors), and how to deal with a damned virus or an equally damned bacterium, when and how get vaccinated, when and how to use drugs.

The word to the doctors

Therefore we are committed to questioning nutritionists to find out what to eat, sports doctors to know how to train, oncologists, cardiologists and neurologists to know how to keep diseases at bay. We have called it “medicine for the healthy”, and it is the theater of a thousand doubts but not of pain or tragedy. Because medicine is also what accompanies us in the battle, if prevention was not possible: a therapy, a surgery, a technology so advanced that until yesterday it seemed like science fiction. In short, there is always an answer. And we want to help you find it. In the certainty that this is useful, while chatting from “web bars” is harmful, the ideas of those who do not know anything but think that their personal experience is science, the illusions of marketing that enrich only those who make them, more or less miraculous and always hoaxes. We promise to tell you only about scientific medicine. And patience if it does not give certainties. Because it is still the only thing that can make us feel good according to science.

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Rheumatoid arthritis, dietary advice for those who suffer from it

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As for the diet, in case of rheumatoid arthritis, as with other autoimmune diseases that include inflammatory phenomena, it is essential to follow the doctor’s advice. For the rest, we can give some general indications.

Fish, extra virgin olive oil, a pinch of chocolate, lots of red pepper to flavor, preferably accompanied by a walk in the sun, could be elements that help those suffering from these inflammatory forms.

In any case, if you have joint problems also linked to rheumatoid arthritis or other autoimmune diseases the power supply can help in combating inflammation. Attention especially in winter when exposure to sunlight is scarce and therefore also the availability of vitamin D.

Do not overdo the consumption of refined carbohydrates and vegetable oils, rich in Omega 6 fatty acids. Instead, try to regularly consume long-chain Omega 3 fatty acids, mainly contained in fish. And don’t overdo it with salty foods. Proper nutrition can at least be protective against rheumatoid arthritis as a study on 100,000 people showed.

In practice, we are describing the Mediterranean diet. Let’s try to give some advice. It cocoa contained in chocolate is an object of scientific interest, because it has antioxidant properties which are mainly attributed to the flavonoid content. The chillies spicy products contain capsaicin, a compound useful against inflammation.

Instead, pay attention to carbonated and artificially sweetened drinks, capable of generating an inflammatory bowel reaction and therefore affect the inflammatory state of the organism in general. This link was demonstrated in a study conducted on 200,000 people, which showed a significant increase in the risk of rheumatoid arthritis, also linked to excessive consumption of sugary and carbonated drinks.

In terms of prevention and maintenance under control of rheumatoid arthritis, we must also think about the eating habits that become even more important when a person has other associated diseases, such as diabetes, hypertension, osteoporosis.

The point of reference is always the rheumatologist specialist for this pathology and the diet must always be fixed case by case.

To follow the Daily Health Pill “Rheumatoid Arthritis, Diet Tips”, click and listen here

“Daily Health Pills” is the podcast series of DiLei TakeCare, edited by Federico Mereta. In each episode we talk about prevention, care and good habits.

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Influenza vaccine, battle between Regions and pharmacies: “To private individuals only 250 thousand doses”

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A record number of flu vaccines, Regions agreeing on their distribution, pharmacists angry that they won’t get enough to meet private demand. Italy is heading towards the beginning of the campaigns against seasonal disease amid discontent and fears for the effect that an infectious disease problem with symptoms almost overlapping with those of Covid while the same Covid is still circulating. It is feared that the two pathologies will be confused, creating problems for doctors, health facilities and obviously citizens.

The vaccines ordered by the Regions this year are many: 16.7 million. Last year, for comparison, 10 million were made. It is expected that the fear of the Italians and the campaigns of the ASL and the Regions will increase membership, which in recent times had been low. Some local authorities would like to order even more lots but it is now very difficult to find them. Pharmaceutical companies receive higher than usual requests from all countries so they are unable to increase supplies. Some of us are also trying with China, for example Lombardy.

Given that the public service has ordered practically all the doses available, there are none left for the pharmacies, where those who do not receive the vaccine for free from the ASL go through their family doctor. The order of those professionals and also the trade associations have been complaining for days and they even made a meeting at the ministry in which it seemed that a solution was near. Yesterday, however, the State-Regions conference closed the agreement to review the share of doses of influenza vaccines to be allocated to the local system. He has decided to deliver 1.5% to private individuals, which is equivalent to about 250,000 doses. Too few for the order, Federfarma and Assofarm. “It takes between 1.2 and 1.5 million”, protest pharmacists. Last year, about 800 thousand were purchased. This year, however, in many Regions it is believed that once the vaccination of subjects at risk is finished, there will still be doses available to doctors, who will be able to do them to those who do not belong to the protected categories.

The president of the State-Regions conference Stefano Bonaccini explains that: “Every year 800 thousand citizens who do not fall within the categories for which vaccination is recommended, still turn to the pharmacist to buy the vaccine at their own expense. Since the recommendation for the vaccine anti-influenza this year has been extended to age categories not previously included, the Regions have provided and are providing for a wider acquisition of vaccines. For this reason, a redistributive intervention of the Regions is now needed to make a minimum percentage available. , 1.5 per cent, (possibly increased by the individual Regions) in pharmacies. The only condition that we have placed and on which we have had assurances from the Government is that the quantity necessary for the categories at risk is ensured in any case “.

Bonaccini also remembers why the vaccination campaign against the flu is important this year. “Influenza vaccination, although not 100% effective, can help reduce the burden of disease in the population and this is even more important if we consider the case in which influenza and Covid-19 are simultaneously present in a community. Containing the number of influenza cases facilitates the differential diagnosis and avoids overloading the health system “.

The Ministry of Health already in June issued a circular to dictate the rules of the new vaccination campaign. Here is a vademecum based on that document and on regional measures

How many doses have the Regions bought this year?
16.7 million but some Regions would be willing to increase their share.

When does the campaign start?
Regions were asked to anticipate times compared to last years. Hopefully, we should leave in the first half of October.

Until when can you be vaccinated?
If the campaign is well attended, it will take weeks to vaccinate everyone. It won’t be a problem because the flu’s peak in recent years came in January-February.

How long after the injection are you covered?
It takes 10-15 days for the vaccine to take effect.

For whom is the vaccine recommended, and therefore free?
This year the age of those who have the right to the vaccine, because they are considered fragile, has been lowered from 65 to 60 years. Theoretically this is 4 million more people to be vaccinated. The Regions were also given the opportunity to recommend vaccination from 6 months to 6 years, an opportunity exploited only by some local administrations. In addition, people with certain diseases of any age, and those who work in services considered essential, for example in healthcare, also get the vaccine for free.

Is there a requirement for an influenza vaccine?
Only Lazio has foreseen this in an ordinance of 17 April in which vaccination against influenza and pneumococcus is made compulsory for the over 65 and for all health personnel. The TAR has recently rejected requests for suspension of that act.

What was the coverage last year?
About 55% of the over 65s.

What is the goal of this year’s vaccination campaign?
According to the WHO, in order to have a good coverage that significantly lowers the circulation of the virus, at least 75% of people at risk must be reached. The ideal diffusion, however, is considered to be that of 95%, impossible to achieve.

Who administers the vaccine?
As always, family doctors but also local health authorities. In certain regions, pediatricians have also been involved.

How much does the vaccine cost at the pharmacy?
The price, depending on the brands, should not exceed 25 euros.

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Digital medicine is not just “tele” Still too many misunderstandings to overcome

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You hear about digital health and assistance, often in a confusing way. In fact, the two concepts are the practical translation of the term telesalute, which many times misused as a synonym for telemedicine. The Digital Health and care Institute, Scottish institute, explains well what it is: spost the balance of care from a traditional treatment model to one based on the development of innovations in the field of health and digital assistance focused on prevention, early diagnosis, post-event assistance and independent assisted living.

Approach to people and not to diseases made with digital tools

Today telemedicine on everyone’s lips, but the telemedicine across the international context a subset of digital health and assistance, digital health, telehealth. We all want Health 4.0, systemic, with an approach to people and not to diseases made with digital tools, but be careful not to confuse everything this with telemedicine. Artificial intelligence, wearable devices, the electronic health record, digital therapies, are all tools. There is much more to digital health and assistance than television or telemonitoring. Attention colleagues, engineers, patient associations. Be careful what you ask for when you clamor for telemedicine: if they give it to you, you may find that it was not what you wanted!

* Member of Digital Health Working Group, European Public Health Alliance (WG-DH EPHA); CIRM medical director

September 14, 2020 (change September 14, 2020 | 19:32)

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Depression, the risk is ‘measured’ with heart rate

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THE HEART as a ‘biomarker’ of depression. For the first time, doctors have found that measuring changes in heart rate over 24 hours can reliably indicate whether or not a person is depressed. A discovery that can give doctors a quick indication of the effectiveness of the therapy followed. The link between depression and heart rate emerged from a pilot study presented at European Congress of Neuropsychopharmacology in progress in virtual mode from 12 to 15 September. Presenting the results of this study, the researcher Carmen schiweck of Goethe University said: “Put simply, our pilot study suggests that by simply measuring heart rate for 24 hours, we can tell with 90 percent accuracy whether a person is currently depressed or not.”

Research

It has been known for some time that the heart rate it is related to depression, but until now it has not been understood exactly how one is related to the other. Part of this is due to the fact that while the heart rate can fluctuate rapidly, the depression it comes and goes over a longer period, and most treatments take months to take effect. Therefore, it is difficult to understand whether the changes in depressive state are actually related to heart rate. “Two innovative elements in this study – he explains Carmen schiweck, from the Department of Psychiatry at Goethe University in Frankfurt and principal investigator – have been continuously recording heart rate over several days and nights and using the new antidepressant ketamine, which can relieve depression more or less instantly. This allowed us to observe that the average resting heart rate can suddenly change and reflect the change in mood ”.

The evolution of ketamine

Ketamine has a history both as an anesthetic and as a ‘drug party’, a very popular drug in clubs and among young people. In December of last year, however, it was also authorized as a drug to treat major depression in Europe, after being introduced in the United States a few months earlier. Traditional antidepressants can take weeks to show an effect, while ketamine works quickly, with results often visible within minutes. “In the past, researchers had shown that depressed patients had consistently higher and less variable heart rates, but because of the time it took to treat depression, it was difficult to track and correlate any improvements in heart rate,” says Schiweck. “But when we saw that ketamine leads to a rapid improvement in mood, we realized we could use it to understand the link between depression and heartbeat.”

Research

The team of researchers worked on a small sample of 16 patients with major depressive disorder, none of whom had responded to their usual treatment, and on 16 healthy subjects. They measured their heartbeats for 4 days and 3 nights, then volunteers with depression were given either ketamine treatment or a placebo. “We found – says the researcher – that those with depression had both a higher base heart rate and less variation. On average we saw that depressed patients had a heart rate that was about 10-15 beats per minute. higher than in the control group. After treatment, we re-measured heart rates and found that both heart rate and heart rate fluctuation of the previously depressed patients had changed and were closer to those seen in the others. ”

Heart rate as a marker of depression

The most surprising discovery was that the scientists were able to use 24-hour heart rate as a ‘biomarker’ for depression. Heart rate was measured using a wearable mini-ECG. The data was sent to artificial intelligence software that was able to correctly classify almost all controls and patients as depressed or healthy. “Normally the heart rate is higher during the day and lower during the night. Interestingly, the drop in heart rate during the night appears to be impaired in people with depression. This appears to be a way to identify patients who are at risk of developing depression or relapse, “explains Carmen Schiweck. The team also found that patients with a higher resting heart rate responded better to ketamine treatment, which it can help to better identify the most suitable patients for various treatments.

Larger studies

The same authors note that this is a small research belonging to the ‘proof-of-concept’ category, or a pilot study on a few subjects: “Six of our initial 16 patients – explains Schiweck – responded to the treatment with a reduction at least 30% on the Hamilton Rating scale for depression, so we need to repeat the work with a larger sample. Our next step is to follow up with depressed patients and those in remission to confirm that the changes we see can be used as an early warning system. ” It reaffirms the need to expand research as well Brenda Penninx of the Department of Psychiatry at the University of Amsterdam Medical Center (and who did not participate in this study): “My group had previously studied short-term heart rate variability in over a thousand depressed patients and in one group control, but we did not detect consistent differentiation and found that antidepressants have a greater impact than the depressive state itself. However, this study monitored heart rate variability in an outpatient setting over several days and nights, providing unique 24-hour information on the autonomic nervous system. Now it is necessary to verify whether these interesting results are valid in wider and more diversified treatment contexts “.

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The Pope: too many vested interests on Covid vaccines, but health is a common good

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“Too many partisan interests in anti Covid vaccines, selfishness does not solve the human and social crisis”: during the Wednesday general audience in the courtyard of San Damaso, Pope Francis hits hard on those “who would like to appropriate possible solutions, as in the case of vaccines, to then sell them the others “, or” take advantage of the situation to foment divisions: to seek economic or political advantages, generating or increasing conflicts. Others simply do not care about the suffering of others, they move on and go their own way. I’m the devotees of Pontius Pilate: they wash their hands ”. Instead, says Francesco, «The crisis we are experiencing due to the pandemic affects everyone; we can come out better if we all seek the common good together. The Christian response to the pandemic and the consequent socio-economic crises is based on love, above all the love of God which always precedes us “.

The virus knows no barriers

And he added: «As well as being individual, health is also a public good. A healthy society is one that takes care of everyone’s health. A virus that knows no barriers, borders or cultural and political distinctions must be faced with a love without barriers, borders or distinctions “. Because «this love can generate social structures that encourage us to share rather than compete, which allow us to include the most vulnerable and not discard them, and which help us to express the best of our human nature and not the worst. True love does not know the throwaway culture ».

Good policy

During the audience, the Pope also spoke of “good politics”, which must have the “common good” as its objective. And he commented: «Politics often do not enjoy a good reputation, and we know why. This does not mean that all politicians are bad ”, in the history of humanity there have been many saintly politicians. Therefore we must not resign ourselves to this negative vision, but react by demonstrating with the facts that a good policy is possible, indeed, a duty. Christians, especially the lay faithful, are called to give good witness to this and can do so thanks to the virtue of charity, cultivating its intrinsic social dimension ”.

«Love the enemies? An art that you learn “

In the end it is love that makes the real difference, according to the Pope: «Loving everyone, including enemies as Jesus asks in the Gospel, is difficult, I would say it is an art! But an art that can be learned and improved ». Precisely “true love, which makes us fruitful and free, is always expansive and inclusive. This love heals, heals and does good. Therefore, love is not limited to relationships between two or three people, or to friends, or to family. It includes civic and political relationships, including the relationship with nature ».

September 9, 2020 (change September 9, 2020 | 14:22)

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