Adipose tissue (AT) is an endocrine metabolically dynamic active tissue that plays a central role in the systemic energy balance and metabolic regulation. Brown AT represents approximately 1% of adult human AT, with an energy-burning function that uses fat to create heat. Brown AT activity was measured using 18F-fluorodeoxyglucose positron emission tomography/computed tomography. It has been shown that cold exposure could promote brown AT activation. However, many factors, such as aging and body mass index, may interfere with this activity. Many authors have discussed the role of factors specifically secreted by the AT in response to cold exposure. The aim of this review is to properly understand the effects of cold on AT and biomarkers and their possible application in rehabilitation medicine. A comprehensive literature review was performed to identify published studies regarding biomarkers of cold effects on Brown AT searching the following databases: PubMed, Science Direct, and Web of Science, from 2012 to 2022. After evaluation of the inclusion and exclusion criteria, 9 studies were included in this review. We reported the overall influence of cold exposure on brown AT activity, its related biomarkers, and metabolism, demonstrating that the therapeutic role of cold exposure needs to be better standardized. From our data, it is important to design proper clinical trials because most cold applied protocols lack a common and homogeneous methodology.
Background: Neurological disease patients present an increased risk of developing pressure ulcers. The primary aim of this study is to evaluate the incidence and prevalence of pressure ulcers and their impact on length of stay and functional recovery. Methods: A retrospective study was conducted in a neurorehabilitation unit over a seven-year period. Data collected include demographic data, length of stay, functional evaluation, risk of pressure ulcers development, nutritional status, and skin. Pressure ulcers were classified according to the European Pressure Ulcer Advisory Panel System. Results: Data from 816 patients were analyzed. On admission, the authors found 236 pressure ulcers in 131 patients (about 16%), divided into stage I (25%), stage II (50%), and stage III–IV (25%). The most common sites were the heel (36%) and sacrum (29%). Among the risk factors for the development of pressure ulcers, malnutrition played a significant role, with approximately 76% of patients with pressure ulcers having mild to moderate malnutrition. Conclusion: The presence of pressure ulcers seems to have a negative impact on the functional recovery of patients, as shown by the outcome scales and the average length of stay: 51 days versus 36 days (p < 0.01).
Introduction: Spinal cord injury (SCI) is a debilitating neurological condition that causes physical dependency, psychological distress, and financial burden. Pain is a common consequence of SCI, significantly impacting quality of life. Effective pain management in SCI is challenging and requires multifaceted approaches. Among rehabilitation methods, non-invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS), theta burst stimulation (TBS), transcranial direct current stimulation (tDCS), transcutaneous electrical nerve stimulation (TENS), and virtual reality (VR) have been explored. This study aims to evaluate the efficacy of rehabilitation and non-invasive brain stimulation techniques on pain relief in SCI patients. Methods: A systematic review of the literature was conducted using PubMed, Scopus, and ScienceDirect with the formula ("spinal cord injury") AND ("pain"). Risk of bias was assessed using the Cochrane Risk of Bias Tool. Results: Sixteen studies involving 319 patients were included. Patients in the control groups received: rTMS in seven trials, tDCS in seven trials, TBS in one trial, and TENS combined with VR in one trial. The trials analyzed were of poor methodological quality, characterized by small sample sizes, weak power analyses, varying clinical scores, and non-comparable follow-up periods. No major complications or serious adverse events were reported. Conclusion: Results were inconsistent, with no solid evidence supporting the superiority of rehabilitation techniques over comparator treatments. However, the favorable safety profile and positive outcomes in some measures suggest potential benefits for pain management and quality of life. Further studies are necessary to better understand SCI-related pain and optimize treatment strategies.
Dysphagia is a frequent and potentially life-threatening complication in patients with neurological disorders. Swallowing is a complex neurophysiological mechanism regulated by a widespread network of central nervous system regions. The control of swallowing functions requires the integrity of the central pattern generator located in the brainstem, the sensorimotor cortex, the basal ganglia, and the cerebellum, but also peripheral nerves and swallowing muscles. Neurological diseases affecting either central or peripheral components of this system commonly result in dysphagia. Despite its clinical relevance, the management of neurogenic dysphagia remains challenging. While rehabilitative strategies such as swallowing therapy currently represent the main treatment option, emerging evidence suggests that non-invasive central and peripheral neuromodulation techniques may provide adjunctive beneficial effects. Further research is warranted to better define their efficacy, optimal protocols, and long-term outcomes.