Marco Monticone

The aim of this study was to culturally adapt and psychometrically evaluate the Polish version of the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS), which consists of three subscales-vaginal symptoms (VS), sexual matters (SM), and quality of life (QoL)-and is designed to assess women with pelvic organ prolapse (POP). The translation and adaptation followed the official ICIQ guidelines. Psychometric evaluation included reliability (internal consistency using Cronbach's alpha and test-retest reliability using the intraclass correlation coefficient [ICC_2.1]), known-groups validity by comparing subscale scores across POP-Q stages (Kruskal-Wallis test), convergent validity by examining correlations between ICIQ-VS subscales and POP-Q scores through hypothesis testing (Spearman's rho correlations), and measurement error through the smallest detectable change (SDC). The study included 152 women (mean age 56.8 ± 12.9 years) for whom POP had been assessed by a gynecologist using the POP-Q staging system (stages 0-IV). Cronbach's alpha values were 0.903 for the VS subscale and 0.735 for the SM subscale. Test-retest reliability was excellent (ICC_2.1 = 0.93, 0.94, and 0.91 for VS, SM, and QoL subscales, respectively). Known-groups validity was significant (p < 0.001), and convergent validity showed moderate to strong correlations (ρ = 0.59-0.62). The SDC values were 6.33, 9.88, and 2.40 points for the VS, SM, and QoL subscales, respectively. The Polish ICIQ-VS demonstrated generally good psychometric properties for assessing women with POP.

Article: The contribution of physical exercise to leukemia and lymphoma in children: a scoping review - Minerva Pediatrics 2024 Oct 07 - Minerva Medica - Journals

Background: Mucositis is a frequent complication of chemo‐ and/or radiotherapy treatments and causes great pain and discomfort to the affected patient. Ozone therapy is a widely studied treatment in numerous disciplines, first and foremost dermatology; the beneficial effects of this treatment have already been confirmed in this field, particularly in the healing of wounds caused by diabetes. However, there is a shortage of studies on the use of this treatment in the management of radio‐ and/or chemo‐induced mucositis. Objectives: This review aims to summarise current evidence on the beneficial effects of ozone treatment in the management of chemo‐ and/or radio‐induced mucositis. Methods: A systematic literature review was carried out on the main databases (Scopus, PubMed and WOS); for each of the included article, the analysis of risk of bias was performed. Results: Seven articles were included in this systematic review, including six preliminary animal studies and one prospective cohort study. Analysing the variables of the studies, it seems that ozone is associated with a decrease in bacterial load, oedema and inflammatory infiltrate at the level of the lesions and a decrease in thiobarbituric acid reactive substances, indicators of oxidative stress. Conclusions: The efficacy of ozone for the management of radio‐ and/or chemo‐induced mucositis is still to be confirmed as current evidence provides only two clinical studies. However, beneficial effects were highlighted and deserve to be further investigated.

Home-based telerehabilitation technologies can support the long-term rehabilitation needs of post-stroke patients. This work describes an Android-based wearable system for telerehabilitation (DoMoMEA), which engages such patients in a full-body customized neuromotor rehabilitation protocol. DoMoMEA features seven inertial units and five force sensors, which capture patient’s body posture, movements, and interactions with a non-immersive virtual reality environment, providing real time scores, motivational feedback, and online automatic corrections for performance errors. Clinically relevant parameters can be collected and sent to a remote server where they can be retrieved by a physiotherapist through a dedicated web application, according to a store-and-forward telemedicine approach. Clinicians can also personalize the training settings to ensure a high level of engagement and challenge for patients, based on their residual motor abilities, needs and progress. Preliminary tests performed on 11 healthy elderly volunteers revealed a high usability of the system ( $82~\pm ~6$ points in the System Usability Scale questionnaire). Furthermore, the system was presented to experienced physiatrists and physiotherapists, who provided their assessment by a semi-structured interview. The evidence underscored the usefulness of DoMoMEA not only at home, but also in daily clinical practice.

Purpose: To determine benefits and adverse effects (AE) of oral muscle-relaxants (MR) (non-benzodiazepines) for acute (< 6 weeks) and chronic (> 12 weeks) primary LBP, administered alone or combined with analgesics/NSAIDs. Methods: CENTRAL, MEDLINE, EMBASE, CINAHL were searched for pertinent randomized controlled trials. Primary outcomes comprised lack of pain relief, global efficacy and AE at 5–7 days follow-up assessed dichotomously (risk ratio, RR). Results: Fifty studies (7531 participants) were included, with data from 4775 pooled in meta-analyses. For acute LBP, non-benzodiazepine MR were associated with increased likelihood of pain relief (moderate certainty; RR: 0.53, p < 0.0001), global efficacy (RR: 0.49, p = 0.0001), muscle spasm (RR: 0.62, p < 0.00001), and physical outcomes (RR: 0.60, p < 0.00001) compared to placebo. AE were more frequent with non-benzodiazepine MR compared to placebo (low-to-moderate certainty; RR: 1.56; p = 0.003), and at central nervous system (CNS; RR: 2.40; p < 0.00001), but not at gastrointestinal (GI) level (RR: 0.77; p = 0.62). Combined non-benzodiazepines + analgesics/non-steroidal anti-inflammatory drugs (NSAIDs) provide a larger and clinically meaningful benefit compared to placebo + analgesics/NSAIDs for global efficacy at 5–7 days (low-certainty; RR: 0.62; p = 0.01). Combined therapy did not result in significant between-group differences for total AE (moderate-certainty; RR: 1.15; p = 0.50) and GI AE (RR: 0.63; p = 0.08), despite responsible for more CNS AE (low-certainty; RR: 1.91; p = 0.002). When comparing non-benzodiazepine MR versus placebo for chronic LBP, only data on total AE could be pooled, without between-group difference (RR: 0.93; p = 0.69). Conclusions: Non-benzodiazepine MR for acute LBP were associated with increased likelihood of pain relief and global efficacy compared to placebo. Combined therapy with analgesics/NSAIDs proved superior for global efficacy. Studies are needed to evaluate if non-benzodiazepine MR are of larger benefit than analgesics/NSAIDs, and if stand-alone administration provides more benefit than combined treatment. The observed AE warrant caution.

Objective: The aim of the study is to provide evidence that catastrophizing is the primer of the cognitive-behavioral model of fear of movement/(re)injury. Design: A cross-sectional analysis of 180 outpatients with chronic nonspecific low back pain who completed the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia, the Roland-Morris Disability Questionnaire, the Hospital Anxiety and Depression Scale–Depression, and a pain intensity numerical rating scale. The intercorrelations of the outcome measures were estimated using Pearson’s correlation coefficient (r), and regression analyses were used to examine their predictive values by following the left side of the fear of movement/(re)injury clockwise from the Pain Catastrophizing Scale (P = 0.05). A postdictive analysis dichotomizing the sample into high- and low-level catastrophizers evaluated the effects of addressing catastrophizing on disability and pain. Results: The intercorrelations of the Pain Catastrophizing Scale with the Tampa Scale of Kinesiophobia, Roland-Morris Disability Questionnaire, Hospital Anxiety and Depression Scale–Depression and numerical rating scale were respectively r = 0.59, r = 0.54, r = 0.18, and r = 0.44. Pain Catastrophizing Scale was a significant predictor of Tampa Scale of Kinesiophobia; Pain Catastrophizing Scale and Tampa Scale of Kinesiophobia significantly predicted Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale–Depression; and Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale–Depression significantly predicted numerical rating scale. The postdictive analysis showed that addressing catastrophizing reduces disability and pain experience by 14% in high-level catastrophizers and 86% in low-level catastrophizers. Conclusions: Our findings provide evidence that catastrophizing is the primer of the fear of movement/(re)injury.

Background/Objectives: Cervical facet joint syndrome (CFJS) is a frequent cause of neck pain and motor disability. Among the available therapies for CFJS, ultrasound (US)-guided injections are becoming more and more widespread, but the evidence about their accuracy and effectiveness is still debated in the scientific literature. The aim of this systematic review is to assess efficacy, accuracy and feasibility of US-guided cervical facet injections for the related chronic neck pain treatment. Methods: This review was conducted following the preferred reporting items for systematic reviews and meta-analysis 2020 (PRISMA) statement guidelines. The scientific articles were identified through the PubMed, Google Scholar and Cochrane Library databases. Qualitative assessment of the selected studies was carried out using the modified Oxford quality scoring system. Nine studies with a total of 958 patients were included in this review. The risk of bias was assessed using the Cochrane Collaboration tool. The protocol was registered at PROSPERO 2024 (n°CRD42024512214). Results: The results of this review suggest that the US-guided cervical facet injection for CFJS treatment is an effective technique in terms of accuracy (using the lateral technique it ranges from 92% to 98%), and efficiency (it grants pain relief with a decrease in the procedure time and fewer needle passes in comparison with the X-ray-guided technique, which also involves radiation exposure). Conclusions: US-guided injections are a safe and effective method to treat this musculoskeletal disease, granting a high functional recovery and long-lasting pain relief, net of the used drugs. However, these procedures are strictly operator-dependent and require important training to acquire good expertise.

Background. Evaluating the psychometric and clinical performances of the RM-18, the shorter version of the Roland Morris Disability Questionnaire (RMQ), in Italian people with non-specific low back pain (NSLBP) as a time-saving and clinically useful method of assessing disability. Methods. This cross-sectional study included 74 people (52 females and 22 males, 53.03 ± 15.25 years old) with NSLBP. The RM-18, the RMQ, the Oswestry Disability Index (ODI), and a pain intensity numerical rating scale (NRS) were administered. Psychometric testing included reliability by internal consistency (Cronbach’s alpha) and test–retest measurement (Intraclass Correlation Coefficient, ICC2.1), and concurrent validity by comparing the RM-18 with the RMQ and the ODI (Pearson’s r correlation). Two separate regression analyses were performed to investigate the different impact of RM-18 and RMQ on NRS. Results. Cronbach’s α of RM-18 was 0.92 and ICC (2,1) = 0.96. Strong correlations were found with the RMQ and the ODI (r = 0.98; r = 0.78, respectively). The regression models showed that the RM-18 and the RMQ similarly impacted the NRS (p < 0.001). Conclusion. The RM-18 showed satisfactory psychometric testing and similarly impacted the NRS when compared to the RMQ. It can be recommended for clinical and research purposes in Italian people with NSLBP.