Aldo Sitibondo

Background/Objectives: Chronic ankle instability (CAI) is a common sequela of lateral ankle sprain and is characterized by recurrent episodes of giving way, sensorimotor deficits, impaired postural control, and diminished functional performance. While exercise-based rehabilitation, including neuromuscular training and proprioceptive exercises, remains the gold standard for managing CAI, patients often require additional support during daily activities. Orthotic interventions predominantly address mechanical instability, yet there is a clinical gap in providing integrated solutions that simultaneously offer mechanical support and sensory feedback to enhance postural control. This study aimed to investigate the effects of a semi-rigid ankle brace combined with vibro-stimulation on tactile sensation and center of pressure excursion in individuals with CAI. Methods: A randomized clinical trial was designed with two parallel groups and repeated measurements over time. Thirty adults (n = 15 per group) aged 18–35 years, who met the International Ankle Consortium criteria for CAI, were recruited. Participants in the experimental group received a semi-rigid ankle brace integrated with a wearable vibro-stimulation system, whereas those in the comparison group used the ankle brace alone. Outcome measures were collected at baseline, after 10 min, and after 2 and 4 weeks. Primary outcomes included Vibration Detection Rate and phase plane portraits assessed using a 128 Hz tuning fork and a force plate. Results: The ankle bracing plus vibration band group demonstrated significantly greater improvement at 4 weeks than the orthosis group in Vibration Detection Rate (F (3,26) = 31.93, p < 0.001, η² = 0.78). Also, the largest effect was observed for the anteroposterior phase plane portrait at 4 weeks (MD = −2.10 ± 0.42, 95% CI: −2.96 to −1.23, p < 0.001, d = −1.79). Conclusions: The findings suggest that combining a semi-rigid ankle bracing with vibro-stimulation provides additional benefits over the use of bracing alone in individuals with CAI.

SARS-CoV-2 has been identified in multiple organs and fluids, including the liver and peritoneal fluid. Gastrointestinal symptoms, such as abdominal pain, diarrhea, nausea, and vomiting, can exacerbate COVID-19 outcomes by contributing to complications, like acid–base imbalances and cardiovascular dysfunction, particularly in patients with pre-existing conditions. We report three cases of COVID-19 cirrhotic patients with SARS-CoV-2 detected in their ascitic fluid and review the relevant literature on the virus’s presence and clinical significance in peritoneal fluid. These findings underscore diagnostic and prognostic challenges in managing COVID-19 in patients with chronic liver disease and highlight the need for further research to clarify viral dissemination mechanisms and optimize protective measures for healthcare workers during surgical procedures.

The Visceral Sensitivity Index (VSI) represents a significant advancement in the assessment of gastrointestinal-specific anxiety among patients with irritable bowel syndrome (IBS) and chronic inflammatory bowel diseases (IBD)—such as ulcerative colitis and Crohn’s disease. However, an Italian version of the instrument is not yet available for the Italian-speaking population. This study utilized a national sample of 500 individuals divided into four groups: (a) patients with Crohn’s disease, (b) patients with ulcerative colitis, (c) patients with IBS, and (d) healthy controls (individuals without any diagnoses) to test the validity and reliability of the Italian VSI. Using back-translation methodology to ensure translation fidelity, this research applied a questionnaire and the VSI through an online format to 500 participants. Confirmatory Factor Analysis (CFA) revealed that the Italian VSI had excellent psychometric properties, demonstrating high internal consistency (Cronbach’s α = 0.949) and construct validity. The scale proved sensitive in detecting significant differences in visceral sensitivity among groups, highlighting its utility as a clinical and research assessment tool. Specifically, the Italian VSI exhibited a unidimensional factorial structure and maintained a strong correlation with interoceptive awareness, type of disease, and gastrointestinal symptom severity, confirming its role in enhancing the understanding and management of IBD and IBS in Italy.

The VSI represents a significant advancement in the assessment of gastrointestinal-specific anxiety among patients with Irritable Bowel Syndrome (IBS) and other Chronic Inflammatory Bowel Diseases (IBD). However, an Italian version of the instrument is not yet available for the reference population. This study utilized a national sample of 500 individuals, including healthy controls and patients with Ulcerative Colitis and Crohn's Disease, to test the validity and reliability of the Italian VSI. Using back-translation methodology to ensure translation fidelity, the research applied a questionnaire and the VSI through an online format to 500 participants. Data analysis revealed that the Italian VSI had excellent psychometric properties, demonstrating high internal consistency (Cronbach’s α = 0.95) and construct validity. The scale proved sensitive in detecting significant differences in visceral sensitivity among groups, highlighting its utility as a clinical and research assessment tool. Specifically, the Italian VSI exhibited a unidimensional factorial structure and maintained a strong correlation with other measures of anxiety and the severity of gastrointestinal symptoms, confirming its role in enhancing the understanding and management of IBS and IBD in Italy.

This study aims to explore the differences in the psychological impact of COVID-19 on physicians, specifically those who volunteered or were contractually obligated to provide care for COVID-19 patients. While previous research has predominantly focused on the physical health consequences and risk of exposure for healthcare workers, limited attention has been given to their work conditions. This sample comprised 300 physicians, with 68.0% of them men (mean age = 54.67 years; SD = 12.44; range: 23–73). Participants completed measurements including the State-Trait Anxiety Inventory (STAI), Coping Inventory in Stressful Situations (CISS), and Coronavirus Anxiety Scale (C.A.S.). Pearson’s correlations were conducted to examine the relationships between the variables of interest. This study employed multivariate models to test the differences between work conditions: (a) involvement in COVID-19 patient care, (b) volunteering for COVID-19 patient management, (c) contractual obligation to care for COVID-19 patients, and (d) COVID-19 contraction in the workplace. The results of the multivariate analysis revealed that direct exposure to COVID-19 patients and contractual obligation to care for them significantly predicted state anxiety and dysfunctional coping strategies [Wilks’ Lambda = 0.917 F = 3.254 p < 0.001]. In contrast, volunteering or being affected by COVID-19 did not emerge as significant predictors for anxiety or dysfunctional coping strategies. The findings emphasize the importance of addressing the psychological well-being of physicians involved in COVID-19 care and highlight the need for targeted interventions to support their mental and occupational health.

Background: The absence of a national register of inflammatory bowel diseases (IBD) hinders effective health care planning in Italy. Aims: to investigate prevalence of IBD in the city of Messina, Italy, based on General Practitioner (GP) records, and to establish current treatments prescribed by different health care providers. Methods: data were extracted from GP databases with the help of disease-specific healthcare cost exemption codes combined with ICD9 codes for ulcerative colitis (UC) and Crohn’s disease (CD), and prescription for mesalazine. Disease and treatment-related data were collected together with information on employment status and the current healthcare provider. Results: Eighty-six GPs participated covering a population of 100,834 people. IBD prevalence (419/10⁵) was 80% higher than estimates of the Regional Health Authorities. Incidence showed a seven-fold increase over the past 30 years. Only 51% of CD and 26% of UC patients were followed by a dedicated IBD centre with more frequent prescriptions of immunomodulators and biologics (pConclusions: Real world data show much higher figures on IBD prevalence than administrative estimates. Differences in therapeutic approaches between IBD-specialists and non-specialists may reflect poor confidence in managing immunosuppressive therapies by the latter, but may lead to inadequate therapy and cancer surveillance.