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The "Burden of Skin Diseases" Project: a population-based study on 44,689 participants from 27 European countries. 皮肤病负担 "项目:一项针对 27 个欧洲国家 44 689 名参与者的人口研究。
Pub Date : 2025-02-01 Epub Date: 2024-05-14 DOI: 10.23736/S0026-4806.24.09262-0
Carle Paul, Alexander J Stratigos, Tamar Nijsten, Paolo Gisondi, Carmen Salavastru, Martin Röecken, Charles Taieb, Francesca Sampogna, Myrto Trakatelli, Luis Puig, Marie A Richard
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引用次数: 0
Reliability and validity of the Italian version of the Caregiver Priorities and Child Health Index of Life with Disabilities in children with cerebral palsy. 意大利语版脑瘫儿童照顾者优先事项和残疾儿童生活健康指数的可靠性和有效性。
Pub Date : 2025-02-01 Epub Date: 2024-11-27 DOI: 10.23736/S0026-4806.24.09537-5
Federica Giorgi, Nicolò Sproccati, Corrado Zenesini, Francesca R Pulvirenti, Nicoletta Battisti, Nadia Sommella, Alessandra Feliciangeli, Antonella Cersosimo

Background: The Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD™) questionnaire is a reliable indirect indicator of functional, health status and quality of life in children with severe Cerebral Palsy (CP), as well as the caregiving burden. The aim of the study is to validate the Italian translation of Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD™) questionnaire and assess its reliability and validity.

Methods: A cross-sectional study was conducted. The study involved 60 caregivers of children with CP, classified according to the Gross Motor Function Classification System (GMFCS) levels I-V. There was a self-compilation of the CPCHILD™ by primary caregivers during the clinical visit and a re-administration of the questionnaire 2-3 weeks after the first to a defined sample (N.=30, GMFCS IV-V). The Italian version of CPCHILD™'s psychometric properties were evaluated through internal consistency, test-retest reliability, and validity analyses.

Results: The translated CPCHILD™ questionnaire showed excellent test-retest reliability (Intraclass Correlation Coefficient - ICC=0.97) across most sections, with significant construct validity, differentiating well between the various GMFCS levels. The internal consistency was robust (Cronbach's alpha=0.852) except for the health section. The face validity indicated high relevance of the questionnaire items to the caregivers, particularly in emotional well-being and social interaction.

Conclusions: The Italian version of CPCHILD™ questionnaire is a reliable and valid tool for assessing the quality of life in children with severe CP, offering insights into the care burden and health status impacts perceived by caregivers.

背景:照顾者优先事项和残疾儿童生活健康指数(CPCHILD™)问卷是一项可靠的间接指标,可反映重度脑瘫(CP)儿童的功能、健康状况和生活质量,以及照顾者的负担。本研究旨在验证意大利语翻译的照顾者优先事项和残疾儿童健康生活指数(CPCHILD™)问卷,并评估其可靠性和有效性:方法:进行了一项横断面研究。研究涉及 60 名根据粗大运动功能分级系统(GMFCS)I-V 级分类的 CP 儿童的照顾者。主要照护者在临床访问期间自行编制了 CPCHILD™,并在第一次问卷调查 2-3 周后对特定样本(N.=30,GMFCS IV-V)重新进行了问卷调查。通过内部一致性、重测信度和有效性分析,对意大利语版 CPCHILD™ 的心理测量特性进行了评估:结果:翻译后的 CPCHILD™ 问卷在大多数部分都显示出极佳的重测信度(类内相关系数 - ICC=0.97),并具有显著的建构效度,能很好地区分 GMFCS 各个级别。除健康部分外,其他部分的内部一致性很好(Cronbach's alpha=0.852)。表面效度表明,问卷项目与照顾者高度相关,尤其是在情绪健康和社会交往方面:意大利版 CPCHILD™ 问卷是评估重度脊柱侧弯症儿童生活质量的可靠而有效的工具,可帮助了解护理人员所感受到的护理负担和健康状况的影响。
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引用次数: 0
Exploring the language of chronic pain stories through a Facebook page. A qualitative study on narratives and unmet needs.
Pub Date : 2025-02-01 DOI: 10.23736/S0026-4806.24.09577-6
Maria Giulia Marini, Alessandro Braga, Chiara Lattuada, Antonietta Cappuccio, Fabio Bianco Madau

Background: Dimensione Sollievo (Dimension of Relief) and its Facebook page represent a patient-centered social media initiative focused on chronic pain. This platform provides users with accurate resources on chronic pain and offers a virtual space for peer interaction - a crucial aspect for a condition often lacking proper recognition. The study's primary objective was to analyze the content in relation to unmet needs, with a secondary objective to explore the role of narrative medicine (NM) in this form of social communication.

Methods: Posts, replies, and comments from the Facebook page between 2020 and 2023 were analyzed using thematic frameworks such as Frank, Kleinmann, Launer classifications, and Berne's transactional analysis. Language styles, semantics, word frequency, and metaphors were also examined. Narratives were analyzed through Nvivo software and Microsoft Office tools.

Results: Users embraced the Facebook page as a safe space for interaction, where they found understanding and connection, unlike their experiences outside the community. While interactions were generally brief, they intensified around issues where users perceived injustices, such as the lack of recognition of their condition by medical professionals and family, and challenges in accessing benefits. Thematic analysis revealed that the most prominent theme was the dimension of disease, with many narratives expressing difficulty coping and a lack of progress.

Conclusions: The application of narrative medicine (NM) tools highlights both explicit and unconscious patient needs, such as the desire to be heard and acknowledged. This study is the first to explore NM's potential in chronic pain. Implementing NM tools through informed moderation could transform pain management culture, improving treatment approaches and enhancing the overall community experience.

背景:Dimensione Sollievo(缓解之维)及其 Facebook 页面是一项以患者为中心、关注慢性疼痛的社交媒体计划。该平台为用户提供了有关慢性疼痛的准确资源,并为同行互动提供了一个虚拟空间--这对于通常缺乏适当认识的病症来说是至关重要的。本研究的主要目的是分析与未满足的需求相关的内容,其次是探讨叙事医学(NM)在这种社交交流形式中的作用:采用弗兰克、克莱因曼、劳纳分类法和伯尔尼的事务分析法等主题框架,对 2020 年至 2023 年期间 Facebook 页面上的帖子、回复和评论进行了分析。此外,还研究了语言风格、语义、词频和隐喻。通过 Nvivo 软件和 Microsoft Office 工具对叙述进行了分析:用户将 Facebook 页面视为一个安全的互动空间,在这里他们找到了理解和联系,这与他们在社区外的经历不同。虽然互动一般都很简短,但围绕用户认为不公正的问题,如医疗专业人员和家人不承认他们的病情,以及在获取福利方面遇到的挑战,互动却愈演愈烈。主题分析表明,最突出的主题是疾病层面,许多叙述表达了应对困难和缺乏进展:叙事医学(NM)工具的应用凸显了患者明确的和无意识的需求,如希望被倾听和认可。本研究首次探索了叙事医学在慢性疼痛中的应用潜力。通过知情调节实施叙事医学工具可以改变疼痛管理文化,改善治疗方法,提高社区的整体体验。
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引用次数: 0
Correction to: Sublingual sufentanil tablet system for postoperative analgesia after gynecological surgery.
Pub Date : 2025-02-01 DOI: 10.23736/S0026-4806.24.09671-X
Yigal Leykin, Alessandro Laudani, Nicola Busetto, Gabriele Chersini, Luca F Lorini, Dario Bugada

This article was published in Volume 110 issue 3 with a mistake in the text, on page 209, when specifying the period of patient recruitment. The correct sentence is: All patients were recruited in two hospitals: Santa Maria degli Angeli (Pordenone, Italy) and Papa Giovanni XXIII (Bergamo, Italy), between July 2016 and March 2017.

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引用次数: 0
Hemoptysis of unknown origin: let's put in order the puzzle pieces. 来历不明的咯血:让我们来整理一下。
Pub Date : 2024-12-20 DOI: 10.23736/S0026-4806.24.09597-1
Francesco Gavelli, Mattia Bellan, Filippo Patrucco
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引用次数: 0
Type 2 diabetes, heart failure and the treatment of their comorbidity. 2型糖尿病、心力衰竭及其合并症的治疗。
Pub Date : 2024-12-06 DOI: 10.23736/S0026-4806.24.09264-4
Si Wang, Sheyu Li

Both heart failure and type 2 diabetes are prevalent conditions and share similar pathogenesis, risk factors, and treatment medications. This review aims to inform clinical practice by summarizing the interaction between heart failure and type 2 diabetes, as well as the medications used to manage them. Novel medications such as Sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-likepeptide-1 receptor agonists, and finerenone have been shown to protect patients with type 2 diabetes from hospitalization for heart failure. SGLT2 inhibitors have also proven effective in patients with heart failure, regardless of the presence of type 2 diabetes. When choosing diabetes treatment medications for patients with heart failure and type 2 diabetes, shared decision-making can be helpful in weighing the benefits and harms based on individual scenarios. The selection of guideline-directed medical therapy aligns with patients without type 2 diabetes. Given the rapid evolution of knowledge in this field, clinicians need to stay updated with the latest evidence to provide optimal medical care.

心力衰竭和2型糖尿病都是常见的疾病,并且有相似的发病机制、危险因素和治疗药物。本综述旨在通过总结心力衰竭和2型糖尿病之间的相互作用,以及用于治疗它们的药物,为临床实践提供信息。新型药物如钠-葡萄糖共转运蛋白2 (SGLT2)抑制剂、胰高血糖素样肽-1受体激动剂和芬纳酮已被证明可保护2型糖尿病患者免于因心力衰竭住院。SGLT2抑制剂也被证明对心力衰竭患者有效,无论是否存在2型糖尿病。在为心力衰竭和2型糖尿病患者选择糖尿病治疗药物时,共同决策有助于根据个人情况权衡利弊。指导药物治疗的选择与没有2型糖尿病的患者一致。鉴于这一领域知识的快速发展,临床医生需要跟上最新的证据,以提供最佳的医疗服务。
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引用次数: 0
Diagnosis and treatment of periorbital and orbital cellulitis in children. 儿童眼眶周围及眼眶蜂窝织炎的诊断与治疗。
Pub Date : 2024-12-06 DOI: 10.23736/S0026-4806.24.09357-1
Xing Zhang, Chen Wang, Haixia Liu, Lulin Bi, Shuxin Wen
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引用次数: 0
Application of percutaneous intervertebral foraminoscopic discectomy in lumbar disc herniation. 经皮椎间孔镜椎间盘切除术在腰椎间盘突出症中的应用。
Pub Date : 2024-12-06 DOI: 10.23736/S0026-4806.24.09403-5
Zhi Ruan, Qinzheng Fang, Xiao Zhang, Liang Shang, Hui Ma
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引用次数: 0
Pulmonary hypertension in patients affected by sleep-related breathing disorders: up to date from the literature. 睡眠呼吸障碍患者的肺动脉高压:最新文献。
Pub Date : 2024-12-01 Epub Date: 2024-07-17 DOI: 10.23736/S0026-4806.24.09112-2
Elvia Battaglia, Elena Compalati, Luca Mapelli, Agata Lax, Paola Pierucci, Paolo Solidoro, Paolo Banfi

Sleep-related breathing disorders (SBD) are conditions of abnormal and difficult respiration during sleep, including chronic snoring, obstructive sleep apnea (OSA), central sleep apnea (CSA), sleep-related hypoventilation disorders and sleep-related hypoxemia. Some of them have a limited impact on health, but others (e.g., OSA) can have serious consequences, because of their dangerous effects on sleep and the hematic balance of oxygen and carbon dioxide. According to several population-based studies, prevalence of OSA is relatively high, approximately 3-7% for adult males and 2-5% for adult females in the general population. However, methodological differences and difficulties in characterizing this syndrome yielded to variability in estimates. Moreover, it is estimated that only about 40% of patients with OSA are diagnosed, which can lead to underestimation of disease prevalence. OSA is directly correlated with age and male sex and to risk factors such as obesity. Several studies found that OSA is associated with an increased risk of diabetes, some cancer types, cardiovascular and cerebrovascular diseases, such as hypertension, coronary artery disease and stroke. Pulmonary hypertension (PH), a noted cardiovascular disease, is significantly associated with sleep-related breathing disorders and lot of scientific studies published in the literature demonstrated a strong link between these conditions and the development of pulmonary hypertension PH. PH is relatively less common than sleep-related breathing disorders. The purpose of this systematic review is to analyze both the current knowledge around the consequences that SBD may have on pulmonary hemodynamics and the effects resulting from pharmacological and non-pharmacological treatments of SDB on PH.

睡眠相关呼吸障碍(SBD)是指睡眠时呼吸异常和困难的情况,包括慢性打鼾、阻塞性睡眠呼吸暂停(OSA)、中枢性睡眠呼吸暂停(CSA)、睡眠相关低通气障碍和睡眠相关低氧血症。其中一些对健康的影响有限,但另一些(如 OSA)则会对睡眠以及氧气和二氧化碳的血液平衡产生危险影响,从而造成严重后果。根据一些基于人群的研究,OSA 的发病率相对较高,在普通人群中,成年男性的发病率约为 3-7%,成年女性的发病率约为 2-5%。然而,由于方法上的差异和对该综合征进行定性的困难,导致估计值存在差异。此外,据估计只有约 40% 的 OSA 患者得到诊断,这可能会导致疾病患病率被低估。OSA 与年龄、男性性别以及肥胖等风险因素直接相关。一些研究发现,OSA 与糖尿病、某些癌症类型、心脑血管疾病(如高血压、冠状动脉疾病和中风)的风险增加有关。肺动脉高压(PH)是一种常见的心血管疾病,与睡眠相关的呼吸紊乱有很大关系,许多发表在文献中的科学研究表明,这些疾病与肺动脉高压 PH 的发生有密切联系。与睡眠相关呼吸障碍相比,肺动脉高压并不常见。本系统性综述的目的是分析当前关于睡眠呼吸障碍可能对肺血流动力学产生的影响的知识,以及药物和非药物治疗睡眠呼吸障碍对 PH 的影响。
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引用次数: 0
Adenosine triphosphate: a new player in complex regional pain syndrome type 1. 三磷酸腺苷:1 型复杂性区域疼痛综合征的新角色。
Pub Date : 2024-12-01 Epub Date: 2024-08-05 DOI: 10.23736/S0026-4806.24.09345-5
Sergio Rosini, Stefano Rosini, Gianantonio Saviola, Luigi Molfetta

The complex regional pain syndrome type 1 (CRPS-1) is one of the most discussed painful syndromes due to the variability and severity of its symptoms. CRPS-1 generally occurs after a trauma, a fracture or a sprain followed by an immobilization. Classical diagnostic criteria are not always clear; hence, the diagnosis is difficult. The definition of CRPS itself defines and considers the pain as key symptom neglecting the bone damage. Early CRPS involves the activation of the innate cutaneous immune system with altered sensory and sympathetic signaling, activation and proliferation of keratinocytes and mast cells in addition to the release of inflammatory mediators and pain. The role of the immune system and the response to the disease is becoming clearer as the microglia is activated as a result of injury and can induce a central sensitization while astrocytes can maintain the process. Adenosine triphosphate (ATP) exerts a fundamental role in the activation of innate cutaneous immune system, in the proliferation of keratinocytes and mast cells, in the release of several proinflammatory cytokines and in the microglia activation. It is essential to intervene on this pathology as soon as possible with drugs, as clodronate, able to reduce bone marrow edema and pain through the inhibition of the primary inflammatory process and the immune reaction, limiting the activation of macrophages and the release of cytokines activating nuclear growth factor (NGF). In this review the role of ATP, bisphosphonates and rehabilitation are discussed.

1 型复杂性区域疼痛综合征(CRPS-1)是讨论最多的疼痛综合征之一,因为其症状多变且严重。CRPS-1 通常发生在外伤、骨折或扭伤后的固定后。经典的诊断标准并不总是很明确,因此诊断很困难。CRPS 的定义本身将疼痛作为主要症状,而忽略了骨骼损伤。除了释放炎症介质和疼痛外,早期 CRPS 还涉及先天性皮肤免疫系统的激活、感觉和交感神经信号的改变、角质形成细胞和肥大细胞的激活和增殖。免疫系统的作用和对疾病的反应正变得越来越清晰,因为小胶质细胞会因损伤而被激活,并能诱发中枢敏化,而星形胶质细胞则能维持这一过程。三磷酸腺苷(ATP)在先天性皮肤免疫系统的激活、角质形成细胞和肥大细胞的增殖、多种促炎细胞因子的释放以及小胶质细胞的活化中发挥着重要作用。必须尽快使用克罗膦酸钠等药物对这种病理现象进行干预,这些药物能够通过抑制原发性炎症过程和免疫反应、限制巨噬细胞的活化和激活核生长因子(NGF)的细胞因子的释放来减轻骨髓水肿和疼痛。本综述将讨论 ATP、双磷酸盐和康复治疗的作用。
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Minerva medica
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