Minerva medica最新文献

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.

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.

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.

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.

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.

Background: To translate and cross-culturally adapt the Parkinson's Disease Caregiver Burden questionnaire (PDBC) into Italian language and to evaluate the psychometric properties of the Italian version in terms of test-retest reliability, internal consistency, and construct validity.

Methods: The PDBC-I was developed by forward-backward translation to establish correspondence with the original English latest version. Psychometric properties were estimated in a sample of primary caregivers of individuals with Parkinson's disease. Reliability testing included internal consistency (Cronbach's alpha), test-retest reliability (ICC), the standard error of measurement (SEM) and the minimal detectable change (MDC), also expressed as percentage (MDC%). Validity was estimated by comparing the PDBC -I to the Caregiver Burden Inventory (CBI) and the Short Form 36 (SF-36) (Pearson correlation coefficient).

Results: The questionnaire was administered to 65 caregivers, showing internal consistency of 0.934. ICC value was 0.811 (95% CI 0.708-0.880) for test-retest reliability, and the SEM and the MDC (MDC%) were 5.04 and 13.97 (38.21%), respectively. Low to moderate correlation with all other investigated scales (CBI: r=0.693; SF-36 physical score: r=-0.309; SF-36 mental score: r=-0.588; SF36 total score: -0.470) were found.

Conclusions: Despite the PDCB-I holds acceptable psychometric properties to be used in clinical settings of Italian-speaking Countries as a measure of caregiver burden in caregivers of individuals with Parkinson Disease, the caregiver might require the support of a clinician to finalize the compilation of the questionnaire.

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously nonalcoholic fatty liver disease (NAFLD), is the number one chronic liver disorder worldwide. Progression to advanced fibrosis marks the emergence of a significant risk of liver-related negative outcomes. However, only a minority of patients will present at this stage. Since widespread liver biopsy in unfeasible at such high disease prevalence, there was a need to develop noninvasive tests (NITs) that could easily and reliably be applied to patients with MASLD, regardless of clinical setting. The NITs include simple scores, like the fibrosis-4 (FIB-4) Index, patented serum tests, like the Enhanced Liver Fibrosis test (ELF™), and imaging-based modalities, like the vibration-controlled transient elastography (VCTE). Guidelines suggests a stepwise approach that utilizes more than one NIT, with FIB-4 <1.30 being used as a first step to rule out patients that do not need further testing. Subsequent choice of NIT will be influenced by setting, cost, and local availability. While these NITs are accurate, they are not perfect. As such, research is ongoing. A promising avenue is that of omics, a group of technologies that provide concomitant results on a large number of molecules (and other variables). With the advance of artificial intelligence, new NITs may arise from large demographic, biochemical, and radiological data sets.