Effects of esters' cetylated fatty acids taping for chronic neck pain with mobility deficit in patients with breast cancer.

PURPOSE: To evaluate the effects of a protocol treatment based on inelastic adhesive tape with cetylated fatty acids (CFAs) esters in breast cancer survivors with chronic neck pain. METHODS: In this observational study, patients have been visited for chronic neck pain using numeric rating scale (NRS) for pain assessment, Neck Disability Index (NDI) for disability caused by neck pain, and range of movement (ROM) measures for cervical mobility. Scales have been performed at T0, after 15 days of treatment (T1) and successively after 15 days of stop treatment (T2). Patients have been treated with an inelastic adhesive tape with CFA esters (Cetilar® Tape, Pharmanutra Spa, Italy) positioned, 8 h/day for 15 days, on specific anatomic sites (upper trapezius, paravertebral cervical muscles, sub-occipitals, and/or levator scapulae muscles). RESULTS: Forty-five patients were included in the study. A statistically significant reduction in pain has been reported from T0 to T1 and maintained at T2 (p < 0.05); a statistically significant improvement in the mobility of the cervical spine, as evidenced by ROMs, and in disability, as resulted by Neck Disability Index, have been reported from T0 to T1 and maintained at T2; moreover, ROM at T0 correlates inversely and statistically significantly with NRS and all NDI variables at T0, similarly at T1 and T2 (p < 0.001). CONCLUSIONS: CFA ester taping is a simple, effective, and side-effect-free treatment in order to reduce pain and improve cervical mobility in breast cancer survivors with chronic neck pain.

Noninvasive Interactive Neurostimulation Therapy for the Treatment of Low-Grade Lateral Ankle Sprain in the Professional Contact Sport Athlete Improves the Short-Term Recovery and Return to Sport: A Randomized Controlled Trial.

Ankle injuries are very common between professional athletes and recreational sports. Lateral stable ligaments injury can be treated conservatively. Noninvasive interactive neurostimulation (NIN) is a form of electric therapy that works by locating areas of lower skin impedance. The objective of this prospective, double-blinded, randomized controlled trial was to compare the results in terms of improvement of a foot functional score, lower level of reported pain, and return to sports in 2 groups of contact sport athlete affected by a grade I or II lateral ankle sprain. Patients were randomized using random blocks to the NIN program (group I) or a sham device (group II). The outcome measurements were the use of a self-reported Inability Walking Scale, patient-reported subjective assessment of the level of pain using a standard visual analogue scale, and daily intake of nonsteroidal antiinflammatory drugs (etoricoxib 60 mg). Patients were also reached by telephone at 2 and 4 months of follow-up to register their return to sport activity. Beyond baseline evaluation, follow-ups were done after 5 (1 week) and 10 sessions (2 weeks) of treatment, and then at 30 days after the end of therapy. Of the 70 athletes admitted to the study, 61 eligible patients were randomized using random blocks to group I (n = 32) and group II (n = 29). Group I patients showed better improvement in terms of functional impairment (Inability Walking Scale), reported pain (visual analogue scale), and daily intake of etoricoxib 60 mg. Athletes of group I registered a faster resuming of sport activities. This prospective, randomized trial showed NIN can improve short-term outcomes in athletes with acute grade I or II ankle sprain and that it can hasten resuming of sport activities.

Validity and reliability of Italian version of the Non-Communicating Children's Pain Checklist: revised version.

BACKGROUND: The Non-Communicating Children Pain Check List-Revised (NCCPC-R) is a clinical assessment tool used to assess and measure pain in children aged 3 to 18 years, with mental and intellectual disabilities, incapable to speak. AIM: Aim of our study was to test the validity and reliability of the Italian version of the NCCPC-R in children with cognitive impairment, in order to obtain a valid tool for pain assessment in these children. DESIGN: Prospective observational study. SETTING: Pediatric Outpatient of Physical and Rehabilitative Medicine Department, and Pediatrics, Child Neurology and Psychiatry Department, Sapienza University, Rome. POPULATION: 55 non-communicating children, with severe intellectual disability, aged 3-18 years. METHODS: The guidelines for "translation, adaptation, and validation of instruments or scales for cross-cultural healthcare research" were used to translate the scale, which was administered by the parents/caregivers twice for 2 consecutive days, in association with NRS (Numerical Rating Scale). The reliability of the scale was evaluated using the intra and inter-class correlation coefficient (ICCs); Cronbach alpha coefficient was used to test the internal validity of the scale; "Receiver Operating Characteristic" (ROC) curves were used to compare pain-free scores with pain scores, determining threshold scores; Pearson correlation between NCCPC-R and NRS values was measured. RESULTS: The InterCC between the first and the second interviewer at T0 was 0,97, the IntraCC of the first interviewer at T0-T1 was 0,89, showing a high correlation; the Cronbach alpha coefficient at T0 was 0,97, showing a high scale's validity. Pearson correlation between NRS and NCCPC-R values at T0 was 0,54 showing a medium level of agreement (P<0,0001). AUC (area under the curve) obtained by ROC curve at T0 was 0,807 (P=0,001), with sensitivity 95,2 and specificity 55,6, while a T1 AUC was 0,814 (P<0,001), with sensitivity 86,49, specificity 78,57. CONCLUSIONS: The Italian version of NCCPC-R scale could be used to asses pain in non-communicating patients with mental and intellectual disabilities, showing a good correlation when compared to the NRS. CLINICAL REHABILITATION IMPACT: The use of NCCPC-R scale in daily life made parents/caregivers able to discriminate the presence/absence of pain in non-communicating children, based on the scores obtained with the questionnaire.

Mobility recovery after arthroscopic rotator cuff repair.

BACKGROUND: Mobility recovery after arthroscopic rotator cuff repair in different tears size. AIM: To investigate, after arthroscopic rotator cuff repair, the range of motion (ROM) progression in different sized tears (small, large and massive), and evaluating ROM changes in the pre- and postoperative periods of each group. DESIGN: Cohort study. SETTING: Policlinico Umberto I, "Sapienza" University, Rome, Italy. POPULATION: Ninety-two patients with reparable rotator cuff tears. METHODS: Patients were divided in three groups: group A (small lesions), group B (large lesions) and group C (reparable massive lesions) composed by 29, 31 and 32 patients, respectively. ROM were measured preoperatively (T0), and after 45 (T1), 70 (T2) and 100 (T3) days after the arthroscopic treatment. RESULTS: From T0 to T3, small lesions are associated to excellent results, with an improvement of all parameters; the same in patients with large lesions, except for flexion parameter; in reparable massive lesions only external and internal rotation improved. CONCLUSIONS: Not all parameters recover in the same way: postoperative rehabilitative protocol is an integral contributor to favorable outcomes in patients with rotator cuff tears. CLINICAL REHABILITATION IMPACT: The knowledge about ROM recovering after arthroscopic rotator cuff repair is a strategic information for the patient, as well as for the surgeon and physiatrist.

Assessment of the Combined Efficacy of Needling and the Use of Silicone Gel in the Treatment of C-Section and Other Surgical Hypertrophic Scars and Keloids.

OBJECTIVE: To evaluate the individual effectiveness of needling therapy using the Dermapen (Dermapen, Salt Lake City, Utah) and topical therapy with silicone gel (Kelo-cote, Sinclair Pharma, London, England), and their combined effectiveness for the treatment of linear surgical scars, hypertrophic scars, and keloids. MATERIALS AND METHODS: Twenty patients were randomly selected and equally divided into 2 groups (A and B), with each group of 10 including 6 patients with keloids and 4 with hypertrophic scars. Treatment assignments were random. In group A, the entire scar was treated by skin needling, with silicone gel applied to half of the scar. Patients in group B were treated with silicone gel on the whole scar, with only half of the scar also treated with skin needling. During follow-up visits, clinical photographs, evaluation of the scars' thickness, skin ultrasound, and modified Vancouver Scar Scale were performed. RESULTS: Group A showed an average improvement of 68% (P < .01) on the half of the scar with the combination treatment (skin needling plus silicone gel) compared with a 52% improvement on the half of the scar that was treated with only skin needling. Group B showed an average improvement of 63% (P < .01) where the combination treatment was performed, compared with 47% improvement on the area treated with only the silicone gel. CONCLUSIONS: In conclusion, the combination of these 2 treatments is safe and effective for the treatment of hypertrophic scars and keloids. These modalities achieved favorable results with each patient adhering to the study paramenters.

Acne smart club: an educational program for patients with acne.

OBJECTIVE: To evaluate adherence to therapy in acne patients using mobile phones and Short Message Service (SMS) to communicate. METHODS: 160 patients were randomly assigned to two groups: the SMS group received 2 text messages twice a day for a period of 12 weeks; the control group did not receive any messages. Before and after 12 weeks, the following evaluations were performed in all patients: digital photographs, the Global Acne Grading System, the Dermatology Life Quality Index, the Cardiff Acne Disability Index, the doctor-patient relationship evaluated through the Patient-Doctor Depth-of-Relationship Scale, and the adherence to treatment evaluated by asking patients how many days a week they had followed the therapy. For statistical analysis we used Student's t test. RESULTS: The SMS group had a better improvement of all parameters compared to the control group. CONCLUSION: Adherence and compliance are higher for patients who are included in a strategy of control.

[Experimental prospective cognitive study on the evaluation of connection of fatigue perception and depression among caregivers and team treating cancer patients receiving oral chemotherapy to systemic chemotherapy. Equi-Car 10 study]. / Studio sperimentale prospettico conoscitivo di valutazione della relazione della percezione di fatigue e depressione tra caregiver, equipe curante e pazienti oncologici in trattamento chemioterapico con terapie somministrate per via orale verso terapie somministrate per via sistemica Studio Equipe-Caregivers 10 (Studio Equi-Car 10).

OBJECTIVE: The Equi-Car 10 is an spontaneous, observational study. The objective was to assess the connection of fatigue perception and depression of caregivers, oncological team and oncological patients in oral chemotherapy to intravenous METHOD: The study recruited 60 patients and 60 caregivers. The study was carried out on patients with lung, breast and colon cancer requiring chemotherapy, and family members were chosen as caregivers. Patients, caregivers and doctors filled in FACT-F and Zung questionnaires at the opening day of the medical record, after three and six cycles of chemotherapy, and three months after the end of the treatment. RESULTS: The Zung depression and Functional Assessment of Cancer therapy-Fatigue (FACT-F) showed: (a) on patients treated with intravenous therapy showed significantly higher levels of fatigue and depression than those of patients treated with oral therapy, even when the latter were treated for advanced disease; (b) on caregivers of patients treated with systemically administered therapies showed elevated levels of Fatigue and depression which proved to be significantly higher than those of caregivers of patients treated with oral therapies, even when treated for advanced disease; (c) on three oncologist has highlighted low levels of Fatigue and depression, for both types of patients, higher for patients with systemic therapy related to the management of side effects. CONCLUSIONS: The results showed that cancer patients and caregivers have high levels of fatigue and depression both related to the disease stage and to the mode of drug administration. It is necessary to provide cancer patients and caregivers with appropriate psychological support and preventive programs for secondary and relapse prevention.