Internalization of the Western Standard of Beauty and Body Satisfaction: Evaluation Utilizing COPS and SATAQ-3 Questionnaires among Girls with Scoliosis.

Background and Objectives: Patients with adolescent idiopathic scoliosis (AIS) more frequently present significant back-related body image disturbances compared with healthy controls. The study aimed to adapt two screening questionnaires: Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-3) and Cosmetic Procedure Screening Questionnaire (COPS), that could identify AIS patients, especially those threatened with body image disorders and might predict dissatisfaction with a desired-by-patients cosmetic result of treatment. Materials and Methods: In total, 34 AIS patients who undergo Cheneau brace treatment were asked to complete SATAQ-3 and COPS. Results: AIS patients presented a high level of internalization. Clinical and radiological factors that play a crucial role in the evaluation and decision process during brace treatment were not significantly associated with COPS and SATAQ-3 total scores. The SATAQ-3 total score and COPS results were also not related to sociodemographic parameters of the analyzed group. Conclusions: The presented study confirms the usefulness of the questionnaires, which aimed to isolate sociocultural risk factors of body image disorders in scoliosis patients as predictors of treatment dissatisfaction and worse compliance.

Prevalence of Emotional Eating in Groups of Students with Varied Diets and Physical Activity in Poland.

BACKGROUND: Emotional eating (EE) is not a separate eating disorder, but rather a type of behavior within a group of various eating behaviors that are influenced by habits, stress, emotions, and individual attitudes toward eating. The relationship between eating and emotions can be considered on two parallel levels: psychological and physiological. In the case of the psychological response, stress generates a variety of bodily responses relating to coping with stress. OBJECTIVE: Therefore, the main objective of this study was to evaluate and compare the prevalence of emotional eating in groups of students in health-related and non-health-related fields in terms of their differential health behaviors-diet and physical activity levels. MATERIAL AND METHODS: The cross-sectional survey study included 300 individuals representing two groups of students distinguished by their fields of study-one group was in health-related fields (HRF) and the other was in non-health-related fields (NRF). The study used standardized questionnaires: the PSS-10 and TFEQ-13. RESULTS: The gender of the subjects was as follows: women, 60.0% (174 subjects) (HRF: 47.1%, n= 82; NRF: 52.9%, n = 92); men, 40.0% (116 subjects) (HRF: 53.4%, n = 62; NRF: 46.6%, n = 54). The age of the subjects was 26 years (±2 years). Based on the results of the TFEQ-13, among 120 subjects (41.4%) there were behaviors consistent with limiting food intake (HRF: 72.4%; NRF: 11.0%), while 64 subjects (20.7%) were characterized by a lack of control over food intake (HRF: 13.8%, 20 subjects; NRF: 27.4%, 20 subjects). Emotional eating was characteristic of 106 students (37.9%), with the NRF group dominating (61.6%, n = 90). It was observed that a high PSS-10 score is mainly characteristic of individuals who exhibit EE. CONCLUSIONS: The results obtained in the study indicate that lifestyle can have a real impact on the development of emotional eating problems. Individuals who are characterized by elevated BMI values, unhealthy diets, low rates of physical activity, who underestimate meal size in terms of weight and calories, and have high-stress feelings are more likely to develop emotional eating. These results also indicate that further research in this area should be undertaken to indicate whether the relationships shown can be generalized.

Prevalence of Orthorexia in Groups of Students with Varied Diets and Physical Activity (Silesia, Poland).

(1) Background: The literature emphasizes the role of many factors influencing the onset of eating disorders (EDs) and their mutual influence on each other. Therefore, this study aimed to evaluate and compare the prevalence of orthorexic behaviors in groups of health-related and non-health-related students in terms of their differential health behaviors-diet and physical activity levels. (2) The study included 300 individuals representing two equal groups of fields of study, which for the study were called the health-related field (HRF) and the non-health-related field (NRF). (3) Results: Based on the results of the dietary assessment, it was found that the best dietary model was characterized by the HRF group; in this group, 97.2% of students were characterized by a very good and good dietary mode. The NRF group, on the other hand, was dominated by a sufficient dietary mode for 64.4% of all cases in this group (94 people), while the dietary model marked as "good" was less popular, at 24.6% of this group (36 people). (4) Conclusions: Based on the cited self-research and information from the literature, it can be concluded that the problem of orthorexia is still a new issue at the level of social sciences, medical sciences, and health sciences. The psychometric tools used in this study allowed us to demonstrate the prevalence of the aforementioned eating disorders in the sample groups of students.

Psychometric Evaluation of the Polish Version of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD).

Purpose: The assessment of the quality of life is an important element of the clinical examination of the patient. The aim of this study was translation and cross-cultural adaptation of the "Caregiver Priorities and Child Health Index of Life with Disabilities" (CPCHILD) questionnaire into Polish language, and testing of reliability and validity of the CPCHILD-PL for children with cerebral palsy (CP). Material and Methods: A Polish version of CPCHILD was created according to internationally accepted guidelines. Parents (n=77) of 51 boys/26 girls between 3 and 17 years with CP with Gross Motor Function Classification System I-V (GMFCS I-V) participated. To assess the reliability each domain and the total measure was tested for internal consistency and test-retest reliability. Convergent validity was evaluated by correlating the CPCHILD-PL with the CHAQ (Childhood Health Assessment Questionnaire) questionnaire. Results: Test-retest reliability assessed by Spearman correlation coefficient for the final result of CPCHILD-PL and for most of domains were above 0.90. The values of Cronbach's-α coefficient (measuring internal consistency) were high for all domains (except for domain 5: Health) and the entire CPCHILD-PL, with the range 0.88-0.96. The comparison between CPCHILD-PL and the Disability Index (DI) of the CHAQ showed a negative correlation. The higher the DI, the lower the CPCHILD result. The Spearman's rank coefficient was -0.75. Conclusion: The Polish version for the CPCHILD for children with CP seems to be reliable and valid tool for assessing health-related quality of life from the caregiver perspective. It can be used in research and clinical practice for evaluation and comparison of health-related quality of life in children with CP in different countries.

Temporomandibular Joint Disorders in Females with Adolescent Idiopathic Scoliosis: Long-Term Effects of Milwaukee Brace Treatment.

Patients with adolescent idiopathic scoliosis (AIS) more frequently suffer dysfunctions of dento-skeletal complex. To our knowledge, no study has ever evaluated the temporomandibular joint disorders (TMD) of AIS patients at least 23 years after the completion of Milwaukee brace treatment. We aimed to provide a complex assessment of TMD and AIS patients treated with a Milwaukee brace, in a minimum 23-year follow-up, using radiological, clinical, and socio-demographical data, and to adapt the TMD Disability Index Questionnaire (TMDQ) and Fonseca's questionnaire (FQ) to Polish conditions. In total, 42 healthy females and 30 AIS patients with a minimum of 23 years after a completed Milwaukee brace treatment were asked to complete the Polish version of (TMDQ-PL) and (FQ-PL). AIS patients present higher TMD levels than healthy controls. Significant differences exist between TMDQ-PL and FQ-PL (both in total scores and particular sub-sections), and AIS patients. Clinical and radiological factors affected the TMDQ-PL and FQ-PL results. Adult patients with scoliosis treated conservatively present limitations in everyday activities connected with the temporomandibular joint (TMJ). The variety of curve-related factors in a long-term follow-up of wearing the Milwaukee brace influence TMJ.

Trabecular bone remodelling in the femur of C57BL/6J mice treated with diclofenac in combination with treadmill exercise.

PURPOSE: Analgesic treatment with diclofenac deteriorates bone structure and decreases biomechanical properties. This bone loss has been though to be reversed by training. The impact of exercise on bone treated with diclofenac (DF) has reminded elusive. In the present study, we assayed the combined impact of exercises and DF on mouse femur. METHODS: The femur samples we obtained from 30 days treated C57BL/6J female mice. The training group ran on a horizontal treadmill at 12 m/min by 30 min a day (5% grade/slope). The group of ten mice treated with DF received the drug subcutaneously every day (5 mg/kg of body weight/day). The combined group ran on the treadmill and obtained DF. After 30 days, we sacrificed mice and studied their femurs using microcomputed tomography (µCT), dynamic mechanical analysis (DMA) and nanoindentation. RESULTS: We observed that treadmill running and DF decreased trabecular bone volume and mineral density. Combined effect of training and DF was not additive. A significant interaction of both parameters suggested protective effect of training on bone loss provoked by DF. The femur cortical bone shell remained untouched by the training and treatment. The training and the DF treatment did not alter the storage modulus E' significantly. The unchanged storage modulus would be suggesting on the unaltered bone strength. CONCLUSIONS: We concluded that even relatively short time of training with concomitant DF treatment could be protective on trabecular bone. Although viscoelastic properties of the entire femur were not modulated, femur trabecular tissue was thinned by treatment with DF and protected by training.

Differences in beliefs about pain control after surgery due to lumbar or cervical discopathy and degenerative spine disease.

BACKGROUND: Clinical, psychological and demographic variables have been investigated to determine factors involved in quality of life of patients with chronic pain. It has been stressed that chronic pain is more associated with beliefs about pain, than with pain intensity. OBJECTIVE: The main aim of this retrospective cross-sectional study was to examine differences between postoperative beliefs about pain control, perception of pain and mood disturbances in patients treated operatively due to neck or lumbar discopathy and degenerative spine disease. METHODS: Forty-four patients treated operatively due to lumbar and forty-one patients treated surgically due to cervical discopathy filled in the Visual Analogue Scale (VAS), The Beck Depression Inventory (BDI-PL) and Beliefs about Pain Control Questionnaire (BPCQ-PL). Patients with lumbar and cervical discopathy additionally completed disease-specific outcome measures. RESULTS: The patient groups do not differ significantly in regards to BPCQ-PL, BDI-PL or VAS. Both study samples differ in regards to dependencies related to beliefs that pain is controlled by powerful others and about internal control of pain. CONCLUSIONS: Cognitive-behavioral interventions, concerning depression and beliefs about pain control, may be appropriate for both lumbar and cervical surgical populations, to improve post-surgical functioning.

Does rigid spinal orthosis carry more psychosocial implications than the flexible brace in AIS patients? A cross-sectional study.

BACKGROUND: A small body of data exists concerning psychosocial issues in adolescent idiopathic scoliosis (AIS) subjected to soft braces. No study was yet performed on the detailed psychosocial implications in AIS patients. OBJECTIVE: To compare the psychosocial implications of the flexible SpineCor with the Cheneau orthosis in AIS females. METHODS: Patients (aged 10-18 years) deliberately assigned to undergo SpineCor (SC group, 30 patients) or Cheneau brace (Ch group, 41 patients) intervention completed the Scoliosis Research Society-22 (SRS-22), the Spinal Appearance Questionnaire (SAQ), the Brace Questionnaire (BrQ) and the Pediatric Outcomes Data Collection Instrument (PODCI). RESULTS: Concerning the BrQ, study groups differ in regards to emotional functioning (p= 0.014), vitality (p= 0.022) and social functioning (p= 0.048), indicating better functioning in the Ch group. Considering the SAQ, the Ch group assesses body curve (p= 0.024) less critically. Regarding the PODCI, the Ch group scored higher in the Global Functioning Scale (p= 0.023), the Upper Extremity and Physical Function Scale (p= 0.000), the Transfer and Basic Mobility Scale (p= 0.088), the Pain/Comfort Scale (p= 0.009) and the Happiness Scale (p= 0.022). CONCLUSIONS: This study shows that patients treated with the rigid brace assess their vitality, physical function, emotional and social functioning better and are less critical towards body curve, in comparison to patients treated with the SpineCor.

Long-term effects of conservative treatment of Milwaukee brace on body image and mental health of patients with idiopathic scoliosis.

We aimed to provide a complex assessment of adult females with adolescent idiopathic scoliosis (AIS) after a minimum of 23 years after completed Milwaukee brace treatment. In the present study, a comparison between healthy female and AIS patients' perception of trunk disfigurement, self-image, mental health, pain level and everyday activity was made. Thirty AIS patients with a mean of 27.77 yrs (SD 3.30) after the treatment were included in the study. The control group consisted of 42 females, matching the age profile of the patient group. Study participants from both groups were examined using the same protocol, except for the radiological evaluation. Patients and healthy controls completed the Polish versions of the Scoliosis Research Society (SRS-22) and Spinal Appearance Questionnaire (SAQ). Patients additionally filled the Bad Sobberheim Stress Questionnaire-Deformity (BSSQ-Deformity) and Bad Sobberheim Stress Questionnaire-Brace (BSSQ-Brace). The study group's SAQ results differ significantly in regard to the total score and all individual domains, indicating better functioning among healthy controls. Except for the General domain (p = 0.002), among the remaining subscales the study group's results differed significantly at p<0.001. Considering SRS-22 results, it was revealed that the patient group scored higher, signaling better functioning with reference to pain level (p = 0.016), function/activity (p<0.001) and the total score (p<0.001). The findings add to the complexity of long-term effect evaluations of AIS, particularly amongst females treated with a Milwaukee brace. Long-term results were not conclusive in terms of nonverbal assessment of body image and emotional tension regarding the experiences of brace-wearing. Future patients can be reassured that scoliosis treated conservatively does not negatively affect everyday activity, pain level, childbearing and mental health. Subjects who declared to have psychological problems due to scoliosis had a bigger curve size after treatment and in this study than the other AIS patients.

Back and neck pain and function in females with adolescent idiopathic scoliosis: A follow-up at least 23 years after conservative treatment with a Milwaukee brace.

We aimed to explore the long-term outcomes of back and neck pain and functionality in adult females with adolescent idiopathic scoliosis (AIS), who had been treated with a Milwaukee brace, in a follow-up study a minimum of 23 years after the completion of the treatment, using radiological, clinical and socio-demographical data. Thirty AIS patients (scoliosis group-SG), were included in the study based on an extensive search of Pediatric Orthopedics and Traumatology Clinic charts. All treatments were successfully completed between 1974 and 1990. In all cases, scoliosis had not been detected before the age of 10 and was not combined with any major spinal deformities at the time when the brace treatment was implemented. In those patients, the Risser sign 4 and minimum two years post-menarche was defined as a maturity, after that time the brace treatment was completed. Patients were excluded from the study if they, at the time of the follow-up examinations, suffered from any other disease leading to trunk deformity. Forty patients met the criteria for inclusion, but due to change some personal details, not all of them were contacted. Finally, 30 women returned for a follow-up evaluation. Patients' follow-up period was mean 27.77 yrs. ± SD 3.30 (range 23-35). Curvature change from the end of the treatment until the present day was mean 9.1 degrees ± SD 7.64 (range 0-27). A control group of 42 healthy females (healthy controls group-HG) matching the age profile of the patient group was randomly selected for comparative purposes.Both SG and HG completed the Polish versions of the Revised Oswestry Lower Back Pain Disability Index (RODI), the Rolland-Morris Questionnaire (RMQ), the Quebec Back Pain Disability Scale (QDS), the Neck Disability Index (NDI) and the Copenhagen Neck Functional Disability Scale (CNFDS). Descriptive statistics were calculated for demographics and baseline questionnaire scores. To determine if the investigated sample sizes are equivalent, the chi-square test was used. The chi-square test was used to compare qualitative features between persons with scoliosis and healthy controls. In addition, a Mann-Whitney test was utilized to compare differences between both groups in regard to quantitative characteristics. To establish relations between quantitative data such as e.g. age, duration of brace application, apical translation, Cobb angle, and questionnaire results, we used Spearman's rank correlation (marked as rS). To determine dependency between quantitative and qualitative characteristics, e.g. between questionnaire numerical data and marital status, place of residence or curve type, ANOVA Kruskal-Wallis test was used. A p<0.05 indicates statistical significance. Statistical calculations were performed by Statistica software. In regards to RODI, RMQ, QDS, NDI and CNFDS (both for total scores and particular sub-sections), statistically significant differences (p <0.001) between both samples were found, indicating higher levels of pain and neck and lower back pain-related disability among persons with scoliosis. Associations exist between RODI and RMQ (rS = 0.76) QDS (rS = 0.70), NDI (rS = 0.69) and CNFDS (rS = 0.60). RMQ was associated with QDS (rS = 0.71) and NDI (rS = 0.69), whereas QDS correlated with NDI (rS = 0.80) and CNFDS (rS = 0.60). NDI was also associated with CNFDS (rS = 0.81). Persons with scoliosis treated in adolescence with a Milwaukee brace display significant restrictions in everyday activities, due to lower back pain (LBP) and neck-related disabilities, compared to healthy controls. In addition, back pain is associated with curve progression in long-term follow-up after conservative treatment. Moreover, LBP-related disability coexists with restrictions experienced due to neck pain.

Mental health and adjustment to juvenile idiopathic arthritis: Level of agreement between parent and adolescent reports according to Strengths and Difficulties Questionnaire and Adolescent Outcomes Questionnaire.

The aims of this study were threefold. Firstly, to analyze the psychometric properties of the Polish-language Pediatric Outcomes Data Collection Instrument (PODCI) questionnaire in the self-report Adolescent Outcomes Questionnaire (adolescents, 11-18 years of age) and in the parent-report Adolescent Outcomes Questionnaire (completed by a parent or guardian of an adolescent aged 11-18 years). Secondly, to determine the level of agreement between parents and adolescents in rating dysfunction in juvenile idiopathic arthritis (JIA) and thirdly, to examine associations between psychological adjustments of patients to JIA and disease as well as their socio-demographic characteristics. The study sample consisted of 52 participants. 26 adolescents between the ages of 11 and 18 years with a diagnosis of JIA and 26 parents were considered for inclusion. Disease course was classified as pauciarticular (n = 12, 46.2%) and polyarticular (n = 14, 53.8%). Participants completed the PODCI (self- and parent- report) twice and the Strengths and Difficulties Questionnaire-25 (SDQ-25). Considering the distribution of results regarding PODCI normative scores, 73.1% of parents and 69.2% of patients scored below 50 on the Global Functioning Scale; that is lower than the average for the general healthy population. Regarding the parent report, the total score of the SDQ-25 equaled 11.86 (SD 2.66), whereas the patient report equaled 11.23 (SD 2.78). The study groups do not differ significantly in regards to either the PODCI or the SDQ-25 results. Parents and adolescents with JIA appear to hold very similar perceptions of patients' health. Greater differences emerge as disease severity and age of patients increase. Excellent internal consistency, intrarater and test-retest reliability of the Global Functioning Scale have been confirmed in the Polish version of the PODCI, the questionnaire may therefore aid identification of patients reporting significant problems in this group.

The Pediatric Outcomes Data Collection Instrument for a Polish sample with juvenile idiopathic arthritis: psychometric properties of proxy version.

AIM: The aims of the study were to investigate the psychometric properties of the Pediatric Outcomes Data Collection Instrument (PODCI) for parents of children aged 2-10 years, in a Polish sample of juvenile idiopathic arthritis and to compare the results from children with chronic arthritis to the results from a normative sample. METHODS: The sample consisted of the parents of 29 (72.5%) girls and 11 (27.5%) boys. The ages of the children ranged from 2 to 10 years (mean 6.50, standard deviation [SD] 2.63). Disease course was classified as oligoarticular (n = 26, 65%) and polyarticular (n = 14, 35%). Parents who took part in the intrarater reliability study completed the Polish version of PODCI twice. The PODCI consists of the following subscales: Upper Extremity and Physical Function, Transfer and Mobility Tasks, Sports/Physical Functioning, Pain/Comfort, and Happiness. A Global Functioning Scale consists of the mean of the 'mean of items' values for the first four scales. RESULTS: The mean standarized Global Functioning Scale was 81.79 (SD 13.45), whereas the mean normative Global Functioning Scale score equaled 33.65 (SD 18.19). Cronbach's alpha value of the Global Functioning Scale was excellent and equaled 0.81. The effect size concerning the Global Functioning Scale equaled 0.123. Test-retest reliability equaled 0.98, whereas intrarater reliability (intraclass correlation coefficient) equaled 0.99. CONCLUSIONS: The translation and cross-cultural adaptation of the PODCI questionnaire provides a Polish equivalent to assess physical function in children with chronic arthritis.

Kinesiophobia in pre-operative patients with cervical discopathy and coexisting degenerative changes in relation to pain-related variables, psychological state and sports activity.

BACKGROUND: No research group has ever investigated the level of kinesiophobia in a well defined group of preoperative patients treated due to cervical discopathy and degenerative spine disease, confirmed by X-ray and magnetic resonance imaging (MRI) examinations. We aimed to investigate the degree of kinesiophobia and the differences in pain-related and psychosocial characteristics between patients with high and low levels of kinesiophobia, in relation to factors commonly associated with neck pain. MATERIAL/METHODS: Sixty-five consecutive patients with cervical discopathy and coexisting degenerative changes were assessed pre-surgically. The mean pain duration was 31.7 SD 34.0 months. Patients completed the Polish versions of the Tampa Scale for Kinesiophobia (TSK-PL) on 2 occasions, and the following once: Neck Disability Index (NDI-PL), State-Trait Anxiety Inventory (STAI-PL), Coping Strategies Questionnaire (CSQ-PL), and the Visual Analogue Scale (VAS-PL). RESULTS: A high level of kinesiophobia was indicated in 81.5% and 87.7% of patients in first and second completion, respectively. Patients with high and low kinesiophobia differ in regards to the recreation section of NDI-PL (p=0.012), gender (p=0.043), and sports activity (p=0.024). Correlations were identified between TSK-PL and marital status (p=0.023) and sports activity (p=0.024). CONCLUSIONS: Kinesiophobia levels are higher in patients with chronic cervical pain before surgical treatment. Fear of movement tends to be higher in women and among patients avoiding sports recreation before surgical treatment. Although sports activity and socio-demographic data are predictors of kinesiophobia, psychological, pain-related, and clinical data are not. These findings should be considered when planning rehabilitation after surgical treatment of cervical discopathy and coexisting degenerative changes.

Isokinetic evaluation of knee joint flexor and extensor muscles after tibial eminence fractures.

The aim of the study was to evaluate the knee joint function in adolescent patients following operative treatment - fixation via arthroscopic or open surgery (arthrotomy), due to tibial eminence fractures. 28 patients, aged from 7 to 16 years, treated operatively between 1994-2009 in four orthopeadic centres underwent evaluation. Evaluation was performed 12-180 months following surgery. Patients were divided into two groups depending on the operative treatment received. Group A consisted of 14 patients who underwent arthroscopic reduction and stabilization. Group B consisted of 14 patients who were treated by open reduction (artrothomy) and stabilization. The results of clinical and radiological examinations and isokinetic tests used in the evaluation declared that operative treatment due to tibial eminence fracture, regardless of surgical method used, does not significantly disrupt knee joint function resulting in a slight weakening of knee joint extensor muscle strength.

Patients' and Parents' Perceptions of Appearance in Scoliosis Treated with a Brace: A Cross-Sectional Analysis.

The perspective of trunk deformity is a matter of special concern for adolescent idiopathic scoliosis (AIS) patients. No research group has ever reported interviewing patients and their parents regarding differences in perception of body appearance in the course of Cheneau brace treatment. We aimed to investigate the level of agreement in the field of concerns and perceptions of spinal appearance in relation to brace- and scoliosis-related data between parents and female patients with AIS, treated with a Cheneau brace, by means of the Spinal Appearance Questionnaire-pl (SAQ-pl). In this cross-sectional study forty-one pairs of parents and female patients with AIS were asked to separately complete the Polish versions of the Spinal Appearance Questionnaire-pl patient form (SAQ-pl patient form) and the SAQ-pl parent form. Age of patients was 13.60 years SD 1.60 (range 10-17). Patients scored 2.70 (SD 0.60) and parents scored 2.70 SD 0.60 in the total score of the SAQ-pl. The study groups do not differ significantly in regards to the SAQ-pl results. The percentage of consistent answers on SAQ-pl items ranges from 34.10 % (item 20) to 78 % (item 8). Height, age and brace-wearing time per day, were significantly related to the differences in the patient-parent General perception of body shape (r s  = -0.51, r s  = -0.34, r s  = 0.36, respectively). Parents and female patients with AIS have similar concerns and perceptions of spinal appearance. The discrepancies in General perception of spinal appearance between parents and AIS females decrease with age of patient. Parental emotional support may contribute to minimizing the risk factors of psychological impairment, especially in late adolescents with AIS.

A longitudinal study of alexithymia in relation to physical activity in adolescent females with scoliosis subjected to cheneau brace treatment: preliminary report.

STUDY DESIGN: A longitudinal pilot study of changes in levels of alexithymia among females with adolescent idiopathic scoliosis (AIS) under brace treatment. OBJECTIVE: To investigate the prevalence of alexithymia and to evaluate changes in alexithymia levels among female patients with AIS treated with a Cheneau brace, in comparison with healthy female adolescents. SUMMARY OF BACKGROUND DATA: Alexithymia is a personality trait incorporating the following core characteristics: difficulty in identifying and describing feelings, difficulty in distinguishing between feelings and the physical sensation of emotional arousal, limited imaginal processes, and an externally oriented cognitive style. Alexithymia can be common among adolescents and young adults with severe idiopathic scoliosis. METHODS: Thirty-six female patients with AIS, aged 13.4 years (standard deviation [SD], 1.7) at the beginning of the study, completed the Polish version of the Toronto Alexithymia Scale-26 (TAS-26). The second and third evaluations took place at 6 and 12 months, respectively, after the beginning of the study. Thirty-six healthy female controls were also included. RESULTS: The mean TAS-26 total score was 63.4 (SD, 9.3), 59.5 (SD, 12.1), and 59.6 (SD, 12.5) during the first, second, and last patient evaluation, whereas in healthy females 60.0 (SD, 10.9). With regard to the TAS-26 total score, results differed significantly between the first and the second (P = 0.007) and between the first and the third patient evaluation (P = 0.007). Regression analysis revealed that during the second and third patient evaluation, duration of recreational sports activity had a statistically significant (P = 0.029 and P = 0.005, respectively) influence on the probability of females reporting no alexithymia. CONCLUSION: The prevalence of alexithymia in healthy female controls is the same as in patients with scoliosis subjected to underarm brace treatment. Statistically significant changes with regard to TAS-26 total score and externally oriented thinking domain were found in patient sample. Physical activity in females with AIS treated nonoperatively coexists with lower scores in the TAS-26. LEVEL OF EVIDENCE: 2.

Psychometric properties of the Polish language version of the chronic pain coping inventory-42 for patients treated surgically due to herniated lumbar discs and spondylotic changes.

BACKGROUND: The development of a pain-management program tailored to the specific needs of patients with chronic low back pain (CLBP) requires the proper assessment of psychosocial factors affecting each individual. The Chronic Pain Coping Inventory-42 (CPCI-42) refers to coping strategies, which are commonly defined as the cognitive and behavioral techniques an individual may resort to in stressful or demanding situations. Evidence from a number of sources suggests that differences in pain coping strategies may significantly affect how an individual deals with chronic pain. We aimed to adapt the CPCI-42 to Polish cultural conditions (PL-CPCI-42) and then verify its psychometric properties based on a group of patients treated surgically due to herniated lumbar discs and coexisting spondylotic changes. MATERIAL AND METHODS: The average age of the study participants (n=90) was 43.47 years (SD 10.21). The average duration of chronic low back pain (CLBP) was 49.37 months (SD 64.71). Lumbosacral spine X-rays and magnetic resonance imaging scans were performed and all patients completed the PL-CPCI-42 and the Polish versions of the Numeric Pain Rating Scale (NPRS-PL) twice. Internal consistency of the PL-CPCI-42, floor and ceiling effects, test-retest reliability, and criterion validity were analyzed. RESULTS: Resting, guarding, and coping self-statements were frequently used as coping strategies both in the test and in the retest, in contrast to relaxation and exercise/stretch. The NPRS-PL result was 5.70 cm in the test and 5.66 in the retest. Cronbach's alpha values were recorded for the asking for assistance, coping self-statements, and seeking social support domains (0.83, 0.80, 0.83, respectively). Test-retest reliability of the PL-CPCI-42 varied from 0.53 (relaxation domain) to 0.84 (asking for assistance and coping self-statements domains). CONCLUSIONS: The present study provides evidence of the validity of the PL-CPCI-42 and supports its usefulness in assessing chronic pain coping strategies, which are especially important to pain adjustment and in the creation of multidisciplinary pain management programs for patients with severe CLBP.

Anti­tuberculosis drugs decrease viability and stimulate the expression of chondrocyte marker genes in human nucleus pulposus cells.

Isoniazid (INH), rifampicin (RIF), ethambutol (ETH) and pyrazinamide (PYR) are first­line drugs used in anti­tuberculosis (TB) therapy. However, no studies have been conducted concerning the effect of anti­TB drugs on the cells of the intervertebral discs (IVDs), the predominant location of the osteoarticular form of TB (OATB). Cells from the nucleus pulposus (NP), which are located in the center of the IVDs, were obtained from 12 adolescent patients who underwent surgery due to idiopathic scoliosis. The NP cells were incubated for 24 h with transforming growth factor ß1 (TGF­ß1) and each anti­TB drug (INH, RIF, ETH and PYR), separately. Incubation with 2.5 ng/ml TGF­ß1 resulted in an 80% decrease in ACAN mRNA levels; while 5 µg/ml INH led to a 2.3­fold increase in COL2A1 and a 2.9­fold increase in ACAN mRNA levels. Treatment with 10 µg/ml RIF initiated a 2.2­fold increase in COL1A1 mRNA levels and 5 µg/ml PYR resulted in an 8­fold increase in SOX9 mRNA levels. Following 192 h of treatment with INH and RIF, NP cell viability was diminished; however, no drugs modified the concentrations of glycosaminoglycans (GAGs). This study aimed to determine the effect of anti­TB drugs on the expression of chondrocyte marker genes in human IVD cells. Anti­TB drugs increased the expression of chondrocyte marker genes and diminished the viability of IVD cells. This study demonstrated that in addition to the common side effects of anti­TB drugs, these drugs also have an effect on IVD cells.

Co­culture of human nucleus pulposus cells with multipotent mesenchymal stromal cells from human bone marrow reveals formation of tunnelling nanotubes.

Degeneration of the intervertebral disc (IVD) is the main cause of age-related damage of spinal tissues. Using multipotent mesenchymal stromal cells (MSCs) regenerative medicine intends to restore the IVD components of annulus fibrosus (AF) and nucleus pulposus (NP). In the present study NP cells (NPCs) and MSCs obtained from adolescent patients suffering from scoliosis were used. IVDs and vertebrae were obtained during surgery and subsequently processed in order to establish cultures of NPCs and MSCs. The two cell types were co-cultured in 1-µm pore size insert system (indirect co-culture) or on one surface (direct co-culture). Prior to co-culture in these systems one of the cell types was stained by lipophilic fluorescent dye DiD (red). The results demonstrated that regardless of the cell type, the flow of DiD from stained to non-stained cells was more efficient in the direct co-culture in comparison with the insert system. Moreover, in the direct system the DiD flow was more efficient from MSCs towards NPCs compared with that in the opposite direction. These data indicated that the membrane interchange between the two cell types was asymmetric. To discriminate the subpopulation of cells that underwent membrane interchange, cells were double stained with DiD and DiO (green). In the first part of the experiment NPCs were stained by DiO and MSCs by DiD. In the second, NPCs were stained by DiD and MSCs by DiO. The cells were co-cultured in the direct system for 8 days and subsequently analyzed by flow cytometry and confocal microscopy. This analysis revealed that >50% of cells were stained by the DiO and DiD dyes. NPCs and MSCs formed structures similar to tunnelling nanotubes (TnT). In conclusion, the formation of TnT-like structures is able to promote, phenotypic changes during the direct co-culture of NPCs with MSCs.