Search

Purpose: A main concern of patients with back problems is pain and its impact on function and quality of life. These are subjective phenomena, and should be probed during the clinical consultation so that the physician can ascertain the extent of the problem. This study evaluated the agreement between clinicians' and patients' independent ratings of patient status on the Core Outcome Measures Index (COMI). Methods: This was an analysis of the data from 5 spine specialists and 108 patients, in two centres. Prior to the consultation, the patient completed the COMI. After the consultation, the clinician (blind to the patient's version) also completed a COMI. Concordance was assessed by % agreement, Kappa values, Bland–Altman plots, Spearman rank, Intraclass Correlation Coefficients and comparisons of mean values, as appropriate. Results: Agreement regarding the "main problem" (back pain, leg/buttock pain, sensory disturbances, other) was 83%, Kappa = 0.70 (95%CI 0.58–0.81). Moderate/strong correlations were found between the doctors' and patients' COMI-item ratings (0.48–0.74; p < 0.0001), although compared with the patients' ratings the doctors systematically underestimated absolute values for leg pain (p = 0.002) and dissatisfaction with symptom state (p = 0.002), and overestimated how much the patient's function was impaired (p = 0.029). Conclusion: The doctors were able to ascertain the location of the main problem and the multidimensional outcome score with good accuracy, but some individual domains were systematically underestimated (pain, symptom-specific well-being) or overestimated (impairment of function). More detailed/direct questioning on these domains during the consultation might deliver a better appreciation of the impact of the back problem on the patient's daily life. [ABSTRACT FROM AUTHOR]

Purpose: In conservative early onset scoliosis treatment, interest in bracing is growing because repeated general anaesthesia (required by casting) has been questioned for possible brain damages. We aimed to check the results in the medium term of bracing, comparing idiopathic (IIS) to secondary (SIS) infantile scoliosis. Methods: We performed a retrospective study in a consecutive prospective cohort. Inclusion criteria were: discovery of scoliosis and bracing below age 3; exclusion criteria: previous spine surgery, less than three consultations. We considered the following results: full (< 20° Cobb) and partial (< 30°) success; hold-up (progression < 5° but curve > 29°); partial (progression > 5°) and full (fusion) failure; statistics: ANOVA for repeated measures; linear mixed effect model with Cobb angle (dependent), time and diagnosis (independent) variables. Results: We included 34 infants (16 IIS and 18 SIS) of age 1·10 ± 0·10 (years·months), 44 ± 17° curves, 27 ± 10° rib vertebral angle difference, average observation 5·05 ± 3·03 years. We found progressive improvement of IIS and stability of SIS patients. Six IIS (37.5%) and one SIS (6%) reached brace weaning before puberty with 13 ± 5° (improvement 61 ± 15%, p < 0.001), after 4·11 ± 3·07 years of treatment. Three patients were fused, one IIS (6%) and two SIS (11%). Two IIS patients also reached end-of-growth with 18° (start 40° at 1·03 years) and 20° (start 32° at 2·12 years), respectively. Conclusion: Bracing shows promising results in the medium term for high-degree IIS, with very few hold-ups (19%) and failures (12%). Conversely, failures prevail for SIS (full 11%), even if the partial failure (39%) is still a time-buying strategy. [ABSTRACT FROM AUTHOR]

Purpose: Adult scoliosis is sometimes associated with back pain and severe curves can progress over time. Despite scoliosis has been estimated to affect up to 68% of the population over 60, there is scant literature about conservative treatment for adult scoliosis. Recently, we tested a new brace designed to alleviate pain for adult patients with chronic pain secondary to scoliosis. The study aims to test the efficacy of a prefabricated brace in reducing pain in adult scoliosis patients. Methods: Twenty adults (age 67.8 ± 10.5, curve 61.9 ± 12.6° Cobb) with chronic low back pain (cLBP) secondary to Idiopathic Scoliosis (IS) were included. Patients were evaluated at baseline immediately before starting with the brace and after 6 months. Outcome measures were GRS, Oswestry Disability Index (ODI), Roland Morris Questionnaire (RM), COMI. The paired t test, ANOVA and Wilcoxon tests were used for statistical analysis Results: At six months, worst pain, leg pain and back pain were significantly improved: from 7.15 to 5.60, from 5.65 to 4.35 and from 6.55 to 5.25 (p < 0.05). Sixty-five percent of patients achieved the minimal clinically important difference of 2 points for worst pain and leg pain, 55% for back pain. RM and COMI improved (p < 0.05), no differences for ODI. Conclusion: The prefabricated brace showed a significant improvement at 6 months of worst, leg and back pain in most patients in a group of adult women with IS and cLBP. The quality of life didn't change in a clinically significant way even if the patients reported satisfaction with the treatment. Trial registration number and date of registration: ClinicalTrials.gov Identifier: NCT02643290, December 31, 2015. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to propose and validate a new unified "Risser+" grade that combines the North American (NA) and European (EU) variants of the classic Risser score. The "Risser+ " grade can effectively combine the North American and European Risser Classifications for skeletal maturity with adequate intra-rater/inter-rater reliability and agreement.Methods: Agreement and reliability were evaluated for 6 raters (3-NA, 3-EU) who assessed 120 pelvic radiographs from the BrAIST trial, all female, average age 13.4 (range 10.1-16.5 years). Blinded raters reviewed x-rays at two time-points. Intra- and inter-rater agreement (RA) were established with Krippendorff's alpha (k-alpha), while intra- and inter-rater reliability (RR) were established with intraclass correlation coefficients (ICC). Acceptable agreement and reliability were set a priori at 0.80.Results: Inter-RA for the second reading met study requirements (k-alpha = 0.86 [0.81-0.90]) compared to the first reading (0.72 [0.63-0.79]) while combined readings was close to target agreement (0.79 [0.74-0.84]). Removal of 20 readings demonstrating outlier tendencies increased agreement for the first, second, and combined reads (k-alpha = 0.85, 0.89, 0.87, respectively). Intra-RA was sufficient for 4 out of 6 raters (k-alpha > 0.80) and one rater from EU and NA presented subpar intra-RA (k-alpha = 0.64 and 0.74, respectively). Inter-RR met study requirements overall reads (ICC = 0.96 [0.95-0.97]) including the first (0.94 [0.92-0.95]) and second (0.97 [0.97-0.98]) reads, independently.Conclusions: The Risser+ system showed excellent reliability across multiple reads and raters and demonstrated 79% agreement overall reads and ratings. Agreement increased to over 85% when raters could distinguish Risser 0 + from Risser 5. These slides can be retrieved from electronic supplementary material. [ABSTRACT FROM AUTHOR]

The Planck design and scanning strategy provide many levels of redundancy that can be exploited to provide tests of internal consistency. One of the most important is the comparison of the 70 GHz (amplifier) and 100 GHz (bolometer) channels. Based on different instrument technologies, with feeds located differently in the focal plane, analysed independently by different teams using different software, and near the minimum of diffuse foreground emission, these channels are in effect two different experiments. The 143 GHz channel has the lowest noise level on Planck, and is near the minimum of unresolved foreground emission. In this paper, we analyse the level of consistency achieved in the 2013 Planck data. We concentrate on comparisons between the 70, 100, and 143 GHz channel maps and power spectra, particularly over the angular scales of the first and second acoustic peaks, on maps masked for diffuse Galactic emission and for strong unresolved sources. Difference maps covering angular scales from 8° to 15' are consistent with noise, and show no evidence of cosmic microwave background structure. Including small but important corrections for unresolved-source residuals, we demonstrate agreement (measured by deviation of the ratio from unity) between 70 and 100 GHz power spectra averaged over 70 ⩽ ࡁ ⩽ 390 at the 0.8% level, and agreement between 143 and 100 GHz power spectra of 0.4% over the same ࡁ range. These values are within and consistent with the overall uncertainties in calibration given in the Planck 2013 results. We also present results based on the 2013 likelihood analysis showing consistency at the 0.35% between the 100, 143, and 217 GHz power spectra. We analyse calibration procedures and beams to determine what fraction of these differences can be accounted for by known approximations or systematic errors that could be controlled even better in the future, reducing uncertainties still further. Several possible small improvements are described. Subsequent analysis of the beams quantifies the importance of asymmetry in the near sidelobes, which was not fully accounted for initially, affecting the 70/100 ratio. Correcting for this, the 70, 100, and 143 GHz power spectra agree to 0.4% over the first two acoustic peaks. The likelihood analysis that produced the 2013 cosmological parameters incorporated uncertainties larger than this. We show explicitly that correction of the missing near side-lobe power in the HFI channels would result in shifts in the posterior distributions of parameters of less than 0:3σ except for As, the amplitude of the primordial curvature perturbations at 0.05 Mpc-1, which changes by about 1σ.We extend these comparisons to include the sky maps from the complete nine-year mission of the Wilkinson Microwave Anisotropy Probe (WMAP), and find a roughly 2% difference between the Planck and WMAP power spectra in the region of the first acoustic peak. [ABSTRACT FROM AUTHOR]

Mutant p53 proteins are expressed at high frequency in human tumors and are associated with poor clinical prognosis and resistance to chemotherapeutic treatments. Here we show that mutant p53 proteins downregulate micro-RNA (miR)-223 expression in breast and colon cancer cell lines. Mutant p53 binds the miR-223 promoter and reduces its transcriptional activity. This requires the transcriptional repressor ZEB-1. We found that miR-223 exogenous expression sensitizes breast and colon cancer cell lines expressing mutant p53 to treatment with DNA-damaging drugs. Among the putative miR-223 targets, we focused on stathmin-1 (STMN-1), an oncoprotein known to confer resistance to chemotherapeutic drugs associated with poor clinical prognosis. Mutant p53 silencing or miR-223 exogenous expression lowers the levels of STMN-1 and knockdown of STMN-1 by small interfering RNA increases cell death of mutant p53-expressing cell lines. On the basis of these findings, we propose that one of the pathways affected by mutant p53 to increase cellular resistance to chemotherapeutic agents involves miR-223 downregulation and the consequent upregulation of STMN-1. [ABSTRACT FROM AUTHOR]

p53 mutations have profound effects on non-small-cell lung cancer (NSCLC) resistance to chemotherapeutic treatments. Mutant p53 proteins are usually expressed at high levels in tumors, where they exert oncogenic functions. Here we show that p53R175H, a hotspot p53 mutant, induces microRNA (miRNA)-128-2 expression. Mutant p53 binds to the putative promoter of miR128-2 host gene, ARPP21, determining a concomitant induction of ARPP21 mRNA and miR-128-2. miR-128-2 expression in lung cancer cells inhibits apoptosis and confers increased resistance to cisplatin, doxorubicin and 5-fluorouracyl treatments. At the molecular level, miR-128-2 post-transcriptionally targets E2F5 and leads to the abrogation of its repressive activity on p21waf1 transcription. p21waf1 protein localizes to the cytoplasmic compartment, where it exerts an anti-apoptotic effect by preventing pro-caspase-3 cleavage. This study emphasizes miRNA-128-2 role as a master regulator in NSCLC chemoresistance. [ABSTRACT FROM AUTHOR]

We present an application of the fast Independent Component Analysis (fastica) to the Wilkinson Microwave Anisotropy Probe ( WMAP) three-year data with the goal of extracting the cosmic microwave background (CMB) signal. We evaluate the confidence of our results by means of Monte Carlo simulations including the CMB, foreground contaminations and instrumental noise specific to each WMAP frequency band. We perform a complete analysis involving all or a subset of the WMAP channels in order to select the optimal combination for CMB extraction, using the frequency scaling of the reconstructed component as a figure of merit. We find that the combination KQVW provides the best CMB frequency scaling, indicating that the low-frequency foreground contamination in Q, V and W bands is better traced by the emission in the K band. The CMB angular power spectrum is recovered up to the degree scale; it is consistent within errors for all WMAP channel combinations considered, and in close agreement with the WMAP three-year results. A power spectrum analysis is made of the sky map divided into two hemispheres that have been previously reported as showing evidence of an asymmetric ratio of power on large angular scales. We then confirm the findings of several previous works with independent techniques. [ABSTRACT FROM AUTHOR]

We present the angular power spectrum of the cosmic microwave background (CMB) component extracted withfastica from the Background Emission Anisotropy Scanning Telescope (BEAST) data. BEAST is a 2.2-m off-axis telescope with a focal plane comprising eight elements at Q (38–45 GHz) and Ka (26–36 GHz) bands. It operates from the UC (University of California) White Mountain Research Station at an altitude of 3800 m. The BEAST CMB angular power spectrum has already been calculated by O'Dwyer et al. using only the Q-band data. With two input channels,fastica returns two possible independent components. We found that one of these two has an unphysical spectral behaviour, while the other is a reasonable CMB component. After a detailed calibration procedure based on Monte Carlo (MC) simulations, we extracted the angular power spectrum for the identified CMB component and found a very good agreement with the already published BEAST CMB angular power spectrum and with the Wilkinson Microwave Anisotropy Probe ( WMAP) data. [ABSTRACT FROM AUTHOR]

Unfortunately, the affiliation of the author Negrini S has been incorrectly published in the original version. The complete correct affiliation of this author should read as follows. [ABSTRACT FROM AUTHOR]

The article cites a research study that analyzes the effectiveness of a complete conservative treatment for adolescent idiopathic scoliosis (AIS). It follows the SRS and SOSORT criteria for the evaluation. The SRS and SOSORT criteria are said to be effective tools to obtain evidence on the effectiveness of bracing for adolescent AIS.

The article cites a research study that examines end growth results of patients treated in a centre fully dedicated to the conservative treatment of Adolescent Idiopathic Scoliosis AIS. It referred to Risser score, Cobb degrees, and curve types at the beginning of the treatment. The study included 388 patients respecting these inclusion criteria.

The article cites a research study that compares the results of studies performed according to SRS criteria for bracing studies (SRS-C) and performs a meta-analysis. It is said that bracing efficacy is questioned due to the lack of standard research protocols. A total of 416 patients were included in 4 retrospective studies.

The article cites a research study that analyzes the postures in idiopathic scoliosis (IS) and determines whether there is any correlation with curve morphology. It verifies whether IS patients adopt specific asymmetric usual everyday postures (UEP). The study validated a questionnaire for parents evaluating 7 UEP.

The article cites a research study that analyzes a unique method for the measurement of the scoliosis angles on x-rays. It also verifies the concordance with the gold standard. The Micro gold standard method is the Cobb, or Cotrel, method, and based on the use of a Bunnell scoliometer. The results of this study show a high reliability of the Micro method.

The article cites a research study that determines whether it is possible to maintain good brace compliance for scoliosis patients. It also measures what factors could influence the adherence to the treatment in the long term. Earlier research has shown that it is possible to obtain a good real compliance in a setting respecting SOSORT criteria for bracing.

The article cites a research study that compares the short term results of the Sforzesco and the Sibilla in order to determine the influence of the material. The difference in the two SPoRT braces Sforzesco and the Sibilla consists in the material. The study included patients who were prescribed a Sibilla, or Sforzesco Brace, 21h per day or more for adolescent idiopathic scoliosis (AIS).

The article cites a research study that analyzes the efficacy of brace treatment in patients with idiopathic scoliosis (IS) above 45. It is said that positive results in bracing IS patients, who refused surgery, have been presented in a retrospective study. It was found that conservative brace treatment is a suitable alternative for those patients who reject any surgical intervention for IS.

The article cites a research study that analyzes idiopathic scoliosis (IS) results of treatment of the superior end-plate of the superior end-vertebra (EV) and the inferior end-plate of the inferior EV of patients. It determines whether there is a difference between the two ways of measurement in treated patients.

The article cites a research study that determines the presence of vertebral alterations linked to Scheuermann's disease in scoliosis considered idiopathic. It is believed that few idiopathic scoliosis cases could be classified by known vertebral spine pathologies. Idiopathic scoliosis is found to be related to dorsal hypokyphosis.

The article cites a research study that examines the association between slopes and Cobb degrees measurements and SRS-Ponseti classification. It describes the concept of "slopes" inclination of the spine with respect to the vertical line. 404 scoliosis frontal radiographs were measured in this study.

The article cites a research study that describes the association between Risser sign and other physiologic parameters in Italian patients with adolescent idiopathic scoliosis (AIS). Risser sign is the parameter used to determine skeletal maturity. The study included a total of 3553 patients, aged between 10 and 21 years.

An abstract of the article "Adolescent with 10° to 20° Cobb scoliosis during growth: efficacy of conservative treatments. A prospective controlled cohort observational study," by M. Romano and colleagues is presented.

An abstract of the article "Mobilization exercises in preparation to bracing must be only at start of brace wearing. Results from a prospective controlled study," by M. Romano and colleagues is presented.

An abstract of the article "Correlation between in-brace radiographic correction and short time brace results," by F. Zaina and colleagues is presented.

An abstract of the article "Sagittal and pelvic arameters analysis in patients with adolescent idiopathic scoliosis," by S. Donzelli and colleagues is presented.

An abstract of the article "It is possible to make patients use braces the hours prescribed: first results from the thermobrace clinical everyday usage," by F. Zaina, S. Donzelli and S. Negrini is presented.

An abstract of the article "Lessons to be learned: best and worst results from a 7 years old clinical database of scoliosis patients," by F. Zaina, S. Donzelli and S. Negrini is presented.

An abstract of the article "Complete validation of plumbline distances as a screening tool for sagittal plane deformities," by S. Negrini and colleagues is presented.

An abstract of the article "Scoliosis in adolescents reduces the risk of eating disorders," by F. Zaina and colleagues is presented.