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Purpose: Shoulder stiffness (SS) is a condition characterised by active and passive restricted glenohumeral range of motion, which can occur spontaneously in an idiopathic manner or be associated with a known underlying aetiology. Several treatment options are available and currently no consensus has been obtained on which treatment algorithm represents the best choice for the patient. Herein we present the results of a national consensus on the treatment of primary SS. Methods: The project followed the modified Delphi consensus process, involving a steering, a rating and a peer‐review group. Sixteen questions were generated and subsequently answered by the steering group after a thorough literature search. A rating group composed by professionals specialised in the diagnosis and treatment of shoulder pathologies rated the question–answer sets according to the scientific evidence and their clinical experience. Results: Recommendations were rated with an average of 8.4 points out of maximum 9 points. None of the 16 answers received a rating of less than 8 and all the answers were considered as appropriate. The majority of responses were assessed as Grade A, signifying a substantial availability of scientific evidence to guide treatment and support recommendations encompassing diagnostics, physiotherapy, electrophysical agents, oral and injective medical therapies, as well as surgical interventions for primary SS. Conclusions: A consensus regarding the conservative and surgical treatment of primary SS could be achieved at a national level. This consensus sets basis for evidence‐based clinical practice in the management of primary SS and can serve as a model for similar initiatives and adaptable guidelines in other European countries and potentially on a global scale. Level of Evidence: Level I. [ABSTRACT FROM AUTHOR]

This chapter examined which APEC 21st-century skills Filipino women educational leaders best exemplify. It looked into the ways in which these leaders manifest these skills in their power roles. It also determined what their plans are for the ASEAN integration as they steer their organizations toward the goal of the Philippines, which is to open the country to better opportunities as it collaborates with its neighbors. Finally, this chapter generated theories based on the power roles of these Filipino women educational leaders. This study is a qualitative examination of the skills these leaders employ and uses a questionnaire to gather data from three women presidents of State Universities and Colleges in Northern Mindanao, the Philippines. [ABSTRACT FROM AUTHOR]

The paper proposed an alternative measure for classification of biological organisms in taxonomy. The alternative measure is based on a normalized Euclidian distance index that is derived from a few orthogonal principal components of the input trait matrix. Using an exploratory, descriptive method of research, data from two (2) species of the biting fly were analyzed. Result revealed that the alternative measure successfully distinguished between the two (2) species of biting fly L. torrens and L. carteri using only the wing dimensions of the flies. The other information such as palp length, palp width, and length of antennal segment were not useful in discriminating between two (2) fly species. The implication is that for taxonomic purposes, only a few traits are sufficient to distinguish between organisms coming from the same genera. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to compare the clinical and subjective difference between transtendon repair or complete/repair in two homogeneous groups of patients affected by deep partial articular supraspinatus tear. Methods: Seventy-four patients were randomized in two groups of 37 patients each. The first group (A) was treated with arthroscopic transtendon repair while the second group (B) was treated with an arthroscopic completion of the tear and formal repair. All the patients were revaluated at a minimum 2 years of follow-up with Constant score and Visual Analogic Scale (VAS). Results: Constant score improved by a mean value of 25 (95 % CI 21-28) ( p < 0.0001) and of 29 (95 % CI 26-31) ( p < 0.0001), respectively; VAS score decreased by a mean value of 3.4 (95 % CI 2.9-3.9) ( p < 0.0001) and of 3.6 (95 % CI 3.3-4.0) ( p < 0.0001), respectively. The improvement was higher in both groups for the ADL, and in Group B, the improvement in strength was higher than in Group A. There were no statistical differences between the two different techniques. Conclusion: Both repairing techniques of deep partial supraspinatus tear provide good results in terms of function and pain. There were no statistically significant differences between the two techniques. Level of evidence: Prospective comparative study, Level II. [ABSTRACT FROM AUTHOR]

Four-part proximal humeral fractures are frequently treated with shoulder replacement. Outcome of this procedure has not been standardized, and there are controversy data on range of motion (ROM) and active function of the shoulder. The aim of this study is to compare shoulder prosthesis position (SPP) in terms of version of humeral head and height of stem with clinical subjective and objective outcome. Fifty patients were treated with shoulder hemiarthroplasty for four-part proximal humeral fracture or fracture-dislocation of the humeral head. Radiological examination and CT-scan were performed preoperatively and at follow-up. Clinical outcome evaluation included active and passive ROM, and subjective perspective collected through SF-36, OSQ, ASES, and DASH. No significant correlation between stem height and clinical outcome were found. The prosthesis version correlates with all subjective questionnaires. The ROM was not correlated with stem height and prosthesis version. SPP involves clinical outcome, with great relevance of implant version. [ABSTRACT FROM AUTHOR]

We performed a multi-perspective follow up in 25 patients with autoimmune neurological disorders treated with intravenous immunoglobulin (IVIg) to evaluate the early effects on patients' health-related quality of life (HRQoL). Diagnoses were based on clinical picture, neurophysiological assessment, nerve biopsy, and therapeutic response. As patient-oriented assessment, we used the Short Form 36 questionnaire (SF-36), the most used generic health tool, and the disability of arm shoulder and hand questionnaire (DASH). Our data indicate that physical aspects of patients' HRQoL improve early and strongly after IVIg. This agrees with the muscle strength improvement previously reported. But, the mental aspects of the HRQoL are not influenced by the therapies. Traditional outcome assessment in neurological diseases has always been based on physician-derived and instrumental findings. Over the last two decades, clinical researchers have underlined the need for a standardized evaluation of concepts such as HRQoL. We believe that this study represents a further step toward an evidence-based therapeutic approach of some neurological diseases and that further fundamental steps should be taken. [ABSTRACT FROM AUTHOR]

Examines how pain can be used as outcome measurement in the management of musculoskeletal disorders. Problems associated with the quantification of pain; Limitation of pain to patient-oriented measures because of difficulties associated with objective measures of pain; Interpretation and validation of results.

Psoriasis is a chronic, recurrent papulosquamous dermatosis that involves the skin and sometimes the joints. Fow orthopedic surgical complications have been reported in psoriatic patients. We report two cases of surgery failure for lumbar disc herniation in patients affected by psoriasis. Both cases underwent surgical treatment because neurological deficits appeared after a period of conservative treatment. The symptoms were completely resolved after surgery. Both patients complained of recurrent pain (no neurological impairment) a few (15 and 20) days after surgery. The imaging evaluation pointed out an over-production of fibrous tissue compressing the nerve root. In our opinion, this condition may be related to the dermatosis. Four hypotheses are proposed to explain the exuberant spinal fibrosis, developed a few days after surgery. This report may represent the starting point for a deeper study of spinal surgery in psoriatic patients. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the influence of the patient–physician interaction and the instrumental awareness of the assessment of patients' answers to a carpal tunnel syndrome-specific questionnaire. Methods: We performed a prospective study of the results of a self-administered questionnaire for carpal tunnel syndrome before and after electrodiagnosis. Thirty-two consecutive patients were referred to our neurophysiological laboratory for suspected carpal tunnel syndrome. A patient-oriented evaluation using the Italian version of the Boston Carpal Tunnel Questionnaire (BCTQ), a widely used disease-specific questionnaire, was carried out before the clinical interaction was performed. The assessment was performed by means of a neurophysiological classification. After the communication of the result, the BCTQ was again administered. Results: The comparison of the BCTQ results, obtained PRE and POST clinical interaction, showed a significant reduction in the reported symptoms and hand function impairment not related to the neurophysiological results. Conclusions: The findings of the patient-oriented evaluation are significantly influenced by the communication of the assessment results. In prospective studies, the baseline assessment by means of a patient-oriented evaluation should consistently be performed in all patients at the same stage of the clinical process. [ABSTRACT FROM AUTHOR]

Surgical decompression of the median nerve is a standardized treatment for carpal tunnel syndrome. After surgery a clinical and neurophysiological improvement is observed also on severe cases. We report 4 cases of carpal tunnel syndrome (CTS) in the hands of 3 patients with prolonged median wrist-thenar distal motor latency (longer than 10 ms, normal values < 4.0 ms) and absence of digit-wrist sensory responses. In these patients surgery caused complete loss of median nerve function. Such a marked increase of median distal motor latency (DML) is rare (0.6% in 500 CTS hands consecutively examined in our laboratory) and suggests the presence of a chronic condition with severe disruption of the myelin. On the basis of these anecdotal observations, we suggest that patients with median DML of 10 ms or more be considered at high risk for CTS surgery failure. [ABSTRACT FROM AUTHOR]