Headache, low back pain, other nociceptive and mixed pain conditions in neurorehabilitation. Evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation.

Pain is a disabling symptom and is often the foremost symptom of conditions for which patients undergo neurorehabilitation. We systematically searched the PubMed and Embase electronic databases for current evidence on the frequency, evolution, predictors, assessment, and pharmacological and non-pharmacological treatment of pain in patients with headache, craniofacial pain, low back pain, failed back surgery syndrome, osteoarticular pain, myofascial pain syndrome, fibromyalgia, and chronic pelvic pain. Despite the heterogeneity of published data, consensus was reached on pain assessment and management of patients with these conditions and on the utility of a multidisciplinary approach to pain therapy that combines the benefits of pharmacological therapy, physiotherapy, neurorehabilitation, and psychotherapy.

Pediatric selective mutism therapy: a randomized controlled trial.

Background: Selective mutism (SM) is a rare disease in children coded by DSM-5 as an anxiety disorder. Despite the disabling nature of the disease, there is still no specific treatment.

Aim: The aims of this study were to verify the efficacy of six-month standard psychomotor treatment and the positive changes in lifestyle, in a population of children affected by SM.

Back pain-related disability and quality of life in patients affected by vertebral fractures: data from baseline characteristics of population enrolled in Denosumab In Real Practice (DIRP).

Background: Spine fragility fractures lead to a significant acute and/or chronic pain and worsening of quality of life. Denosumab is effective in reducing the risk of new vertebral fractures, but its effectiveness on pain relief and improvement of the quality of life in patients with spine fractures are not well known.

Aim: The aim of this paper is to describe the baseline demographic and clinical characteristics, back pain-related disability and quality of life of the Denosumab In Real Practice (DIRP) study population.

Hypovitaminosis D is associated with a reduction in upper and lower limb muscle strength and physical performance in post-menopausal women: a retrospective study.

Background: Elderly people experience a gradual loss of muscle strength and a reduction of serum levels of vitamin D and of vitamin D receptor expression in skeletal muscle cells.

Aims: The aim of our study was to evaluate the association among serum levels of 25-hydroxy-vitamin D [25(OH)D3], muscle strength, and physical performance in post-menopausal women.

Methods: In our retrospective case-control study, we analyzed data from medical records of post-menopausal women aged ≥ 50 years.

Effectiveness of teriparatide treatment on back pain-related functional limitations in individuals affected by severe osteoporosis: a prospective pilot study.

Introduction: Vertebral fractures have been associated with back pain, functional limitations and reduced health-related quality of life (HRQoL). Teriparatide is the first effective anabolic agent that demonstrated to significantly reduce the risk of vertebral fracture by 65%, as compared to placebo. The aims of this study were to evaluate the effectiveness of teriparatide treatment on back pain-related functional limitations and to investigate on patients HRQoL.

Incidence and costs of hip fractures vs strokes and acute myocardial infarction in Italy: comparative analysis based on national hospitalization records.

Objectives: As osteoporotic fractures are becoming a major health care problem in countries characterized by an increasing number of older adults, in this study we aimed to compare the incidence and costs of hip fragility fractures in Italian elderly people versus those of major cardiovascular diseases (strokes and acute myocardial infarctions [AMI]) occurring in the whole adult population.

Methods: We analyzed hospitalization records maintained at the national level by the Italian Ministry of Health for the diagnosis of hip fractures (ICD-9-CM codes 820-821), AMI (code 410), hemorrhagic (codes 430, 431, 432) and ischemic strokes (codes 433-434), and TIA (code 435) between 2001-2005. Cost analyses were based on diagnosis-related groups.

Does robotic gait training improve balance in Parkinson's disease? A randomized controlled trial.

Background: Treadmill training (with or without robotic assistance) has been reported to improve balance skills in patients with Parkinson's disease (PD). However, its effectiveness on postural instability has been evaluated mainly in patients with mild to moderate PD (Hoehn & Yahr stage ≤3). Patients with more severe disease may benefit from robot-assisted gait training performed by the Gait-Trainer GT1, as a harness supports them with their feet placed on motor-driven footplates.

Accuracy of botulinum toxin type A injection into the gastrocnemius muscle of adults with spastic equinus: manual needle placement and electrical stimulation guidance compared using ultrasonography.

Objective: To investigate the accuracy of manual needle placement and electrical stimulation guidance, compared using ultrasonography, for injection of botulinum toxin type A into the gastrocnemius muscle of adults with spastic equinus.

Design: Prospective clinical study.

Subjects: A total of 81 adults with stroke who were scheduled to receive botulinum toxin type A injection into the gastrocnemius muscle.

Is spastic muscle echo intensity related to the response to botulinum toxin type A in patients with stroke? A cohort study.

Objective: To investigate the relationship between gastrocnemius muscle echo intensity and response to botulinum toxin type A (BoNT-A) in patients with spastic equinus foot resulting from stroke.

Design: Cohort study.

Setting: University hospital.

Neuropsychiatric disorders in hip fracture.

Hip fractures most frequently occur in the elderly population. They are mainly caused by falls from standing position. The presence of several comorbidities, in particular neuropsychiatric disorders, are related to high percentages of falls, disability and mortality rates.

Prevention of falls and role of calcium and vitamin D.

Falls in the elderly are very common and represent a serious cause of morbidity, severe disability and death. Impairments of the mechanisms of postural stability with age and the presence of acute and chronic diseases may favour the occurrence of falls in the elderly. Together with the adoption of non-pharmacological measures, supplementation of calcium and vitamin D demonstrated to reduce hip fracture risk, particularly in institutionalized people.

Development of knowledge about osteoporosis in the world of orthopedics and traumatology.

The development of Orthopedics and Traumatology in the last 50 years have been characterized by the concurrence of several milestone events, such as the disappearance of polio and osteoarticular tuberculosis, the progress of some disciplines such as Anesthesia and Intensive Care, Diagnostic Imaging and technology development. As for other common diseases, also for osteoporosis the evolution of knowledge about pathophysiology and treatment represents a "must" to know for the orthopaedic surgeons.

The occurrence of acute myocardial infarction in Italy: a five-year analysis of hospital discharge records.

Background: The incidence and costs of acute myocardial infarction (AMI) in Europe represent a substantial problem due to population aging.

Methods: Between 2001 and 2005, Italian hospitalization records were examined to evaluate hospital admissions and costs of AMI in adults aged ≥ 45 and in elderly people ≥ 65 or ≥ 75. Hospital costs were calculated on the basis of Diagnosis Related Groups (DRGs).

Pharmaco-economic issues in the treatment of severe osteoporosis.

Introduction: clinical guidelines recommend to identify and treat people at high risk of fracture.

Methods: we have carried out a simulation concerning pharmaco-economic issues in the treatment of severe osteoporosis and particularly those people with previous femoral fragility fractures, assuming that only 13.1% of hip fractured patients had started a proper antifracture therapy, as shown by the analysis of the Tuscany regional database.

Risedronate's efficacy: from randomized clinical trials to real clinical practice.

Osteoporosis represents the most common human bone disorder with a large medical and economical burden on the Health Care System. Bisphosphonates are the major drugs used for the treatment of osteoporosis. Differences in their chemical structures and pharmacokinetic actions can explain the different clinical efficacy among these molecules.

Rehabilitative treatment in flexible flatfoot: a perspective cohort study.

Paediatric valgus flexible flatfoot is a common childhood paramorphism. Its treatment options consist of rehabilitation, corrective footwear and, if necessary, surgical intervention. The aim of our study was to compare a group of children who followed a rehabilitative programme versus a historical group of children who had been treated with insoles and orthopaedic footwear.

Incidence of breast cancer in Italy: mastectomies and quadrantectomies performed between 2000 and 2005.

Objectives: We aimed to determine the incidence of women's breast cancer in Italy without using statistical approximations.

Methods: We analyzed the national hospitalizations database at the Ministry of Health to calculate the number of major surgeries in Italian women (mastectomies and quadrantectomies) due to breast cancer between 2000 and 2005, overall and by age groups (<44, 45-64, 65-74 and >or= 75 years old).

Results: Over the six years examined, an overall number of 100,745 mastectomies and 168,147 quadrantectomies were performed.

Rehabilitation in esophageal cancer.

Cancer of the esophagus has an unfavorable prognosis with a five-year survival rate after radical surgery of less than 10%; early diagnosis is difficult. The appearance of symptoms, particulary dysphagia, is due to more than 2/3 tumor involvement of the esophageal circumference, already present in 2/3 of patients at diagnosis. Symptoms can be local and/or systemic; they can be physical, psychic, iatrogenic and evolutive.