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Currado D, Biaggi A, Pilato A, Marino A, Ruscitti P, Pantano I, Di Donato S, Vomero M, Berardicurti O, Pavlych V, Di Vico C, Caso F, Costa L, Tasso M, Camarda F, Misceo F, De Vincenzo F, Corrado A, Cantatore FP, Perosa F, Guggino G, Scarpa R, Cipriani P, Ciccia F, Giacomelli R, Navarini L. The negative impact of pain catastrophising on disease activity: analyses of data derived from patient-reported outcomes in psoriatic arthritis and axial spondyloarthritis. Clin Exp Rheumatol 2023; 41:1856-1861. [PMID: 37083177 DOI: 10.55563/clinexprheumatol/r0kgp8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 01/16/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES Psychosocial factors are recognised as important determinants of pain experience in patients with inflammatory arthritides. Among them, pain catastrophising, a maladaptive cognitive style, observed in patients with anxiety and depressive disorders, garnered specific attention. Here, we evaluated pain catastrophising (PC) and its related domains (Rumination, Magnification, and Helplessness), in psoriatic arthritis (PsA) and axial spondyloarhtiritis (axSpA) participants, to assess its impact on disease activity. Furthermore, we analysed possible correlations of PC-Scale (PCS) with those psychometric domains which have been already related to catastrophisation in patients with chronic pain. Lastly, we aimed to define the relationship between PCS and the different variables included in the composite indices of disease activity. METHODS A multi-centre, cross-sectional, observational study has been conducted on 135 PsA (age 56 (47-64) years, males/females 40.74/59.26%; Disease Activity in Psoriasic Arthritis (DAPSA) 13.34 (5.21-22.22)) and 71 axSpA (age 49 (37-58) years, males/females 56.34/43.66%; Bath Ankylosing Spondylitis Arthritis Activity (BASDAI) 4.17 (2.1-6.3)) participants. Multivariable regressions and correlations were performed to evaluate the relationship between pain catastrophising and both disease activity and patient-reported outcomes. RESULTS The adjusted linear regression model showed a positive association between PCS and DAPSA as well as between PCS and BASDAI; PCS negative impacts on the subjective domains of disease activity scores. CONCLUSIONS This study suggests the role of PC, independently of inflammation, in disease perception and achievement of remission or low disease activity in chronic arthritides.
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Affiliation(s)
- Damiano Currado
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
| | - Alice Biaggi
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Andrea Pilato
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Annalisa Marino
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Piero Ruscitti
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Ilenia Pantano
- Rheumatology Unit, Department of Precision Medicine, University of Campania L. Vanvitelli, Caserta, Italy
| | - Stefano Di Donato
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Marta Vomero
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Onorina Berardicurti
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Viktoriya Pavlych
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Claudio Di Vico
- Rheumatology Unit, Department of Precision Medicine, University of Campania L. Vanvitelli, Caserta, Italy
| | - Francesco Caso
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luisa Costa
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Marco Tasso
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Federica Camarda
- Rheumatology Section, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University Hospital P. Giaccone, Palermo, Italy
| | - Francesca Misceo
- Rheumatic and Systemic Autoimmune Diseases Unit, Department of Biomedical Science and Human Oncology (DIMO), University of Bari Medical School, Bari, Italy
| | | | - Addolorata Corrado
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | | | - Federico Perosa
- Rheumatic and Systemic Autoimmune Diseases Unit, Department of Biomedical Science and Human Oncology (DIMO), University of Bari Medical School, Bari, Italy
| | - Giuliana Guggino
- Rheumatology Section, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University Hospital P. Giaccone, Palermo, Italy
| | - Raffaele Scarpa
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Paola Cipriani
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Francesco Ciccia
- Rheumatology Unit, Department of Precision Medicine, University of Campania L. Vanvitelli, Caserta, Italy
| | - Roberto Giacomelli
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, and Immunorheumatology Unit, Fondazione Policlinico Universitario Campus Bio Medico, Rome, Italy
| | - Luca Navarini
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, and Immunorheumatology Unit, Fondazione Policlinico Universitario Campus Bio Medico, Rome, Italy
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Favoino E, Urso L, Serafino A, Misceo F, Catacchio G, Prete M, Perosa F. HLA Allele Prevalence in Disease-Modifying Antirheumatic Drugs-Responsive Enthesitis and/or Arthritis Not Fulfilling ASAS Criteria: Comparison with Psoriatic and Undifferentiated Spondyloarthritis. J Clin Med 2021; 10:jcm10143006. [PMID: 34300172 PMCID: PMC8305973 DOI: 10.3390/jcm10143006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/30/2021] [Accepted: 07/03/2021] [Indexed: 12/30/2022] Open
Abstract
Spondyloarthritis (SpA) is a group of inflammatory rheumatic diseases characterized by common clinical features, such as inflammatory enthesitis, arthritis and/or back pain. SpA is strongly associated with human leukocyte antigen (HLA) class I allotype B27. Ankylosing spondylitis has historically been the SpA subgroup with one of the strongest, best-proven associations with HLA-B27. The remaining SpA subgroups, namely psoriatic arthritis (PsA), inflammatory bowel diseases-associated arthritis/spondylitis, reactive arthritis, and undifferentiated SpA (uSpA), have also been associated with HLA allotypes other than HLA-B27. In this retrospective study, we analyzed the association between the HLA class I and II haplotypes and the susceptibility to enthesitis and/or arthritis (E/A). Special attention was paid to E/A responding to disease-modifying antirheumatic drugs (DMARDs) not fulfilling ASAS classification criteria (ASAS−), as compared to ASAS+ forms including PsA and uSpA. The whole E/A group showed significant independent associations with HLA-A28(68), B27, Cw3, Cw12, and DQ1; taken singly, PsA was associated with HLA-B27 and DQ1, uSpA with HLA-B16(38,39) and B27, and E/A ASAS− with HLA-A28(68), Cw8, and Cw12. This study identified novel risk HLA allotypes for different SpA subgroups in an Italian population. HLA typing could aid the diagnosis and treatment of E/A subgroups, including DMARDS-responsive forms not fulfilling ASAS classification criteria.
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Affiliation(s)
| | | | | | | | | | | | - Federico Perosa
- Correspondence: ; Tel.: +39-80-547-88-91; Fax: +39-80-547-88-20
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Ferorelli D, Nardelli L, Spagnolo L, Corradi S, Silvestre M, Misceo F, Marrone M, Zotti F, Mandarelli G, Solarino B, Dell'Erba A. Medical Legal Aspects of Telemedicine in Italy: Application Fields, Professional Liability and Focus on Care Services During the COVID-19 Health Emergency. J Prim Care Community Health 2021; 11:2150132720985055. [PMID: 33372570 PMCID: PMC7780315 DOI: 10.1177/2150132720985055] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Telemedicine services can be classified into the macro-categories of specialist Telemedicine, Tele-health and Tele-assistance. From a regulatory perspective, in Italy, the first provision dedicated to the implementation of Telemedicine services is represented by the Agreement between the Government and the Regions on the document bearing “Telemedicine—National guidelines,” approved by the General Assembly of the Superior Health Council in the session of 10th July 2012 and by the State Regions Conference in the session of 20th February 2014. Scientifically, several studies in the literature state that information and communication technologies have great potential to reduce the costs of health care services in terms of planning and making appropriate decisions that provide timely tools to patients. Another clear benefit is the equity of access to health care. The evolution of telemedicine poses a series of legal problems ranging from the profiles on the subject of authorization and accreditation to those concerning the protection of patient confidentiality, the definition and solution of which, in the absence of specific regulatory provisions, is mainly left to the assessment of compatibility of the practices adopted so far, with the general regulatory framework. In terms of professional liability, it is necessary to first clarify that the telemedicine service is comparable to any diagnostic-therapeutic health service considering that the telemedicine service does not replace the traditional health service, but integrates the latter to improve its effectiveness, efficiency and appropriateness.
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Affiliation(s)
- D Ferorelli
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - L Nardelli
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - L Spagnolo
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - S Corradi
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - M Silvestre
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - F Misceo
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - M Marrone
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - F Zotti
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - G Mandarelli
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - B Solarino
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
| | - A Dell'Erba
- University of Bari-Section of Legal Medicine, Policlinico di Bari Hospital. Bari, Italy
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Romano CA, Ravagnani L, Convertini A, Dassisti L, Fanizza AR, Misceo F, Corbi GM, Campobasso CP, Tafuri S, Bianchi FP, Ferrannini L, Ferrara N, Grattagliano I. The aging process in prison: pathologies and health conditions in old inmates. An epidemiological research in Italy. Clin Ter 2020; 171:e340-e345. [PMID: 32614369 DOI: 10.7417/ct.2020.2237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Elderly may suffer from different pathologies during their detention in jail because of their age. Conditions in jails were tough and adapting to that life could be problematic for the elder population. This article aimed to analyse the pathologies and health conditions in a sample of elder inmates from Italy. METHODS The sample was composed by 94 elderly inmates. The research is multicentric. We selected jails from the cities of Bari, Taranto, Foggia, Lecce, Brescia, Bergamo, Cremona and Mantua. The study was conducted by interviewing the prisoners over 60 years of age, in the period between September and December 2017. RESULTS 64% of the sample was in a "Not Optimal" health status. Most of pathologies were Cardiac pathologies (23.4%), Diabetes (12.8 %) and Surgery (9.6%). Statistically significant differences were found for heart disease (p=0.02) and Neoplasia (p=0.025) in the prison of Bari compared to all the other prisons. Statistically significant differences were found for Hypertension in Foggia and Taranto prisons compared to all the other (p=0.023). Furthermore, 18.1% of inmates ended up having an addiction. CONCLUSIONS Our analysis showed that in our sample physical problems were more frequent than psychological one. In fact, in spite of in the literature there was a high prevalence of mental health problems among elderly inmates, we did not find this result. However, stress conditions may increase the risk of pathologies: for example, being in jail and adapt to new hard environment may increase the risk of getting sick. Heart disease pathologies and diabetes were very common in our sample as confirmed by the literature.
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Affiliation(s)
| | | | - A Convertini
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - L Dassisti
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - A R Fanizza
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - F Misceo
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - G M Corbi
- Department Medicine and Health Sciences, University of Molise
| | - C P Campobasso
- Department of Experimental Medicine, University of Naples "L. Vanvitelli"
| | - S Tafuri
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro"
| | - F P Bianchi
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro"
| | - L Ferrannini
- Faculty of medicine and surgery, University of Genova
| | - N Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples
| | - I Grattagliano
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
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Grattagliano I, Ostuni A, Marrone M, Cassano A, Tafuri S, Bianchi FP, Misceo F, Miniello M, Catanesi R. The wish 'not to be'. Survey of suicide cases arriving at the Prosecutor's Office of the Court in Bari in the years 2014-2016. Clin Ter 2019; 170:e16-e26. [PMID: 30789193 DOI: 10.7417/ct.2019.2103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The issue of suicide has always been a very sensitive and important problem, that raises many questions in the society where it occurs, that is not always able to oppose an adequate response. Every scientist in the field agrees that this is an act provoked by multifaceted reasons, which include cultural, social and biographical motives. Therefore, this topic also poses ethical and civil problems, as well as epistemologic and research methodology issues, because of its complexity as a subject of study. The authors propose a case-by-case contribution, evaluating the judicial acts on 73 suicides made available by the Bari Public Prosecutor's Office for the years 2014-2016. The authors believe collected and systematized data, and the ensuing considerations, can offer a contribution to the debate in the field of legal and socio-healthcare actors, who are often the first to deal with and confront this complex and tragic phenomenon.
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Affiliation(s)
- I Grattagliano
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - A Ostuni
- Interdisciplinary Department of Medicine, Section of Criminology and Forensic Psychiatry, University of Bari "Aldo Moro"
| | - M Marrone
- Institute of Cancer Research and the Medical Research, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - A Cassano
- Interdisciplinary Department of Medicine, Section of Criminology and Forensic Psychiatry, University of Bari "Aldo Moro"
| | - S Tafuri
- Department of Biomedical Science and Human Oncology Università degli Studi di Bari "Aldo Moro"
| | - F P Bianchi
- Department of Biomedical Science and Human Oncology Università degli Studi di Bari "Aldo Moro"
| | - F Misceo
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - M Miniello
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - R Catanesi
- Interdisciplinary Department of Medicine, Section of Criminology and Forensic Psychiatry, University of Bari "Aldo Moro"
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Campobasso N, Misceo F, Gesualdo L, Manno C, Pannarale G, Schena FP. [Echography in the diagnosis and follow-up of renal biopsy complications]. Arch Ital Urol Androl 1997; 69:193-9. [PMID: 9273094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The introduction of echography represented a focal step in the management of renal biopsy, resulting in easier and faster procedures. Chiefly, echography allows the diagnosis and monitoring of complications of bioptic procedure. Here we present a series of 722 consecutive echo-guided renal biopsies, carried out from 1990 to 1995, 97 of which on kidney allografts. Echographic examination, performed 24 to 48 hours after renal biopsy, enable to diagnose the presence of perirenal hematoma in 30% of patients. Of these, only 10% presented with clinical symptoms and/or signs (reduction of Hct and arterial pressure, local pain). Our protocol comprises an echographic follow-up to control the evolution of hematoma, that usually resolves within 15-40 days, according to the initial size of the lesion. One time we observed an intra-parenchimal hematoma, which resulted in kidney rupture and consequent nephrectomy. 14% of all patients complained with macrohematuria: in 10% of these cases, echography showed the presence of coaguli in the urinary tract, which was associated with the clinical features of renal colic pain. Only in two cases of persistent macrohematuria, the echography together with echo- and color-doppler, allowed the diagnosis of the arterio-venous fistula. In conclusion, our experience demonstrates that the echographic examination allows not only to simplify the bioptic procedure, but also to early diagnose the complications due to this invasive manouvre.
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