A new sign of the slipping rib syndrome? Romano, Rosalia; Gavezzoli, Diego; Gallazzi, Maria Sole ...
Interactive cardiovascular and thoracic surgery,
01/2022, Letnik:
34, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Abstract
The slipping rib syndrome is characterized by burning pain in the lower thorax and upper abdomen, often disabling, caused by hypermobility of the costal cartilage with entrapment of the ...intercostal nerve. The syndrome is often underdiagnosed. The diagnosis is clinical and the definitive treatment is surgical, with an excellent result for pain relief. Based on the observation of 4 cases undergoing rib resection for SRS, we noticed a new possible sign of the disease. Our patients showed less thickness of the ipsilateral rectus abdominis muscle on ultrasound of the abdomen. The aim of this study is to demonstrate this sign in the diagnosis of SRS, to make this disease more recognizable and treatable.
The slipping rib syndrome (SRS) is characterized by intense pain in the lower rib arch radiating to the side and the upper abdomen, or by chest pain.
The aim of this study was to develop a Delphi consensus statement between rheumatologists and radiologists for the diagnosis and monitoring of axial spondyloarthritis (axial-SpA).
Following an ...extensive literature search to identify unmet needs and potential goals for a multidisciplinary approach, a scientific board comprising 28 Italian hospital-based rheumatologists (n=19) and radiologists (n=9) identified 8 "starting points", resulting in the development of 23 consensus statements covering issues from current practice guidelines to specific MRI protocols for the assessment of axial-SpA. Each participant anonymously expressed a level of agreement for each statement using a 5-point Likert scale (1="strongly disagree"; 5="strongly agree") via an online Delphi method.Total cumulative agreement (TCA) was defined as the sum of the percentage of response to items 4 ("agree") and 5 ("absolutely agree"). Consensus was defined as ≥80% total cumulative agreement for each statement.
After the first round of voting (28 participants), positive consensus was reached for 28/31 (90.3%) statements. Statements without consensus (n=3) were discussed in a face-to-face plenary session prior to the second vote (28 participants). After the second round voting, positive consensus was attained for all 31 statements, with mean final TCA of 95.5% (range 82.1-100%).
This Delphi consensus statement provides an aid to rheumatologists and radiologists for the diagnosis and monitoring of axial-SpA.
Aims
The prevention of pulmonary toxicity is an important goal for patient candidate to radiation therapy for lung cancer. There is a lack of evidence on the role of exercise training for patients ...with unresectable stage III lung cancer candidated to radical treatment. The aim of this study was to evaluate the feasibility of a home-based pulmonary rehabilitation (PR) program and to identify reliable tools in terms of respiratory function, exercise capacity and quality of life.
Methods
Patients’ recruitment lasted from April 2020 till February 2022. The PR program was proposed concomitantly to radiation therapy to the first 20 patients (interventional group, IG), and the other 20 patients were identified as an observational group (OG). All patients were assessed at baseline (T0) and after 8 weeks (T2) with 6 minute walking test (6MWT), modified Borg Scale (mBORG), SF-36 questionnaire (SF-36) and pulmonary function test (PFT); after 4 weeks (T1), only SF-36 was administered.
Results
A decrease of 13.8 m in the walked-distance was registered in the OG between T0 and T2 (
p
= 0.083). Instead, an increase of 56.6 m in the distance walked was recorded in the IG between T0 and T2 (
p
≤ 0.001).
In the OG, the mBORG scores showed a negative trend. On the contrary, in the IG, these scores showed a slight improvement. In the OG, all the items of SF-36 scores decreased between T0 and T1. In the IG, an increased trend from T0 to T2 was observed for all the items of SF-36. No clinically significant variations were detected from baseline to T2 in both groups regarding PFT.
Conclusion
The 6MWT, mBORG and SF-36 resulted as useful tools to assess the role of a PR program. A significant gain in functional exercise capacity and a prevention of the physiological impairment of QoL during radio(chemo)therapy was registered.
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