The Fear Avoidance Components Scale (FACS) is a new patient-reported outcome (PRO) questionnaire designed to comprehensively evaluate fear avoidance (FA) beliefs and attitudes in persons with painful ...medical conditions. The original English version has demonstrated acceptable psychometric properties, including concurrent and predictive validity. Two factors have been identified: 1. general fear avoidance; and 2. types of activities that are avoided.
The FACS was first translated into Serbian, and then psychometrically validated. A cohort of 322 chronic musculoskeletal pain subjects completed the FACS-Serb and additional FA-related patient-reported outcome (PRO) measures. Their FACS-Serb scores were then compared to a cohort of 68 acute pain subjects.
Test-retest reliability (ICC2,1 = 0.928) and internal consistency for both Factors (Cronbach α 0.904 and 0,880 respectively) were very good. An acceptable fit was found with a confirmatory factor analysis of the 2-factor model found with the original English version of the FACS. Strong associations were found among FACS-Serb scores and other PRO measures of pain catastrophizing, depressive/anxiety symptoms, perceived disability, and pain intensity (p<0.001 for all analyses). FACS-Serb total scores, separate Factor scores, and subjective pain ratings were significantly higher in the chronic vs. acute pain cohorts (p<0.001 for all analyses).
The FACS-Serb demonstrated strong psychometric properties, including strong reliability and internal consistency, criterion validity (through associations with other FA-related PRO measures), and discriminant validity (through comparisons with a separate acute pain cohort). The FACS-Serb appears to be a potentially useful pain-related assessment tool.
Objectives
It has been increasingly recognized that many chronic pain conditions are associated with central sensitization (CS). The Central Sensitization Inventory (CSI) is a potentially useful tool ...for screening patients whose presenting symptoms are suspected of being related to CS, so that additional diagnostic evaluation can be performed and appropriate treatment can be initiated. The original English version is currently not available in Serbian.
Methods
The CSI was translated into Serbian (CSI‐Serb) and then psychometrically evaluated in a sample of 363 chronic pain subjects.
Results
The CSI‐Serb showed a high degree of internal consistency (Cronbach's α = 0.909), excellent test‐retest reliability (intraclass correlation coefficient type 2.1 = 0.947), and a significant goodness of fit test result (χ2 = 888.44; P < 0.001). A factor analysis confirmed a 4‐factor solution, as found by the original authors of the CSI, with all items retained. Higher CSI‐Serb scores were associated with higher pain severity and longer pain duration. Total CSI scores distinguished between 3 subject groups with presumably different levels of CS, including fibromyalgia (53.3, SD = 11.2), chronic regional pain only (29.7, SD = 11.6), and a pain‐free control group (20.9, SD = 9.1).
Conclusions
The results of the present study indicate strong psychometric properties, including evidence of convergent and discriminant validity, of the CSI‐Serb. These results correspond with those of other translated versions of the CSI that have been psychometrically evaluated and published. Due to the current interest in CS, and its relationship with many chronic pain conditions, it is anticipated that the CSI‐Serb will benefit Serbian‐speaking clinicians in the evaluation of patients with chronic pain conditions.
Objectives
The goal of the present study was to explore additional evidence of validity of the Serbian version of the Central Sensitization Inventory (CSI), a patient‐reported outcome measure of ...symptoms that have been found to be associated with central sensitization (CS). The CSI has been found to be psychometrically sound, and has demonstrated evidence of convergent and discriminant validity in numerous published studies and in multiple languages.
Methods
CSI data were collected from 399 patients with chronic pain who had various diagnoses and from 146 pain‐free controls. In addition, the patient sample completed a battery of validated patient‐reported outcome measures of sleep problems, cognitive problems, pain catastrophizing, pain‐related fear‐avoidance, decreased quality of life, and decreased perception of social support. Six patient subgroups were formed, with presumably different levels of CS (including those with fibromyalgia, multiple pain sites, and localized pain sites).
Results
Significant differences were found in total CSI scores among the controls and patient subgroups. Those with fibromyalgia and multiple pathologies scored highest and the control subjects scored lowest. Other patient‐reported CS‐related symptom dimensions were significantly correlated with total CSI scores. When the patients were divided into CSI severity subgroups (from subclinical to extreme), the severity of these other symptom dimensions increased with the severity of CSI scores.
Conclusions
The current study successfully demonstrated additional evidence of the convergent and discriminant validity of the Serbian version of the CSI.
(1) Background: The aim of this study was to investigate the agreement between a clinical diagnosis based on research diagnostic criteria/temporomandibular disorders (RDC/TMD) and high-field magnetic ...resonance imaging (MRI) findings of temporomandibular joints (TMJs) in asymptomatic females. (2) Methods: A prospective study on 100 females (200 TMJs) was performed, using clinical examinations (RDC/TMD) and same-day MRIs of TMJs on a 3T MR unit. The inclusion criteria were as follows: females, age > 18, the presence of upper and lower incisors, and an understanding of the Serbian language. Descriptive statistics (means and standard deviations) and ANOVA with a post hoc Tukey test for differences among the patient subgroups was performed. The agreement between the clinical and MRI findings was determined using Cohen's kappa coefficient (k < 0.21 slight, 0.21-0.4 fair, 0.41-0.6 moderate, 0.61-0.8 substantial, and 0.81-1 almost perfect). The statistical significance was set at
≤ 0.05. (3) Results: Normal findings were observed in 86.7%, disc dislocation (DD) was observed in 9.2%, and arthralgia/osteoarthritis/osteoarthrosis was observed in 2.6% of TMJs using RDC/TMD. On the MRI, normal findings were observed in 50.5%, disc dislocation was observed in 16.3%, and arthralgia/osteoarthritis/osteoarthrosis was observed in 23.5% of TMJs. The anterior DD with reduction showed fair agreement of the clinical and MRI findings (k = 0.240,
< 0.001) compared with the DD without reduction (k = 0.355,
< 0.001). Both showed high specificity (94.9% and 99.4%) but low sensitivity (24.2% and 25.0%). The sensitivity in osteoarthritic changes was low (4.8%), but the specificity remained high (96.2%). (4) Conclusions: The sensitivity of the clinical examination remains low compared with 3T MRI, especially in osteoarthritic changes and anterior DD with reduction. However, the number of false positive diagnoses using RDC/TMD is low in asymptomatic patients. RDC/TMD remains a sensible method for establishing a clinical diagnosis and avoiding the overtreatment of asymptomatic patients.
(1) Background: During the magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ), it is necessary to scan the joints in the closed- and open-jaw position, as well as in the maximally ...open-jaw position. In order to examine both joints in these positions, an MRI compatible mouth opener is required, which allows the articular surfaces to maintain their position stably. (2) Methods: In this study, we included 200 patients aged 18 to 65, with various levels of clinical severity. The mouth opener is made of polymethyl methacrylate and used for dynamic imaging of TMJ. It is in the form of an arrow, with incisures on upper and lower surfaces 1 mm apart and these match possible variations in jaw opening. All the patients were scanned with mouth opener and, immediately after this scanning, with syringe (20 ccm) as a standard device used for mouth opening in clinical setting. (3) Results: A total of 200 MR examinations of TMJs were performed and the mechanical mouth opener was successfully applied without artifacts in all patients. The mouth opener device proved to be adequate in case of MRI of the TMJ for different ranges of mouth opening with the proper protocol for provoked imaging, because the incisures are located at a distance of 1 mm and no objective artifacts were observed in any examination that degraded the diagnostic quality of the examination. (4) Conclusions: The design of the acrylate mouth opener is precisely defined, and it has a purpose in the MRI diagnosis of TMJ disorders.
In a last few decades mushrooms are increasingly attracting attention as functional food and sources of biologically active compounds. Several Trametes species have been used for centuries in ...traditional medicine of East Asia cultures, but only T. versicolor was studied sufficiently while there are less substantial data about medicinal properties of other species. Trametes versicolor, T. hirsuta and T. gibbosa were the species tested for biological activities. Antifungal potentials of extracts were assessed for clinical strains of selected Candida and Aspergillus species. ABTS and FRAP assays were used to evaluate antioxidant capacities of studied extracts. Cytotoxic activity was determined against human cervix and lung adenocarcinoma and colon carcinoma cell lines. Antineurodegenerative activity was assessed by determining the rate of acetylcholinesterase and tyrosinase activity. The presence of metabolites in extracts of mycelia and basidiocarps of studied Trametes species was analyzed by 1H NMR spectroscopy. Studied extracts showed low antifungal potential in comparison with ketoconazole. Basidiocarp extracts were more effective ABTS+ scavengers and Fe2+ reducers than mycelium ones but less effective in comparison with L-ascorbic acid. Results showed that mycelium extracts had stronger cytotoxic effects against three cancer cell lines than basidiocarp ones, and that cervix adenocarcinoma cells were the most sensitive to the extracts and commercial cytostatics. T. versicolor mycelium extract was the most effective inhibitor of acetylcholinesterase activity but double weaker than galantamine, and T. gibbosa mycelium extract was significantly better inhibitor of tyrosinase activity than kojic acid for 40.9%. Chemical analysis indicated strong synergistic action of triterpenes, sugars and polyphenols in applied assays. The results suggest that tested Trametes species have significant medicinal potentials which could be attributed to antioxidative and cytotoxic activity. Additionally both, basidiocarps and mycelia extracts can strongly inhibit activity of acetylcholinesterase and tyrosinase.
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