Quality of life changes over time and predictors in a large head and neck patients' cohort: secondary analysis from an Italian multi-center longitudinal, prospective, observational study-a study of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) head and neck working group.

PURPOSE: The present study examined the longitudinal trajectories, through hierarchical modeling, of quality of life among patients with head and neck cancer, specifically symptoms burden, during radiotherapy, and in the follow-up period (1, 3, 6, and 12 months after completion of radiotherapy), through the M.D. Anderson Symptom Inventory Head and Neck questionnaire, formed by three factors. Furthermore, analyses were conducted controlling for socio-demographic as well as clinical characteristics. METHODS: Multi-level mixed-effects linear regression was used to estimate the association between quality of life and time, age, gender, household, educational level, employment status, ECOG performance status, human papilloma virus (HPV) status, surgery, chemotherapy, alcohol intake, and smoking. RESULTS: Among the 166 participants, time resulted to be a predictor of all the three questionnaire factors, namely, general and specific related symptoms and interference with daily life. Moreover, regarding symptom interference with daily activities factor, HPV-positive status played a significant role. Considering only HPV-negative patients, only time predicted patients' quality of life. Differently, among HPV-positive patients, other variables, such as gender, educational level, alcohol use, surgery, age at diagnosis, employment status, and ECOG status, resulted significant. CONCLUSION: It was evident that quality of life of patients with head and neck cancer declined during RT, whereas it slowly improved after ending treatment. Our results clarified the role of some socio-demographic and clinical variables, for instance, HPV, which would allow to develop treatments tailored to each patient.

The Casuccio-Santacroce-Banfo knee arthroscope: an avant-garde Italian tale in the history of arthroscopy.

PURPOSE: This brief historical note describes an arthroscopic instrument presented in Italy in 1950, and still preserved to this day at the library of the Rizzoli Orthopedic Institute in Bologna, Italy. MATERIAL AND METHODS: A research on Casuccio, Santacroce, and Banfo prolific scientific collaboration was performed. RESULTS: The arthroscopic instrument was designed and utilized at the Orthopedic Clinic of the University of Bari, directed by Professor Casuccio, in collaboration with his assistant, Antonio Santacroce, and Giorgio Banfo, an orthopedist, entrepreneur, and owner of a modern establishment dedicated to the production of orthopaedic products and medical instruments. CONCLUSION: Much like America and Japan, 1950s Italy offered avant-garde arthroscopic instruments, which resulted from a masterful collaboration of research and development.

A historical perspective on ankle ligaments reconstructive surgery.

Ankle sprains are by far the most common injuries treated by sport medicine physicians. Treatment is mainly conservative, but in some cases surgical intervention is required. The aim of the present manuscript is to give an insight into the origins and developments of ankle ligaments reconstructive surgery, underlining the fundamental steps that marked the transition from a mere conservative approach to surgical treatment options. In this historical note, the most illustrious figures who contributed to this particular field of orthopaedic practice are also acknowledged. Level of evidence V.

The Masters of the Bolognese Orthopaedic School.

Bologna is one of the most ancient cradles of medical knowledge, as the city hosts one of the oldest medical faculties in the world. Among its best known institutions there is the Rizzoli Orthopaedic Institute, founded in the late nineteenth century, whose history is strictly connected with the evolution and development of the Italian orthopaedic practice of the last 120 years. The present manuscript acknowledges the main contributions by Francesco Rizzoli, Alessandro Codivilla and Vittorio Putti, who prompted the foundation and the international recognition of the Rizzoli Institute and the related Bolognese Orthopaedic School.

Knee multi-ligament reconstruction: a historical note on the fundamental landmarks.

Several eminent surgeons made breakthroughs in knee surgery throughout the nineteenth and twentieth centuries. Before that, knee injuries were only treated conservatively and it was thanks to the progress made in the field of biomechanics and biology that new surgical treatments were proposed. The history of medicine recalls some illustrious surgeons such as Thomas Annandale and Mayo Robson who were the first to perform and describe their revolutionary experience regarding meniscal and anterior cruciate ligament surgery. Less famous are the forefathers of multi-ligament reconstructive surgery: the purpose of this paper was to shed some light on the pioneers of this particular field of orthopaedic practice, which is gaining increasing interest in current clinical practice. Level of evidence V.

Sir Robert Jones: orthopaedic surgeon and war hero.

The First World War was a very harsh conflict and statistics recorded a great number of victims, both soldiers and civilians. One hundred years later, the whole world is commemorating the Great War by celebrating people and events that contributed to shaping the XX century. Beyond remembering political figures, war heroes or even famous battles, it is also important to underline the contribution of those who devoted their efforts to improve the living conditions during war campaigns. This is the case of Sir Robert Jones, one of the fathers of XX century orthopaedics, who contributed to re-organize the military medical assistance during war times and whose teachings, coming directly from his "on the field" experience, inspired an entire generation of European surgeons.

An orthopaedic conquest: the first inter-human tissue transplantation.

UNLABELLED: Nineteenth century Scottish surgeon William Macewen performed, in 1879, the first inter-human living donor transplantation in medical history. It was a bone allograft performed on a 3-year-old boy affected by a huge humeral bone loss. This paper analyses the historical context around Macewen, briefly introducing his life and the discoveries made by Lister and by the pioneers of anaesthesia. It focuses on the details of the bone allograft procedure invented by Macewen. He was both a basic researcher and a skilled surgeon, a combination that is rare nowadays. The paper includes a description of the surgical procedure and is also enriched by the reproduction of the original image used by Macewen in his 1881 article to explain the clinical evolution. William Macewen was one of the greatest pioneers in musculoskeletal medicine whose brilliant intuition led to the origin and development of bone grafting, one of the most common orthopaedic procedures in the world today. LEVEL OF EVIDENCE: V.

Postcards from the past: the Third SICOT Congress, Bologna 1936.

This manuscript describes the events and eminent personalities who animated the third Congress of the "Société Internationale de Chirurgie Orthopédique et Traumatologie", held in Bologna (Italy) in 1936. During this meeting the Society acquired its definitive name and the acronym under which it is now internationally recognized, SICOT. Some of the most illustrious clinicians and scientists of those times gathered in Bologna to discuss the progress of orthopaedic science, thus contributing to highlight the relevance of this discipline in the medical field. Italian surgeon Vittorio Putti was the Congress Chairman and his words, together with some original pictures from his 1936 photo gallery, are shown to celebrate appropriately a prestigious moment in the history of SICOT.

John Rhea Barton: the birth of osteotomy.

Osteotomy is one of the most common surgical procedures performed everyday all over the world. This technique dates back to the first half of nineteenth century and to the fundamental contribution made by Pennsylvania Hospital surgeon John Rhea Barton (1794-1871), who can be considered the pioneer of modern osteotomies; this paper focuses on his life and career highlights with a description of the first corrective osteotomies for hip and knee ankylosis (documented in two fundamental papers whose original pictures are here reproduced). The success of osteotomy as a current surgical approach to treat several orthopaedic conditions is confirmation of the importance of this procedure in the orthopaedic discipline and prompted an investigation into the pioneering mind who introduced it.

Thomas Annandale: the first meniscus repair.

A biographical insight about nineteenth century Scottish surgeon Thomas Annandale (1838-1907), describing his life and his milestone contribution to the orthopaedics field, particularly analysing the first meniscus repair in history, that Annandale performed in 1883 and documented in his original paper titled "An Operation for Displaced Semilunar Cartilage" (1885). The experience of Annandale marks a shift in the treatment of meniscal injuries, by introducing the practice of restoring and repairing the original status of the tissue.

The "GENESIS" of modern orthopaedics: portraits of three illustrious pioneers.

There are some key figures in medical history whose achievements can be regarded as crucial in the definition of new knowledge and in setting new standards for clinical practice. This manuscript depicts the lives and work of three eminent physicians who were forerunners in the foundation of orthopaedics as an independent medical specialty. They are: Nicholas Andry, Jean-Andrè Venel, and John Ball Brown. The first was the inventor of the name of our discipline, whereas the other two, besides being renowned practitioners, were also the founders, respectively, of the first orthopaedic institutions in Europe and the United States. Therefore, they can be included among the illustrious fathers of modern orthopaedic practice.

The Renaissance and the universal surgeon: Giovanni Andrea Della Croce, a master of traumatology.

All the medical knowledge of all time in one book, the universal and perfect manual for the Renaissance surgeon, and the man who wrote it. This paper depicts the life and works of Giovanni Andrea della Croce, a 16th Century physician and surgeon, who, endowed with true spirit of Renaissance humanism, wanted to teach and share all his medical knowledge through his opus magnum, titled "Universal Surgery Complete with All the Relevant Parts for the Optimum Surgeon". An extraordinary book which truly represents a defining moment and a founding stone for traumatology, written by a lesser known historical personality, but nonetheless the Renaissance Master of Traumatology.

Narrative Review and Analysis of the Use of "Lifestyle" in Health Psychology.

Lifestyle is a complex and often generic concept that has been used and defined in different ways in scientific research. Currently, there is no single definition of lifestyle, and various fields of knowledge have developed theories and research variables that are also distant from each other. This paper is a narrative review of the literature and an analysis of the concept of lifestyle and its relationship to health. This contribution aims to shed light on the lifestyle construct in health psychology. In particular, the first part of this manuscript reexamines the main definitions of lifestyle in the psychological and sociological fields through three perspectives: internal, external, and temporal. The main components that characterise lifestyle are highlighted. The second part of this paper explores the main concepts of lifestyle in health, underlining their strengths and weaknesses, and proposes an alternative definition of a healthy lifestyle, which integrates the individual dimensions with the social and cycle dimensions of life. In conclusion, a brief indication of a research agenda is presented.

The role of sense of coherence in reducing anxiety and depressive symptoms among patients at the first acute coronary event: A three-year longitudinal study.

OBJECTIVE: Although several studies suggest an association between psychological distress and increased morbidity and mortality in various cardiac populations, little is known about positive psychological resources, like Sense of Coherence (SOC), that may reduce distress. This longitudinal observational study aimed to test the hypothesis that a strong SOC predicted a longitudinal decrease in anxiety and depression in a sample of patients after their first acute coronary event. METHODS: A sample of 275 patients completed the Hospital Anxiety Depression Scale (HADS) and the SOC Scale at five time-points (at the baseline and after 6, 12, 24, and 36 months). Longitudinal trajectories of anxiety, depression, and SOC were examined through hierarchical (generalized) linear models, controlling for sociodemographic and clinical indicators. RESULTS: 38.6% of patients experienced clinically relevant anxiety symptoms soon after the cardiovascular event, whereas only 20.8% experienced clinically relevant depressive symptoms. Anxiety symptoms decreased over time, plateaued, and then slightly increased, whereas depressive symptoms tended to be stable; these variables were positively associated during all time points. The SOC did not change over time; a strong SOC at baseline predicted decreased anxiety and depression. CONCLUSION: Findings showed a strong relationship between SOC and symptoms of anxiety and depression, and they suggested the importance of a salutogenic approach in clinical practice and the relevance of interventions aimed at increasing resilience resources like the SOC in patients with cardiovascular diseases.

M. D. Anderson symptom inventory head neck (MDASI-HN) questionnaire: Italian language psychometric validation in head and neck cancer patients treated with radiotherapy ± systemic therapy - A study of the Italian Association of Radiotherapy and Clinical Oncology (AIRO).

PURPOSE: Head and neck cancer (HNC) patients are likely to develop severe side effects, which may persist long after the end of treatment and may be responsible for decrease patient's quality of life. The M.D. Anderson Symptom Inventory- Head and Neck Module (MDASI-HN) is a questionnaire developed to detect patient's symptom burden. To conduct an Italian language psychometric validation of MDASI-HN among Italian HNC patients on behalf of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Head and Neck Working Group. METHOD AND MATERIALS: To assess construct validity, it was performed a confirmatory factor analysis (CFA) with both a five-factor solution and three-factor solution, which were compared by a chi-square difference test. The concurrent validity was evaluated by the correlation with EORTC QLQ-C30 and HN35, and it was also assessed known-group validity. The internal consistency was tested using Cronbach's alpha coefficient. RESULTS: In total 166 patients (71.7% male) were included in the study, most of patients (56.2%) had an oropharynx cancer and received definitive chemoradiotherapy (51.2%). The chi-square difference test was significant and indicated that the five-factor solution fits the data better than the other one. Regarding CFA, all items had a significant saturation with their respective factors; besides, significant and strong correlations were found among factors. Most of the correlations between MDASI-HN factors and EORTC QLQ-C30 and HN35 were significant. It was found a good internal consistency. CONCLUSION: The MDASI-HN is a valid, short, and easy patient-reported outcome questionnaire which would be useful and efficient in clinical setting.

When neurosurgery and orthopedics were close in the past: Harvey Cushing and Vittorio Putti.

Harvey Cushing and Vittorio Putti are well-recognized medical authorities. The Italian orthopedic surgeon Vittorio Putti was an advocate of modern orthopedics and a scholar in orthopedic history. Putti was a frequent traveler and an esteemed lecturer, and a close friend of the American neurosurgeon, pathologist, and writer Dr. Harvey Cushing. Correspondence between the two can be found at the Yale Medical Historical Library, in New Haven, CT, and at the Rizzoli Institute in Bologna. A research was performed, which yielded an extensive documentation on the correspondence between the two surgeons. The research allowed to analyze and confirm the strong relationship between the two surgeons and highlighted their passion for collecting antique medical books. This paper is a tribute to two great surgeons in the history of medicine and aims at describing their personality and witnessing their great friendship through an unprecedented documentation. Both surgeons still live on through those who can continue to admire and study the fruit of their passion, as both men donated their precious collection of antique texts to public institutions, Putti to the Rizzoli Orthopedic Institute in Bologna, and Cushing to Yale University.