The Pain Self‐Efficacy Questionnaire: Cross‐Cultural Adaptation into Italian and Assessment of Its Measurement Properties

The Pain Self‐Efficacy Questionnaire (PSEQ) is a patient self‐reported measurement instrument that evaluates pain self‐efficacy beliefs in patients with chronic pain. The measurement properties of the PSEQ have been tested in its original and translated versions, showing satisfactory results for validity and reliability. The aims of this study were 2 fold as follows: (1) to translate the PSEQ into Italian through a process of cross‐cultural adaptation, (2) to test the measurement properties of the Italian PSEQ (PSEQ‐I). The cross‐cultural adaptation was completed in 5 months without omitting any item of the original PSEQ. Measurement properties were tested in 165 patients with chronic low back pain (CLBP) (65% women, mean age 49.9 years). Factor analysis confirmed the one‐factor structure of the questionnaire. Internal consistency (Cronbach's α = 0.94) and test–retest reliability (ICC_agreement = 0.82) of the PSEQ‐I showed good results. The smallest detectable change was equal to 15.69 scale points. The PSEQ‐I displayed a high construct validity by meeting more than 75% of a priori hypotheses on correlations with measurement instruments assessing pain intensity, disability, anxiety, depression, pain catastrophizing, fear of movement, and coping strategies. Additionally, the PSEQ‐I differentiated patients taking pain medication or not. The results of this study suggest that the PSEQ‐I can be used as a valid and reliable tool in Italian patients with CLBP.     

(Aγδβ)° thalassaemia: similarity of phenotype in four different molecular defects, including one newly described

Globin gene mapping of DNA from families with (A gamma delta beta) thalassaemia has revealed a previously unreported gene deletion responsible for this condition. The deletion removes the A gamma, delta and beta genes and while its 5' end is in a similar position to that described in a previous deletion of this type, the 3' ends of the two deletions are quite different. In addition we have observed further examples of two other previously described deletions which result in this disorder. Phenotypic comparisons of families with (A gamma delta beta) thalassaemia, in which the molecular basis has been defined, show a remarkable similarity among the four different deletion defects, with important implications with regard to the mechanism by which deletions allow the continued expression of gamma genes.     

Developmental and Acquired Variations in Erythrocyte Carbonic Anhydrase Isozymes

Two carbonic anhydrase fractions, designated B and C, can be seen readily on starch-gel electrophoretic patterns of human red-cell lysates stained for protein. Both isozymes are low in infancy and reach their adult intensity at the second to third year of life. Enzyme 13 is markedly reduced in patients with thyrotoxicosis and elevated in hypothyroidism, returning to normal after treatment. These findings are associated with appropriate changes in total red-cell enzyme activity. Carbonic anhydrase activity is markedly elevated in red cells from patients with megaloblastic anaemia secondary to vitamin B₁₂ deficiency and is probably elevated in folic acid deficiency. These findings, their diagnostic possibilities, and the light which they throw on enzyme induction in human red cells, are discussed.     

The dose-response relationship of inhaled corticosteroids in asthma

Inhaled corticosteroids are the only class of asthma medication that can reduce symptoms, improve lung function, reduce the frequency of severe exacerbations, including hospital and ICU admissions, and decrease the risk of mortality. The therapeutic dose range for all clinical outcome measures in adults is 100 to 1000 ώg/d of beclomethasone dipropionate or budesonide, or 50 to 500 ώg/d of fluticasone propionate. Doses in excess of this range are not recommended for routine use because they are likely to increase the risk of systemic side-effects without further major improvement in efficacy. The recommendations are qualified by the recognition that there is considerable individual variability in the response to inhaled corticosteroids in asthma, which would suggest that some patients might obtain greater benefit at higher doses, just as some might obtain maximum benefit at lower doses.