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Background The number of people living with congenital heart disease (CHD) in 2017 was estimated to be 12 million, which was 19% higher than that in 1990. However, their death rate declined by 35%, emphasizing the importance of monitoring their quality of life due to its impact on several patient outcomes. The main objective of this study is to analyze how parents’ psychosocial factors contribute to children’s and adolescents’ perceptions of their QoL, focusing on their medical condition. More specifically, we explore how parental psychological dimensions, such as anxiety and depression, are related to patients’ health-related quality of life (HRQoL). Methods We recruited 447 children aged 5 to 18 years with a CHD diagnosis and their parents (319 mothers and 229 fathers) from January to December 2018. Patients were referred to the Cardiology Department of “Bambino Gesù” Children’s Hospital and participated in multidisciplinary standardized follow-up. Children and adolescents were submitted to a comprehensive evaluation by different physicians, including pediatric cardiologists, surgeons, and psychologists, at preset time frames. A series of standardized questionnaires were administered during psychological assessment. Results The main findings show a negative correlation between mothers’ anxiety and three patients’ HRQoL subscales (Treatment II, Treatment anxiety, and Communication). Similarly, mothers’ depression correlates negatively with other patients’ HRQoL subscales (heart problems, symptoms, perceived physical appearance, cognitive problems, and communication). Fathers’ anxiety and depression show negative correlations with only the subscale of Treatment II. More generally, the perceived quality of life of children and adolescents with CHD is influenced by their medical conditions as well as the parents’ psychological dimensions. Conclusions Our findings suggest that the caregivers of pediatric patients with CHD are more exposed to psychological problems of anxiety and depression, which affect the perceived quality of life of their children. Longitudinal research with a healthy control group is recommended to further consolidate this evidence.

Background Congenital heart disease (CHD) is the most common congenital anomaly at birth, affecting approximately 1% of live births. In recent decades great medical and surgical advances have significantly increased life expectancy, shifting healthcare professionals' and researchers’ interests in patients' Quality of Life (QoL). The main aims of our study were to evaluate generic and condition-specific QoL in a group of Italian children and adolescents with CHD and their parents and examine the level of agreement and directional disagreement between child/adolescent and parents reports on generic and condition-specific QoL. Methods A cross-sectional study was designed with CHD children and adolescents and their parents referred to the Cardiology Department of “Bambino Gesù” Children’s Hospital. The PedsQL scale was used, including generic (PedsQL 4.0) and cardiac-specific modules (PedsQL 3.0) were administered to patients and caregivers. A Kruskal–Wallis test was used to compare generic and cardiac module scores between patients with different ages, CHD diagnoses, and between patients who underwent surgery interventions and/or are currently taking cardiac medications. Results 498 families were enrolled in this study. On average, patients reported a good level of generic and condition-specific QoL, as well as their mothers and fathers. Children aged between 5–7 years old reported lower generic and cardiac-specific total QoL levels than children aged 8–12 years and adolescents (13–18 years). With regard to the agreement, patient-parent agreement on condition-specific QoL ranged from 25 to 75% while on generic QoL, it ranged from 19 to 76%. The highest percentage of disagreement between parents and children was found in patients aged 5–7 years old, both for condition-specific and generic QoL rates. Conclusions Our study contributed to the growing body of knowledge on QoL in CHD, emphasizing the need for these families to receive support from multidisciplinary standardized care, including psychological consultations and support.

IntroductionThe concept of quality of life is broad and multidimensional. The temporal dimension of its evaluation is very important because the quality of life is not a stable and defined condition, but changes over time.Heart disease is classified among the most severe chronic disabilities in children and as more and more children and adolescents with severe cardiac defects survive into adulthood, the quality of their life becomes increasingly important.The quality of life in cardiopaths may vary depending on various factors, ranging from the intake of a drug therapy, to the possible prohibition of performing sports, to the results of surgery as scars, a possible source of shame.Parents of children with heart disease may experience higher stress levels than normal parental function and may feel very stressed about issues related to accountability and social integration.MethodsThis research aims to investigate the quality of life in pediatric age both in terms of purely cardiological aspects (CardioPeds) and of general quality of life (PedsQL), also evaluating, starting from 12 years, the possible presence of depressive symptoms (PHQ-9) or anxious symptoms (GAD-7). These tests were administered both to the children and the parents, with the addition for these last ones of the compilation of the PSI, to investigate the parental distress.The research allowed to divide the sample of 500 patients into 6 predominant pathologies, in order to compare the quality of life of children in different diseases and to understand if a specific pathology is associated or not with a lower quality of life.ResultsThrough an adequate statistical analysis it was found that the quality of life perceived by the subjects included in the study is significantly better than that perceived by the parents about the same children and adolescents.ConclusionsThis study was one of the first to investigate the quality of life in congenital and/or acquired pediatric heart disease. However, the results obtained require further studies, in order to deepen what has emerged.

Congenital heart disease represents the most common malformation diagnosed in newborns, and the majority, during their lifetime, will have to undergo medical surgery, causing body scars that could impact perceived physical appearance and, subsequentially, their quality of life. In this study, we investigated how anxiety and depression mediate the relationship between perceived physical appearance and quality of life in patients with congenital heart disease. Participants were 708 Italian patients (58.8% male, M age = 27.03, DS = 7.03. They completed self-report measures assessing perceived physical appearance, anxiety, depression, and quality of life. The results show that perceived physical appearance has a significant, negative, and total effect on quality of life, and even when anxiety and depression are included in the parallel mediation model, perceived physical appearance remains significant. These findings may be important to better understand the mechanism that underlie the relationship between negative self-perception and quality of life, considering the impact of anxiety and depression, particularly among female patients. These results could be used to improve patients’ quality of life and reduce anxiety and depression, enhancing awareness and acceptation of self-body.

Objectives: Cleft lip and/or palate (CLP) is the most common congenital craniofacial abnormality, with a prevalence of 9.92 per 10,000 live births. In treating patients with CLP, oral rehabilitation is definitely a very important phase of the treatment in order to improve the patient's oral health related quality of life (OH-QoL). The aim of this retrospective study is to assess the OH-QoL in patients rehabilitated with different prosthetic options, thus comparing the conventional treatments, which include removable partial dentures and fixed partial dentures, with the implant-supported prostheses. Materials and Methods: Sixty-three patients were enrolled in this retrospective survey [44 females (69.84%) and 19 males (30.16%)] with a mean age of 34.93 +- 7.04 years (age range 21-53 years). They were all treated for CLP and rehabilitated with a conventional prosthesis or an implant-supported denture. Two different questionnaires were used in the present study to evaluate patients' OH-QoL: The Italian version of the 49-item Oral Health Impact Profile (OHIP-49) and the Italian version of the Cleft Evaluation Profile (CEP). Statistical analysis was performed using analysis of variance (ANOVA) test, with a significant P < 0,05. Results: Data analysis revealed that patients rehabilitated with implant-supported dentures and fixed partial dentures showed a good level of satisfaction with their prostheses, scoring low values in the OHIP-49 and high values in the CEP, while subjects with removable partial dentures scored the highest values in the OHIP-49 and the lowest values in the CEP, which means an unsatisfactory feeling (P < 0.05). Conclusions: OH-QoL is a challenging demand for all prosthodontists. Our results show, clearly, that patients rehabilitated with implant-supported dentures are more satisfied compared to subjects with fixed partial dentures and removable partial dentures.

Nutritional strategies based on sourdough fermented breads with wholemeal ancient grains and legumes are emerging as promising modulators of (neuro)immune processes. This study investigated whether prolonged consumption of a sourdough bread enriched with a mixture of ancient cereals and legumes, commercially available in Italy (Primus® bread, P®B), modulates neuroimmune systemic responses to repeated lipopolysaccharide (LPS) challenge in mice. For this study, male C57BL/6J mice were fed for 14 days with either a standard diet (SD) or P®B. Animals then received intraperitoneal LPS (3 mg/kg/day for 3 days) or vehicle. Body weight and food intake were monitored throughout. Pain-like behaviours were assessed by von Frey, plantar and tail flick tests, and plasma cytokine (32-plex panel), splenocyte and peritoneal macrophage cytokine expression, and expression of pro-inflammatory cytokines in sciatic nerves, dorsal root ganglia (DRG) and the spinal cord were analyzed by Reverse Transcription–quantitative Polymerase Chain Reaction (RT-qPCR). P®B prevented LPS-induced body weight loss and reduced splenomegaly. Unlike SD mice, which exhibited widespread plasmatic cytokine upregulation, P®B-fed mice displayed only limited increases Interleukin (IL)-1β, IL-12p40 and Tumor Necrosis Factor (TNF)α. Ex vivo cultures of splenocytes and macrophages confirmed attenuated cytokine overexpression. LPS-induced hypersensitivity to mechanical, thermal and nociceptive stimuli was significantly reduced in P®B mice. Molecular analyses revealed that the P®B diet blunted the pro-inflammatory cytokine expression present after LPS challenge in the sciatic nerves and DRG, with partial attenuation in the spinal cord. Our findings highlight the great potential of functional foods as affordable dietary strategies to mitigate systemic immune and neuroimmune dysregulation.

Chronic pain is a pervasive global health issue that significantly impairs quality of life and remains inadequately managed by current therapeutic options. Traditional pharmacological treatments often offer limited relief and are associated with significant side effects, highlighting the urgent need for safer and more effective alternatives. Among emerging strategies, mesenchymal stem cell (MSC)-derived secretome, an acellular product composed of bioactive molecules such as cytokines, growth factors and extracellular vesicles, has gained increasing attention for its potent anti-inflammatory, neuroprotective and immunomodulatory properties. Unlike whole-cell therapies, secretome-based interventions offer advantages, including lower immunogenicity, higher safety and easier standardization and storage. Preclinical studies demonstrated that MSC secretome effectively alleviates pain-like behavior across various models of neuropathic, inflammatory and degenerative pain, primarily through neuroimmune modulation and glial cell reprogramming. In vitro experiments confirm its role in promoting neuronal survival, regulating opioid receptor expression and modulating (neuro)inflammatory responses. Preliminary clinical evidence supports its analgesic efficacy in conditions such as osteoarthritis, chronic low back pain and post-surgical pain, with a favorable safety profile and promising therapeutic outcomes. However, challenges remain, including variabilities in secretome composition, lack of standardized production protocols and absence of large-scale clinical trials. Despite these limitations, MSC secretome therapy represents a transformative approach in pain medicine. Continued research efforts are essential to optimize formulation, dosing and delivery strategies, as well as to clarify the regulatory landscape. With further validation, the MSC secretome could emerge as a novel, scalable and clinically viable solution for the management of chronic pain, bridging critical gaps in current treatment paradigms.

Spinal cord stimulation (SCS) is a well-established intervention for chronic pain, but the factors predicting treatment success remain unclear. This pilot study investigated psychometric and inflammatory biomarkers associated with clinical outcomes in patients undergoing SCS for chronic low back pain. Twenty-two eligible patients were enrolled. Clinical evaluations, psychometric assessments, and blood samples were collected at baseline and at 1-, 3-, and 6-month post-implantation. Pain intensity, psychological status, and quality of life were assessed using validated questionnaires. Inflammatory markers were analyzed in peripheral blood mononuclear cells (PBMCs) at both mRNA and protein levels. Nineteen patients completed the trial and received definitive SCS implantation (Trial Completed, TC group), while three were discontinued (Trial Failed, TF group). In the TC group, pain intensity and its interference with emotional and work life significantly improved. Psychometric scores also improved: pain catastrophizing decreased below the clinical threshold, and anxiety and depression scores were significantly reduced, alongside enhanced quality of life. Greater pain relief at follow-up was associated with lower pre-implant anxiety and depression levels. Cytokine analysis revealed downregulation of pro-inflammatory IL-1β and upregulation of anti-inflammatory IL-10 and IL-4 post-SCS. In the TF group, baseline depression was higher compared to the TC group. SCS trial implantation in these patients induced only IL-4 upregulation, without broader cytokine modulation. SCS significantly improved clinical and psychometric outcomes and positively modulated inflammatory profiles in patients with chronic low back pain. High baseline depressive symptoms may predict poorer SCS outcomes, suggesting the importance of psychological assessment in patient selection.

Osteoarthritis (OA) is the most prevalent joint disease associated with chronic pain. OA pain is often accompanied by mood disorders. We addressed the role of the Prokineticin (PK) system in pain and mood alterations in a mice OA model induced with monosodium iodoacetate (MIA). The effect of a PK antagonist (PC1) was compared to that of diclofenac. C57BL/6J male mice injected with MIA in the knee joint were characterized by allodynia, motor deficits, and fatigue. Twenty-eight days after MIA, in the knee joint, we measured high mRNA of PK2 and its receptor PKR1, pro-inflammatory cytokines, and MMP13. At the same time, in the sciatic nerve and spinal cord, we found increased levels of PK2, PKR1, IL-1β, and IL-6. These changes were in the presence of high GFAP and CD11b mRNA in the sciatic nerve and GFAP in the spinal cord. OA mice were also characterized by anxiety, depression, and neuroinflammation in the prefrontal cortex and hippocampus. In both stations, we found increased pro-inflammatory cytokines. In addition, PK upregulation and reactive astrogliosis in the hippocampus and microglia reactivity in the prefrontal cortex were detected. PC1 reduced joint inflammation and neuroinflammation in PNS and CNS and counteracted OA pain and emotional disturbances.

The objectives of this study were to investigate the main risk factors associated with calving ease (CE) in Italian Holstein cow herds, and to estimate the association between CE and subsequent survival, fertility and milk production. Data obtained from Holstein cows in 40 Italian herds were retrospectively investigated. Calvings were surveilled and classified into two categories of CE, unassisted calving or assisted calving, based on the need for intervention. The following factors were analyzed as possible risk factor affecting CE: herd, number of calvings/herd/year, age at first calving (AFC), cow parity, gestation length, twinning, calf sex, previous calving-to-conception interval, previous milk yield, dry period and close-up length, and season of calving. The association between CE and culling risk within the first 30 days-in-milk (DIM), cumulative 60-d milk yield and predicted 305-d milk yield, and pregnancy risk within 150 DIM were also investigated. Of the 47,672 calvings, 37,892 (79.5%) were unassisted, while 9780 (20.5%) required some type of assistance. Among the risk factors, only the AFC was not correlated with CE, while for all the other risk factors an association with CE was detected. Assisted calvings were associated with an increased culling risk at 30 DIM, decreased 60-d milk yield, decreased 305-d milk yield and reduced pregnancy risk at 150 DIM. In conclusion, dairy herd management should aim at correcting/reducing the risk factors in order to limit the incidence of assisted calving, and possibly improve the quality of calving assistance; controlling CE within the herd is crucial to reducing culling risk, and achieving higher lactation and reproductive performance.