Background: Osteoarthritis (OA) is the most common form of chronic pain in Europe (34%), representing a great economic and social cost to society. There are studies that suggest an intestine–brain–articulation axis and hint at the existence of low-grade intestinal inflammation in OA, which would be related to an alteration of the microbiota and to the impairment of the epithelial barrier, with leakage of the microbial components. Purpose: The purpose of this study was to review the association between gut microbiome and pain in the OA population through a review of the literature. Methods: A literature search was conducted to identify all available studies on the association between the gut microbiome and pain in the OA population, with no publication date limit until September 2020 and no language limit, in the MEDLINE, CINAHL, Web of Science and Cochrane Central Register of Controlled Trials databases. Results: Only three of 2084 studies detected and analyzed by performing the proposed searches in the detailed databases, were finally selected for this review, of which one was with and two were without intervention. These studies only weakly support a relationship between the gut microbiome and OA, specifically a correlation between certain taxa or microbial products and the inflammatory landscape and severity of OA symptoms, including knee pain. Conclusions: Despite encouraging results, this review highlights the paucity of high-quality studies addressing the potential role of the gut microbiome in OA-related pain, along with the disparity of the techniques used so far, making it impossible to draw firm conclusions on the topic.

Head and Neck Cancer (HNC) is a globally rare cancer that includes a variety of tumors affecting the upper aerodigestive tract. It presents with difficulty breathing or swallowing and is mainly treated with radiation therapy, chemotherapy, or surgery for tumors that have spread locally or throughout the body. Alternatively, exercise can be used during cancer treatment to improve function, including pain relief, increase range of motion and muscle strength, and reduce cancer-related fatigue, thereby enhancing quality of life. Although existing evidence suggests the adjunctive use of exercise in other cancer types, no previous studies have examined the effects on HNC survivors. The aim of this meta-analysis was to quantify the effect of exercise-based rehabilitation on functionality and quality of life in HNC survivors who underwent surgery and/or chemoradiotherapy. A systematic review and meta-analysis were carried out following PRISMA statement and registered in PROSPERO (CRD42023390300). The search was performed in MEDLINE (PubMED), Cochrane Library, CINAHL and Web of Science (WOS) databases from inception to 31st December 2022 using the terms “cancer”, “head and neck neoplasms”, “exercise”, “rehabilitation”, “complications”, “muscle contraction”, “muscle stretching exercises” combining with booleans “AND”/“OR”. PEDro scale, Cochrane Risk of Bias Tool and GRADE were used to assess methodological quality, risk of bias and grade of recommendation of included studies respectively. 18 studies (n = 1322) were finally included which 1039 (78.6%) were men and 283 (21.4%) were women. In patients who underwent radio-chemotherapy, overall pain [SMD = − 0.62 [− 4.07, 2.83] CI 95%, Z = 0.35, p = 0.72] and OP [SMD = − 0.07 [− 0.62, 0.48] CI 95%, Z = 0.25, p = 0.81] were slightly reduced with exercise in comparison to controls. Besides, lower limb muscle strength [SMD = − 0.10 [− 1.52, 1.32] CI 95%, Z = 0.14, p = 0.89] and fatigue [SMD = − 0.51 [− 0.97, − 0.057] CI 95%, Z = 2.15, p < 0.01] were also improved in those who receive radio-chemoradiation. In HNC survivors treated with neck dissection surgery, exercise was superior to controls in overall pain [SMD = − 1.04 [− 3.31, 1.23] CI 95%, Z = 0.90, p = 0.37] and, in mid-term, on shoulder pain SMD = − 2.81 [− 7.06, 1.43] CI 95%, Z = 1.76, p = 0.08]. No differences in quality of life were found at any of the follow-up periods. There is evidence of fair to good methodological quality, low to moderate risk of bias, and weak recommendations supporting the use of exercise-based rehabilitation to increase functionality. However, no evidence was found in favor of the use of this modality for improving the quality of life of HNC survivors who underwent chemoradiotherapy or surgery.

Background: Osteoporosis (OP) is a systemic disease that is characterized by decreased bone density and quality. Purpose: The purpose of this systematic review was to determine the effects of muscle strengthening exercise in postmenopausal women with OP. Methods: A literature search was conducted systematically in MEDLINE, CINAHL, EMBASE databases for human studies up to 31 March 2021. Two researchers screened the articles against predefined inclusion criteria; a third resolved discrepancies. Articles were included if they assessed the effects of muscle strengthening exercise in postmenopausal women with OP. The protocol for this systematic review was registered on PROSPERO (CRD42021207917) and a qualitative systematic review was carried out following the PRISMA statement. Methodological quality was evaluated through the scientific validity scales PEDro. Finally, RTCs and NRCTs risk of bias was assessed with the Cochrane risk of bias tool (Risk of Bias-ROB 2.0) and ROBINS-1, respectively. Results: A total of 16 studies (1028 subjects) that met the different eligibility criteria previously established were selected. There is evidence of good methodological quality and a low to moderate risk of bias that supports that muscle strengthening exercise alone or in combination with other therapeutic modalities improves BMD (9, n = 401) in proximal femur and lumbar vertebra body, muscle strength (10, n = 558), balance (4, n = 159), functionality (7, n = 617), and quality of life (5, n = 291). Conclusions: Exercise programs focused on muscle strengthening have benefits for all variables studied in postmenopausal women with OP.

Aim: The aim was to identify, evaluate, and summarize the findings of relevant individual studies on the precision and accuracy of radiological BA assessment procedures among children from different ethnic groups. Materials and Methods: A qualitative systematic review was carried out following the MOOSE statement and previously registered in PROSPERO (CRD42023449512). A search was performed in MEDLINE (PubMed) (n = 561), the Cochrane Library (n = 261), CINAHL (n = 103), Web of Science (WOS) (n = 181), and institutional repositories (n = 37) using MeSH and free terms combined with the Booleans “AND” and “OR”. NOS and ROBINS-E were used to assess the methodological quality and the risk of bias of the included studies, respectively. Results: A total of 51 articles (n = 20,100) on radiological BA assessment procedures were precise in terms of intra-observer and inter-observer reliability for all ethnic groups. In Caucasian and Hispanic children, the Greulich–Pyle Atlas (GPA) was accurate at all ages, but in youths, Tanner–Whitehouse radius–ulna–short bones 3 (TW3-RUS) could be an alternative. In Asian and Arab subjects, GPA and Tanner–Whitehouse 3 (TW3) overestimated the BA in adolescents near adulthood. In African youths, GPA overestimated the BA while TW3 was more accurate. Conclusion: GPA and TW3 radiological BA assessment procedures are both precise but their accuracy in estimating CA among children of different ethnic groups can be altered by racial bias.

Tendinopathy is a common disease that affects athletes, causing pain and dysfunction to the afflicted tendon. A clinical diagnose is usually combined with imaging and, among all the existing techniques, ultrasound is widely adopted. The aim of this review is to sum up the existing evidence on ultrasound as an imaging tool and guide for treatments in lower limbs tendinopathy. Using three different databases—PubMed, MEDLINE and CENTRAL—a literature search has been performed in May 2020 combining MeSH terms and free terms with Boolean operators. Authors independently selected studies, conducted quality assessment, and extracted results. Ultrasound imaging has a good reliability in the differentiation between healthy and abnormal tendon tissue, while there are difficulties in the identification of tendinopathy stages. The main parameters considered by ultrasound imaging are tendon thickness, hypoechogenicity of tendon structure and neovascularization of the tendon bound tissue. Ultrasound-guide is also used in many tendinopathy treatments and the available studies gave encouraging results, even if further studies are needed in this field.

Introduction: Bone-age assessment using posteroanterior left hand–wrist radiographs is indispensable in pediatric endocrinology and forensic age determination. Traditional methods—Greulich–Pyle atlas and Tanner–Whitehouse scoring—are time-consuming, operator-dependent, and prone to inter- and intra-observer variability. Aim: To systematically review the performance of AI-based models for automated bone-age estimation from left PA hand–wrist radiographs. Materials and Methods: A systematic review was carried out and previously registered in PROSPERO (CRD42024619808) in MEDLINE (PubMed), Google Scholar, ELSEVIER (Scopus), EBSCOhost, Cochrane Library, Web of Science (WoS), IEEE Xplore, and ProQuest for original studies published between 2019 and 2024. Two independent reviewers extracted study characteristics and outcomes, assessed methodological quality via the Newcastle–Ottawa Scale, and evaluated bias using ROBINS-E. Results: Seventy-seven studies met inclusion criteria, encompassing convolutional neural networks, ensemble and hybrid models, and transfer-learning approaches. Commercial systems (e.g., BoneXpert^®, Physis^®, VUNO Med^®-BoneAge) achieved mean absolute errors of 2–31.8 months—significantly surpassing Greulich–Pyle and Tanner–Whitehouse benchmarks—and reduced reading times by up to 87%. Common limitations included demographic bias, heterogeneous imaging protocols, and scarce external validation. Conclusions: AI-based approaches have substantially advanced automated bone-age estimation, delivering clinical-grade speed and mean absolute errors below 6 months. To ensure equitable, generalizable performance, future work must prioritize demographically diverse training cohorts, implement bias-mitigation strategies, and perform local calibration against region-specific standards.