Parent and self-report health-related quality of life measures in young patients with Tourette syndrome

Tourette syndrome is a neurodevelopmental disorder characterized by tics and comorbid behavioral problems. This study compared child- and parent-reported quality of life and everyday functioning. We assessed 75 children with Tourette syndrome, of which 42 (56%) had comorbid conditions (obsessive-compulsive disorder = 25; attention-deficit hyperactivity disorder = 6; both comorbidities = 4). All patients completed psychometric instruments, including the Gilles de la Tourette Syndrome-Quality of Life Scale for Children and Adolescents (child report) and the Child Tourette's Syndrome Impairment Scale (parent report). Data were compared for patients with pure Tourette syndrome, Tourette syndrome + obsessive-compulsive disorder, Tourette syndrome + attention-deficit hyperactivity disorder, and Tourette syndrome + both comorbidities. There were no group differences in quality of life. However, there were differences for total, school, and home activities impairment scores. Children and parents may not share similar views about the impact of Tourette syndrome on functioning. The measurement of health-related quality of life in Tourette syndrome is more complex in children than adults

Oral HPV Infection: Current Strategies for Prevention and Therapy

Infection with High Risk (HR) Human Papillomaviruses (HPVs) is the main aetiological agent of Cervical Squamous Cell Carcinoma (CSCC) and also associated in a subgroup of other neoplasms, including Oropharyngeal Squamous cell Carcinoma (OPSCC). HPV infection, in genital as in oral mucosa can also be subclinical or associated with benign proliferative lesions (common warts, condylomas, papillomas) caused mostly by infection with Low Risk (LR)-HPVs. In the last decades, extensive research has resulted in growing knowledge on HPV biology and specifically viral life cycle, biochemical properties of viral proteins and their interaction with the host proteins leading to potential new targets of prophylactic or therapeutic vaccines and therapies for HPV infection. In addition, notable progresses have been made in the field of diagnostics to detect HPV DNA or RNA. The recent epidemiological data suggest the significant changes in HPV endemic, due to the changes in sexual habits especially among young generations (i.e. early sexual debuts, multiple sexual partners, oral and anal sex); this scenario has urged on the need of adequate campaigns of primary (sexual education, vaccination programs) and secondary prevention (diagnostics of HPV-related diseases). Due to the growing interest on HPV infection and HPV related cancers, the authors made a narrative review of the literature on oral HPV infection and oral-genital transmission. After this, in view of the controversies about the strategies of therapy and prevention of HPV infection, the present review focuses on the current state of art about the available tools for the therapeutic and, if any, preventive management of oral HPV infection

Overview of diagnosis and management of paediatric headache. Part I: diagnosis.

Headache is the most common somatic complaint in children and adolescents. The evaluation should include detailed history of children and adolescents completed by detailed general and neurological examinations. Moreover, the possible role of psychological factors, life events and excessively stressful lifestyle in influencing recurrent headache need to be checked. The choice of laboratory tests rests on the differential diagnosis suggested by the history, the character and temporal pattern of the headache, and the physical and neurological examinations. Subjects who have any signs or symptoms of focal/progressive neurological disturbances should be investigated by neuroimaging techniques. The electroencephalogram and other neurophysiological examinations are of limited value in the routine evaluation of headaches. In a primary headache disorder, headache itself is the illness and headache is not attributed to any other disorder (e.g. migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalgias). In secondary headache disorders, headache is the symptom of identifiable structural, metabolic or other abnormality. Red flags include the first or worst headache ever in the life, recent headache onset, increasing severity or frequency, occipital location, awakening from sleep because of headache, headache occurring exclusively in the morning associated with severe vomiting and headache associated with straining. Thus, the differential diagnosis between primary and secondary headaches rests mainly on clinical criteria. A thorough evaluation of headache in children and adolescents is necessary to make the correct diagnosis and initiate treatment, bearing in mind that children with headache are more likely to experience psychosocial adversity and to grow up with an excess of both headache and other physical and psychiatric symptoms and this creates an important healthcare problem for their future life

Mother-Child Agreement on Behavioral Ratings in Tourette Syndrome: A Controlled Study.

In Tourette syndrome, motor and phonic tics are associated with a spectrum of psychiatric disorders. As proxy report instruments are commonly used to assess children with Tourette syndrome, we investigated the relationship between child and mother ratings of behavioral problems. We enrolled 28 children with Tourette syndrome (25 males; mean age, 13.9 years) and 61 gender- and age-matched healthy controls (55 males; mean age, 14.7 years). Clinicians completed measures of tic severity, and all children completed the Youth Self-Report version of the Child Behavior Checklist, while their mothers completed the Child Behavior Checklist. In the clinical group, Youth Self-Report scores were significantly lower than mothers' Child Behavior Checklist scores across the majority of subscales (especially affect and somatization). In contrast, for the control group, mother and child ratings only differed for the externalizing behavior subscales. Clinicians should be aware of these differences between self and mother ratings for specific behavioral problems in Tourette syndrome

Visuo-spatial attention deficit in children with reading difficulties

Although developmental reading disorders (developmental dyslexia) have been mainly associated with auditory-phonological deficits, recent longitudinal and training studies have shown a possible causal role of visuo-attentional skills in reading acquisition. Indeed, visuo-attentional mechanisms could be involved in the orthographic processing of the letter string and the graphemic parsing that precede the grapheme-to-phoneme mapping. Here, we used a simple paper-and-pencil task composed of three labyrinths to measure visuo-spatial attention in a large sample of primary school children (n = 398). In comparison to visual search tasks requiring visual working memory, our labyrinth task mainly measures distributed and focused visuo-spatial attention, also controlling for sensorimotor learning. Compared to typical readers (n = 340), children with reading difficulties (n = 58) showed clear visuo-spatial attention impairments that appear not linked to motor coordination and procedural learning skills implicated in this paper and pencil task. Since visual attention is dysfunctional in about 40% of the children with reading difficulties, an efficient reading remediation program should integrate both auditory-phonological and visuo-attentional interventions

Anatomical variants of sphenoid sinuses pneumatisation: a CT scan study on a Northern Italian population

Sphenoid bone may be affected by different variants of pneumatisation, which have a relevant importance from a clinical and surgical point of view. The description of such variants in different populations may give useful information. However, few articles describe the variability of sphenoid pneumatised structures and none of them focuses on Northern Italian population. Variants of pneumatisation of sphenoid bone were described in a sample of 300 Northern Italian patients who underwent a CT scan. More than fifty-seven percent of patients showed a form of anatomical variant: the most common form was the pneumatised pterygoid processes (39.6%), followed by dorsum sellae (32.9%) and clinoid processes (20.3%), without statistically significant differences between males and females (p\ua0>\ua00.01). In 26.3% of patients, a combined pneumatisation of these three structures was observed, being the combination pterygoid processes-dorsum sellae the most frequent (11.3%). In 9.3%, all the three sphenoid structures were affected. This article is the first description of the prevalence of different variants of pneumatisation in a Northern Italian population: the occurrence of such forms has to be acknowledged for their possible clinical and surgical consequences

Anatomical Characteristics Of Intrapetrous Carotid Artery : A 3d Segmentation Study On Head Ct-Scan

The intrapetrous portion of internal carotid artery (IPCA) is one of the most unexplored anatomical regions, and its three-dimensional reconstruction in living subjects is still missing. The present study aims at describing IPCA on 3D models extracted from head CT-scans. The intrapetrous carotid artery was manually segmented on head CT-scans of 100 healthy patients free from vascular and neurological pathologies (50 males and 50 females aged between 18 and 91 years). Angles of the posterior and anterior genu, diameter and length of the horizontal portion, and volume of the entire canal were calculated through VAM\uae software. Statistically significant differences according to sex and side were assessed through two-way ANOVA test (p<0.05). Correlation of each measurement with age was calculated as well. On average the angles of the posterior and anterior genu were 120.1\ub110.4\ub0 and 118.0\ub110.0\ub0 in males, 119.5\ub19.2\ub0 and 117.6\ub110.3\ub0 in females, respectively, without statistically significant differences according to sex or side (p>0.05). Average length and diameter of the horizontal part were respectively 25.5\ub12.9 mm and 5.8\ub10.8 mm in males, 24.0\ub12.3 mm and 5.3\ub10.8 mm in females. The volume of IPCA was 0.941\ub10.215 cm3 in males, and 0.752\ub10.159 cm3 in females. Length and diameter of horizontal portion, and volume of IPCA showed statistically significant differences according to sex (p<0.05). No correlation with age was found. This study first provided data concerning not only linear and angular measurements, but also volumes of IPCA, useful in planning surgical interventions of the cranial base

ENDOCANNABINOIDS CB1 AND CB2: A POSSIBLE ROLE IN ORAL SQUAMOUS CELL CARCINOMA PATHOGENESIS

Aim. Cancer of the oral cavity is the eighth most common malignancy in the world. The disease is diagnosed after a considerable delay and predict the individual progression is difficult. The improvements of the therapy did not increased the rate of survival at 5 years, that is still about 50%. The identification of the possible markers that indicates the progression of the tumor is therefore necessary. Endocannabinoids may play an important role in the process of carcinogenesis in the oral mucosa. They are able to bind and activate specific membrane receptors coupled to G proteins, cannabinoid receptors CB1 and CB2. The purpose of this study is to evaluate the expression of CB1 and CB2 receptors in the development of oral cancer through the immunohistochemical study on samples of OSCC. Materials and methods. We selected 44 cases of patients with the primary tumor in the oral cavity. The stage of the tumor was classified according to the TNM system. The tumors grading was divided into I, II and III grade. The paraffin sections were analyzed by immunohistochemistry. The assessment of the immunoreactivity for CB1 and CB2 receptors was weak or strong. For quantitative analysis the expression of CB1 and CB2 receptors was evaluated in percentage with scale of values ??ranging from 0 to 100%. Results. The immunohistochemical examination of the samples analyzed showed the absence of expression of CB1 and CB2 receptors in normal mucosa, while peritumoral mucosa showed a weak expression in the vicinity of cancer and tumor mucosa showed an overexpression of receptors. Furthermore, the intensity of staining increased with the increase of the grading. It can be concluded that the strong immunoreactivity of CB1 and CB2 receptors is related to aggressive behavior of oral carcinoma. Conclusions. The analysis of endocannabinoids and their receptors on tissue biopsies taken from carcinoma of the oral cavity may therefore indicate future therapeutic targets and new prognostic biomarkers in these patients, especially in the early stages of the disease. The ultimate goal of this work is to indicate the possible role of CB1 and CB2 receptors such as tumor biomarker that may help in the early diagnosis of oral cancer and therefore contribute to reduce drastically the mortality of this disease

Identification and characterization of learning weakness from drawing analysis at the pre-literacy stage

Handwriting learning delays should be addressed early to prevent their exacerbation and long-lasting consequences on whole children’s lives. Ideally, proper training should start even before learning how to write. This work presents a novel method to disclose potential handwriting problems, from a pre-literacy stage, based on drawings instead of words production analysis. Two hundred forty-one kindergartners drew on a tablet, and we computed features known to be distinctive of poor handwriting from symbols drawings. We verified that abnormal features patterns reflected abnormal drawings, and found correspondence in experts’ evaluation of the potential risk of developing a learning delay in the graphical sphere. A machine learning model was able to discriminate with 0.75 sensitivity and 0.76 specificity children at risk. Finally, we explained why children were considered at risk by the algorithms to inform teachers on the specific weaknesses that need training. Thanks to this system, early intervention to train specific learning delays will be finally possible

Overview of the molecular determinants contributing to the expression of Psoriasis and Psoriatic Arthritis phenotypes

Psoriasis and psoriatic arthritis are multifactorial chronic disorders whose etiopathogenesis essentially derives from the alteration of several signalling pathways and the co-occurrence of genetic, epigenetic and non-genetic susceptibility factors that altogether affect the functional and structural property of the skin. Although shared and differential susceptibility genes and molecular pathways are known to contribute to the onset of pathological phenotypes, further research is needed to dissect the molecular causes of psoriatic disease and its progression towards Psoriatic Arthritis. This review will therefore be addressed to explore differences and similarities in the etiopathogenesis and progression of both disorders, with a particular focus on genes involved in the maintenance of the skin structure and integrity (keratins and collagens), modulation of patterns of recognition (through Toll-like receptors and dectin-1) and immuno-inflammatory response (by NLRP3-dependent inflammasome) to microbial pathogens. In addition, special emphasis will be given to the contribution of epigenetic elements (methylation pattern, non-coding RNAs, chromatin modifiers and 3D genome organization) to the etiopathogenesis and progression of psoriasis and psoriatic arthritis. The evidence discussed in this review highlights how the knowledge of patients' clinical and (epi)genomic make-up could be helpful for improving the available therapeutic strategies for psoriasis and psoriatic arthritis treatment