CT-guided radiofrequency ablation of spinal osteoblastoma: treatment and long-term follow-up.

Osteoblastoma (OB) is a painful, rare, benign bone tumour usually observed in young populations, and this condition involves the spine in up to one-third of cases. We sought to focus on the minimally invasive treatment of spinal OB with radiofrequency ablation (RFA) under computed tomography (CT) guidance. When performed near the spinal cord, surgery can lead to instability of the spine, sometimes requiring additional interventions to stabilise the segments involved, and can cause the precocious onset of arthrosis or other degenerative diseases. The results were evaluated both clinically and with the aid of diagnostic imaging techniques during a 5-year follow-up study.Eleven patients affected by spinal OB were treated in a single session with biopsy and CT-guided RFA. Pre- and post-evaluations of the patients were performed both clinically and with CT and magnetic resonance imaging (MRI).Complete success in terms of pain relief was achieved in all patients. Additional treatments were not required in any patients. There were no complications. During follow-up, neither complications nor pathological findings related to the treatment were observed.Our experience demonstrates that RFA for spinal OB is safe and effective. One of the main advantages of this technique is represented by its lower grade of invasiveness compared with that for potentially hazardous surgical manoeuvres

La distribuzione del genere Rosa in Cilento (Italia meridionale)

Distribution of the genus Rosa in Cilento (Campania, Southern Italy) – We present the results of a floristic research carried out in the area of Cilento (Campania region, Southern Italy) regarding the occurrence and distribution of the genus Rosa L. We listed, from original data, 22 taxa: 6 are considered new records for the flora of Cilento (R. balsamica, R. corymbifera, R. dumalis, R. micrantha, R. montana, R. tomentosa) one of them (R. montana) is here confirmed for the flora of Campania

Contribution to the floristic knowledge of the Maddalena Mountains (Basilicata and Campania, southern Italy)

The inventory of the taxa collected during the annual field trip of the working group for Floristics, Systematics and Evolution of the Italian Botanical Society is reported. It was held in 2013 along the Maddalena Mountains, a mountain ridge of the southern Apennines located between the Basilicata and Campania administrative regions (southern Italy), considered as being poorly characterized in terms of vascular flora. A total of 701 units belonging to 74 plant families were recorded including two varieties and four hybrids.Thirty-five taxa resulted endemic to Italy and only 11 alien species were detected, while 36 taxa are new or confirmed for the regional floras of Basilicata and/or Campania. In particular, 12 taxa are new for Basilicata, while four are confirmed. Regarding Campania, 14 taxa resulted new for the regional flora and five were confirmed

Italian Vascular Flora: New Findings, Updates and Exploration of Floristic Similarities between Regions

The tradition of floristic studies in Italy has made it possible to obtain a good knowledge of plant diversity both on a national and regional scale. However, the lack of knowledge for some areas, advances in plant systematics and human activities related to globalization, highlight the need for further studies aimed at improving floristic knowledge. In this paper, based on fieldwork and herbaria and literature surveys, we update the knowledge on the Italian vascular flora and analyze the floristic similarities between the administrative regions. Four taxa, all exotic, were recorded for the first time in Italy and Europe. In detail, Elaeodendron croceum, Kalanchoë blossfeldiana, and Sedum spathulifolium var. spathulifolium were found as casual aliens, while Oxalis brasiliensis was reported as historical record based on some herbarium specimens. Furthermore, Kalanchoë laxiflora was confirmed as a casual alien species for Italy and Europe. Status changes for some taxa were proposed at both national and regional levels, as well as many taxa were reported as new or confirmed at the regional level. Currently the Italian vascular flora comprises 9150 taxa of which 7547 are native (of which 1598 are Italian endemics) and 1603 are exotic at the national level. The multivariate analysis of updated floristic data on a regional scale showed a clear distribution along the latitudinal gradient, in accordance with the natural geographical location of the regions in Italy. This pattern of plants distribution was not affected by the introduction of alien species. Despite some taxonomic and methodological issues which are still open, the data obtained confirm the important role of floristic investigations in the field and in herbaria, as well as the collaborative approach among botanists, in order to improve the knowledge of the Italian and European vascular flora

Contribution to the floristic knowledge of the head of the Po Valley (Piedmont, north Italy)

In 2014, the annual field trip of the working group for Floristics, Systematics, and Evolution of the Italian Botanical Society was held in Piemonte (northern Italy), at the head of the Po Valley. This valley, at whose extremity is located the Monviso (3,841 m a.s.l.), belongs to the Cottian Alps about which very little is known from a floristic point of view. An inventory of the taxa of vascular plants collected during the field trip is reported here. The research led to the identification of 3,546 exsiccata, kept in nine public and nine private collections. A total of 669 taxa belonging to 79 plant families were recorded. Six taxa resulted endemic to Italy and three exclusive to Piemonte, while only nine alien species were detected; six taxa are new and five confirmed for the regional flora

ERNICA guidelines for the management of rectosigmoid Hirschsprung's disease

Background Hirschsprung's disease (HSCR) is a serious congenital bowel disorder with a prevalence of 1/5000. Currently, there is a lack of systematically developed guidelines to assist clinical decision-making regarding diagnostics and management. Aims This guideline aims to cover the diagnostics and management of rectosigmoid HSCR up to adulthood. It aims to describe the preferred approach of ERNICA, the European Reference Network for rare inherited and congenital digestive disorders. Methods Recommendations within key topics covering the care pathway for rectosigmoid HSCR were developed by an international workgroup of experts from 8 European countries within ERNICA European Reference Network from the disciplines of surgery, medicine, histopathology, microbiology, genetics, and patient organization representatives. Recommendation statements were based on a comprehensive review of the available literature and expert consensus. AGREE II and GRADE approaches were used during development. Evidence levels and levels of agreement are noted. Results Thirty-three statements within 9 key areas were generated. Most recommendations were based on expert opinion. Conclusion In rare or low-prevalence diseases such as HSCR, there remains limited availability of high-quality clinical evidence. Consensus-based guidelines for care are presented.Peer reviewe

ERNICA guidelines for the management of rectosigmoid Hirschsprung's disease

Background Hirschsprung's disease (HSCR) is a serious congenital bowel disorder with a prevalence of 1/5000. Currently, there is a lack of systematically developed guidelines to assist clinical decision-making regarding diagnostics and management. Aims This guideline aims to cover the diagnostics and management of rectosigmoid HSCR up to adulthood. It aims to describe the preferred approach of ERNICA, the European Reference Network for rare inherited and congenital digestive disorders. Methods Recommendations within key topics covering the care pathway for rectosigmoid HSCR were developed by an international workgroup of experts from 8 European countries within ERNICA European Reference Network from the disciplines of surgery, medicine, histopathology, microbiology, genetics, and patient organization representatives. Recommendation statements were based on a comprehensive review of the available literature and expert consensus. AGREE II and GRADE approaches were used during development. Evidence levels and levels of agreement are noted. Results Thirty-three statements within 9 key areas were generated. Most recommendations were based on expert opinion. Conclusion In rare or low-prevalence diseases such as HSCR, there remains limited availability of high-quality clinical evidence. Consensus-based guidelines for care are presented.Peer reviewe

Bowel function and associated risk factors at preschool and early childhood age in children with anorectal malformation type rectovestibular fistula:An ARM-Net consortium study

Background: Outcome of patients operated for anorectal malformation (ARM) type rectovestibular fistula (RVF) is generally considered to be good. However, large multi-center studies are scarce, mostly describing pooled outcome of different ARM-types, in adult patients. Therefore, counseling parents concerning the bowel function at early age is challenging. Aim of this study was to evaluate bowel function of RVF-patients at preschool/early childhood age and determine risk factors for poor functional outcome. Methods: A multi-center cohort study was performed. Patient characteristics, associated anomalies, sacral ratio, surgical procedures, post-reconstructive complications, one-year constipation, and Bowel Function Score (BFS) at 4–7 years of follow-up were registered. Groups with below normal (BFS < 17; subgroups ‘poor’ ≤ 11, and ‘fair’ 11 < BFS < 17) and good outcome (BFS ≥ 17) were formed. Univariable analyses were performed to detect risk factors for outcome. Results: The study included 111 RVF-patients. Median BFS was 16 (range 6–20). The ‘below normal’ group consisted of 61 patients (55.0%). Overall, we reported soiling, fecal accidents, and constipation in 64.9%, 35.1% and 70.3%, respectively. Bowel management was performed in 23.4% of patients. Risk factors for poor outcome were tethered cord and low sacral ratio, while sacral anomalies, low sacral ratio, prior enterostomy, post-reconstructive complications, and one-year constipation were for being on bowel management. Conclusions: Although median BFS at 4–7 year follow-up is nearly normal, the majority of patients suffers from some degree of soiling and constipation, and almost 25% needs bowel management. Several factors were associated with poor bowel function outcome and bowel management. Level of Evidence: Level III