Radical Prostatectomy and Intraoperative Radiation Therapy in High-Risk Prostate Cancer

Intraoperative electron beam radiotherapy (IOERT) for prostate cancer (PC) is a radiotherapeutic technique, giving high doses of radiation during radical prostatectomy (RP). This paper presents the published treatment approaches for intraoperative radiotherapy analyzing functional outcome, morbidity, and oncological outcome in patients with clinical intermediate-high-risk prostate cancer. A systematic review of the literature was performed, searching PubMed and Web of Science. A “free text” protocol using the term intraoperative radiotherapy and prostate cancer was applied. Ten records were retrieved and analyzed including more than 150 prostate cancer patients treated with IOERT. IOERT represents a feasible technique with acceptable surgical time and minimal toxicity. A greater number of cases and longer follow-up time are needed in order to assess the long-term side effects and oncological outcome

Stereotactic radiation therapy for skull base recurrences: Is a salvage approach still possible?

AimA literature review was performed to analyse the role of stereotactic radiotherapy given in a single shot or in a fractionated fashion for recurrent skull base tumours in order to ascertain if it can be a real salvage approach.BackgroundThe management of recurrent skull base tumours can have a curative or palliative intent and mainly includes surgery and RT.Materials and methodsOne-thousand-ninety-one articles were found in the search databases and the most relevant of them were analysed and briefly described.ResultsData on recurrences of meningioma, pituitary adenoma, craniopharyngioma, chordoma and chondrosarcoma, vestibular schwannoma, glomus jugulare tumours, olfactory neuroblastoma and recurrences from head and neck tumours invading the base of skull are reported highlighting the most relevant results in terms of local control, survival, side effects and complications.ConclusionsIn conclusion, it emerges that SRS and FSRT are effective and safe radiation modalities of realize real salvage treatment for recurrent skull base tumours

Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder

BackgroundSleep disorders are one of the most common problems in children with Autism Spectrum Disorder (ASD). However, they often tend to be underdiagnosed and incorrectly treated in clinical practice. This study aims to identify sleep disorders in preschool children with ASD and to explore their relationship with the core symptoms of autism, the child's developmental and cognitive level as well as the psychiatric comorbidities. MethodsWe recruited 163 preschool children with a diagnosis of ASD. The Children's Sleep Habits Questionnaire (CSHQ) assessed sleep conditions. Multiple standardized tests were used to evaluate intellectual abilities, the presence of repetitive behaviors (through the Repetitive Behavior Scale-Revised), as well as the emotional-behavioral problems and the psychiatric comorbidities (through the Child Behavior Checklist -CBCL 1(1/2)-5). ResultsThe results showed that poor disorders had consistently higher scores in all areas assessed by the CSHQ and on the CBCL across all domains. The correlational analysis showed that severe sleep disorders were associated with higher scores in internalizing, externalizing, and total problems at the CBCL syndromic scales, and in all DSM-oriented CBCL subscales. Moreover, we found that the association between sleep disorders and restricted and repetitive behaviors (RRBs) is explained by the anxiety-related symptoms. ConclusionBased on these findings, the study recommends that screening for sleep problems followed by early intervention should constitute a routine part of clinical practice for children with ASD

Radiotherapy for vestibular schwannoma: Review of recent literature results

BackgroundThe management of vestibular schwannoma is still a quite controversial issue and can include wait and see policy, surgery and radiotherapy, mainly with stereotactic technique. The purpose of this study is to review the results of recent clinical series treated by radiotherapy.Materials and methodsLiterature search was performed by Pubmed and Scopus by using the words "vestibular schwannoma, acoustic neuroma, radiotherapy, radiosurgery".ResultsManagement options of VS include wait and see, surgery and radiotherapy. In case of small lesions, literature data report local control rates higher than 90% after radiosurgery (SRS) similar those of surgical techniques. Recent literature reviews show favourable functional outcome by using SRS. Several literature data support the use of fractionated stereotactic radiotherapy (FSRT) in case of large inoperable lesions.ConclusionRadiotherapy plays a relevant role in the treatment of VS. In small-size lesions, SRS can guarantee similar local control and potentially better function outcome compared to surgery. In case of large and irregularly shaped lesions, FSRT can be the used when surgery is not feasible

Biodegradable films based on poly(lactic acid) coatings and natural olive-wastewater extracts for active food packaging,

The goal of this work was to develop innovative, 100% biodegradable films with antioxidant effectiveness, based on poly(lactic acid) (PLA) and a natural olive wastewater extract (OWE). Active PLA coatings were realized by spreading a PLA/OWE coating solution, with an OWE amount up to 20 wt%, on a Poly(lactic acid)/Poly(butylene adipate-co-terephthalate) substrate. The study of active films antioxidant activity and release kinetics in foods with high lipid content was accomplished using 95% ethanol as food simulant. Preliminary shelf-life tests on a sensitive greasy food matrix (i.e. avocado fruits) were also carried out, in order to qualitatively examine the films potential in limiting fruit oxidative/browning phenomena. Finally, the effect of the OWE on the films color and photo-oxidative stability under natural light exposure was also examined. The results pointed out the influence of the morphology and distribution of the active agent on the coatings release rate, and the antioxidant activity and equilibrium time increased by increasing the antioxidant concentration. The shelf-life tests highlighted the promising perspectives for the films in retarding the oxidation/browning reactions of short shelf-life foods, and pave the way to more in-depth investigations on the most appropriate strategies to prevent the transfer of the OWE brown color while keeping intact the benefits of the antioxidant packaging

TRANS-AURICULAR VAGUS NERVE STIMULATION IN THE TREATMENT OF RECOVERED PATIENTS AFFECTED BY EATING AND FEEDING DISORDERS AND THEIR COMORBIDITIES

Introduction: Eating and feeding disorders (EFD’s) represent the psychiatric pathology with the highest mortality rate and one of the major disorders with the highest psychiatric and clinical comorbidity. The vagus nerve represents one of the main components of the sympathetic and parasympathetic nervous system and is involved in important neurophysiological functions. Previous studies have shown that vagal nerve stimulation is effective in the treatment of resistant major depression, epilepsy and anxiety disorders. In EFD’s there are a spectrum of symptoms which with Transcutaneous auricular Vagus Nerve Stimulation (Ta-VNS) therapy could have a therapeutic efficacy. Subjects and methods: Sample subjects is composed by 15 female subjects aged 18-51. Admitted to a psychiatry community having diagnosed in according to DSM-5: anorexia nervosa (AN) (N=9), bulimia nervosa (BN) (N=5), binge eating disorder (BED) (N=1). Psychiatric comorbidities: bipolar disorder type 1 (N=4), bipolar disorder type 2 (N=6), border line disorder (N=5). The protocol included 9 weeks of Ta-VNS stimulation at a frequency of 1.5-3.5 mA for 4 hours per day. The variables detected in four different times (t0, t1, t2, t3, t4) are the following: Heart Rate Variability (HRV), Hamilton Depression Rating Scale (HAMD-HDRS- 17), Body Mass Index (BMI), Beck Anxiety Index (BAI). Results: Data analysis showed statistically significant differences between recording times (p>0.05) in HAM-D (t0=18.28±5.31; t4=9.14±7.15), in BAI (t0=24.7±10.99; t4=13.8±7.0) the reported values show how during (T0-T4) the treatment there are a decay of the degree in the depressive state, in the state of anxiety and an improvement in the value of BMI. In particular, the BMI in the AN-BN sub-sample had a minimum gain of 5% and a maximum of 11%. The analysis of H.R.V. did not show a significant changes among subjects thus confirming the discordance of the activity of the sympathetic and parasympathetic nervous system in EFD’s. Conclusions: Although the sample does not possess a relevant value to determine long-term efficacy of Ta-VNS or on a larger number of patients, this study reports how the application of neuro-stimulation in EFD’s may become an ADD-ON in therapeutic approach. Indeed, substantial improvements are highlighted in the results and confirmed hypotheses proposed by the study