Adhd-like symptoms in children affected by obstructive sleep apnea syndrome: A case-control study

Introduction: ADHD is characterized by inattention, hyperactivity, impulsivity, or a combination of these symptoms. Sleep disorders may be considered as a not secondary underlying cause of ADHD and growing evidence evidenced that obstructive sleep apnea syndrome (OSA) symptoms may overlap ADHD's ones. Aim of the present study is verifying the presence of ADHD-like symptoms in other frequent condition such as sleep-related breathing disorders in pediatric age. Materials and methods: 34 children (19 males and 15 females) aged 6-10 years (mean age 9.706 \ub1 3.434) with polysomnographic diagnosis of OSA, according to ICSD-3 criteria, were recruited. Control group was composed by 89 typical developing children (47 males, 42 females) (mean age 9,528 \ub1 3,351). The Conners' Rating Scale- Revised (CRS-R) test was administered to mothers to assess their children's behavior. Results: The two groups are comparable for age (p = 0.794) and sex distribution (p = 0.918). Subjects affected by OSA present higher scores in pathological range in all scales of CRS-R than controls (Table 1). Conclusions: Scientific and clinical evidences tend to stress the similarities between ADHD and OSA effects/comorbidities in pediatric age, suggesting sleep screening as mandatory before starting stimulant drugs treatment

Internalizing symptoms in children affected by childhood absence epilepsy: A preliminary study

Introduction: Childhood absence epilepsy (CAE) is a common type of pediatric idiopathic generalized epilepsy, characterized by multiple seizures of typical absence, with typical EEG pattern consisting in bilateral synchronous and symmetrical discharges of generalized 3 Hz spike-wave (SWDs). Recently, some researchers have suggested that the underlying epileptogenic mechanism of absence seizures selectively involves the frontal cortical circuits, also supported by video-electroencephalography data(3). These data may be considered as a new window in CAE comprehension and management, particularly about symptoms different from seizure that children affected may present. In this light, aim of the present study is evaluating the presence of internalizing problems in prepubertal children affected by CAE. Material and methods: 18 patients (10 females, 8 males) ranging age from 8-11 years (mean age 9.36 ± 1.32) affected by typical CAE were recruited. Control group was composed by 43 subjects (32 females, 11 males) (mean age 8.54 ± 2.01). All subjects were screened for internalizing symptoms with SAFA-A scale and CDI test. Results: The two groups were comparable for age (p=0.117) and sex distribution (p=0.251). CAE children showed significantly higher score than controls for anxiety (p<0.001) and depressive symptoms screening tests (p<0.001) (Table 1). Conclusions: Results of present study suggest the importance of screening for anxiety and depressive signs in CAE children, in order to optimize their management beyond the exclusive idea to control and stop epileptic seizure only

Plant patch hydrodynamics in streams : Mean flow, turbulence, and drag forces

Peer reviewedPreprin

Borderline intellectual functioning and parental stress: An italian case-control study

Introduction: Borderline intellectual functioning (BIF) children comprises a group of subjects whit intelligence quotient (IQ) ranging 71-85, with a prevalence about 13.6%. Several studies pinpointed the role of parenting on BIF management. Aim of present study was evaluating with objective and validated tool the parental stress rate in mothers of an Italian sample of BIF children. Materials and methods: 26 BIF children (20 males and 6 females) aged 6-10 years (mean age 10.36\ub1 2.03), according to DSM-5 criteria, and 53 (42 males and 11 females) typical developing children (mean age 10.58 \ub1 1.97) were recruited for present study. Mothers of all enrolled children underwent an evaluation with Parental Stress Index (PSI) test. Results: The two studied groups were comparable for age (p = 0.646) and gender (p = 0.956). Table 1 shows comparison between BIF and Control groups among PSI-SF scale results (Table 1), specifically mothers of BIF children have a significantly higher levels of global parental stress (p <0.001 ), stress related to parenting (p <0.001), stress linked to difficult child (p <0.001) and stress related to parent-child interaction (p <0.001) than mothers of control children. (Table 1) Conclusion: Several reports showed the key role of BIF as risk factor for psychiatric troubles and poor long-term adjustment. Our findings emphasize the need to approach this condition also from a family point of view, stressing that care should not be limited to child rehabilitative treatment but must also involve a family centered intervention

Circulating Brain-Injury Markers After Surgery for Craniosynostosis

Objective: Historically, there have been few quantitative methods for effectively evaluating outcomes after surgery for craniosynostosis. In this prospective study, we assessed a novel approach for detecting possible postsurgery brain injury in patients with craniosynostosis. Methods: We included consecutive patients operated on for sagittal (pi-plasty or craniotomy combined with springs) or metopic (frontal remodeling) synostosis at the Craniofacial Unit at Sahlgrenska University Hospital, Gothenburg, Sweden, from January 2019 to September 2020. Plasma concentrations of the brain-injury biomarkers neurofilament light (NfL), glial fibrillary acidic protein (GFAP), and tau were measured immediately before induction of anesthesia, immediately before and after surgery, and on the first and the third postoperative days using single-molecule array assays. Results: Of the 74 patients included, 44 underwent craniotomy combined with springs for sagittal synostosis, 10 underwent pi-plasty for sagittal synostosis, and 20 underwent frontal remodeling for metopic synostosis. Compared with baseline, GFAP level showed a maximal significant increase at day 1 after frontal remodeling for metopic synostosis and pi-plasty (P = 0.0004 and P = 0.003, respectively). By contrast, craniotomy combined with springs for sagittal synostosis showed no increase in GFAP. For neurofilament light, we found a maximal significant increase at day 3 after surgery for all procedures, with significantly higher levels observed after frontal remodeling and pi-plasty compared with craniotomy combined with springs (P < 0.001). Conclusions: These represent the first results showing significantly increased plasma levels of brain-injury biomarkers after surgery for craniosynostosis. Furthermore, we found that more extensive cranial vault procedures resulted in higher levels of these biomarkers relative to less extensive procedures

A MINIREVIEW ABOUT SPORTING PRACTICE IN EPILEPTIC CHILDREN

Movement is important for neuropsycho-physical development, ensuring the correct growth and giving many benefits from childhood to adulthood. Motor activity plays a pivotal role in psychological, educational and social terms: sport practice induces harmonious physical development with common important benefits independently from sport type and each sport imposes rules respect that children learns to know and respect step by step improving the social skills and cognitive abilities. Sport has a very important role in the growth of children and adolescents. Sport and physical activity work as a moral laboratory to practice decisionmaking and problem-solving skills, as well as teamwork and cooperation. In many pathological conditions, the sport practice is strongly discouraged, as in epileptic patients for the negative consequences on their physical condition and psychic. In general, several studies reported that physical activity has positive influence on seizure frequency and severity. As a result, attitudes regarding sports and epilepsy have changed considerably in the last decades and presently, the risk of convulsive seizures during sports practice is minimal in case of well-managed epilepsy. Evaluating the control of convulsive disease is therefore a key point to allow sports in the children and adolescents

High concordance of KRAS status between primary colorectal tumors and related metastatic sites: implications for clinical practice.

Purpose. Several studies have suggested that KRAS somatic mutations may predict resistance to cetuximab- and panitumumab-based treatments in metastatic colorectal cancer (CRC) patients. Nevertheless, most experiences were conducted on samples from primaries. The aim of this study was to evaluate the grade of concordance in terms of KRAS status between primaries and related metastases. Patients and Methods. We analyzed KRAS codon 12 and 13 mutations from formalin-fixed sections of 107 CRC primaries and related metastases. Eight pairs were excluded from the analysis because of the low amount of tumor tissue in the available samples. The main characteristics were: 50 men, 49 women; median age at diagnosis, 71 years (range, 41-84). The metastatic sites analyzed were the liver in 80 patients (80.8%), lung in seven patients (7.1%), and other sites in 12 patients (12.1%). Results. A KRAS mutation was found in 38 (38.4%) primary tumors and in 36 (36.4%) related metastases. The rate of concordance was 96.0% (95% confidence interval, 90.0%-98.9%). Discordance was observed in only four (4%) patients. Conclusions. Our results indicate that the detection of KRAS mutations in either primary or metastatic tumors from patients with CRC is concordant and this assessment could be used to predict response to targeted therapies such as cetuximab and panitumumab