Pediatric oncological spondylolisthesis: the contribution of Physical Medicine and Rehabilitation and Orthodontics. A narrative review

Different forms of spondylolisthesis (SP) have been described. This pathological condition is often due to a birth defect in the lumbar area, but it can also be caused by a sudden injury resulting from an acute trauma. In athletic children and adolescents, SP may represent a stress fracture triggered by overuse. SP can also be consequent to cancer, although this clinical condition is rare. The first manifestation of SP is pain. Neoplasm related SP may also induce physical impairment and postural alterations of the spine, such as flatback and hyperkyphosis. These changes may also affect the entire spine, including the cervical region (i.e., forward neck) and the head (i.e., forward head). A prompt assessment of children with oncological SP is crucial and involves clinical and radiological evaluations. Multiple healthcare professionals are involved in the management of children with oncological SP, including spinal specialists, pediatricians, oncologists, and psychologists. Orthodontists may also contribute to cervical posture evaluation. The authors of this review aim to provide a comprehensive overview of the topic, particularly focusing on the clinical assessment of children with oncological SP and the possibilities for rehabilitative treatment

Pediatric oncological pain: the influence on the posture of the head and the spine. A narrative review

Pediatric oncological pain (OP) is a common condition in children with cancer, resulting in postural changes in the head and spine, which significantly impact their quality of life. Osteosarcoma is the most prevalent type of pediatric tumor affecting head and spine districts. Its exact cause is still unknown, although it may be attributed to DNA mutations in bone cells, either inherited or acquired after birth; it often leads to bone and muscle pain and discomfort. This can initiate a harmful cycle, including mood disorders like anxiety and depression and maladaptive thoughts. Conducting a thorough functional assessment of children with OP is crucial, involving clinical and psychological evaluations and multidisciplinary rehabilitative approaches. A physical evaluation of the head and spine primarily focuses on assessing motor abilities through inspection of joint mobility, muscle strength, palpation, reflexes, and sensitivity. This narrative review considered randomized clinical trials, observational and cohort studies, and case reports; studies that did not meet inclusion criteria were excluded; 41 studies were selected for this review. A team of healthcare professionals, including orthodontists, physiatrists, pediatricians, oncologists, and psychologists, collaboratively manage children with OP, aiming to minimize the physical and mental disability caused by OP. It is based on education, exercise therapy, and psychological approaches. Education should include proper ergonomic postural guidance for sitting and standing, pain education (neuroscience education), and management of mood disorders and maladaptive thoughts (cognitive-behavioral education). Exercise therapy should focus on active postural correction, including exercises to counteract forward head posture, hyperkyphosis, and swayback; strengthening exercises for spinal deep muscles; segmental stretching involving limbs and back muscles; and functional exercises. Psychological therapy, particularly cognitivebehavioral therapy, involves cognitive restructuring, time-based activity pacing, relaxation techniques, and adaptive coping strategies. This review pro vides a comprehensive overview of the clinical postural assessment of the head and spine, which is essential for planning effective multidisciplinary rehabilitative treatments

Regional scale analysis of the altimetric stream network evolution

International audienceFloods result from the limited carrying capacity of stream channels when compared to the discharge peak value. The transit of flood waves - with the associated erosion and sedimentation processes - often modifies local stream geometry. In some cases this results in a reduction of the stream carrying capacity, and consequently in an enhancement of the flooding risk. A mathematical model for the prediction of potential altimetric stream network evolution due to erosion and sedimentation processes is here formalized. It works at the regional scale, identifying the tendency of river segments to sedimentation, stability, or erosion. The model builds on geomorphologic concepts, and derives its parameters from extensive surveys. As a case study, tendencies of rivers pertaining to the Valle d'Aosta region are analyzed. Some validation is provided both at regional and local scales of analysis. Local validation is performed both through a mathematical model able to simulate the temporal evolution of the stream profile, and through comparison of the prediction with ante and post-event river surveys, where available. Overall results are strongly encouraging. Possible use of the information derived from the model in the context of flood and landslide hazard mitigation is briefly discussed

Assessing ant diversity in agroecosystems: The case of italian vineyards of the adige valley

Assessing ant diversity in agroecosystems: The case of Italian vineyards of the Adige Valley Agroecosystems have gained a dominant position on worldwide land-usage, and therefore preserving their biodiversity is crucial for environmental sustainability. Ants are one of the most widespread groups of terres-Trial arthropods, and, thanks to their significant diversification, they are considered as a good proxy group for bio-diversity monitoring, also in agroecosystems. Vineyards are economically valuable cultures widespread worldwide, and hosting many ant species, that provide meaningful ecosystem services and disservices. Despite the important role that ants play in these agroecosystems, ant biodiversity in vineyards is still poorly studied, especially in Italy. In this context, we present a first detailed quantitative and qualitative assessment of the ant fauna of Italian vine-yards from the Adige Valley based on pitfall traps data, and discuss the results in comparison with the few other similar assessments from Europe and other continents. We document an assemblage of 22 species (7-16 per or-chard), mostly dominated by three disturbance-Tolerant species (including an introduced species). Vineyards ant faunas appear to be rather heterogeneous worldwide, mainly following local ecological and biogeographical con-straints, and the role that most ant species play in these agroecosystems is presently unknown

Effect of pre-season training phase on anthropometric, hormonal and fitness parameters in young soccer players

The aims of the study were to investigate 1) the effect of 8 weeks of PSP training on anthropometrics, salivary hormones and fitness parameters in youth soccer players, 2) the correlations between fitness and hormonal parameters, and 3) the impact of the experience of the coach and his methodology of training on these parameters. Weight, height, BMI, pubertal development (PDS), salivary Cortisol (sC), salivary Testosterone (sT), salivary sDHEAS, intermittent tests (VO2max), and countermovement jump test (CMJ) modifications of 35 youth soccer players (age: 14±0 yrs; BMI: 20.8±1.8 k/m2 ) from two Italian clubs (“Lupa Frascati” -LF-; “Albalonga” -AL) were analysed. A significant (p<0.05) time by club effect was observed in sC (F(1,31) = 9.7, ES = 1.13), sT (F(1,31) = 4.2, ES = 0.74), CMJ (F(1,28) = 26.5, ES = 1.94), and VO2max (F(1,28) = 8.5, ES = 1.10). Statistical differences (p<0.05) in weight (F(1,32) = 25.5, ES = 0.11), sC (F(1,31) = 32.1, ES = 1.43), sT/sC ratio (F(1,31) = 10.1, ES = 0.97), sDHEAS/sC ratio (F(1,31) = 6.3, ES = 0.70), and VO2max (F(1,28) = 64.3, ES = 1.74) were found within time factor. Between clubs, differences (p<0.05) in sC (F(1,32) = 8.5, ES = 1.17), sT (F(1,31) = 4.2, ES = 0.74), CMJ (F(1,28) = 26.5, ES = 1.50), and VO2max (F(1,28) = 8.5, ES = 1.10) were found. CMJ was inversely correlated with sDHEAS (r = -0.38) before PSP, while Δ of CMJ showed significant correlations with Δ of sC (r = 0.43) and ΔVO2max was inversely correlated with ΔBMI (r = -0.54) and ΔsC (r = -0.37) in all subjects. Considering each single club, ΔVO2max showed correlations with ΔBMI (r = -0.45) in AL, while ΔCMJ showed correlations with ΔPDS (r = 0.72) in LF club. Since the PSP is often limited training time to simultaneously develop physical, technical and tactical qualities, an efficient method to distribute the training load is important in youth soccer players to increase the performance and to avoid injuries

Luteinizing Hormone/Human Chorionic Gonadotropin Receptor Immunohistochemical Score Associated with Poor Prognosis in Endometrial Cancer Patients.

The aim of this study was to develop a scoring system of the immunohistochemical (IHC) expression of luteinizing hormone/human chorionic gonadotropin receptor (LHCG-R) in endometrial cancer (EC) patients. Nonconsecutive hysterectomy specimens containing EC collected from April 2013 to October 2015 were selected. Hematoxylin-eosin stained sections from each case were reviewed and representative sections from each tumor were selected. IHC staining was performed for the detection of LHCG-R. The percentage of stained cells and the staining intensity were assessed in order to develop an immunohistochemical score. Moreover, we examined the correlation of the score with grading and lymphovascular space invasion (LVSI). There was a statistically significant positive correlation between grading and IHC scoring (p=0.01) and a statistically significant positive correlation between LVSI and IHC score (p<0.01). In conclusion, we suggest that the immunohistochemical score presented here could be used as a marker of bad prognosis of EC patients. Nevertheless, further studies are needed in order to validate it. The study was registered in the Careggi Hospital public trials registry with the following number: 2013/0011391

Relationship of CYP21A2 genotype and serum 17-hydroxyprogesterone and cortisol levels in a large cohort of Italian children with premature pubarche.

ObjectivePremature pubarche (PP) is the most frequent sign of nonclassic congenital adrenal hyperplasia (NCCAH) due to 21-hydroxylase deficiency in childhood. The aim of this study was to assess the relationship between the CYP21A2 genotype and baseline and ACTH-stimulated 17-hydroxyprogesterone (17-OHP) and cortisol serum levels in patients presenting with PP.Patients and methodsA total of 152 Italian children with PP were studied. Baseline and ACTH-stimulated 17-OHP and cortisol serum levels were measured and CYP21A2 gene was genotyped in all subjects.ResultsBaseline and ACTH-stimulated serum 17-OHP levels were significantly higher in NCCAH patients than in both heterozygotes and children with idiopathic PP (IPP). Of the patient population, four NCCAH patients (7.3%) exhibited baseline 17-OHP values &lt;2 ng/ml (6 nmol/l). An ACTH-stimulated 17-OHP cutoff level of 14 ng/ml (42 nmol/l) identified by the receiver-operating characteristics curves showed the best sensitivity (90.9%) and specificity (100%) in distinguishing NCCAH patients. This value, while correctly identifying all unaffected children, missed 9% of affected individuals. Cortisol response to ACTH stimulation was &lt;18.2 μg/dl (500 nmol/l) in 14 NCCAH patients (28%) and none of the heterozygotes or IPP children. Among the 55 NCCAH patients, 54.5% were homozygous for mild CYP21A2 mutations, 41.8% were compound heterozygotes for one mild and one severe CYP21A2 gene mutations, and 3.6% had two severe CYP21A2 gene mutations.ConclusionIn children with PP, baseline 17-OHP levels are not useful to rule out the diagnosis of NCCAH, which is accomplished by means of ACTH testing only. The different percentages of severe and mild CYP21A2 gene mutations found in PP children compared with adult NCCAH patients is an indirect evidence that the enzyme defect is under-diagnosed in childhood, and it might not lead to the development of hyperandrogenic symptoms in adulthood. Stress-dose glucocorticoids should be considered in patients with suboptimal cortisol response to ACTH stimulation.</jats:sec

Double gamers—can modified natural regulators of higher plants act as antagonists against phytopathogens? The case of jasmonic acid derivatives

As key players in biotic stress response of plants, jasmonic acid (JA) and its derivatives cover a specific and prominent role in pathogens-mediated signaling and hence are promising candidates for a sustainable management of phytopathogenic fungi. Recently, JA directed antimicrobial effects on plant pathogens has been suggested, supporting the theory of oxylipins as double gamers in plant-pathogen interaction. Based on these premises, six derivatives (dihydrojasmone and cis-jasmone, two thiosemicarbazonic derivatives and their corresponding complexes with copper) have been evaluated against 13 fungal species affecting various economically important herbaceous and woody crops, such as cereals, grapes and horticultural crops: Phaeoacremonium minimum, Neofusicoccum parvum, Phaeomoniella chlamydospora, Fomitiporia mediterranea, Fusarium poae, F. culmorum, F. graminearum, F. oxysporum f. sp. lactucae, F. sporotrichioides, Aspergillus flavus, Rhizoctonia solani, Sclerotinia spp. and Verticillium dahliae. The biological activity of these compounds was assessed in terms of growth inhibition and, for the two mycotoxigenic species A. flavus and F. sporotrichioides, also in terms of toxin containment. As expected, the inhibitory effect of molecules greatly varied amongst both genera and species; cis-jasmone thiosemicarbazone in particular has shown the wider range of effectiveness. However, our results show that thiosemicarbazones derivatives are more effective than the parent ketones in limiting fungal growth and mycotoxins production, supporting possible applications for the control of pathogenic fungi

A Summary of the Endocrine Society Clinical Practice Guidelines on Congenital Adrenal Hyperplasia due to Steroid 21-Hydroxylase Deficiency

Steroid 21-hydroxylase deficiency accounts for about 95% of cases of congenital adrenal hyperplasia (CAH). Newborns are currently being screened for the classical forms of this disease throughout the United States and in 12 other countries. As such, it seems important to develop the best practice guidelines for treating not only infants and children, but affected adults as well. This report gives a brief overview of the most recent expert opinion and clinical practice guidelines for CAH as formulated by The Endocrine Society Task Force