The clinical features of the piriformis syndrome: a systematic review

Piriformis syndrome, sciatica caused by compression of the sciatic nerve by the piriformis muscle, has been described for over 70 years; yet, it remains controversial. The literature consists mainly of case series and narrative reviews. The objectives of the study were: first, to make the best use of existing evidence to estimate the frequencies of clinical features in patients reported to have PS; second, to identify future research questions. A systematic review was conducted of any study type that reported extractable data relevant to diagnosis. The search included all studies up to 1 March 2008 in four databases: AMED, CINAHL, Embase and Medline. Screening, data extraction and analysis were all performed independently by two reviewers. A total of 55 studies were included: 51 individual and 3 aggregated data studies, and 1 combined study. The most common features found were: buttock pain, external tenderness over the greater sciatic notch, aggravation of the pain through sitting and augmentation of the pain with manoeuvres that increase piriformis muscle tension. Future research could start with comparing the frequencies of these features in sciatica patients with and without disc herniation or spinal stenosis

Dynamics and effects of the Vesuvius Pomici di Avellino Plinian eruption and related phenomena on the Bronze Age landscape of Campania region (Southern Italy)

The Pomici di Avellino eruption is the Plinian event of Vesuvius with the highest territorial impact. It affected an area densely inhabited by Early Bronze Age human communities and resulted in the long-term abandonment of an extensive zone surrounding the volcano. Traces of human life beneath the eruption products are very common throughout the Campania Region. A systematic review of the available archaeological data, the study of geological and archaeological sequences exposed in excavations, and the reconstruction of the volcanic phenomena affecting single sites has yielded an understanding of local effects and their duration. The archaeological and volcanological analyses have shown that the territory was rapidly abandoned before and during the eruption, with rare post-eruption attempts at resettlement of the same sites inhabited previously. The definition of the distribution and stratigraphy of alluvial deposits in many of the studied sequences leads us to hypothesise that the scarce presence of humans during phases 1 and 2 of the Middle Bronze Age in the wide area affected by the eruption was due to diffuse phenomena of remobilisation of the eruption products, generating long-lasting alluvial processes. These were favoured by the deposition of loose fine pyroclastic material on the slopes of the volcano and the Apennines, and by climatic conditions. A significant resettlement of the territory occurred only hundreds of years after the Pomici di Avellino eruption, during phase 3 of the Middle Bronze Age. This study show the role of volcanic and related phenomena from a Plinian event in the settlement dynamics of a complex territory like Campania

Sr isotopic composition as a tool for unraveling human mobility in the Campania area

Recent strontium isotope (87Sr/86Sr) analyses of bones and teeth have provided useful archeological results for reconstructing past human migration and diet. We report 87Sr/86Sr ratios and DNA analyses of tooth enamel from individuals buried in some necropolises in Nola town, near Napoli (Campania, South Italy). These individuals lived in the period between the Avellino (1925 years BCE) and CE 472 Pollena Vesuvian eruptions and are dated on archeological basis to the time span between the sixth and second century BCE. Tooth enamel 87Sr/86Sr ratios (0.70788–0.70864) are higher than baseline values in the necropolises (0.70756–0.70792): this can be explained by assuming either that all the analyzed individuals are not local—an unlikely possibility—or that they ate both local and foreign food (within about 50 km), including 87Sr-rich seafood. An explanation for such a varied diet might be that the individuals from Nola were living near the Ancient Appia and Popilia ways and not far from the coastline. Whatever its origin, the 87Sr/86Sr ratios represent the isotopic signature of the local community living on the slopes of Mt. Somma-Vesuvius between the sixth and second centuries BCE. This knowledge will support future isotope studies on volcanic eruptions as possible causes of human migration

In Amyotrophic Lateral Sclerosis Blood Cytokines Are Altered, but Do Not Correlate with Changes in Brain Topology

Aim: The present study aims at investigating the possible correlation between peripheral markers of inflammation and brain networks. Introduction: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease dominated by progressive motor impairment. Among the complex mechanisms contributing to the pathogenesis of the disease, neuroinflammation, which is associated with altered circulating cytokine levels, is suggested to play a prominent role. Methods: Based on magnetoencephalography data, we estimated topological properties of the brain networks in ALS patients and healthy controls. Subsequently, the blood levels of a subset of cytokines were assayed. Finally, we modeled the brain topological features in the function of the cytokine levels. Results: Significant differences were found in the levels of the cytokines interleukin (IL)-4, IL-1β, and interferon-gamma (IFN-γ) between patients and controls. In particular, IL-4 and IL-1β levels increased in ALS patients, while the IFN-γlevel was higher in healthy controls. We also detected modifications in brain global topological parameters in terms of hyperconnectedness. Despite both blood cytokines and brain topology being altered in ALS patients, such changes do not appear to be in a direct relationship. Conclusion: Our results would be in line with the idea that topological changes relate to neurodegenerative processes. However, the absence of correlation between blood cytokines and topological parameters of brain networks does not preclude that inflammatory processes contribute to the alterations of the brain networks. The progression of amyotrophic lateral sclerosis entails both neurodegenerative and inflammatory processes. Furthermore, disease progression induces global modifications of the brain networks, with advanced stages showing a more compact, hyperconnected network topology. The pathophysiological processes underlying topological changes are unknown. In this article, we hypothesized that the global inflammatory profile would relate to the topological alterations. Our results showed that this is not the case, as modeling the topological properties as a function of the inflammatory state did not yield good predictions. Hence, our results suggest that topological changes might directly relate to neurodegenerative processes instead