Endometrial carcinoma in a single horn of a bicornuate uterus: A case report

We discuss the diagnosis and the management of endometrial carcinoma in a single horn of bicornuate uterus in a 64-year-old woman as a case report. The case underwent laparoscopic radical hysterectomy and bilateral iliac lymphadenectomy.The gross examination of the uterus revealed a bicornuate uterus with a greater horn of 12 × 9 × 8 cm and a smaller horn of 10 × 3 cm. The cavity of the greater horn showed a neoplastic growth of 10 cm with infiltration of about 1,8 cm of the myometrium from whole thickness of 1.9 cm. while the other horn was free of tumor tissue.The microscopic examination of the uterus revealed G2 endometrioid adenocarcinoma of the endometrium of the greater horn with infiltration of more than 50% of the myometrium.In the presence of bicornuate uterus, a bilateral endometrial biopsy should be performed in order to reduce the risk of delayed or missed diagnosis.The management of a case of bicornuate unicollis uterus with endometrial carcinoma in only one horn is the same as patients with endometrial cancer in single uterus and depends mainly on stage and histological grade of the tumor.The possibility of existence of a separate uterine cavity should always be considered when endometrial cancer is clinically suspected but pathology fails to confirm the diagnosis. This points out the importance of a careful physical examination and radiographic evaluation in such cases. Keywords: Bicornuate uterus, Endometrial cance

Physical Education on the Beach: An Alternative Way to Improve Primary School Children’s Skill- and Health-Related Outcomes during the COVID-19 Pandemic

: The COVID-19 restrictions could preclude children from participating in physical education (PE) interventions. This study aimed to evaluate the efficacy of a PE intervention conducted on the beach on children's skill- and health-related outcomes, as a possible alternative PE intervention that could be also applied during the COVID-19 pandemic. The study involved 106 primary school children, randomly assigned to the traditional indoor (TI) intervention or to the experimental outdoor (EO) intervention. The intervention period lasted 4 months and consisted of two 1-h sessions per week. Intervention was conducted just before the beginning of the COVID-19 pandemic. Children's anthropometric parameters (height, weight, BMI, body fat percentage, and abdominal circumference), fitness parameter (VO2peak), health parameters (resting heart rate, and systolic and diastolic blood pressure), gross motor coordination, and physical activity level were assessed before and after intervention. Both groups significantly improved fitness and motor coordination but worsened some anthropometric parameters (weight, abdominal circumference) after the intervention period. The EO group showed a higher increase of gross motor coordination than the TI group. Results of this study demonstrated that children benefited from a well-structured PE intervention conducted in the natural environment of the beach improving physical fitness and gross motor coordination. Therefore, planning outdoor PE interventions could be an alternative and safe way to encourage and implement physical activity at school during the particular period of COVID-19 pandemic

Effects of sports experience on children's gross motor coordination level

Background: Gross motor coordination (GMC) development could be influenced by age, gender, weight status, geographical area, living setting, home environment, socio-economic status, sports practice. Purpose: To verify whether practicing sports and practicing different sports could influence children's GMC level. Methods: A total of 295 children aged 8-11 years were involved in the study and divided into 5 groups in relation to the sport they practiced: gymnastics group (n = 67; 51F, 16M), cycling group (n = 64; 15F, 49M), athletics group (n = 47; 22F, 25M), swimming group (n = 35; 20F, 15M), control group (n = 82; 42F, 40M). The four subtests of the Körperkoordinations Test für Kinder (KTK) assessed children's GMC level. The scores from each of the four subtests were summed into the KTK total raw score (RS) and then converted into a gender- and age-specific motor quotient (MQ). Results: Children practicing sports showed significantly higher RS and MQ score than children of control group (203.14 ± 38.55 vs. 163.63 ± 43.50 and 98.56 ± 15.79 vs. 83.01 ± 16.71, respectively; p < 0.001). Children practicing gymnastics had a significantly higher RS and MQ than children of cycling, swimming, and control groups (p < 0.05), children of control group had a significantly lower RS and MQ than children of all other groups (p < 0.05). Children practicing gymnastics performed better walking backwards subtest than all other children's groups (p < 0.001). Children of control group performed worse jumping sideways subtest than children of gymnastics, athletics and swimming groups (p < 0.01). Children practicing gymnastics performed better moving sideways subtest than children of athletics, cycling and control groups (p < 0.01); children of control group performed worse than children of all other groups (p < 0.01). Children of control group performed worse hopping for height subtest than children of gymnastics, athletics and cycling groups (p < 0.05); children practicing gymnastics performed better than children of swimming and control groups (p < 0.05). Conclusions: The performance model and therefore the specialized training that each sport discipline required, could justified the differences in children's GMC level among sports groups. Thus, coaches should plan individualized interventions and choose activity contents to support children's GMC development

Körperkoordinations test für Kinder: A short form is not fully satisfactory

Assessment of motor competence (MC) is crucial to finding deficiencies in children's motor development. Because of the need to ensure validity, reliability, and feasibility, the selection of contemporary testing batteries is a difficult task. Many papers report the validity of the KTK test in describing MC in school aged children. KTK consists of 4 four separate items: walking back, jumping sideways, moving sideways, and hopping for height. Some authors suggested the use of a short version of KTK that includes 3 items excluding one subtest: hopping for height. This study aimed to evaluate the effectiveness of short versions of Körperkoordinationstest für Kinder (KTK). A sample of 2,231 participants (boys: n=1,188; girls: n = 1,043; age range: 6–12 years) were recruited from Italian schools between January 2019 and February 2020 and they performed the complete version of KTK. Stepwise linear regression was performed on the dataset to evaluate the ideal number of variables to describe the KTK short form version. Data for both the sexes and all ages indicated that considering the item combinations of each short version, the highest R squares were obtained in those that included exactly the deleted subtest (ranging from 0.881–0.979). The adoption of a short form does not seem to provide a fully satisfactory condition for measuring MC in children 6–12 years

Interrelationship between age, gender, and weight status on motor coordination in Italian children and early adolescents aged 6-13 years old

Although numerous evidences reported a negative correlation between motor coordination (MC) and overweight/obesity in children and adolescents, the interrelationship between age, gender, and weight status is still debatable. Hence, the aim of this cross-sectional study was to examine the association between MC and weight status according to age and gender across childhood and early adolescence in a large sample of Italian elementary and middle school students. A number of 1961 Italian school students (1,026 boys, 935 girls) was stratified in three consecutive age groups (6-7, 8-10, and 11-13 years) and four weight status categories (underweight, normal weight, overweight, and obese) according to Cole's body mass index (BMI) cut-off points for children. MC performance was assessed measuring motor quotient (MQ) with the Körperkoordinationstest für Kinder (KTK). Results showed significantly lower MQ levels in children in overweight (OW) and with obesity (OB) in both sexes for all age groups than peers in normal weight (NW), except in 6-7-year-old boys. Girls in OW and with OB had similar MQ levels across all age groups, while younger boys in OW and with OB showed higher MQ levels than older ones (p < 0.05). The 6-7-year-old boys showed better MQ levels than girls peers in NW, OW, and with OB, while 8-10-year-old boys in underweight (UW), NW, and OW; and 11-13-year-old boys only in NW (p < 0.05). No interaction effect was found between age, gender, and weight status on MQ levels. These outcomes showed the negative impact of higher weight status on MC performance according to age and gender, pointing out the importance of planning targeted motor programs that consider these variables to improve MC performance

Special Issue: “Management of Early Stage Cervical Cancer”

Cervical carcinoma is a common gynecological malignancy that remains a challenge for oncologic gynecologists around the world [...

Total Microlaparoscopic Radical Hysterectomy in Early Cervical Cancer

BACKGROUND AND OBJECTIVE: In less than 2 decades, laparoscopy has contributed to modification in the management of early cervical cancer patients, and all comparisons between open and laparoscopic-based radical operations showed an identical oncological outcome. The aim of this study is to describe surgical instrumentations and technique to perform total microlaparoscopy radical hysterectomy in early cervical cancer patients and report our preliminary results in terms of operative time and perioperative outcomes. METHODS: Between January 1, 2012, and March 25, 2012, 4 consecutive early cervical cancer patients were enrolled in this study. RESULTS: We performed 3 type B2 and 1 type C1-B2 total microlaparoscopy radical hysterectomy, and in all cases concomitant bilateral salpingo-oophorectomy and pelvic lymphadenectomy were carried out. Median operative time was 165 minutes (range: 155 to 215) (mean: 186), and median estimated blood loss was 30 mL (range: 20 to 50). Median number of pelvic lymph nodes removed was 12 (range: 11 to 15). All procedures were completed without 5-mm port insertion and without conversion. No intraoperative or early postoperative complications were reported. CONCLUSIONS: This report suggests a role of microlaparoscopy in the surgical management of early cervical cancer with adequate oncological results, superimposable operative time, and perioperative outcomes with respect to standard laparoscopy

Effects of open (Racket) and closed (running) skill sports practice on children’s attentional performance.

Aims: The first aim of the study was to examine the attentional performance of children (8–13 years of age) who practiced two different sport disciplines: Open skill sport – racket and closed skill sport – running and also to investigate the acute effects of these two specific training sessions on children’s immediate and delayed attentional performance. The second aim of the present study was to verify gender differences in attentional performance. Eighteen children+ (8 girls and 10 boys; age = 10.6 ± 1.5 yrs; height = 144.3 ± 12.2 cm; weight = 44.2 ± 12.5 kg; BMI = 20.8 ± 2.7 kg/m2) engaged in a racket sports and eighteen children (9 girls and 9 boys; age = 9.9 ± 1.2 yrs; height = 142.4 ± 9.5 cm; weight = 40.0 ± 8.6 kg; BMI = 19.6 ± 2.4 kg/m2) engaged in running were enrolled. Methods: Children’s training and experience with these activities averaged 2.3 (± 1.0) years. Children’s attentional capacity was measured before, immediately after and 50 minutes after each specific training session by the d2 test of attention. This paper -and -pencil letter cancellation test evaluated concentration and sustained attention under stress induced by a fixed executing time. A 2 (Sport: open vs closed skill) x 2 (Gender: boys vs girls) x 3 (Time: pre vs 0’ post vs 50’ post) repeated measures ANOVA for time was used to compare the effect of an open skill session and a closed skill session on the individual attentional variables. Results: Children of open skill sport showed higher attentional scores (higher processing speed - TN, higher concentration performance - CP and lower percentage of errors - E%; p < 0.01), improved CP from pre to 0’ post intervention (p = 0.01) and maintained this improved performance at 50’ post intervention (50’ post vs pre; p < 0.01), and decreased E% from pre to 0’ post intervention (p = 0.01) and maintained this improvement at 50’ post intervention (50’ post vs pre; p < 0.001). Children of closed skill sport significantly decreased their CP from pre to 50’ post intervention (50’ post vs pre; p = 0.001 and 50’ post vs 0’ post; p < 0.0001) and worsened their E% across the time (50’ post vs pre; p = 0.001 and 50’ post vs 0’ post; p < 0.0001). Boys showed significantly higher TN values than girls only in closed skill sport (p = 0.023). Finally, all girls of both open and closed skill sports significantly improved their CP from pre to 0’ post intervention (p = 0.04). Conclusion: Results of the study showed that open skill sport practice and training session positively affects children’s attentional performance

Laparoendoscopic Single-Site Surgery for the Treatment of Benign Adnexal Disease: A Prospective Trial

Background. To validate feasibility, efficacy, and safeness of laparoscopic treatment of benign adnexal diseases through a single transumbilical access (LESS) in a prospective series of patients. Methods. A prospective clinical trial including 30 women has been conducted at the Division of Gynecology of Catholic University of Sacred Hearth of Rome. Patients underwent different laparoscopic procedures by LESS utilizing a multiport trocar and conventional straight laparoscopic instrumentation. Intra and perioperative outcome has been reported. Results. Ten mono/bilateral adnexectomies and 20 cystectomies have been performed by LESS approach. Laparoscopic procedures were completed through a single access in 28 cases (93.4%). No major intra- or postoperative complications were observed. Mean hospital stay was 1.3 days. Conclusions. LESS approach is feasible to treat benign adnexal disease with a very low conversion rate and no early or late complications. More clinical data are needed to confirm these advantages compared to standard laparoscopic technique