Nonsurgical lumbar radiculopathies treated with ultramicronized palmitoylethanolamide (umPEA): A series of 100 cases

In this clinical/observational study we have reported the administration of Palmitoylethanolamide (PEA) in patients suffering from radicular lumbar spinal pathology, who had no indication for surgical treatment. We analyzed a series of 100 cases retrospectively, all undergoing clinical and diagnostic investigations, which had shown the presence of abnormalities of the vertebral body and intervertebral discs, mainly degenerative, such as spondyloarthrosis, spondylo-discarthrosis, disc protrusion, excluding disc herniation, which fell within surgical cases. We then administered ultramicronized PEA (umPEA) to these patients, in combination with paracetamol and codeine, obtaining interesting results regarding the improvement of pain symptoms of the spine pathology, in the various checks carried out, through the administration of pain assessment scales. We also noted its safety due to the total absence of adverse effects. The obtained results encourage the use of PEA in degenerative spine pathologies

Discrepancy between clinical-neurophysiological-neuroimaging examinations in lumbar spine degenerative disease: To the neurosurgeon the choice

Background: Degenerative lumbar spinal surgery is preceded by diagnostic investigations, like clinical, radiological, neurophysiological ones. The presurgical evaluation is made easier by the concordance of the diagnostic investigations. In a percentage of cases, however, there is a discrepancy, especially with regard to the correlation between electromyography and neuroimaging. It is the case of a normal EMG and a CT or MRI showing the presence of a protrusion or a herniated disc. Material and methods: Our study covers 30 subjects suffering from herniated disc pain and undergone surgery. 15 patients presented with lumbar pain, with CT and MRI showing herniated disc, but normal electromyographic results. Despite this discordance, all patients underwent surgery. Results: The results were satisfactory. The results of this study highlighted the possible discrepancy between neurophysiological, neuroradiological and clinical examinations but the surgeon's decision to intervene was appropriate since the 5-year follow-up showed the resolution of the disc pathology, with disappearance of pain. Conclusions: The discrepancy between the diagnostic examinations is a problem creating for the purpose of the preoperative evaluation, whereby the decision to intervene is entrusted to neurosurgeon, who will choose the better option for surgery. Keywords: Herniation disc, Lumbar spine, Neuroimaging, Elecromyograph

A Unique Case of Bilateral Thalamic High-Grade Glioma in a Pediatric Patient with LI-Fraumeni Syndrome: Case Presentation and Review of the Literature

Li-Fraumeni syndrome (LFS) is a rare high-penetrance and autosomal-dominant pathological condition caused by the germline mutation of the TP53 gene, predisposing to the development of tumors from pediatric age. We conducted a qualitative systematic review following the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) framework. A search was made in MEDLINE/Pubmed and MeSH Database using the terms “Li-Fraumeni” AND “pediatric high-grade glioma (HGG)”, identifying six cases of HGGs in pediatric patients with LFS. We added a further case with peculiar features such as no familiar history of LFS, association of embryonal rhabdomyosarcoma and bithalamic HGG, whose immunohistochemical profile was accurately defined by Next Generation Sequencing. Knowledge synthesis and case analysis grounded the discussion about challenges in the management of this pathology in pediatric age

Communication about vaccination: A shared responsibility

Vaccine hesitancy is an important issue to be addressed, due to the risk of decrease of vaccination coverage and consequent control of preventable diseases. While it is not considered a specific determinant, poor or inadequate communication can contribute to vaccine hesitancy and negatively influence vaccination uptake. As a contribution to the ongoing discussion regarding this theme and in the perspective of the implementation of the upcoming national vaccination plan in Italy, the Erice Declaration was drafted by experts in the field of immunization following a 5-day residential, independent workshop regarding communication topics in vaccinology. The aim of the current letter is to present to the broader international audience such a contribution, proposing the identification of the main actions that should be taken into account and prioritized in order to improve communication in the domain of vaccination

A finite mixture latent trajectory model for hirings and separations in the labor market

We propose a finite mixture latent trajectory model to study the behavior of firms in terms of open-ended employment contracts that are activated and terminated during a certain period. The model is based on the assumption that the population of firms is composed by unobservable clusters (or latent classes) with a homogeneous time trend in the number of hirings and separations. Our proposal also accounts for the presence of informative drop-out due to the exit of a firm from the market. Parameter estimation is based on the maximum likelihood method, which is efficiently performed through an EM algorithm. The model is applied to data coming from the Compulsory Communication dataset of the local labor office of the province of Perugia (Italy) for the period 2009-2012. The application reveals the presence of six latent classes of firms