Influence of thermal cycles and disinfection on the roughness, microhardness and color of PETG/TPU and PMMA.

BACKGROUND: Occlusal splints can protect teeth during bruxism, preventing tooth wear, as well as during sports activities, shielding them from impacts. OBJECTIVES: To verify the influence of thermal cycles and disinfection on the roughness, microhardness and color of polyethylene terephthalate glycol/thermoplastic polyurethane (PETG/TPU) and poly(methyl methacrylate) (PMMA). MATERIAL AND METHODS: Thirty-six PETG/TPU samples and 36 PMMA samples were prepared (ø10 mm × 3 mm). Six groups were created according to the material and the disinfection method used (n = 12 each): PETG/TPU (glister), PETG/TPU (hypochlorite), PETG/TPU (soap), PMMA (glister), PMMA (hypochlorite), and PMMA (soap). Roughness, Knoop microhardness and color evaluations were performed before the experiments (T1), after thermocycling (T2) and after disinfection (T3). Three-way repeated measures analysis of variance (ANOVA) and Tukey's test were used for statistical evaluations. RESULTS: For roughness and color, ANOVA showed statistical significance based on the interaction between thermal cycling, material and disinfectant factors. In terms of Knoop microhardness, ANOVA showed statistical significance based on the interaction between thermal cycling and material factors. CONCLUSIONS: Roughness results were clinically acceptable in all groups at all time points, except the PETG/TPU and PMMA groups disinfected with hypochlorite. Microhardness significantly increased for both materials after thermal cycling, and at all time points, the microhardness of PMMA was significantly higher than that of PETG/TPU. After thermal cycling, the color changes were clinically unacceptable in all groups.

Presenting features of neuroblastoma with spinal canal invasion. A prospective study of the International Society of Pediatric Oncology Europe - Neuroblastoma (SIOPEN).

Introduction: Between 5 and 15% of children with neuroblastoma (NB) present with or develop spinal canal invasion (SCI). The majority of these children have symptoms of epidural compression of spinal cord and/or spinal nerves. Treatment of NB-SCI is considered an emergency but its modalities are not yet well-established. Independently of treatment, NB-SCI may result in significant long-term disabilities. We report on the first prospective study of NB-SCI focused on presenting characteristics of both symptomatic and asymptomatic patients and correlation between SCI-related symptoms and imaging features. Materials and methods: This SIOPEN prospective NB-SCI study opened in June 2014. Patient data including SCI symptoms evaluated by standardized measures and spinal cord imaging studies were collected for each patient. For the purpose of this study data entry was locked on July 2021. Results: Of the 208 NB-SCI patients registered, 196 were evaluable for this analysis of whom 67% were symptomatic and 33% asymptomatic. Median age was 11 months. The thorax was the commonest primary tumor site. The median intervals between initial symptoms and diagnosis and between first medical visit and diagnosis were 14 and 3 days, respectively. The was no statistical difference in frequency of presenting characteristics between symptomatic and asymptomatic patients. Presenting features of NB-SCI patients differed from other NBs for older median age, prevalence of thoracic vs. abdominal primary site, prevalence of localized vs. metastatic disease and lower incidence of MYCN gene amplification. The most common SCI features were motor deficit in the younger and pain in the older patients that correlated on imaging with both transverse and longitudinal extent but not with the level of intraspinal tumor. Spinal cord T2-hyperintensity was more frequently detected in symptomatic patients (not significant). Conclusion: This prospective study confirms that children with NB-SCI differ from NBs without SCI. Compared to previous studies, it provides more detailed information regarding presenting symptoms, time intervals between SCI symptoms, medical visit and diagnosis, and correlations between symptoms and imaging features.

Bilateral adrenal primary tumor in Stage 4S neuroblastoma: The Italian experience and review of the literature.

Bilateral adrenal neuroblastoma (NB) is rare and is mainly stage 4S. Its incidence, presenting features, management, and outcome have not been fully defined yet. We searched the Italian NB Registry (RINB) for stage 4S NB infants with bilateral adrenal primary tumor to compare them with stage 4S NB with unilateral tumor. Between 1979 and 2016, the RINB enrolled 3731 NB patients aged 0-18 years including 317 infants (8.5%) diagnosed with stage 4S NB. Eleven/317 (3.5%) had a bilateral adrenal primary tumor (Group 1) and 190/317 (59.9%) had a unilateral tumor (Group 2). Group 1 infants were significantly younger (51 vs. 89 days) but were comparable with Group 2 for any other presenting features. In the absence of specific protocols, upfront treatment was based on symptoms, size of adrenal tumors, and biology, and consisted of observation in 5 cases, radiotherapy in one, chemotherapy in 2, and surgery in 3. Five/11 developed progression and 2 of them, both with MYCN amplification, died. The 5-year EFS rates of Group 1 and 2 were 54.5% vs. 73.3% (P=.14) and 5-year OSs were 81.8% and 89.4%, respectively (P=.44). Our data support the hypothesis that 4S NB infants with bilateral adrenal tumors can have favorable outcome with personalized therapeutic approach. The three patients with MYCN amplified tumor benefited from upfront aggressive chemotherapy, in accordance with current protocols. Because of the rarity of this intriguing form of neuroblastoma, collaborative prospective studies are warranted, especially in view of gaining a better insight on its biological and genetic features.

Reabilitação de pacientes com comunicação buco nasal: relato de casos / Rehabilitation of patients with oral and nasal communication: case report

A sobrevivência de pacientes com câncer de cabeça e pescoço vêm melhorando, entretanto, algumas deformidades podem ocorrer devido dos tratamentos cirúrgicos que geram mutilações bucomaxilofaciais como perda de dentes, estruturas do palato, língua ou assoalho, resultando em alterações na fonética, mastigação e deglutição. Nesses casos há a necessidade que seja realizado uma reabilitação protética buscando torná-los indivíduos com menos problemas sociais, psicológicos e físicos, visto que mais procedimentos cirúrgicos estão contra indicados para solucionar os efeitos colaterais gerados pelo tratamento das neoplasias. Esse tipo de reabilitação protética com prótese ou placa obturadora possibilita benefícios na fonética, facilita a convivência social e atividades nutricionais como alimentação e deglutição, permitindo ao paciente uma vida com menos constrangimentos. Este trabalho tem como objetivo relatar dois casos clínicos onde os pacientes foram submetidos a reabilitação com placa obturadora palatina feitos após cirurgias oncológicas. Os pacientes de gêneros diferentes e com comunicações buco-nasal similares receberam o mesmo planejamento reabilitador que foram confeccionadas a partir de um molde que foi enviado ao laboratório. Após a instalação foi possível verificar que houve sucesso no tratamento, notando uma melhora imediata comprovando a eficácia do método reabilitador(AU)

This paper relates two clinical cases where patients were recovered with a palatal splint made after oncological surgeries. Survival of patients and necks can occur, however, some deformities can occur during oral and maxillofacial treatment, such as the appearance of teeth, palate structures, mutilations or posterior jaws, leading to changes in aesthetics, surgery and swallowing. If the need to perform a prosthetic rehabilitation is necessary so that the results are seen with less problems, psychological and physical, that more procedures are performed so that the effects of neoplasms are contraindicated by the treatment. This type of prosthetic rehabilitation with prosthesis or obturator plate provides benefits in phonetics, facilitates social coexistence and nutritional activities such as eating and swallowing, allowing the patient a life with less constraints. Patients of different genders and with similar oral and nasal communications received the same rehabilitation plan that were made from a mold that was sent to the laboratory. After installation, it was possible to verify that the treatment was successful, noting an immediate improvement, proving the effectiveness of the rehabilitation method(AU)

Increasing the Content of Olive Mill Wastewater in Biogas Reactors for a Sustainable Recovery: Methane Productivity and Life Cycle Analyses of the Process.

Anaerobic codigestion of olive mill wastewater for renewable energy production constitutes a promising process to overcome management and environmental issues due to their conventional disposal. The present study aims at assessing biogas and biomethane production from olive mill wastewater by performing biochemical methane potential tests. Hence, mixtures containing 0% (blank), 20% and 30% olive mill wastewater, in volume, were experimented on under mesophilic conditions. In addition, life cycle assessment and life cycle costing were performed for sustainability analysis. Particularly, life cycle assessment allowed assessing the potential environmental impact resulting from the tested process, while life cycle costing in conjunction with specific economic indicators allowed performing the economic feasibility analysis. The research highlighted reliable outcomes: higher amounts of biogas (80.22 ± 24.49 NL.kgSV-1) and methane (47.68 ± 17.55 NL.kgSV-1) were obtained when implementing a higher amount of olive mill wastewater (30%) (v/v) in the batch reactors. According to life cycle assessment, the biogas ecoprofile was better when using 20% (v/v) olive mill wastewater. Similarly, the economic results demonstrated the profitability of the process, with better performances when using 20% (v/v) olive mill wastewater. These findings confirm the advantages from using farm and food industry by-products for the production of renewable energy as well as organic fertilizers, which could be used in situ to enhance farm sustainability.

Metastatic progression in infants diagnosed with stage 4S neuroblastoma. A study of the Italian Neuroblastoma Registry.

PURPOSE: Stage 4S neuroblastoma, a tumor affecting infants, is characterized by the capacity to regress spontaneously and high cure rate. About a third of these infants undergo tumor progression requiring antitumor treatment and 10-15% eventually die. In case of metastatic progression, it may occur either at 4S sites (mainly liver) or sites characterizing stage 4 (mainly bone). Aim of this study was to estimate incidence, presenting features and outcome of infants who progressed to stage 4S or stage 4 sites. PATIENTS: Of 280 Italian infants diagnosed with stage 4S neuroblastoma between 1979 and 2013 and registered in the Italian Neuroblastoma Registry, 268 were evaluable for this study, of whom 57 developed metastatic progression. RESULTS: Progression to stage 4S sites occurred in 29/268 infants (10.8%) (Group A) and to stage 4 in 28/268 (10.4%) (Group B). No significant difference was observed between the two groups at the time of diagnosis. At the time of progression, Group A infants were younger (7.3 vs 14.4 months, P = .001) and had a shorter interval from diagnosis to progression (3.8 vs 9.6 months, P = .001). Survival after progression was worse for Group B infants (45% vs 69%, P = .058) and was associated with age at diagnosis lower than 2 months (P = .005) and adrenal primary tumor site (P = .008). Survival rates increased for both groups along the study period. CONCLUSIONS: Infants who progressed to stage 4 did worse, possibly in relation to older age at progression and longer interval between diagnosis and progression. Large prospective studies of these patients may lead to more effective treatments.

Harvesting system sustainability in Mediterranean olive cultivation: Other principal cultivar.

In the olive production sector, which is increasingly expanding beyond the borders of the Mediterranean basin, harvesting is the most demanding phase, from both an economic and organisational point of view. Traditional olive orchards are still predominant, with centuries-old and large plants, and are characterised by the gradual ripening of drupes and irregular planting patterns. Even though the structural conversion of these olive orchards into more modern cultivations may be difficult owing to their historical, monumental, and landscaping importance, as well as the existing legal restrictions, supporting a "modernisation" process aimed at mechanising the main farming operations remains a priority. Technological innovation is, therefore, a primary objective for Mediterranean olive growing, as well as for the enhancement of its strengths. The present study aimed at assessing different olive harvesting sites, considering the technical, economic, and environmental aspects, to develop a better version of the "olive harvesting database". The applied methodology, also called the "modular approach", represents a useful tool to apply in unitary process assessment to obtain a comprehensive database of diverse agricultural operations. Eight olive harvesting systems were compared: six highly mechanised scenarios, one based on mechanical-aided harvesting, and the final one based on fully manual harvesting. The mechanised systems obtained a better performance in terms of working capacity, as only 3.5 h ha-1 were needed to harvest 12 t using a self-propelled trunk shaker. In addition, the economic results revealed that mechanical harvesting, diversely from manual or aided harvesting, is the only way to decrease production costs. From an environmental point of view, manual and mechanical-aided harvesting showed the best performance in terms of impact per hour. However, using the mass-based unit (1 kg of harvested olives), the results were the opposite and this could be very relevant for the ecoprofile of olive oil.

Resection of primary tumor in stage 4S neuroblastoma: a second study by the Italian Neuroblastoma Group.

PURPOSE: To clarify the role of primary tumor resection in stage 4S neuroblastoma. METHODS: We investigated a cohort of 172 infants diagnosed with stage 4S neuroblastoma between 1994 and 2013. Of 160 evaluable patients, 62 underwent upfront resection of the primary tumor and 98 did not. RESULTS: Five-year progression-free and overall survival were significantly better in those who had undergone upfront surgery (83.6% vs 64.2% and 96.8% vs 85.7%, respectively). One post-operative death and four non-fatal complications occurred in the resection group. Three patients who had not undergone resection died of chemotherapy-related toxicity. Thirteen patients underwent late surgery to remove a residual tumor, without complications: all but one alive. Outcomes were better in patients diagnosed from 2000 onwards. CONCLUSION: Infants diagnosed with stage 4S neuroblastoma who underwent upfront tumor resection had a better outcome. However, this result cannot be definitely attributed to surgery, since these patients were selected on the basis of their favorable presenting features. Although the question of whether to operate or not at disease onset is still unsolved, this study confirms the importance of obtaining enough adequate tumor tissue to enable histological and biological studies to properly address treatment, to achieve the best possible outcome.

Age Dependency of the Prognostic Impact of Tumor Genomics in Localized Resectable MYCN-Nonamplified Neuroblastomas. Report From the SIOPEN Biology Group on the LNESG Trials and a COG Validation Group.

PURPOSE: For localized, resectable neuroblastoma without MYCN amplification, surgery only is recommended even if incomplete. However, it is not known whether the genomic background of these tumors may influence outcome. PATIENTS AND METHODS: Diagnostic samples were obtained from 317 tumors, International Neuroblastoma Staging System stages 1/2A/2B, from 3 cohorts: Localized Neuroblastoma European Study Group I/II and Children's Oncology Group. Genomic data were analyzed using multi- and pangenomic techniques and fluorescence in-situ hybridization in 2 age groups (cutoff age, 18 months) and were quality controlled by the International Society of Pediatric Oncology European Neuroblastoma (SIOPEN) Biology Group. RESULTS: Patients with stage 1 tumors had an excellent outcome (5-year event-free survival [EFS] ± standard deviation [SD], 95% ± 2%; 5-year overall survival [OS], 99% ± 1%). In contrast, patients with stage 2 tumors had a reduced EFS in both age groups (5-year EFS ± SD, 84% ± 3% in patients < 18 months of age and 75% ± 7% in patients ≥ 18 months of age). However, OS was significantly decreased only in the latter group (5-year OS ± SD in < 18months and ≥ 18months, 96% ± 2% and 81% ± 7%, respectively; P = .001). In < 18months, relapses occurred independent of segmental chromosome aberrations (SCAs); only 1p loss decreased EFS (5-year EFS ± SD in patients 1p loss and no 1p loss, 62% ± 13% and 87% ± 3%, respectively; P = .019) but not OS (5-year OS ± SD, 92% ± 8% and 97% ± 2%, respectively). In patients ≥ 18 months, only SCAs led to relapse and death, with 11q loss as the strongest marker (11q loss and no 11q loss: 5-year EFS ± SD, 48% ± 16% and 85% ± 7%, P = .033; 5-year OS ± SD, 46% ± 22% and 92% ± 6%, P = .038). CONCLUSION: Genomic aberrations of resectable non-MYCN-amplified stage 2 neuroblastomas have a distinct age-dependent prognostic impact. Chromosome 1p loss is a risk factor for relapse but not for diminished OS in patients < 18 months, SCAs (especially 11q loss) are risk factors for reduced EFS and OS in those > 18months. In older patients with SCA, a randomized trial of postoperative chemotherapy compared with observation alone may be indicated.

A Review of Infants With Localized Neuroblastoma That Evolve to Stage 4s Disease.

The authors describe a newborn diagnosed with localized neuroblastoma that evolved to stage 4s at the age of 5 months. Peculiar features of the case included a bilateral adrenal primary, the skin as the only metastatic site, and the development of a muscular lesion late in the clinical course. The patient underwent left adrenalectomy and all other lesions regressed without further therapy. The case prompted a search for similar cases both in the Italian Neuroblastoma Registry and in the literature. All patients identified, although variously treated, survived with the exception of the 2 with MYCN gene amplification. We conclude that infants with neuroblastoma who undergo a transition from a localized to stage 4s disease could be less rare than expected. In the absence of unfavorable biology, a wait-and-see policy with strict follow-up could be adopted for these patients, avoiding potentially damaging systemic therapy.

Stage 4 s neuroblastoma: features, management and outcome of 268 cases from the Italian Neuroblastoma Registry.

BACKGROUND: Infants diagnosed with stage 4 s neuroblastoma commonly experience spontaneous disease regression, with few succumbing without response to therapy. We analyzed a large cohort of such infants enrolled in the Italian Neuroblastoma Registry to detect changes over time in presenting features, treatment and outcome. METHODS: Of 3355 subjects aged 0-18 years with previously untreated neuroblastoma diagnosed between 1979 and 2013, a total of 280 infants (8.3%) had stage 4 s characteristics, 268 of whom were eligible for analyses. Three treatment eras were identified on the basis of based diagnostic and chemotherapy adopted. Group 1 patients received upfront chemotherapy; Group 2 and 3 patients underwent observation in the absence of life-threatening symptoms (LTS), except for Group 3 patients with amplified MYCN gene, who received more aggressive therapy. RESULTS: The three groups were comparable, with few exceptions. Ten-year overall survival significantly increased from 76.9 to 89.7% and was worse for male gender, age 0-29 days and presence of selected LTS on diagnosis, elevated LDH, and abnormal biologic features. Infants who underwent primary resection ± chemotherapy did significantly better. On multivariate analysis, treatment eras and the association of hepatomegaly to dyspnea were independently associated with worse outcome. CONCLUSIONS: Our data confirm that stage 4 s neuroblastoma is curable in nearly 90% of cases. Hepatomegaly associated to dyspnea was the most important independent risk factor. The cure rate could be further increased through timely identification of patients at risk who might benefit from surgical techniques, such as intra-arterial chemoembolization and/or liver transplantation, which must be carried out in institutions with specific expertise.

Harvesting system sustainability in Mediterranean olive cultivation.

The mechanization of farming operation plays an important role in improving the profitability of the agricultural sector by increasing work productivity and reducing production costs. However, the new challenges of agriculture also include the environmental issues. The choice between different alternatives to perform a determined agricultural practice should be based on reliable information, considering technical, economic and environmental aspects. Olive growing represents the most important agricultural production in the Mediterranean Basin and its mechanization, particularly harvesting, could have major impacts on the sustainability of this production. This study aims at assessing various olive-harvesting scenarios, while considering technical, economic and environmental aspects in order to build a beta version of the "olive-harvesting database". The proposed methodology called "modular approach" could represent a useful tool to apply in unitary process assessment in order to obtain a comprehensive database of the diverse agricultural operations. The methodology was based on Life Cycle Assessment and production cost analysis. Technical performance evaluation showed that the recorded work capacities varied between 5 tons of harvested olives per day when employing mechanical harvest aids and 18 tons per day when employing trunk shakers. The economic evaluation highlighted that the harvesting costs are variable as a function of the given cost type (costs per hour, costs per kg of harvested olives and costs per hectare). The LCA revealed that mechanically aided techniques were the most sustainable ones when the functional unit is considered as one harvesting hour, although this FU is not the most suitable unit for choosing the best environmental solution. The surface and production mass units are more appropriate FUs in comparative studies, although they are strictly linked to the "work capacity". A significant variation in the environmental performances depended on the FUs and on the average yields when the FU represented one kg of harvested olives.

Occupational risks related to vibrations using a brush cutter for green area management.

INTRODUCTION: Weed control is one of the most important issues in the maintenance sectors of both agriculture and green areas. Small tools are employed for controlling grass and other growths on steep verges and river banks. This leads the operators being exposed to many risks among which vibration is one. The purpose of this study is to measure and evaluate hand-arm vibration and to verify the daily exposure to which workers are often subjected while weeding. MATERIAL AND METHODS: Two cutting heads, a brush knife and a mowing head were compared. Both were mounted on the same cow-horn brush cutter. The vibration total value was expressed as the root-mean-square (rms) of three component values according to the axes X, Y and Z. The signal was frequency weighted using the weighting curve Wh, as described in the ISO 5349-1 (2001) standard. In addition, the daily vibration exposure was calculated and compared with the thresholds set by EU Directive 2002/44/EC (2005). RESULTS: The obtained results showed that the exposure action value (EAV) of 2.5 ms-2 was exceeded while using both cutting heads. The exposure limit value (ELV) using the brush knife also exceeded 5 ms-2. CONCLUSIONS: The results highlighted important aspects in terms of exposure values that should be considered with the view of preventing the risk of Hand-Arm Vibration Syndrome (HAVS) to which the operators who frequently use these tools are exposed. Specific measures should therefore be taken to protect the exposed workers.

Signal intensity at unenhanced T1-weighted magnetic resonance in the globus pallidus and dentate nucleus after serial administrations of a macrocyclic gadolinium-based contrast agent in children.

BACKGROUND: Few studies have been conducted on the relations between T1-weighted signal intensity changes in the pediatric brain following gadolinium-based contrast agent (GBCA) exposure. OBJECTIVE: The purpose of this study is to investigate the effect of multiple administrations of a macrocyclic GBCA on signal intensity in the globus pallidus and dentate nucleus of the pediatric brain on unenhanced T1-weighted MR images. MATERIALS AND METHODS: This retrospective study included 50 patients, mean age: 8 years (standard deviation: 4.8 years), with normal renal function exposed to ≥6 administrations of the same macrocyclic GBCA (gadoterate meglumine) and a control group of 59 age-matched GBCA-naïve patients. The globus pallidus-to-thalamus signal intensity ratio and dentate nucleus-to-pons signal intensity ratio were calculated from unenhanced T1-weighted images for both patients and controls. A mixed linear model was used to evaluate the effects on signal intensity ratios of the number of GBCA administrations, the time interval between administrations, age, radiotherapy and chemotherapy. T-test analyses were performed to compare signal intensity ratio differences between successive administrations and baseline MR signal intensity ratios in patients compared to controls. P-values were considered significant if <0.05. RESULTS: A significant effect of the number of GBCA administrations on relative signal intensities globus pallidus-to-thalamus (F[8]=3.09; P=0.002) and dentate nucleus-to-pons (F[8]=2.36; P=0.021) was found. The relative signal intensities were higher at last MR examination than at baseline (P<0.001). CONCLUSION: Quantitative analysis evaluation of globus pallidus:thalamus and dentate nucleus:pons of the pediatric brain demonstrated an increase after serial administrations of macrocyclic GBCA. Further research is necessary to fully understand GBCA pharmacokinetic in children.

Neuroblastoma (Peripheral neuroblastic tumours).

Peripheral neuroblastic tumours (PNTs), a family of tumours arising in the embryonal remnants of the sympathetic nervous system, account for 7-10% of all tumours in children. In two-thirds of cases, PNTs originate in the adrenal glands or the retroperitoneal ganglia. At least one third present metastases at onset, with bone and bone marrow being the most frequent metastatic sites. Disease extension, MYCN oncogene status and age are the most relevant prognostic factors, and their influence on outcome have been considered in the design of the recent treatment protocols. Consequently, the probability of cure has increased significantly in the last two decades. In children with localised operable disease, surgical resection alone is usually a sufficient treatment, with 3-year event-free survival (EFS) being greater than 85%. For locally advanced disease, primary chemotherapy followed by surgery and/or radiotherapy yields an EFS of around 75%. The greatest problem is posed by children with metastatic disease or amplified MYCN gene, who continue to do badly despite intensive treatments. Ongoing trials are exploring the efficacy of new drugs and novel immunological approaches in order to save a greater number of these patients.

White matter disruption is associated with persistent seizures in tuberous sclerosis complex.

BACKGROUND AND AIMS: White matter is diffusely altered in tuberous sclerosis complex (TSC), and these alterations appear to be more evident in subjects with a more severe neurologic phenotype. However, little is known on the correlation between white matter alterations and epilepsy in TSC. The aims of this study were to evaluate the effects of early onset and refractory seizures on white matter by using diffusion tensor imaging (DTI). METHODS: We enrolled 20 children with TSC and epilepsy onset in the first 3years of life and grouped them according to seizure persistence or freedom. All patients underwent brain MRI with DTI. Specific ROIs have were placed to generate tracks to calculate fractional anisotropy (FA) and apparent diffusion coefficient (ADC). Statistical analysis was performed by ANOVA. RESULTS: Children with persistent seizures presented an overall reduced FA, with statistically significant differences on the cingulum (right p=0.003, left p=0.016), the left cerebral peduncle (p=0.020), the superior cerebellar peduncles (right p=0.008, left p=0.002), the posterior limbs of internal capsule (right p=0.037, left p=0.015), the external capsule (right p=0.018, left p=0.031), the inferior frontooccipital fasciculus (right p=0.010, left p=0.026), and the temporal trunk (right p=0.017, left p=0.001). CONCLUSIONS: Our study demonstrated that children with persistent seizures present more significant alterations of brain connectivity in areas crucial for global cognitive maturation, executive functions, and verbal abilities, implying a higher risk of cognitive impairment, attention-deficit hyperactivity disorder, and autism.

Neuroblastoma presenting with symptoms of epidural compression at birth: a case report.

BACKGROUND: Five to 10 % of children with neuroblastoma present with symptoms of epidural compression (EC). More than half these patients are diagnosed in the first year of life. The case of a neuroblastoma presenting symptoms of EC at birth is exceptional and deserves to be reported. CASE PRESENTATION: We describe a case of female born at the 36(th) week of pregnancy by caesarian section decided following ultrasonographic discovery of oligohydramnios. At birth, she was noted to have motor deficit involving both legs and continuous urinary dripping. These symptoms were found to be secondary to a paraspinal neuroblastoma infiltrating the spinal canal. Tumor responded well to chemotherapy, but neurologic deficit only slightly improved and bladder dysfunction remained unchanged. At 2 years of age, patient is able to walk with help of leg orthoses, suffers chronic constipation requiring daily medications, and has neurologic bladder necessitating multiple daily catheterizations. CONCLUSIONS: The finding of a newborn presenting with symptoms of EC secondary to a neuroblastoma invading the spinal canal is quite uncommon. The case described herewith confirms that these rare patients have an excellent survival probability, but almost always develop severe functional sequelae.

Cerebral sinovenous thrombosis (CSVT) in children: what the pediatric radiologists need to know.

Cerebral sinovenous thrombosis (CSVT) is a relatively uncommon and potentially life-threatening condition in childhood, occurring in various clinical settings. Nowadays, however, it is increasingly diagnosed as related to many causes, likely due to greater clinical awareness and improvement of neuroradiologic techniques. The prompt diagnosis is an important goal to significantly reduce the risk of acute complications and long-term sequelae. The purpose of this narrative overview is to provide a useful educational tool in daily clinical practice for radiologists with a broad perspective of CSVT including a discussion of more common potential pitfalls related to misinterpretation of images in children. This paper will also review the normal venous anatomy, its variants, risk factors that contribute to cause CSVT (neonates with their specific causes of CSVT are not included in this review) and the practical imaging feature of cerebral sinovenous thrombosis on MRI and CT. Finally, a brief overview of frequent and severe CSVT conditions in children with key points in imaging is shown.