Flat scalp melanoma dermoscopic and reflectance confocal microscopy features correspond to histopathologic type and lesion location.

BACKGROUND: Dermoscopy and Reflectance Confocal Microscopy (RCM) features of scalp melanoma according to lesion location and histopathology have not been fully investigated. OBJECTIVES: To reveal dermoscopic and RCM features of scalp melanoma according to lesion location and histopathology. METHODS: We retrospectively retrieved images of suspicious, atypical excised, flat melanocytic lesions of the scalp, assessed on dermoscopy and RCM at five centres, from June 2007 to April 2020. Lesions were classified according to histopathological diagnoses of nevi, lentigo maligna melanoma (LM/LMM) or superficial spreading melanoma (SSM). Clinical, dermoscopic and RCM images were evaluated; LM/LMM and SSM subtypes were compared through multivariate analysis. RESULTS: Two hundred forty-seven lesions were included. In situ melanomas were mostly LM (81.3%), while invasive melanomas were mostly SSM (75.8%). Male sex, baldness and chronic sun-damaged skin were associated with all types of melanomas and in particular with LM/LMM. LMs were mostly located in the vertex area and SSM in the frontal (OR: 8.8; P < 0.05, CI 95%) and temporal (OR: 16.7; P < 0.005, CI 95%) areas. The dermoscopy presence of pseudo-network, pigmented rhomboidal structures, obliterated hair follicles and annular-granular pattern were associated with LM diagnoses, whereas bluish-white veil was more typical of SSM. Observations on RCM of atypical roundish and dendritic cells in the epidermis were associated with SSM (42.4%) and dendritic cells with LM (62.5%) diagnoses. Folliculotropism on RCM was confirmed as a typical sign of LM. CONCLUSIONS: Flat scalp melanomas reveal specific dermoscopic and RCM features according to histopathologic type and scalp location.

Nodular skin lesions: correlation of reflectance confocal microscopy and optical coherence tomography features.

BACKGROUND: Nodular lesions have common clinical appearance but different prognoses. Differential diagnosis between melanoma (MM), basal cell carcinoma (BCC) and dermal naevus (DN) poses a challenge in clinical practice. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) are promising non-invasive imaging techniques, potentially able to decrease redundant biopsies. RCM allows in vivo visualization of skin down to the papillary dermis at almost histological resolution, while OCT, particularly dynamic OCT (D-OCT), provides images deeper within the dermis and reveals the vascular pattern. OBJECTIVES: To identify correlating features observed with RCM and OCT associated with the different nodular lesion diagnoses. METHODS: We retrospectively assessed 68 nodular lesions (30 MM, 20 BCC and 18 DN) with RCM and subsequently OCT. At the end of the study, evaluations were matched with histopathological diagnosis and statistical analysis was performed. RESULTS: In MM, 57% (17/30) evidenced both cerebriform nests at RCM and icicle-shaped structures at OCT, with higher average Breslow index. In 80% of BCCs with basaloid islands at RCM, OCT showed ovoid structures. More than half of DN (56%) showed hyporeflective nests at OCT and either dense nests or dense and sparse nests at RCM. CONCLUSIONS: The combined use of RCM and OCT offers a better understanding of the morphological architecture of nodular lesions, correlating RCM parameters with OCT and vice versa, assisting in turn with early differential diagnosis of malignant and benign nodular lesions. The correlation between icicle-shaped structures and cerebriform nests in MM and their association with Breslow index requires future research.

Can probiotic administration during pregnancy and the first year of life effectively reduce the risk of infections and allergic diseases in childhood?

Infections and allergic disorders are common pediatric diseases. It has been reported that probiotics, which are live microorganisms, confer health benefits to hosts when administered in appropriate amounts. Probiotics have been widely used in the treatment of pediatric infections and allergic disorders through modulating the microbial environment of host. However, it is still not clear whether probiotic administration during pregnancy and/or the first year of life is an efficient approach for the prevention of infections and allergic diseases in childhood. The present study aims to address this question through reviewing previous publications on this topic. Analysis of previous studies suggests that probiotic administration during pregnancy and/or the first year of life could reduce the prevalence of infectious diseases in infancy. The effects of probiotic administration during pregnancy and/or the first year of life on the prevention of allergic disorders are still not clear. In addition, the available studies differ in probiotic species, number of probiotics, dosage of probiotics, inclusion and exclusion criteria, outcomes, and diagnostic and follow-up methods. These differences highlight further studies for better understanding the effects of probiotic administration on the prevention of infections and allergic diseases in childhood.

[Effect of prematurity on fat mass distribution and blood pressure at prepubertal age: a follow-up study]. / Effetto della prematurità sulla distribuzione della massa grassa e sulla pressione arteriosa in età prepubere: studio di follow-up.

OBJECTIVES: Preterm infants may develop altered adiposity, a risk factor for metabolic syndrome. The aim was to evaluate if body composition and blood pressure were altered in a cohort of children born preterm followed up to prepubertal age. METHODS: Observational, longitudinal, explorative study. Forty children born preterm underwent growth and body composition assessment by an air displacement plethysmography system at term c.a. and at 5 years. BMI, skinfold thicknesses and blood pressure were further measured at 5 years. Inclusion criteria were birth weight <1500 g and gestational age <32 weeks. Exclusion criteria were congenital/chromosomal or surgical diseases. Forty-three healthy children born at term were the reference group. RESULTS: At term c.a. preterm children were lighter (2455 +/- 484 g vs 3247 +/- 345 g; p<0.001) and shorter (45.6 +/- 3.4 cm vs 49.1 +/- 2.3 cm; p<0.001) than children born at term and their fat mass was higher (14.8% vs 8.6%; p=0.02). At 5 years of life, weight and height of children born preterm were lower than those of their counterpart (18.328 +/- 3.01 vs 20.302 +/- 3.01 g; p=0.008 and 109.7 +/- 6.5 vs 112.7 +/- 4.3 cm; p=0.02, respectively). No difference in percentage of fat mass was detected. Abdominal, subscapular and suprailiac skinfolds (mm) were larger in the preterm group (6.9 +/- 3.6 vs 5.3 +/- 2.8, p=0.002; 6.5 +/- 2.8 vs 5.0 +/- 1.6, p=0,01 and 11.8 +/- 4.3 vs 9.3 +/- 3.8, p=0,01, respectively). Diastolic pressure (mmHg) was higher in the preterm group (62.2 vs 57.5, p=0.01). CONCLUSIONS: At prepubertal age children born preterm tend towards a greater truncal adiposity and increased values of diastolic pressure which might have adverse consequences for later health.

[Growth and body composition changes in late preterm infants in the first months of life]. / Crescita e composizione corporea di neonati late-preterm nei primi mesi di vita.

OBJECTIVES: The aim of this study was to compare growth and body composition of late preterm infants to that of extremely preterm and full-term infants. METHODS: Observational longitudinal study. Forty-nine late preterm infants and 63 extremely preterm infants were included in the study. Forty healthy, full-term, breast-fed infants were enrolled as a reference group. Anthropometric parameters and body composition by an air displacement plethysmography system were assessed at 36th week, at term, at 1 and 3 months of corrected age in all groups. Late preterm infants were also assessed on the fifth day of life. RESULTS: Late preterm infants showed higher weight, length and head circumference values than those of very low birth weight infants but lower fat mass values on the fifth day of life and at 36th week of corrected age. However, at 3 months of corrected age, percentage of fat mass in late preterm infants reached values comparable with those of very low birth weight infants, probably because of the fast catch-up fat recorded between the fifth day of life and term corrected age. Moreover, percentage of fat mass in the first month of corrected age in preterm infants was higher as compared with full-term infants. This difference was no longer found at 3 months of corrected age. CONCLUSIONS: Further studies are needed to investigate whether this rapid increase in fat mass may modulate the risk of chronic diseases.

Consequences of prematurity on adult morbidities.

Early life events play a key role in the development of adult diseases. Survival is promoted by the developmental adaptation to environment although advantage in the short term implies a long-term cost with regard to the development of adult morbidities. This is particularly true for the infant born prematurely as preterm birth is accompanied by a disruption of the normal organogenesis of multiple organ systems. This review will examine the effect of prematurity on the development of cardiovascular, kidney, respiratory and metabolic diseases in later life in addition to the neurodevelopment disabilities associated with preterm birth.

[Prevalence and duration of breastfeeding during the first six months of life: factors affecting an early cessation]. / Prevalenza e durata dell'allattamento al seno nei primi sei mesi di vita e fattori che influenzano.

OBJECTIVES: To assess the mean duration, prevalence and reasons that lead to an early cessation of breastfeeding in a group of healthy term infants in the first six months of life. METHODS: Prospective, observational study. One-hundred Caucasian, non smoking mothers, that intended to breastfeed for at least 12 weeks, were enrolled. Information on anthropometric parameters, type of delivery, socio-demographic characteristics, mode of feeding and reasons for stopping breastfeeding have been obtained through three different questionnaires (submitted at enrollment, on the 7th day, at 1, 2, 3 and 6 months). RESULTS: Exclusive breastfeeding gradually decreased from the 7th day to the 6th month of life. Most of the mothers stopped breastfeeding during the first month and a half or after 3 months and a half. Two percent of the mothers stopped on the 7th day whereas at 6 months the percentage of cessation was 14%. The cumulative percentage of interruption at 6th month was 45%. Maternal factors, like sore nipples or delayed onset of lactation, were the most frequent reasons that led to an early cessation, while during the following months inadequate breast milk and latch-on problems were predominant. On the other hand, attending a pre-natal course or having a previous successful breastfeeding experience were significantly associated with a long-lasting breastfeeding. CONCLUSIONS: Promotion of breastfeeding during the prenatal course and a better support for lactation management during the first months seem to be the areas where more efforts are needed to implement breastfeeding rates.

[Intra-abdominal adiposity in preterm infants: an explorative study]. / Adiposità intra-addominale in nati pretermine: studio esplorativo.

OBJECTIVE: The aim of the present study was to compare the total body fat mass and the intra-abdominal adipose tissue between preterm infants assessed at term corrected age and full-term newborns. METHODS: An observational explorative study was conducted. 25 preterm and 10 full term infants were evaluated at 0-1 month of corrected and postnatal age, respectively. The total body fat mass was assessed by means of an air displacement plethysmography system (Pea Pod COSMED, USA) and the intra-abdominal adipose tissue by means of magnetic resonance imaging (software program SliceOMatic, Version 4.3,Tomovision, Canada). RESULTS: Total body fat mass (g) of preterm and term infants was 633 (+/- 183) and 538 (+/- 203) respectively while intra-abdominal fat mass (g) was 14.2 (+/- 4.9) and 19.9 (+/- 11.4). CONCLUSIONS: Preterm infants, although exhibiting a total body fat mass higher than full term infants, do not show an increased intra-abdominal adipose tissue.

Randomized clinical trial on the effects of full mouth disinfection versus conventional quadrant therapy in the control of chronic periodontitis.

AIM: This clinical trial investigates the effectiveness of full-mouth disinfection (FMD) versus conventional etiological therapy in patients with chronic periodontitis (CP). METHODS: The therapy effectiveness was assessed by a randomized trial, performed over 20 adult periodontitis (AP) patients, divided into two groups. Patients were recruited undergoing strict inclusion/exclusion criteria. The following parameters were considered to evaluate and compare the two procedures: bleeding on probing (BOP), Plaque Index (PLI), probing depth (PD), clinical attachment level (CAL). These clinical data were collected at baseline and at three follow-ups (three months, six months and twelve months from baseline). Each parameter was averaged within each group; then statistic comparisons were performed within groups and between groups. RESULTS: In the test-group statistically significant improvements (P<0.001) were found for all parameters between baseline and every following review. The same result was reported in the control group (with a further significant difference between first and second review). Finally, the comparison between groups did not show any difference at any time for every parameter considered. CONCLUSION: FMD outcomes are similar to those of the conventional therapy and improvements can be achieved more quickly. FMD does not cause remarkable side effects and reduces the number of therapy sessions. Some aspects about this treatment need further research: maybe FMD could give an extra reduction of bacterial load, in comparison with traditional therapy, resulting in a longer free-infection period; that could allow a decrease in the frequency of supporting periodontal treatment.