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Much research has focused on the differentiation of human mesenchymal stem cells (hMSCs) in monolayer culture; however, little is known about their differentiation potential in three-dimensional culture conditions. In this research, hMSCs were encapsulated in a photocrosslinkable, injectable scaffolding system based on poly(ethylene glycol) (PEG) hydrogels. To demonstrate the ability of hMSCs to differentiate in PEG hydrogels, cell/polymer constructs were cultured in osteogenic differentiation media to elicit an osteoblastic response. First, viability of encapsulated hMSCs up to 4 weeks in culture was investigated using a membrane integrity assay. Second, gene expression of encapsulated cells was determined with reverse transcription polymerase chain reaction (RT-PCR) as a function of media composition. After 1 week in osteogenic differentiation media, encapsulated hMSCs expressed osteonectin, osteopontin, and alkaline phosphatase, which are all characteristic of osteoblasts. Finally, von Kossa staining was used to evaluate mineralization of the PEG gels. Results support the hypothesis that hMSCs photoencapsulated in PEG hydrogels and cultured in the presence of osteogenic differentiation media are able to differentiate to osteoblasts inside the gel and mineralize the matrix. These experiments demonstrate the feasibility of using a PEG-based, photocrosslinkable system to culture and deliver human mesenchymal stem cells for bone tissue regeneration and repair. © 2004 Wiley Periodicals, Inc. J Biomed Mater Res 68A: 773–782, 2004 [ABSTRACT FROM AUTHOR]

Background: Poor affect recognition is an early sign of frontotemporal dementia (FTD). Here, we applied the abbreviated version of the Comprehensive Affect Testing System (CATS-A) battery to Italian FTD cases and healthy controls (HC) to provide cut-offs of emotional dysfunction in the whole group and in different FTD clinical syndromes., Methods: One hundred thirty-nine FTD patients (60 behavioural variant [bvFTD],13 semantic behavioural variant of FTD [sbvFTD], 28 progressive supranuclear palsy [PSP], 21 semantic [svPPA] and 17 nonfluent [nfvPPA] variants of primary progressive aphasia) and 116 HC were administered the CATS-A, yielding an Affective Recognition Quotient (ARQ), which was used as outcome measure. Age- and education-adjusted, regression-based norms were derived in HC. In patients, the ARQ was assessed for its internal reliability, factorial validity and construct validity by testing its association with another social cognition paradigm, the Story-Based Empath Task (SET). The diagnostic accuracy of the ARQ in discriminating patients from HC, genetic cases from HC and patient groups among each other was tested via ROC analyses., Results: In the whole FTD cohort, CATS-A proved to be underpinned by a mono-component factor (51.1%) and was internally consistent (McDonald's ω = 0.76). Moreover, the ARQ converged with the SET (r(122) = 0.50; p < 0.001) and optimally discriminated HC from both the whole cohort (AUC = 0.89) and each clinical syndrome (AUC range: 0.83-0.92). Conversely, CATS-A subtests were able to distinguish patient groups., Conclusions: The ARQ score from the CATS-A distinguishes FTD clinical syndromes from HC with high accuracy, making it an excellent tool for immediate use in clinical practice., (© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

The ability to predict the pathology spreading in patients with frontotemporal dementia (FTD) is crucial for early diagnosis and targeted interventions. This study examined the relationship between network vulnerability and longitudinal atrophy progression in FTD patients, using Network Diffusion Model (NDM) of pathology spread. Thirty behavioural-variant FTD (bvFTD), 13 semantic-variant primary progressive aphasia (svPPA), 14 nonfluent-variant PPA (nfvPPA) and 12 semantic behavioral variant FTD (sbvFTD) patients underwent longitudinal T1-weighted MRI. Fifty young controls (YC) (20-31 years) underwent multi-shell diffusion MRI scan. NDM was developed to model FTD pathology progression as a spreading process from a seed through the healthy structural connectome, using connectivity measures from fractional anisotropy (FA) and intra-cellular volume fraction (ICVF) in YC. Four disease epicenters were initially identified from the peaks of atrophy of each FTD variant: left insula (bvFTD), left temporal pole (svPPA), right temporal pole (sbvFTD) and left supplementary motor area (nfvPPA). Pearson's correlations were calculated between NDM-predicted atrophy in YC and the observed longitudinal atrophy in FTD patients over a follow-up of 24 months. The NDM was then run for all the 220 brain seeds to verify whether the four epicenters were among those that yielded the highest correlation. Using NDM, predictive maps in YC showed pathology progression from the peaks of atrophy in svPPA, nfvPPA, and sbvFTD over 24-months. svPPA exhibited early involvement of left temporal and occipital lobes, progressing to extensive left hemisphere impairment. nfvPPA and sbvFTD similarly spread bilaterally to frontal, sensorimotor, and temporal regions, with sbvFTD additionally affecting the right hemisphere. Moreover, the NDM-predicted atrophy of each region was positively correlated to longitudinal real atrophy, with a greater effect in svPPA and sbvFTD. In bvFTD, the model starting from the left insula (the peak of atrophy) demonstrated a highly left-lateralized pattern, with pathology spreading to frontal, sensorimotor, temporal, and basal ganglia regions, with minimal extension to the contralateral hemisphere by 24 months. However, unlike the atrophy peaks observed in the other three phenotypes, the left insula did not show the strongest correlation between the estimated and actual atrophy. Instead, the bilateral superior frontal gyrus emerged as optimal seeds for modelling atrophy spread, showing the highest correlation ranking in both hemispheres. Overall, NDM applied on ICVF connectome yielded higher correlations relative to NDM applied on FA maps. The NDM implementation using cross-sectional structural connectome is a valuable tool to predict atrophy patterns and pathology spreading in FTD clinical variants., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Guarantors of Brain.)

Objective: To define the clinical usability of an affect recognition (AR) battery-the Comprehensive Affect Testing System (CATS)-in an Italian sample of patients with amyotrophic lateral sclerosis (ALS)., Methods: 96 ALS patients and 116 healthy controls underwent a neuropsychological assessment including the AR subtests of the abbreviated version of the CATS (CATS-A). CATS-A AR subtests and their global score (CATS-A AR Quotient, ARQ) were assessed for their factorial, convergent, and divergent validity. The diagnostic accuracy of each CATS-A AR measure in discriminating ALS patients with cognitive impairment from cognitively normal controls and patients was tested via receiver-operating characteristics analyses. Optimal cut-offs were identified for CATS-A AR measures yielding an acceptable AUC value (≥ .70). The ability of CATS-A ARQ to discriminate between different ALS cognitive phenotypes was also tested. Gray-matter (GM) volumes of controls, ALS with normal (ALS-nARQ), and impaired ARQ score (ALS-iARQ) were compared using ANCOVA models., Results: CATS-A AR subtests and ARQ proved to have moderate-to-strong convergent and divergent validity. Almost all considered CATS-A measures reached acceptable accuracy and diagnostic power (AUC range = .79-.83). ARQ showed to be the best diagnostic measure (sensitivity = .80; specificity = .75) and discriminated between different ALS cognitive phenotypes. Compared to ALS-nARQ, ALS-iARQ patients showed reduced GM volumes in the right anterior cingulate, right middle frontal, left inferior temporal, and superior occipital regions., Conclusions: The AR subtests of the CATS-A, and in particular the CATS-A ARQ, are sound measures of AR in ALS. AR deficits may be a valid marker of frontotemporal involvement in these patients., Competing Interests: Declarations Conflicts of interest V. Castelnovo has nothing to disclose; E. Canu has received research supports from the Italian Ministry of Health; E.N. Aiello serves as an Editorial Board Member for BMC Neurology; B. Curti, E. Sibilla, S.Torre, F. Freri, C. Tripodi, and L. Lumaca have nothing to disclose; E. G. Spinelli, P. Schito, T. Russo, and Y. Falzone have nothing to disclose; F. Verde is Associated Editor for Journal of Alzheimer’s Disease; V. Silani received compensation for consulting services and/or speaking activities from AveXis, Cytokinetics, Italfarmaco, Liquidweb S.r.l., Novartis Pharma AG, Amylyx Pharmaceuticals, Biogen, and Zambon Biotech SA; receives or has received research supports from the Italian Ministry of Health, AriSLA, and E-Rare Joint Transnational Call. He is in the Editorial Board of Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, European Neurology, American Journal of Neurodegenerative Diseases, Frontiers in Neurology; N. Ticozzi received compensation for consulting services from Amylyx Pharmaceuticals and Zambon Biotech SA. He is Associate Editor for Frontiers in Aging Neuroscience; V.E. Sturm, K.P. Rankin, and M.L. Gorno-Tempini have nothing to disclose; B. Poletti received compensation for consulting services and/or speaking activities from Liquidweb S.r.l. She is Associate Editor for Frontiers in Neuroscience; M. Filippi is the Editor-in-Chief of the Journal of Neurology, Associate Editor of Human Brain Mapping, Neurological Sciences, and Radiology, received compensation for consulting services from Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi, speaking activities from Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA, participation in Advisory Boards for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda, scientific direction of educational events for Biogen, Merck, Roche, Celgene, Bristol-Myers Squibb, Lilly, Novartis, Sanofi-Genzyme, and he receives research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla; F. Agosta is Associate Editor of NeuroImage: Clinical, has received speaker honoraria from Biogen Idec, Italfarmaco, Roche, Zambon and Eli Lilly, and receives or has received research supports from the Italian Ministry of Health, the Italian Ministry of University and Research, AriSLA (Fondazione Italiana di Ricerca per la SLA), the European Research Council, the EU Joint Programme—Neurodegenerative Disease Research (JPND), and Foundation Research on Alzheimer Disease (France). Ethical approval Before participating, all participants provided written informed consent according to the Declaration of Helsinki. The local ethical standards committee on human experimentation approved the study protocol., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Bradykinesia is defined as a "complex" of motor alterations including decreased movement amplitude and/or speed and tendency to reduce them with movement repetition (sequence effect). This study aimed at investigating the neural and kinematic correlates of bradykinesia during hand-tapping in people with Parkinson's disease (pwPD) relative to healthy controls. Twenty-five pwPD and 25 age- and sex-matched healthy controls underwent brain functional MRI (fMRI) during a hand-tapping task: subjects alternatively opened and closed their right hand as fully and quickly as possible. Hand-tapping kinematic parameters were objectively measured during the fMRI task using an optical fibre glove. During the fMRI task, pwPD showed reduced hand-tapping amplitude (hypokinesia) and a greater sequence effect. PwPD relative to healthy controls showed a reduced activity of fronto-parietal areas, middle cingulum/supplementary motor area (SMA), parahippocampus, pallidum/thalamus and motor cerebellar areas. Moreover, pwPD showed an increased activity of brain cognitive areas such as superior temporal gyrus, posterior cingulum, and cerebellum crus I. The decreased activity of cerebellum IV-V-VI, vermis IV-V, inferior frontal gyrus, and cingulum/SMA correlated with hypokinesia and with the sequence effect. Interestingly, a reduced activity of areas involved in motor planning and timing correlated both with hypokinesia and with the sequence effect in pwPD. This study has the major strength of collecting objective motor parameters and brain activity simultaneously, providing a unique opportunity to investigate the neural correlates of the "bradykinesia complex"., (© 2024. The Author(s).)

Objective: To describe a clear and intuitive way to analyse the anatomical meaning of images observed in Drug-induced Sleep Endoscopy (DISE) to fully understand the obstructive dynamics and therefore opt for a tailor-made pharyngeal surgical technique., Methods: From January 2016 to December 2020, 298 patients who underwent DISE were selected according to inclusion criteria., Results: The case series consisted of 204 males and 94 females with a mean age of 56 years. Body mass index ranged from 19 kg/m 2 to 34 kg/m 2 with a median of 26.5 kg/m 2 . Median Apnoea-Hypopnea Index (AHI) was 27 (range 5-62.3). The authors also observed four palate pharyngeal phenotypic patterns of collapse and clarify the morphology and role of the main muscles involved in upper airway collapse., Conclusions: DISE is fundamental to determine the collapse site in patients affected by obstructive sleep apnoea syndrome. The velopharyngeal region is the most common site of obstruction and lateral pharyngeal wall collapse is the major determining factor. DISE can lead to a deeper understanding of the obstructive dynamic patterns and a more precise identification of the muscle bundles responsible for upper airway collapse., (Copyright © 2022 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)

Background: Diminished olfactory functioning has been reported in depression, whereas evidence in anxiety disorders is still controversial. Olfactory meta-cognitive abilities (i.e., olfactory awareness, imagery and reactivity, and the importance of odors) are essential in shaping olfaction. Few studies examined these meta-cognitive abilities in relation to depressive, anxiety, and social anxiety symptoms, and none of them considered the awareness of social odors (i.e., body odors)., Methods: This pre-registered study examined the relationship between olfactory meta-cognitive abilities and symptoms of depression, general anxiety, and social anxiety in 429 individuals. Self-report measures of symptoms of depression, general anxiety, and social anxiety, along with self-report olfactory meta-cognitive scales, were collected using an online survey., Results: Linear regression analyses revealed that olfactory awareness and importance of common odors were significantly directly predicted by symptoms of general anxiety, while affective importance to odors was negatively predicted by symptoms of depression. Regarding social odors, higher symptoms of depression and lower symptoms of social anxiety predicted increased awareness., Limitations: Higher prevalence of women and narrow age range of the participants. Depressive and anxiety symptoms were assessed only with self-report questionnaires., Conclusions: Symptoms of anxiety seem to be associated with higher levels of common odor awareness, corroborating the importance of olfactory functions in anxiety. In addition, results on social odors seem to reflect dysfunctional social behaviour that characterized symptoms of depression and social anxiety. Hence, the assessment of meta-cognitive abilities may represent a useful tool in the prevention and assessment of depressive, anxiety, and social anxiety symptoms., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objective: To review our 5-year experience with a modified version of glossoepiglottopexy for treatment of obstructive sleep apnoea syndrome (OSA) in two hospitals., Methods: A retrospective analysis was carried out on a cohort of adult patients affected by OSA suffering from primary collapse of the epiglottis who underwent a modified glossoepiglottopexy. All patients underwent drug-induced sleep endoscopy, polysomnographic and swallowing evaluation, and assessment with the Epworth Sleepiness Scale (ESS)., Results: Forty-nine patients were retrospectively evaluated. Both the apnoea-hypopnoea index (AHI) (median AHI post -AHI pre = -22.4 events/h; p < 0.001) and oxygen desaturation index (ODI) showed a significant postoperative decrease (median ODI post -ODI pre = -18 events/h; p < 0.001), as did hypoxaemia index (median T 90% post -T 90% pre = -5%; p < 0.001). The ESS questionnaire revealed a significant decrease in postoperative scores (median ESS post -ESS pre =- 9; p < 0.001). None of the patients developed postoperative dysphagia., Conclusions: Our 5-year experience demonstrates that modified glossoepiglottopexy is a safe and reliable surgical technique for treatment of primary epiglottic collapse in OSA patients., (Copyright © 2022 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)

The degree of attention individuals pay to olfactory cues (called odor awareness) influences the role of odors in everyday life. Particularly, odors produced by the human body (i.e., social odors) are able to carry a wide variety of information and to elicit a broad spectrum of emotional reactions, making them essential in interpersonal relationships. Hence, despite the assessment of awareness toward social odors is crucial, a proper tool is still lacking. Here, we designed and initially validated the Social Odor Scale (SOS), a 12-item scale designed to measure the individual differences in awareness towards different social odors. In Study 1, an exploratory factor analysis (EFA; KMO test: MSA = 0.78; Bartlett's test: χ2(78) = 631.34, p < 0.001; Chi-squared test: χ2(42) = 71.84, p = 0.003) suggests that the three factors structure was the model that best fit with the Italian version of the scale. The confirmatory factor analysis (CFA) supports a second-order model with one higher-order factor representing social odor awareness in general and three lower-order factors representing familiar, romantic partner, and stranger social odors. The final version of the scale presented a good fit (RMSEA = 0.012, SRMR = 0.069, CFI = 0.998, TLI = 0.997). In Study 2, CFA was performed in the German version of the scale confirming the validity of scale structure. Study 3 and 4 revealed that SOS total score and its subscales were positively correlated with other validated olfactory scales, but not with olfactory abilities. Moreover, SOS was found to be related to the gender of the participants: women reported to be more aware to social odors and, specifically, to familiar social odors than men. Overall, the results indicated that SOS is a valid and reliable instrument to assess awareness toward social odors in everyday life., Competing Interests: The authors have declared that no competing interests exist.

Objectives Clinical laboratories plays a key role in screening, diagnosis and containment of the Coronavirus 2019 infection epidemic. The etiological diagnosis presupposes the isolation of virus genetic material in the patient's biological sample but laboratory diagnostics also make use of searching possibility for immunoglobulin (Ig)G, IgM classes antibodies. The characteristics of the antibody response are not yet completely clear. Methods This study describes a serological monitoring of subjects, elderly nursing care residence guests, interested by a very large infection outbreak. After first nasopharyngeal swab, all the positive subjects (43) were monitored for the persistence of the virus infection through nasopharyngeal swab after 20 days (16-24), 32 days (28-36) and after 49 days (47-50). At the same time, during the second (day 32) and third (day 49) follow up, all the guests were investigated for IgM and IgG anti SARS-CoV-2 antibodies, by using a quantitative chemiluminescence method. Results Thirty two days after performing the first diagnostic swab, 39 of 43 patients (90%) had IgG higher than the cut off value. After 49 days the four patients with negative IgG were still negative. The comparison of the levels of IgG-Ab between the controls shows a significant decrease in concentrations (-10%). Conclusions Our study confirms that in most patients affected by COVID-19 there is a typical antibody response with IgG-Ab present in 90% of nursing care COVID-19 positive residence guests. For IgM-Ab only 23% of tested subjects were positive on the 32nd and 49th day of illness, always in parallel with the IgG-Ab positivity.

Cystic fibrosis (CF) is an autosomal recessive disorder, caused by genetic mutations in CF transmembrane conductance regulator protein. Several reports have indicated the presence of specific fatty acid alterations in CF patients, most notably decreased levels of plasmatic and tissue docosahexaenoic acid (DHA), the precursor of specialized pro-resolving mediators. We hypothesized that DHA supplementation could restore the production of DHA-derived products and possibly contribute to a better control of the chronic pulmonary inflammation observed in CF subjects. Sputum samples from 15 CF and 10 chronic obstructive pulmonary disease (COPD) subjects were collected and analyzed by LC/MS/MS, and blood fatty acid were profiled by gas chromatography upon lipid extraction and transmethylation. Interestingly, CF subjects showed increased concentrations of leukotriene B 4 (LTB 4 ), prostaglandin E 2 (PGE 2 ), and 15-hydroxyeicosatetraenoic acid (15-HETE), when compared with COPD patients, whereas the concentrations of DHA metabolites did not differ between the two groups. After DHA supplementation, not only DHA/arachidonic acid (AA) ratio and highly unsaturated fatty acid index were significantly increased in the subjects completing the study ( p < 0.05) but also a reduction in LTB 4 and 15-HETE was observed, together with a tendency for a decrease in PGE 2, and an increase in 17-hydroxy-docosahexaenoic acid (17OH-DHA) levels. At the end of the washout period, LTB 4 , PGE 2 , 15-HETE, and 17OH-DHA showed a trend to return to baseline values. In addition, 15-HETE/17OH-DHA ratio in the same sample significantly decreased after DHA supplementation ( p < 0.01) when compared with baseline. In conclusion, our results show here that in CF patients, an impairment in fatty acid metabolism, characterized by increased AA-derived metabolites and decreased DHA-derived metabolites, could be partially corrected by DHA supplementation.

Background: The G1 stage of chronic kidney disease (CKD) is defined in the 2012 KDIGO Guideline as kidney damage characterized by structural or functional kidney abnormalities without deterioration of glomerular filtration rate. Albuminuria and electrolyte abnormalities due to tubular disorders are considered functional markers of kidney damage. Changes in renal water handling are not explicitly cited in these guidelines. A large sample of children with abnormal dimercaptosuccinic acid (DMSA) scan located in the G1 stage was used in this study., Methods: Ambispective, cross-sectional study to evaluate the clinical histories of 116 pediatric patients. 100 patients were included in the first group (G1 stage) and 16 patients in the G2-G5 stages according to the classification of CKD Guideline KDIGO. All the patients had a renal pathologic DMSA scan. GFR, maximum urine osmolality and albumin/creatinine and NAG/creatinine ratios were determined., Results: The patients with normal GFR, in relation to those with reduced GFR, had significantly higher values of maximum urine osmolality and significantly reduced values of urine volume and albumin/creatinine and NAG/creatinine ratios. The most frequently observed alterations in children in the KDIGO G1 stage were those involving the water renal management such as urinary concentrating ability defect (29%) and increased urinary volume (20%). The frequency of children with increased urinary elimination of albumin (12%) and NAG (3%) was more lower. All children in KDIGO G2-G5 stages had alterations in water renal management., Conclusions: The parameters related with the water renal management are affected more frequently than albumin urinary excretion in children who have loss of parenchyma and normal GFR.

Objectives: Sinonasal disease (SND) is a common finding in subjects with Cystic Fibrosis (CF). Even though it does not play a key role in the life expectancy of these patients, it increases the morbidity rate of CF, with deterioration of the quality of life and of general health status. The aim of this study is the evaluation of the impact of sinonasal disease and Extensive Endoscopic Sinus Surgery (eESS) on the quality of life (QOL) of CF patients by means of the 22 item Sino-Nasal Outcome Test (SNOT-22) and define if there is a correlation between SNOT-22 and the Lund-Mackay score., Patients and Methods: We performed a prospective study in 33 CF patients with medically refractory SND. The extent of polyposis was graded both endoscopically and on computed tomography images in accordance with the Lund-Mackay score. All patients underwent eESS. The SNOT was administered in order to assess the quality of life related to SND both before surgery and during follow-up at 6 months, 1 year and 2 years postoperatively., Results: The SNOT-22 and Lund-Mackay score showed a remarkable mean improvement during follow-up. The differences between the initial examination and last score were significant (p < 0.001), but there was no statistic correlation between SNOT-22 and Lund-Mackay., Conclusions: More attention should be paid to sinonasal symptoms in CF patients and SNOT-22 is a simple and effective tool for this purpose. This score is also important for indicating the outcome of the eESS procedure. In all patients SNOT showed a significant improvement in QoL.

Background: Some lateral cervical lymphadenopathies may lead to the discovery of papillary microcarcinomas (PMC) of the thyroid that are not radiologically apparent. This relatively rare clinical situation raises questions about the diagnostic approach to chronic cervical lymphadenopathy and the impact of lymph node metastasis on PMC prognosis. PURPOSE OF THE ARTICLE: To study the epidemiologic, clinical, and prognostic criteria of cases of lymphadenopathy that signaled PMC., Patients and Methods: A retrospective study of 167 consecutive cases of PMC compared with 13 cases where a cervical mass signaled other forms of PMC., Results: The mean age was 48.5 years, the ratio of men to women was 5:8, and the mean PMC size was 5.5mm. These data did not differently significantly from those of the other PMC cases. The preoperative imaging found fluid content in six cases, with microcalcifications in three cases. All cases were treated by modified radical neck dissection on the side with the lymphadenopathy and total thyroidectomy with central neck dissection. The lymphadenopathy included a ruptured capsule in five cases and was accompanied by central lymph node metastases in three cases. Thyroid capsule involvement was significantly more common in cases of PMC discovered due to lymphadenopathy than in other cases of PMC (69% versus 9.7%, respectively; p<0.001). The mean follow-up was 7.3 years. There were no deaths due to PMC signaled by lymphadenopathy. Two cases of lymph node recurrence after 8 and 10 years were controlled by another surgery and radioactive iodine treatment., Conclusion: Any chronic cervical mass should suggest the possibility of thyroid origin, especially in cases with cystic content or microcalcifications in subjects with no particular risk factors. An ultrasound of the thyroid should be done, as well as a fine needle aspiration biopsy of the lymphadenopathy with a thyroglobulin assay. Treatment is the same as for any thyroid carcinoma, and results in a good oncological outcome, despite the possibility of lymph node recurrences., (Copyright © 2011. Published by Elsevier Masson SAS.)

Objective: To assess short- and long-term effects of rapid maxillary expansion (RME) on nasal flow in young children. Since RME has been reported to positively influence nasal obstruction in subjects with respiratory problems by reducing nasal resistance, a similar efficacy of RME could be expected in children with deciduous and/or mixed dentition who are affected by maxillary constriction and nasal obstruction from a different cause., Design: Prospective study of children younger than 12 years, with different grades of malocclusion and oral breathing. Data included active anterior rhinomanometry in both the supine and orthostatic positions, as well as radiographic cephalometric measurements., Setting: Tertiary care university hospital. Data were prospectively collected from 2005 to 2007., Patients: Nasal flow and resistance were measured in 65 children younger than 12 years, with mixed or deciduous dentition and different grades of malocclusion and oral breathing., Main Outcome Measure: Efficacy of RME for resolution of maxillary constriction., Results: After RME, an improvement of nasal flow and resistance has been recorded in patients, in the supine position, who presented both anterior and posterior obstruction. Less notable changes were shown in isolated forms of obstruction and in the orthostatic position., Conclusion: In cases of maxillary constriction and nasal airway obstruction, RME has proved to be efficient for the improvement of nasal respiration in children via a widening effect on the nasopharyngeal cavity.

The first textbook of Pediatric Endocrinology in the early 1950s reported an association of neurofibromatosis type 1 (NF1) and precocious puberty (PP) and/or short stature. Recent studies have indicated that children with NF1 grow normally until puberty; thereafter height velocity and relative height (SDS or percentiles) decreases with respect to healthy peers, reaching a mean adult height close to the 25th percentile for the general population. Moreover, the percentage of patients with true short stature (<3rd percentile) increases from childhood (5%) to late puberty (20-30% in literature, 18% in our study), and final height is significantly below the genetic target and predicted adult height calculated just before or at the beginning of puberty. Finally, among the shortest patients (<10th percentile) there is a high incidence of severe complications, such as CNS tumors, huge plexiform neurofibromas and severe scoliosis. Precocious puberty is a frequent complication of NF1, and occurs mainly in association with optic pathway tumors (OPT); however, occasionally it has been reported in the absence of optic gliomas, probably with a similar incidence as in the general population. GnRH agonist therapy must be decided individually as in some patients further growth could be normal and/or treatment would not improve final height. In the presence of early pubertal signs, an OPT must be ruled out. In addition to PP, delayed puberty has been frequently reported in NF1. In a study of 123 girls with NF1, we found that the mean age at menarche (13.0 +/- 1.9 yr) was later than in their mothers (12.7 +/- 1.4 yr) and in the general population (12.4 +/- 1.2 yr; p <0.05), with a very high incidence of delayed menarche (>2 SD): 16% vs 6.8% (mothers) vs 3.4% (controls) (p <0.01). In conclusion, growth and puberty present unusual patterns in NF1, often with true pathological findings increasing medical and psychological problems.

Objective: To assess if leuprolide acetate stimulation discriminates between hypogonadotropic hypogonadism (HH) and constitutional delay of puberty (CDP) in males., Design: Case-control study., Setting: Patients attending an academic research environment., Patients: Only male patients were studied: 10 with HH (group 1, age 16.5 +/- 6.0 years), 8 prepubertal with CDP (group 2, age 14.3 +/- 1.2 years), 6 healthy prepubertal (group 3, age 9.5 +/- 3.3 years), and 8 healthy late-pubertal (group 4, age 15.1 +/- 3.1 years)., Intervention(s): Blood samples were obtained after an overnight fast. Leuprolide acetate was then administered SC, and blood samples were drawn at 0, 30, 60, 120, 180 minutes, and 6 and 24 hours after stimulation., Main Outcome Measure(s): Clinical follow-up evaluations of data and serum levels of LH, FSH, 17-hydroxyprogesterone, and testosterone., Result(s): Basal LH levels were similar in groups 1 through 3 and differed significantly from those in group 4. Peak serum LH levels were significantly higher in CDP compared with HH (8.9 +/- 1.4 vs. 1.4 +/- 0.2 IU/L). Baseline FSH levels were significantly higher only in pubertal boys (versus the HH group); peak levels did not differ among the groups. Basal and peak testosterone levels were significantly higher only in the control pubertal group when compared to the other groups; peak 17-hydroxyprogesterone concentrations were significantly higher in pubertal controls compared with HH and CDP., Conclusion(s): Peak LH responses clearly discriminate HH from CDP. Timing for blood sampling should be fixed at 0, 60, 120, 180 minutes after stimulation.