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BACKGROUND The treatments for early-onset scoliosis (EOS), defined as curvature of the spine with onset before 10 years of age, continue to pose a great challenge for pediatric orthopedics. The treatment goals for EOS include minimizing spinal deformity while maximizing thoracic volume and pulmonary function. Different surgical techniques have different advantages and drawbacks; however, the two major concerns in the management of EOS are repeated surgeries and complications. AIM To review the current literature to assess the safety of EOS surgical treatment in terms of the rate of complications and unplanned surgeries. METHODS In January 2021 two independent reviewers systematically searched three electronic medical databases (PubMed, the Cochrane Library, and Embase) for relevant articles. Every step of the review was done according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Due to the heterogeneity of articles and topics after data analysis, a descriptive (synthetic) analysis was performed. RESULTS A total of 2136 articles were found. Forty articles were included in this systematic review, after applying our inclusion and exclusion criteria. EOS surgery has a varying but high rate of complications. The most frequent complications were categorized as implant (54%), general (17%), wound (15%) and alignment (12%). The rate of complications might have been even higher than reported, as some authors do not report all types of complications. About 54% of patients required unplanned surgeries due to complications, which comprised 15% of all surgeries. CONCLUSION The literature concerning the definitions, collection, and interpretation of data regarding EOS surgery complications is often difficult to interpret. This creates problems in the comparison, analysis, and improvement of spine surgery practice. Additionally, this observation indicates that data on the incidence of complications can be underestimated, and should be interpreted with caution. Awareness of the high rate of complications of EOS surgery is crucial, and an optimal strategy for prevention should become a priority.

Purpose The aim of current systematic review was to update the body of evidence on associations between adherence to the Mediterranean diet (MedDiet) and risk of cancer mortality, site-specific cancer in the general population; all-cause, and cancer mortality as well as cancer reoccurrence among cancer survivors. Methods A literature search for randomized controlled trials (RCTs), case–control and cohort studies published up to April 2020 was performed using PubMed and Scopus. Study-specific risk estimates for the highest versus lowest adherence to the MedDiet category were pooled using random-effects meta-analyses. Certainty of evidence from cohort studies and RCTs was evaluated using the NutriGrade scoring system. Results The updated search revealed 44 studies not identified in the previous review. Altogether, 117 studies including 3,202,496 participants were enclosed for meta-analysis. The highest adherence to MedDiet was inversely associated with cancer mortality (RRcohort: 0.87, 95% CI 0.82, 0.92; N = 18 studies), all-cause mortality among cancer survivors (RRcohort: 0.75, 95% CI 0.66, 0.86; N = 8), breast (RRobservational: 0.94, 95% CI 0.90, 0.97; N = 23), colorectal (RRobservational: 0.83, 95% CI 0.76, 0.90; N = 17), head and neck (RRobservational: 0.56, 95% CI 0.44, 0.72; N = 9), respiratory (RRcohort: 0.84, 95% CI 0.76, 0.94; N = 5), gastric (RRobservational: 0.70, 95% CI 0.61, 0.80; N = 7), bladder (RRobservational: 0.87, 95% CI 0.76, 0.98; N = 4), and liver cancer (RRobservational: 0.64, 95% CI 0.54, 0.75; N = 4). Adhering to MedDiet did not modify risk of blood, esophageal, pancreatic and prostate cancer risk. Conclusion In conclusion, our results suggest that highest adherence to the MedDiet was related to lower risk of cancer mortality in the general population, and all-cause mortality among cancer survivors as well as colorectal, head and neck, respiratory, gastric, liver and bladder cancer risks. Moderate certainty of evidence from cohort studies suggest an inverse association for cancer mortality and colorectal cancer, but most of the comparisons were rated as low or very low certainty of evidence.

Simple Summary According to the available data, colorectal cancer (CRC) is one of the most common malignant neoplasms. Depending on the location, type of cancer or gender, it is ranked 2nd to 4th in terms of incidence in the world. CRC, year by year, shows an increasing tendency in terms of both morbidity and deaths. Many factors may be responsible for the development of this disease, including genetic and environmental factors. Considering all the aspects, we made efforts to systematize the available literature data in terms of epidemiology, risk factors, type and nature of symptoms, development stages, available and future diagnosis of colorectal cancer. Abstract This review article contains a concise consideration of genetic and environmental risk factors for colorectal cancer. Known risk factors associated with colorectal cancer include familial and hereditary factors and lifestyle-related and ecological factors. Lifestyle factors are significant because of the potential for improving our understanding of the disease. Physical inactivity, obesity, smoking and alcohol consumption can also be addressed through therapeutic interventions. We also made efforts to systematize available literature and data on epidemiology, diagnosis, type and nature of symptoms and disease stages. Further study of colorectal cancer and progress made globally is crucial to inform future strategies in controlling the disease’s burden through population-based preventative initiatives.

Summary Obesity management guidelines consistently advise aerobic training for weight loss, whereas recommendations for other training modalities are sparse. This systematic review and network meta‐analysis (NMA) aimed to compare the long‐term effects of different training modalities on anthropometric outcomes in patients with obesity. MEDLINE, Cochrane CENTRAL, and Web of Science were searched to identify the following: (1) randomized controlled trials (RCTs); (2) conducted in adults with a mean body mass index (BMI) ≥30 kg/m2; (3) comparing aerobic, resistance, combined, or high‐intensity interval training head‐to‐head or to control for ≥6 months; and (4) reporting changes in body weight (BW), BMI, waist circumference (WC), fat mass (FM), or fat‐free mass (FFM). Random‐effects NMA models were fitted in a frequentist approach. GRADE framework was used to assess certainty of evidence. Thirty‐two RCTs with 4774 participants with obesity were included in this review. Aerobic training was ranked as best for improving BW, BMI, and WC and combined training for improving FM, as well as equally with resistance training most effective for improving FFM. Low to moderate certainty of evidence supports use of aerobic training to improve anthropometric outcomes in obesity, and its combination with resistance training provides additional benefit for reducing FM and increasing FFM.

The role of nutritional status of pregnant women and birth outcomes is ambiguous. Recent studies show that pre-pregnancy body weight is equally important as weight gain during pregnancy. Body mass index (BMI) is the most accessible and easy to check a nutritional status index, which may help to control the gestation and predict infant health outcome. This study aimed to examine the associations between pre-pregnancy body mass index and the infant birth parameters. A presented observational study was offered to 200 pregnant women from Antenatal Clinic at Jersey General Hospital in 2017. Total number of 83 women agreed to take part in this project. Diet, lifestyle, socio-economic, and demographic data were obtained from participants. Delivery and birth data were taken from hospital records. Offspring feeding data and selected anthropometric measurements for mothers and their newborns were also collected. Differences between BMI for delivery type and way of feeding were verified with chi-square test. Differences and correlation between maternal BMI and newborn outcomes were verified with Kruskal-Wallis’ test and Spearman's rank test. Mean BMI of mothers included to the study was 22.8 ± 4.4 with mean weight 61.9 ± 11.6. Before pregnancy BMI was normal in 67% women and about 23% was overweight or obese. We do not observed differences between delivery type and way of feeding during first 48 hours, and women in BMI categories. Also no differences and correlation were observed for the Apgar score, gestational age of birth, and newborn's weight and length at birth. However, newborn weight correlated with newborn length (r = 0.433) and gestational age (r = 0.568) at birth. Concluding, the maternal pre-pregnancy BMI was not correlated with type of delivery, way of feeding and newborn outcomes. Previous studies show that high pre-pregnancy maternal BMI may be associated with adverse offspring outcomes at birth and later life. Future extended research is needed to explain these relations, with inclusion of the specific factors as maternal diet, lifestyle and ethnicity.

Semen quality is a key indicator of male fecundity and therefore is closely related to male fertility. In recent decades a significant decrease of semen parameters was observed worldwide. Except for environmental pollution, low physical activity, body weight and comorbidities, unhealthy diet was linked to semen quality decline. Mediterranean Diet (MedDiet) due to its anti-oxidative and anti-inflammatory properties, is considered as beneficial for semen. However, results of existing studies are inconclusive. The aim of this review was to pool associations between adherence to the MedDiet and semen quality parameters in observational studies. Electronic databases including PubMed, Embase and Scopus were searched until April 2019 with no restriction to language or time. Studies were eligible for inclusion if they filled following criteria: (1) observational design (retrospective or prospective), (2) adherence to MedDiet assessed using score or data-driven method and (3) semen quality parameters (total motility, progressive motility, total count, concentration or volume) as outcomes. Mean differences or odds ratios of abnormal semen parameters between the highest and lowest quintiles of MedDiet were converted to standardized mean differences (SMD). Random effects models with inverse variance method were used to pool differences. Heterogeneity was assessed using the Cochrane Q test and I2 statistic with value > 50% indicating substantial heterogeneity. Five cross-sectional studies extracted from 840 articles, met the eligibility criteria and were included in the meta-analysis. Higher adherence to MedDiet compared to lower adherence was associated with increased total (SMD = 0.59 95%CI: 0.12–1.06, I2 = 80%, pheterogenity < 0.01, n = 4) and progressive (SMD = 0.53 95%CI: 0.16–0.91, I2 = 0%, pheterogenity = 0.94, n = 2) sperm motility. No associations were observed between adherence to MedDiet and total sperm count (SMD = 0.14 95%CI: -0.20–0.48, I2 = 70%, pheterogenity < 0.01, n = 5), concentration (SMD = 0.22 95%CI: -0.04–0.47, I2 = 48%, pheterogenity = 0.10, n = 5), volume (SMD = 0.02 95%CI: -0.20–0.25, I2 = 21%, pheterogenity = 0.28, n = 5), as well as morphology (SMD = -0.10 95%CI: -0.36–0.16, I2 = 38%, pheterogenity = 0.18, n = 4). The results suggest that higher adherence to the MedDiet may have a protective effect on semen quality, probably by increased intake of antioxidant-rich products. Limitations of findings include substantial between-study heterogeneity and use of cross-sectional design. Beneficial effects of the MedDiet on semen quality have to be confirmed in further prospective studies.

Background The management of early-onset scoliosis (EOS) remains a serious challenge in pediatric orthopedics. The growth-guidance system (GGS) is a surgical option that allows continuous growth along a rod, averting the need for repeated operative lengthening. Objectives The objective of this study was to evaluate the outcomes of the GGS in the treatment of EOS. Material and methods A prospective study, including 81 patients from 4 departments treated with this method from 2013 to 2015, was conducted with a minimum follow-up period of 24 months. The follow-up data of 57 patients was available, thus the drop-out rate was 29.63%. There were 44 girls with a mean age of 10.03 years and 13 boys with a mean age of 8.04 years. Results The mean preoperative Cobb angle was 65.3° (range 36°-139°) was corrected to 23.7° (2°-94°), and at the end of the 2-year follow-up increased to 30.7° (8°-93°). The predominant proximal level of instrumentation was T5 and the distal was L1. The combined length of T1-T12 and T12-S1 increased on average by 33.19 mm in 24 months. The overall rate of serious complications was 43.86%. The most prevalent device-related complications were: the dislodgement of top screws because of the short length of the rod (14 cases), the implant failure (11 cases) and loss of correction (9 cases). Conclusions The results show that the GGS used in this study allows for a good and stable correction while preserving the ability of the spine to grow in at least a 2-year follow-up. The complication rate is acceptable and comparable with other growth-friendly techniques. To date, this is the largest successful study on the use of titanium-made GGSs.

Rationale In the recent years, growing interest is focused on the use of platelet-rich plasma (PRP) in wound healing and tissue regeneration. There are a number of papers regarding the usefulness of PRP in the healing of ulcerations, skin injures, bone loss or distraction osteogenesis. Most authors emphasize the safety of PRP usage due to its authogenic nature. Patient concerns We present a case of a 14 -year-old boy admitted to our department due to simple bone cyst of the distal tibia, qualified for injection of PRP into the cyst. PRP was separated with the use of Magellan Autologous Platelet Separator System (Arteriocyte Medical Systems Hopkington, MA) according to the manufacturers' manual. Immediately after separation during short-term IV anaesthesia, 3 mL of PRP was installed to the bone cyst under image intensifier control. Diagnoses Within the first 24 hours after exposure to PRP, the skin rash appeared. Physical examination revealed the small red papular, regionally purpuric eruptions, mainly concentrated on the upper extremities and on more warmed regions of skin, in association with pharyngitis, tonsillar enlargement, mucopurulent discharge in the posterior pharynx and swelling of the eyelids. Interventions As the patient received calcium citrate with the PRP injection additional calcium citrate test were performed. Skin prick testing (negative) was and an intradermal test was positive (10×13 mm). Treatment included Claritine (Loratidinum) and Clemastin (Clemastinum)-both antihistaminic drugs. Outcomes All symptoms withdrew and the patient was released home after 4 days. The patient is in 6 years follow-up without any symptoms of allergic disease. Lessons Our case shows that safety of use of PRP is not absolutely sure. The pure autologous tissue is safe, but preparation for its use can substantially decrease this safety. In our patient, only limited skin reaction to calcium citrate was observed, but general reaction leading to anaphylactic shock cannot be excluded. In order to reduce the risk of side effects skin test should be performed but as there were no records of allergic diseases on family and patients medical history this should apply to all patients.

Strictly speaking, business ethics is the applied ethics discipline that addresses the moral features of commercial activity. In practice, however, various studies may fall under this category, as long as they touch upon such issues as moral values and beliefs, (in)justice, legal compliance and the like, as related to management-employee relationship, or, generally, a company's relations with its stakeholders. Previous research has, for instance, dealt with the behaviour of individuals when faced with ethical choices, assessment of choices made by business executives (Jones 1991; Trevino 1986), with the interest focused on the effects of situational or contextual variables on ethical behaviour (e.g. Ford and Richardson 1994; Jones and Kavanagh 1996; Mesmer-Magnus and Viswesvaran 2005; Robertson and Ross 1995; Trevino 1986). Quinn (1997) suggested a distinction between personal ethics and business ethics, He found some evidence that people's personal ethical attitudes are not brought to bear on business issues. Carlson, Kacmar, and Wadsworth (2002) found that the context of a given situation had an effect on perceptions of ethical or non-ethical behaviour.The paper will discuss corporate business practices perceived through the lens of the employee’s work ethics; exposing the dichotomies and dilemmas faced by employees despite numerous business ethics policies and guidelines. To start with, work ethics will be presented from the cross-cultural perspective, spanning from work ethics and Islam and focusing on Saudi Arabia, to Japan and the impact of the Japanese culture on the Japanese work ethics. Against the background of cross-cultural differences in ethical values related to work, 'global' but 'Americanised' corporate business ethics, in particular that of American IT companies will be examined. The author will argue that translating policies and other business-ethics-related documents into several languages is an insufficient strategy in a multinational working environment, leading to increased clashes between the employee’s ethical values embedded in a given culture, on the one hand, and the imposed business ethics values of the parent company on the other. This in turn calls for more localised measures, which will be put forward tentatively.In particular, the author will look into corporate framing and execution of power by companies that goes against their codes of business ethics. Corporate code of ethics and business conduct are discussed since employees are supposed to familiarise themselves with it and apply its standards to their daily working life. All employee of a given company, regardless of employment level, position, or geographic location, are expected to meet its business values and to practise ethical behaviour in all business dealings. New employees are also commonly required to complete an internal ethics course, and then retake it in predefined intervals. Other documents will also be mentioned, whereby employee dilemmas in dealings with external stakeholders, such as partners and suppliers ('partner and supplier codes'; 'directives for relationship with partners') will be taken into consideration.