Testicular germ cell tumors (TGCTs) are prevalent in males of reproductive age. Among the available therapeutic choices, pelvic radiotherapy (RT) and simple surveillance (SURV) are usually pursued. However, RT is considered to have life-threatening effects on testicular functions. In this study we sought to clarify this issue by evaluating sperm parameters and sex hormones in 131 TGCTs RT-treated-patients at both baseline (T0) and 12 (T1) and 24 months (T2) of follow-up. An age-matched group of 61 SURV patients served as control. Sperm parameters were comparable between SURV and RT at T0.The RT group showed a significant reduction of all sperm parameters at T1 (all P values < 0.05 vs T0 and vs SURV at T1) and increased levels of sperm aneuploidies, with some degree of recovery at T2. On the other hand, despite normal levels of total testosterone being detected in both groups, luteinizing hormone (LH) levels in the RT group progressively increased at T1 and T2 with a relative risk of developing subclinical hypogonadism of 3.03 (95% CI: 1,50–6,11) compared to SURV. Again, compared to SURV, exposure to RT was associated with a 5.78 fold (95% CI: 2,91–11,48) risk of developing vitamin D insufficiency. These data suggest a likely RT-dependent impairment of the Leydig cell compartment.

Background Falls are the most frequent domestic accidents and their impact on subjects' quality of life, healthcare system and potentially serious complications, make their prevention fundamental. 80% of patients with Parkinson's disease fall in their homes, therefore the prevention of falls becomes a priority in caring for these patients. The aim of the study is to identify the evidence relating to home falls prevention interventions in patients with Parkinson's disease. Methods A literature review was performed considering articles published between 2000 and 2017 and indexed in PubMed, Cinhal and Cochrane Library. 655 articles were identified and 28 selected and considered for review. Results Four macro types of intervention have been identified: environmental and educational interventions, through the preparation of aids, lighting systems, room adaptation, adequate footwear and involvement of caregivers; physical and rehabilitative interventions, through programs of Qigong Baduanjin, Hi-Balance, Tai-Chi, Ai-Chi, vestibular rehabilitation and exercises marked by the metronome; pharmacological interventions, through a continuous infusion system of Rivastigmine or Levodopa; alternative therapies such as vitamin C and Macuna Pruriens. Conclusions The available literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. To ensure these interventions, a multidisciplinary team management is needed. This approach allows an improvement in the management of the Parkinsonian patient, promoting the maintenance of health and quality of life, preventing complications and optimizing subject's residual abilities and promoting caregivers' involvement. Key messages The literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. Four macro types of intervention have been identified: environmental and educational, physical and rehabilitative interventions, pharmacological and alternative therapies.

Testicular germ cell tumors (TGCTs) are prevalent in males of reproductive age. Among the available therapeutic choices, pelvic radiotherapy (RT) and simple surveillance (SURV) are usually pursued. However, RT is considered to have lifethreatening effects on testicular functions. In this study we sought to clarify this issue by evaluating sperm parameters and sex hormones in 131 TGCTs RT-treated-patients at both baseline (T0) and 12 (T1) and 24 months (T2) of follow-up. An agematched group of 61 SURV patients served as control. Sperm parameters were comparable between SURV and RT at T0.