rehabilitation protocol for unilateral laryngeal and lingual paralysis tapia syndrome comment about a challenging case of tapia syndrome after total thyroidectomy by ildem deveci mehmet surmeli and reyhan surmeli

Tapia syndrome is a rare complication after surgery, with ipsilateral paralysis of vocal cord and tongue due to extracranial involvement of recurrent laryngeal and hypoglossal nerves. Tapia's case report is extremely interesting for both the rarity of the reported cases and for the importance of an early rehabilitation. In a previous work, we reported a case of Tapia syndrome after cardiac surgery for aortic aneurysm, and the protocol of logopedic rehabilitation adopted. In the postoperative period, he developed severe dyspnea and dysphagia that required a tracheostomy and a logopedic rehabilitation therapy that led to a fast and efficient swallowing without aspiration after 47 sessions (less than 4 months). The progressive recovery of the function suggests aprassic nerve damage. However, the logopedic therapy is recommended to limit the possibility of permanent functional deficits and quickly recover swallowing and phonation

Nasal, pharyngeal and laryngeal endoscopy proceduresduring COVID‐19 pandemic: available recommendations from national and international societies

The Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2), also known as COVID-19, pandemic is engaging clinicians around the world in an unprecedented effort to limit the viral spread and treat affected patients; the rapid diffusion of the disease represents a risk for healthcare providers who have a close contact with the upper aerodiges- tive tract during medical, diagnostic and surgical procedure

Cosmic Background Bose Condensation (CBBC)

Degeneracy effects for bosons are more important for smaller particle mass, smaller temperature and higher number density. Bose condensation requires that particles be in the same lowest energy quantum state. We propose a cosmic background Bose condensation, present everywhere, with its particles having the lowest quantum energy state, A c/lambda, with lambda about the size of the visible universe, and therefore unlocalized. This we identify with the quantum of the self gravitational potential energy of any particle, and with the bit of information of minimum energy. The entropy of the universe (similar to 10(122) bits) has the highest number density (similar to 10(36) bits/cm(3)) of particles inside the visible universe, the smallest mass, similar to 10(-66) g, and the smallest temperature, similar to 10(-29) K. Therefore it is the best candidate for a Cosmic Background Bose Condensation (CBBC), a completely calmed fluid, with no viscosity, in a superfluidity state, and possibly responsible for the expansion of the universe.Alfonso-Faus, A.; Fullana Alfonso, MJ. (2013). Cosmic Background Bose Condensation (CBBC). Astrophysics and Space Science. 347(1):193-196. doi:10.1007/s10509-013-1500-8S1931963471Alfonso-Faus, A.: Universality of the self gravitational potential energy of any fundamental particle. Astrophys. Space Sci. 337, 363 (2010a)Alfonso-Faus, A.: The case for the Universe to be a quantum black hole. Astrophys. Space Sci. 325, 113 (2010b)Alfonso-Faus, A.: Galaxies: kinematics as a proof of the existence of a universal field of minimum acceleration. arXiv:0708.0308 (2010c, preprint)Alfonso-Faus, A.: Quantum gravity and information theories linked by the physical properties of the bit. arXiv:1105.3143 (2011, preprint)Anderson, J.D., et al.: Indication, from Pioneer 10/11, Galileo, and Ulysses data, of an apparent anomalous, weak, long-range acceleration. Phys. Rev. Lett. 81, 2858 (1998)Bekenstein, J.D.: Phys. Rev. D 23(2), 287 (1981)Bérut, A., et al.: Experimental verification of Landauer’s principle linking information and thermodynamics. Nature 483, 187 (2012)Drees, M., Chung-Lin, S.: Theoretical interpretation of experimental data from direct dark matter detection. J. Cosmol. Astropart. Phys. 0706, 011 (2007)Eisberg, R., Resnick, R.: Quantum Physics of Atoms, Molecules, Solids, Nuclei and Particles, 2nd edn. Wiley, New York (1985)Funo, K., Watanabe, Y., Ueda, M.: Thermodynamic work gain from entanglement. arXiv:1207.6872 [quant-ph] (2012, preprint)Hawking, S.W.: Black hole explosions? Nature 248, 30 (1974)Landauer, R.: Irreversibility and heat generation in the computing process. IBM J. Res. Dev. 5, 183 (1961)Landauer, R.: Dissipation and noise immunity in computation and communication. Nature 335, 779 (1988)Lloyd, S.: Computational capacity of the universe. Phys. Rev. Lett. 88, 237901 (2002)Misner, C.W., Thorne, K.S., Wheeler, J.A.: Gravitation. Freeman, Reading (1973), p. 466 (“Why the energy of the gravitational field cannot be localized”)Scarpa, R., Falomo, R.: Testing Newtonian gravity in the low acceleration regime with globular clusters: the case of omega Centauri revisited. Astron. Astrophys. 523, A43 (2010)Sivaram, C.: Cosmological and quantum constraint on particle masses. Am. J. Phys. 50, 279 (1982)Susskind, L.: The World as a hologram. J. Math. Phys. 36, 6377 (1995)’t Hooft, G.: Dimensional reduction in quantum gravity. arXiv:gr-qc/9310026 (1993, preprint)Toyabe, S., et al.: Experimental demonstration of information-to-energy conversion and validation of the generalized Jarzynski equality. Nat. Phys. 6, 988 (2010)Unruh, W.G.: Notes on black-hole evaporation. Phys. Rev. D, Part. Fields 14(4), 870 (1976)Weinberg, S.: Gravitation and Cosmology: Principles and Applications of the General Theory of Relativity p. 619. Wiley, New York (1972

Impact of COVID-19 on otolaryngology in Italy: a commentary from the COVID-19 task force of the young otolaryngologists of the Italian Society of Otolaryngology

The ongoing pandemic of coronavirus disease 2019 is having a dramatic effect on most medical disciplines. Otolaryngology Head and Neck Surgery is one of the most engaged disciplines, and otolaryngology specialists are facing a radical change of their role and daily activities that will have severe impact on the return to the ordinary. In this paper, the COVID-19 Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology comment on the changes that occurred for otolaryngology in Italy during the pandemic with a special focus on the organizational rearrangement of Otolaryngology Units, including merges and closures that affected a significant portion of them; the reallocation of otolaryngology personnel, mainly to COVID-19 wards; the significant reduction of elective clinical and surgical activity, that was mainly limited to oncology and emergency procedures; and the execution of screening procedures for SARS-CoV-2 among healthcare providers and patients in otolaryngology units in Italy

Impact of COVID-19 pandemic on Italian Otolaryngology Units: a nationwide study

Objective. The aim of this study was to provide an accurate picture of the changes which have occurred during the COVID-19 pandemic, and the contributions given by Italian Otolaryngology Units. Methods. A 29-item questionnaire was completed and returned by 154 Otorhinolaryngology Units across Italy. This investigated their geographic distribution involvement, the main changes which occurred in workload management and in clinical and surgical activities, and the screening procedures for COVID-19 in healthcare personnel and patients. Results. Nearly half of the Otolaryngology Units that responded to the questionnaire were merged with other units, while 22% were converted into COVID-19 units or temporarily closed. A reduction of 8.55% in the number of team members was reported, and about 50% of the units applied uniform work shifts for all staff. Elective activities were uniformly stopped or delayed, passing from 30,295 (pre-COVID data) to 5,684 (COVID data) weekly procedures, with a mean decrease of 81.24% (p<0.001). Conclusions. Most of the elective otolaryngology activities were suspended during the pandemic; the only procedures were for oncology and emergency patients. Italian Otolaryngologists have demonstrated a high availability to collaborate with non-surgery colleagues

Cerebrospinal Fluid Leak During Stapes Surgery: The Importance of Temporal Bone CT Reconstructions in Oblique Anatomically Oriented Planes.

Stapes gusher is a massive flow of perilymph and cerebrospinal fluid leak that fills the middle ear immediately after surgical opening of the labyrinth, such as during stapedectomy. Stapes gusher usually occurs as the result of a congenital malformation that causes an abnormal communication between the perilymphatic space and the subarachnoid space involving the internal auditory canal or the cochlear duct. To date, the potential risk of stapes gusher cannot be assessed preoperatively, as there are not pathognomonic signs suggestive of this complication. However, high-resolution computed tomography scan (HRCT) of the temporal bone can provide information that may help recognizing patients at risk. Recently, an anatomic evaluation of the inner ear with oblique reformation at HRCT has been described. This reformation offers a new and more detailed topographic vision of temporal bone structures compared to the classic axial and coronal planes and may help identifying anatomical alterations otherwise not visible. In this article, we present a case of stapes gusher and the role of preoperative HRCT with oblique reformation in its prevention

Comparison of different oval window sealing materials in stapes surgery: systematic review and meta-analysis

To compare the efficacy and safety characteristics of different materials used for oval window sealing during stapedotomy

Colorectal cancer development is affected by the ECM molecule EMILIN-2 hinging on macrophage polarization via the TLR-4/MyD88 pathway

Background Colorectal cancer is one of the most frequent and deadly tumors. Among the key regulators of CRC growth and progression, the microenvironment has emerged as a crucial player and as a possible route for the development of new therapeutic opportunities. More specifically, the extracellular matrix acts directly on cancer cells and indirectly affecting the behavior of stromal and inflammatory cells, as well as the bioavailability of growth factors. Among the ECM molecules, EMILIN-2 is frequently down-regulated by methylation in CRC and the purpose of this study was to verify the impact of EMILIN-2 loss in CRC development and its possible value as a prognostic biomarker. Methods The AOM/DSS CRC protocol was applied to Emilin-2 null and wild type mice. Tumor development was monitored by endoscopy, the molecular analyses performed by IHC, IF and WB and the immune subpopulations characterized by flow cytometry. Ex vivo cultures of monocyte/macrophages from the murine models were used to verify the molecular pathways. Publicly available datasets were exploited to determine the CRC patients' expression profile; Spearman's correlation analyses and Cox regression were applied to evaluate the association with the inflammatory response; the clinical outcome was predicted by Kaplan-Meier survival curves. Pearson correlation analyses were also applied to a cohort of patients enrolled in our Institute. Results In preclinical settings, loss of EMILIN-2 associated with an increased number of tumor lesions upon AOM/DSS treatment. In addition, in the early stages of the disease, the Emilin-2 knockout mice displayed a myeloid-derived suppressor cells-rich infiltrate. Instead, in the late stages, lack of EMILIN-2 associated with a decreased number of M1 macrophages, resulting in a higher percentage of the tumor-promoting M2 macrophages. Mechanistically, EMILIN-2 triggered the activation of the Toll-like Receptor 4/MyD88/NF-kappa B pathway, instrumental for the polarization of macrophages towards the M1 phenotype. Accordingly, dataset and immunofluorescence analyses indicated that low EMILIN-2 expression levels correlated with an increased M2/M1 ratio and with poor CRC patients' prognosis. Conclusions These novel results indicate that EMILIN-2 is a key regulator of the tumor-associated inflammatory environment and may represent a promising prognostic biomarker for CRC patients

Bridging Representation and Visualization in Prosopographic Research: A Case Study

In the last decade, the research on ancient civilizations has started to rely more and more on data science to extract knowledge on ancient societies from the written sources delivered from the past. In this paper, we combine two well-established frameworks: Linked Data to obtain a rich data structure, and Network Science to explore different research questions regarding the structure and the evolution of ancient societies. We propose a multi-disciplinary pipeline where, starting from a semantically annotated prosopographic archive, a research question is translated into a query on the archive and the obtained dataset is the input to the network model. We applied this pipeline to different archives, a Hittite and a Kassite collection of cuneiform tablets. Finally, network visualization is presented as a powerful tool to highlight both the data structure and the social network analysis results