Effect of surgery, delivery device and head position on sinus irrigant penetration in a cadaver model

AbstractObjectiveThe extent of surgery, the type of device used and head position may influence nasal irrigation. The aim of this study was to determine the effectiveness of topical irrigant delivery to the paranasal sinuses according to these factors.MethodFour cadaveric heads underwent four stepwise endoscopic dissections. Irrigations were evaluated after every stage using different delivery devices (squeeze-bottle, gravity-dependent device and syringe) in two head positions (nose-to-sink and vertex down). Irrigant penetration into each sinus was estimated using a four-point scale.ResultsA significant positive effect of surgery was demonstrated for each sinus as well as for the delivery device. High-volume irrigant devices are more effective, and the head position plays a significant role in irrigant distribution to the frontal sinus.ConclusionThis study further confirms the efficacy of high-volume irrigant devices. A vertex down position during the irrigation could improve delivery to the frontal sinus, and the widening of the ostia increases irrigant access to the sinuses

Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0-18 years

After a previous survey on the incidence of diabetic ketoacidosis (DKA) at onset of type 1 diabetes in children in 2013-2014 in Italy, we aimed to verify a possible decline in the incidence of DKA at onset during a national prevention campaign

The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

To compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

CMOS detector and system developments for LHC detector upgrades

The CERN Large Hadron Collider (LHC) will undergo a major upgrade to increase its instantaneous luminosity, allowing precision measurements of known processes and the search of new physics. The renewed machine requires an upgrade of several subdetectors of its experiments, including silicon trackers. This work focuses on the design and integration of novel radiation-hard monolithic CMOS pixel sensors for new trackers, such as ATLAS ITk. Two sensors have been produced using a process modification of a 180 nm CMOS technology: a large scale prototype (MALTA) and a small scale prototype (MiniMALTA). The sensors implement fully depleted square pixels of 36 micrometers with a small collection electrode, a fast front-end, and a novel asynchronous architecture. Each of these factors contributes to an efficient and low-power design. The work includes the design of a low-power 5 Gb/s data driver and receiver integrated in both sensors. Finally, the integration of monolithic sensors in tracker systems has been addressed with studies on the design of a module prototype and the development of a CMOS compatible microfabrication technique to implement silicon-embedded microchannels cooling

CMOS Detector and System Developments for LHC Detector Upgrades

The CERN Large Hadron Collider (LHC) will undergo a major upgrade to increase its instantaneous luminosity, allowing precision measurements of known processes and the search of new physics. The renewed machine requires an upgrade of several subdetectors of its experiments, including silicon trackers. This work focuses on the design and integration of novel radiation-hard monolithic CMOS pixel sensors for new trackers, such as ATLAS ITk. Two sensors have been produced using a process modification of a 180 nm CMOS technology: a large scale prototype (MALTA) and a small scale prototype (MiniMALTA). The sensors implement fully depleted square pixels of 36 micrometers with a small collection electrode, a fast front-end, and a novel asynchronous architecture. Each of these factors contributes to an efficient and low-power design. The work includes the design of a low-power 5 Gb/s data driver and receiver integrated in both sensors. Finally, the integration of monolithic sensors in tracker systems has been addressed with studies on the design of a module prototype and the development of a CMOS compatible microfabrication technique to implement silicon-embedded microchannels cooling

A 60 μW front-end for 10 ps resolution monolithic pixel sensors in a 130nm SiGe BiCMOS process

This paper presents the development and optimization of a front-end circuit and the design of a monolithic sensor demonstrator with a high spatial resolution (hexagonal pixels with 50 μ m pitch) and sub-10 picosecond timing capability for the detection of ionizing radiation. The system combines a monolithic sensor in a SiGe BiCMOS process with a front-end architecture based on a SiGe Heterojunction Bipolar Transistor (HBT). The design of the prototype has been optimized to achieve improved timing performance while maintaining low power consumption by analyzing the trade-off between sensor input capacitance and power consumption. The goal is to achieve a timing resolution below 10 ps, a significant improvement over the previous prototype, which demonstrated a time resolution of 20 ps. This prototype has been developed in the framework of the MONOLITH H2020 ERC project

Endoscopic sinus surgery for foreign body extraction in an adult patient

Abstract Foreign bodies are an unusual indication for endoscopic sinus surgery. If outpatient extraction is not possible and acute sinusitis ensues, thorough exploration and extended surgical dissection should be considered to clear the nasal cavities