On the role of depletive tests. a review analysis

An overview of the diagnostic role of depletion tests for staging Meniere’s disease, especially in the first phase of the disease, is reported. Pros and cons, as well reliability and specificity of this diagnostic procedure is thoroughly analysed

Early assessment of vestibular function after unilateral cochlear implant surgery

Introduction : Cochlear implantation (CI) has been reported to negatively effect on the vestibular function. The study of the vestibular function has variably been conducted by different types of diagnostic tools. The combined use of modern, rapidly performable diagnostic tools could reveal useful for standardizing the evaluation protocol. Methods: In a group of 28 subjects undergoing CI, the video Head Impulse Test (vHIT), the cervical Vestibular Evoked Myogenic Potentials (cVEMPS) and the short-form of Dizziness Handicap Inventory (DHI) questionnaire were investigated pre-operatively and post-operatively (implant on and off) in both the implanted and the contralateral, non-implanted ear. All surgeries were performed with a round window approach (RWA), except for three otosclerosis cases were the extended RWA (eRWA) was used. Results: The vHIT of the lateral semicircular canal showed a pre-operative vestibular involvement in nearly 50% of the cases, whilst the three canals were contemporarily affected in only 14% of them. In all the hypo-functional subjects, cVEMPs were absent. A low VOR gain in all the investigated SSCC was found in 4 subjects (14%). In those subjects, (21.7%) in whom cVEMPs were pre-operatively present and normal in the operated side, absence of response was post-operatives recorded. Discussion/Conclusion: The vestibular protocol applied for the study showed to be appropriate for distinguishing between the CI operated and the non-operated ear. In this regard, cVEMPs showed to be more sensitive than vHIT for revealing a vestibular sufferance after CI, although without statistical significance. Finally, the use of the RWA surgery was apparently not avoiding signs of vestibular impairment to occur

Simultaneous Contralateral Vestibular Schwannoma and Middle Ear Paraganglioma Tumor

To the best of our knowledge, only 2 cases of a simultaneous contralateral vestibular schwannoma (VS) and middle ear paraganglioma (MEP) have previously been reported in literature. We report the third case observed in a 43-year-old male, who presented with an 11-year history of right-sided hearing loss and a 1-year history of left-sided pulsatile tinnitus. A magnetic resonance imaging (MRI) showed a VS on the right side and computer tomography (CT) identified a Fisch type A1 paraganglioma on the left side. The VS was treated using a translabyrinthine approach and the MEP was kept under radiological observation for 1 year. Due to the growth of the MEP (Fisch type A2), it was treated with excision via a retroauricular approach. Our case was very challenging because there was a different and important pathology on each side, both carrying a risk of deafness as a consequence of the disease and/or the treatments

Evasion of Gaseous Elemental Mercury from Forest and Urban Soils Contaminated by Historical and Modern Ore Roasting Processes (Idrija, Slovenia)

Considerable amounts of gaseous elemental mercury (Hg-0) can be released into the atmosphere from Hg-enriched substrates, such as those from former mining areas, posing a potential environmental threat. In this work, Hg-0 fluxes at the soil-air interface under natural vegetation covers were measured in various locations within the Idrija Hg mining area (Slovenia) and its surroundings. Sites were selected in order to compare Hg-0 fluxes from both forest soils heavily impacted by historical ore roasting and urban soils characterised by a different degree of Hg enrichment due to the natural occurrence of Hg in rocks or recent mining and roasting processes. Replicate measurements at each site were conducted using a non-steady state flux chamber coupled with a real-time Hg-0 analyser (Lumex RA-915M). Moreover, topsoil samples (0-2 cm) were analysed for Hg total concentration and speciation. Cinnabar was the predominant Hg form in almost all the sites. Despite Hg-0 being undetectable in soils using thermo-desorption, substantial emissions were observed (70.7-701.8 ng m(-2) h(-1)). Urban soils in a naturally enriched area showed on average the highest Hg-0 fluxes, whereas relatively low emissions were found at the historical roasting site, which is currently forested, despite the significantly high total Hg content in soils (up to 219.0 and 10,400 mg kg(-1), respectively). Overall, our findings confirm that shading by trees or litter may effectively limit the amount of Hg-0 released into the atmosphere even from extremely enriched soils, thus acting as a natural mitigation

Fluxes and fate of particulate mercury in a contaminated coastal environment (Gulf of Trieste, northern Adriatic Sea)

As the result of historical mining activity in Idrija (western Slovenia), mercury (Hg) contamination in the Gulf of Trieste (northern Adriatic Sea) still represents an environmental issue of great concern for the local authorities. The element has been conveyed into the marine-coastal area by the Isonzo/Soča River freshwater inputs for centuries, mainly in association with the suspended particulate matter (SPM) during periods of medium-high discharge often corresponding to river plume events. The aim of this study was to investigate the occurrence of Hg bound to SPM (particulate Hg, PHg) in the coastal water twentyfive years after the mine closure and to assess sedimentary Hg fluxes in the northernmost sector of the Gulf, a shallow and sheltered embayment where the accumulation of fine sediments is promoted Sediment traps were placed both at the surface and at bottom water layers at four different sites and settling particles accumulated into each trap were collected approximately every 15 days during 6 sampling campaigns. In terms of grain size composition, the SPM consisted predominantly of silt (77.7 ± 10.1 %) and differences were observed among sites, water layers and sampling campaigns Concentrations of PHg were consistent with previous studies focused on the sediment compartment and ranged overall between 0.61 and 6.87 μg g-1 showing slightly higher values at the bottom (1.50 ± 0.52 and 2.31 ± 1.58 μg g-1 in surface and bottom water layers, respectively) most likely due to resuspension of fine particles enriched in Hg from bottom sediments. The estimated daily Hg fluxes associated with settling particles showed a notable variability, up to an order of magnitude, both in the surface water layer (3.07 – 94.6 μg m-2 d-1) and at the bottom (11.3 – 245 μg m-2 d-1) Moreover, a significant correlation (r = 0.762) was observed between Hg and SPM daily fluxes thus confirming that, still nowadays, periods of high PHg concentrations in the water column as well as of Hg sedimentary fluxes at the sea bottom roughly corresponds to higher SPM inputs from the Isonzo River

POLYPHENOLS FROM RED WINE MODULATE IMMUNE RESPONSIVENESS: BIOLOGICAL AND CLINICAL SIGNIFICANCE.

Many studies have been conducted on the effects of red wine polyphenols on certain diseases, primarily, coronary heart disease (CHD) and, in this respect, evidence has been demonstrated that intake of red wine is associated with a reduction of CHD symptomatology. In this framework, the purpose of this review is to illustrate the effects of polyphenols on immune cells from human healthy peripheral blood. Data will show that polyphenols are able to stimulate both innate and adaptive immune responses. In particular, the release of cytokines such as interleukin (IL)-12, interferon (IFN)-, and IL-10 as well as immunoglobulins may be important for host protection in different immune related disorders. Another important aspect pointed out in this review is the release of nitric oxide (NO) from peripheral blood mononuclear cells (PBMC), stimulated by red wine polyphenols despite the fact that the majority of studies have reported NO production only by endothelial cells. Release of NO from PBMC may play an important role in cardiovascular disease, because it is known that this molecule acts as an inhibitor of platelet aggregation. On the other hand, NO exerts a protective role against infectious organisms. Finally, some molecular cytoplasmatic pathways elicited by polyphenols able to regulate certain immune responses will also be discussed. In particular, it seems that p38, a molecule belonging to the MAPK family, is involved in the release of IFN- and, therefore, in NO production. All these data confirm the beneficial effects of polyphenols in some chronic diseases

Concomitant dehiscences of the temporal bone: a case-based study

Otic capsule dehiscences create a pathological third window in the inner ear that results in a dissipation of the acoustic energy consequent to the lowered impedance. Superior semicircular canal dehiscence (SSCD) was identified by Minor et al. in 1998 as a syndrome leading to vertigo and inner ear conductive hearing loss. The authors reported the relation between the dehiscence and pressure- or sound-induced vertigo (Tullio phenomenon). The pathophysiology of this entity still remains controversial. Prevalence rates of SSCD in anatomical studies range from 0.4 to 0.7 % with a majority of patients being asymptomatic. The observed association with other temporal bone dehiscences, as well as the propensity toward a bilateral or contralateral near-dehiscence, raises the question of whether a specific local bone demineralization or systemic mechanisms could be considered. The present report regards a case of a patient with a previous episode of meningitis, with a concomitant bilateral SSCD and tegmen tympani dehiscence from the side of meningitis. The patient was affected by dizziness, left moderate conductive hearing loss and pressure/sound-induced vertigo. Because of disabling vestibular symptoms, the patient underwent surgical treatment. A middle cranial fossa approach allowed to reach both dehiscences on the symptomatic side, where bone wax and fascia were used. At 6 months from the procedure, hearing was preserved and the vestibular symptoms disappeared

Understanding Hunting Constraints and Negotiation Strategies: A Typology of Female Hunters

This article examined a typology of female hunters, factors constraining participation, and negotiation strategies females used to overcome constraints. A survey of Oregon hunters was conducted in the summer of 2010 to understand hunting characteristics using the 2008 big game license database (n = 392). We created a typology of female hunters using a cluster analysis of Recreation Experience Preference items. Four clusters were identified: less-engaged, family oriented, nature-sport, and all around enthusiast. Analysis of variance revealed differences among female hunter segments. Differences existed among the four groups on both constraints and negotiation strategies. One of the notable groups was the family-oriented hunter. This type of hunter was the most likely to perceive constraints and the most likely to utilize negotiation strategies to increase their participation in hunting. Findings reveal nuanced differences between types of female hunters. These findings can assist managers with outreach strategies and facilitate future female hunting participation

Transaminase abnormalities and adaptations of the liver lobule manifest at specific cut-offs of steatosis

There is little documented evidence suggesting that liver fat is responsible for liver injury in the absence of other disease processes. We investigated the relationships between liver fat, aminotransferases and hepatic architecture in liver biopsies with simple steatosis. We identified 136 biopsies with simple steatosis from the Royal Free Hospital Archives with both clinical data and sufficient material. Digital image analysis was employed to measure fat proportionate area (mFPA). Hepatocyte area (HA) and lobule radius (LR) were also measured. There were significant increases in ALT (p < 0.001) and AST (p = 0.013) with increased fat content and evidence to suggest both 5% and 20% mFPA as a cut-off for raised ALT. In liver with increased fat content there were significant increases in HA (p < 0.001). LR also increased as mFPA increased to 10% (p < 0.001), at which point the lobule ceased to expand further and was counterbalanced with a decrease in the number of hepatocytes per lobule (p = 0.029). Consequently there are mechanisms of adaption in the liver architecture to accommodate the accumulation of fat and these are accompanied by significant increases in transaminases. These results support the generally accepted cut-off of 5% fat for steatosis and indicate 20% as a threshold of more severe liver injury

Bell's palsy: Symptoms preceding and accompanying the facial paresis

This individual prospective cohort study aims to report and analyze the symptoms preceding and accompanying the facial paresis in Bell's palsy (BP). Two hundred sixty-nine patients affected by BP with a maximum delay of 48 hours from the onset were enrolled in the study. The evolution of the facial paresis expressed as House-Brackmann grade in the first 10 days and its correlation with symptoms were analyzed. At the onset, 136 patients presented postauricular pain, 114 were affected by dry eye, and 94 reported dysgeusia. Dry mouth was present in 54 patients (19.7%), facial pain, hyperlacrimation, aural fullness, and hyperacusis represented a smaller percentage of the reported symptoms. After 10 days, 39.9% of the group had a severe paresis while 10.2% reached a complete recovery. Dry mouth at the onset was correlated with severe grade of palsy and was prognostic for poor recovery in the early period. These outcomes lead to the deduction that the nervus intermedius plays an important role in the presentation of the BP and it might be responsible for most of the accompanying symptomatology of the paresis. Our findings could be of important interest to early address a BP patient to further examinations and subsequent therapy