Hearing loss, tinnitus, hyperacusis, and diplacusis in professional musicians: a systematic review

Professional musicians (PMs) are at high risk of developing hearing loss (HL) and other audiological symptoms such as tinnitus, hyperacusis, and diplacusis. The aim of this systematic review is to (A) assess the risk of developing HL and audiological symptoms in PMs and (B) evaluate if different music genres (Pop/Rock Music-PR; Classical Music-CL) expose PMs to different levels of risk of developing such conditions. Forty-one articles including 4618 PMs were included in the study. HL was found in 38.6% PMs; prevalence was significantly higher among PR (63.5%) than CL (32.8%) PMs; HL mainly affected the high frequencies in the 3000-6000 Hz range and was symmetric in 68% PR PMs and in 44.5% CL PMs. Tinnitus was the most common audiological symptom, followed by hyperacusis and diplacusis. Tinnitus was almost equally distributed between PR and CL PMs; diplacusis was more common in CL than in PR PMs, while prevalence of hyperacusis was higher among PR PMs. Our review showed that PR musicians have a higher risk of developing HL compared to CL PMs; exposure to sounds of high frequency and intensity and absence of ear protection may justify these results. Difference in HL symmetry could be explained by the type of instruments used and consequent single-sided exposure

DYNLRB1 is essential for dynein mediated transport and neuronal survival

The cytoplasmic dynein motor complex transports essential signals and organelles from the cell periphery to the perinuclear region, hence is critical for the survival and function of highly polarized cells such as neurons. Dynein Light Chain Roadblock-Type 1 (DYNLRB1) is thought to be an accessory subunit required for specific cargos, but here we show that it is essential for general dynein-mediated transport and sensory neuron survival. Homozygous Dynlrb1 null mice are not viable and die during early embryonic development. Furthermore, heterozygous or adult knockdown animals display reduced neuronal growth, and selective depletion of Dynlrb1 in proprioceptive neurons compromises their survival. Conditional depletion of Dynlrb1 in sensory neurons causes deficits in several signaling pathways, including beta-catenin subcellular localization, and a severe impairment in the axonal transport of both lysosomes and retrograde signaling endosomes. Hence, DYNLRB1 is an essential component of the dynein complex, and given dynein\u27s critical functions in neuronal physiology, DYNLRB1 could have a prominent role in the etiology of human neurodegenerative diseases

Residual neurotoxicity in ovarian cancer patients in clinical remission after first-line chemotherapy with carboplatin and paclitaxel: The Multicenter Italian Trial in Ovarian cancer (MITO-4) retrospective study

BACKGROUND: Carboplatin/paclitaxel is the chemotherapy of choice for advanced ovarian cancer, both in first line and in platinum-sensitive recurrence. Although a significant proportion of patients have some neurotoxicity during treatment, the long-term outcome of chemotherapy-induced neuropathy has been scantly studied. We retrospectively assessed the prevalence of residual neuropathy in a cohort of patients in clinical remission after first-line carboplatin/paclitaxel for advanced ovarian cancer. METHODS: 120 patients have been included in this study (101 participating in a multicentre phase III trial evaluating the efficacy of consolidation treatment with topotecan, and 19 treated at the National Cancer Institute of Naples after the end of the trial). All patients received carboplatin (AUC 5) plus paclitaxel (175 mg/m(2)) every 3 weeks for 6 cycles, completing treatment between 1998 and 2003. Data were collected between May and September 2004. Residual sensory and motor neurotoxicity were coded according to the National Cancer Institute – Common Toxicity Criteria. RESULTS: 55 patients (46%) did not experience any grade of neurological toxicity during chemotherapy and of these none had signs of neuropathy during follow-up. The other 65 patients (54%) had chemotherapy-induced neurotoxicity during treatment and follow-up data are available for 60 of them. Fourteen out of 60 patients (23%) referred residual neuropathy at the most recent follow-up visit, after a median follow up of 18 months (range, 7–58 months): 12 patients had grade 1 and 2 patients grade 2 peripheral sensory neuropathy; 3 patients also had grade 1 motor neuropathy. The remaining 46/60 patients (77%) had no residual neuropathy at the moment of interview: recovery from neurotoxicity had occurred in the first 2 months after the end of chemotherapy in 22 (37%), between 2 and 6 months in 15 (25%), or after more than 6 months in 9 patients (15%). Considering all 120 treated patients, there was a 15% probability of persistent neurological toxicity 6 months after the end of chemotherapy. CONCLUSION: A significant proportion of patients with advanced ovarian cancer treated with first-line carboplatin/paclitaxel suffer long-term residual neuropathy. This issue should be carefully taken into account before considering re-treatment with the same agents in sensitive recurrent disease

Inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants

Acute bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1 year of age worldwide. It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with pre-existing risk factors (prematurity, bronchopulmonary dysplasia, congenital heart diseases and immunodeficiency) may be predisposed to a severe form of the disease. Clinical diagnosis of bronchiolitis is manly based on medical history and physical examination (rhinorrhea, cough, crackles, wheezing and signs of respiratory distress). Etiological diagnosis, with antigen or genome detection to identify viruses involved, may have a role in reducing hospital transmission of the infection. Criteria for hospitalization include low oxygen saturation (<90-92%), moderate-to-severe respiratory distress, dehydration and presence of apnea. Children with pre-existing risk factors should be carefully assessed. To date, there is no specific treatment for viral bronchiolitis, and the mainstay of therapy is supportive care. This consists of nasal suctioning and nebulized 3% hypertonic saline, assisted feeding and hydration, humidified O2 delivery. The possible role of any pharmacological approach is still debated, and till now there is no evidence to support the use of bronchodilators, corticosteroids, chest physiotherapy, antibiotics or antivirals. Nebulized adrenaline may be sometimes useful in the emergency room. Nebulized adrenaline can be useful in the hospital setting for treatment as needed. Lacking a specific etiological treatment, prophylaxis and prevention, especially in children at high risk of severe infection, have a fundamental role. Environmental preventive measures minimize viral transmission in hospital, in the outpatient setting and at home. Pharmacological prophylaxis with palivizumab for RSV bronchiolitis is indicated in specific categories of children at risk during the epidemic period. Viral bronchiolitis, especially in the case of severe form, may correlate with an increased incidence of recurrent wheezing in pre-schooled children and with asthma at school age. The aim of this document is to provide a multidisciplinary update on the current recommendations for the management and prevention of bronchiolitis, in order to share useful indications, identify gaps in knowledge and drive future research

Surgical management of Glioma Grade 4: technical update from the neuro-oncology section of the Italian Society of Neurosurgery (SINch®): a systematic review

Purpose: The extent of resection (EOR) is an independent prognostic factor for overall survival (OS) in adult patients with Glioma Grade 4 (GG4). The aim of the neuro-oncology section of the Italian Society of Neurosurgery (SINch®) was to provide a general overview of the current trends and technical tools to reach this goal. Methods: A systematic review was performed. The results were divided and ordered, by an expert team of surgeons, to assess the Class of Evidence (CE) and Strength of Recommendation (SR) of perioperative drugs management, imaging, surgery, intraoperative imaging, estimation&nbsp;of EOR, surgery at tumor progression and surgery in elderly patients. Results: A total of 352 studies were identified, including 299 retrospective studies and 53 reviews/meta-analysis. The use of Dexamethasone and the avoidance of prophylaxis with anti-seizure medications reached a CE I and SR A. A preoperative imaging standard protocol was defined with CE II and SR B and usefulness of an early postoperative MRI, with CE II and SR B. The EOR was defined the strongest independent risk factor for both OS and tumor recurrence with CE II and SR B. For intraoperative imaging only the use of 5-ALA reached a CE II and SR B. The estimation of EOR was established to be fundamental in planning postoperative adjuvant treatments with CE II and SR B and the stereotactic image-guided brain biopsy to be the procedure of choice when an extensive surgical resection is not feasible (CE II and SR B). Conclusions: A growing number of evidences evidence support the role of maximal safe resection as primary OS predictor in GG4 patients. The ongoing development of intraoperative techniques for a precise real-time identification of peritumoral functional pathways enables surgeons to maximize EOR minimizing the post-operative morbidity

Interaction of the Sea Breeze with the Urban Area of Rome: WRF Mesoscale and WRF Large-Eddy Simulations Compared to Ground-Based Observations

The Weather Research and Forecast (WRF) model is used to simulate atmospheric circulation during the summer season in a coastal region of central Italy, including the city of Rome. The time series of surface air temperature, wind speed, and direction are compared with insitu observations in urban Rome and its rural surroundings. Moreover, the vertical wind profiles are compared to sodar urban measurements. To improve the WRF model’s ability to reproduce the local circulation, and the onset and propagation of the sea breeze, several simulations are carried out modifying the landuse and the thermal and physical properties of the surfaces. Based on the results of the correlation coefficient and the root mean square error, the heat capacity and albedo are the parameters mostly influencing the daily temperature cycle. Particularly, the temperature in the urban area is reproduced more realistically when the heat capacity is increased. Hence, the best simulations are used to initialize a large-eddy simulation (LES) at high spatial resolution to analyze the interaction between the sea breeze and the urban heat island and to investigate the interaction of the sea breeze front with orography and surface roughness. As confirmed by observations collected by insitu weather stations in the surroundings of Rome, the front, entering the city, splits into three branches: i) a west component in the western flank of the city, closer to the sea; ii) a north-west component in the northern, inland side, and iii) a south-west component in the south area of the city

Seasonal variability of tropospheric aerosols in Rome

The seasonal evolution of the tropospheric aerosol vertical distribution and of its optical properties is investigated using lidar and multi-filter rotating shadow-band radiometer (MFRSR) measurements collected throughout the period 2006-2009 in the urban environment of Rome. The evolution of the aerosol distribution is studied also in relation to long range transport of dust.Hybrid Single-Particle Lagrangian Integrated Trajectory model backward trajectories are used to identify possible aerosol sources in remote regions.Aerosol optical depth at 500. nm, τ, and Ångström exponent, α, are derived from MFRSR measurements. The Ångström exponent generally displays relatively high values, indicating the predominance of fine particle over the entire column. The average optical depth at 500. nm and Ångström exponent over the whole period are 0.18 ± 0.09 and 1.12 ± 0.39, respectively. Cases affected by Saharan dust (class 1) are separated from those not influenced by dust (class 0) by using backward trajectories. The average values of τ and α are 0.17 ± 0.08 and 1.17 ± 0.36 for class 0, respectively, and 0.22 ± 0.09 and 0.95 ± 0.46 for class 1.About 214. days of lidar measurements are selected for the analysis. The aerosol vertical distribution is influenced by dust events that induce a marked seasonal behaviour. Desert dust generally reaches higher altitudes than other aerosol types; the maxima altitudes are observed during Spring and Summer, when the monthly average altitude exceeds 5. km. The annual average occurrence of desert dust is 27%, with maxima in Spring and in the first part of Summer. The decrease in the dust event frequency observed in winter months is mainly linked to the seasonal behaviour of the synoptic circulation in the Mediterranean. According to the back-trajectories aerosols are primarily observed below 3. km altitude throughout the year when classified as not affected by desert dust. The extinction coefficient vertical profiles for the two classes show largest differences during Spring and Summer. The extinction for non-dust profiles decreases monotonically with altitude throughout the year, except in Summer. Conversely, the aerosol extinction coefficient shows a relative minimum at the lowest sounded altitude, always except in winter, for class 1 cases. A winter maximum of the aerosol is evidently present in winter in the lower troposphere. Using the MFRSR optical depth and the lidar profiles, the lidar ratio was derived. The overall average lidar ratio is 58. sr. © 2012 Elsevier B.V