Facial taping as biofeedback to improve the outcomes of physical rehab in Bell’s palsy: preliminary results of a randomized case–control study

Purpose: This study aimed to investigate the efficacy of taping in association with Kabat rehabilitation to ameliorate the outcomes of Bell’s palsy. Methods: This case–control study was conducted on hospital-outbound patients. 20 patients over 18 years affected from Bell’s palsy were recruited at the onset of the disease (< 5 days). Patients were simply randomized into two groups. Patients in group A underwent exclusively Kabat rehabilitation, while patients in group B were treated by combining facial taping and Kabat. Facial palsy severity was evaluated with ADS assessment at baseline (T0), 1 week (T1), 1 month (T2) and 3 months (T3) after treatment. One-way ANOVA was used to compare ADS scores variance between groups to evaluate differences between the two treatments. Results: Both groups presented statistically significant differences comparing the baseline with the other observational points (within analysis) (p < 0.0001). Patients in group B showed a statistically significant improvement compared to group A (between analyses) (p < 0.0001), especially at T2 (p < 0.01). Conclusions: Facial taping combined with Kabat rehabilitation allowed to reduce the time of recovery and improved the outcomes of Bell’s palsy

Thyroid scintigraphy and perchlorate test after recombinant human TSH: a new tool for the differential diagnosis of congenital hypothyroidism during infancy

Purpose: Prompt initiation of l-thyroxine therapy in neonates with congenital hypothyroidism (CH) often prevents the performance of functional studies. Aetiological diagnosis is thus postponed until after infancy, when the required investigations are performed after l-thyroxine withdrawal. The aim of this study was to verify the efficacy and safety of new protocols for rhTSH (Thyrogen) testing during l-thyroxine replacement in the differential diagnosis of CH. Methods: Ten CH patients (15-144 months old) were studied. Seven had neonatal evidence of gland in situ at the ultrasound examination performed at enrolment and received two rhTSH injections (4 \u3bcg/kg daily, i.m.) with 123I scintigraphy and perchlorate test on day 3. Three patients with an ultrasound diagnosis of thyroid dysgenesis received three rhTSH injections with 123I scintigraphy on days 3 and 4. TSH and thyroglobulin (Tg) determinations were performed on days 1, 3 and 4, and neck ultrasound on day 1. Results: rhTSH stimulation caused Tg levels to increase in eight cases. Blunted Tg responses were seen in two patients with ectopia and hypoplasia. Interestingly, in two cases the association of different developmental defects was demonstrated. Perchlorate test revealed a total iodide organification defect in two patients, including one with a neonatal diagnosis of Pendred's syndrome, who were subsequently found to harbour TPO mutations. rhTSH did not cause notable side-effects. Conclusion: These new rhTSH protocols always resulted in accurate disease characterisation, allowing specific management and targeted genetic analyses. Thus, rhTSH represents a valid and safe alternative to l-thyroxine withdrawal in the differential diagnosis of CH in paediatric patients

La cd. legge 'spazzacorrotti'. Croniche innovazioni tra diritto e processo penale

La legge spazzacorrotti predispone l'ennesimo doppio binario, equiparando il corrotto al mafioso, con l'espansione di moduli eccezionali, che introducono regimi procedimentali di tipo investigativo e probatorio, differenziati sulla base del solo titolo di reato. Si affidano, così, al processo finalità preventive con il predominio di illusorie pulsioni panpenalistiche, destinate a risolversi in forme illiberali di mera repressione. L'inasprimento sanzionatorio, la perpetuità delle pene accessorie, l'aggressività delle indagini - attraverso l'uso del captatore informatico e l'ampliamento delle operazioni sotto copertura - delineano un contesto di emergenzialismo, appiattito su presunte esigenze di una politica criminale dell'efficienza, che trascura del tutto l'aspetto positivo della prevenzione generale. La riforma, inoltre, ignora che la prescrizione sia un diritto dell'imputato, lasciando prevalere l'interesse pubblico alla non dispersione del processo, anche al prezzo del sacrificio della presunzione di non colpevolezza. Per questa via, l'imputato diviene prigioniero di una giustizia, non troppo latamente, autoritaria. La convinzione è che la diffusione delle pratiche corruttive, nelle molteplici articolazioni della vita sociale, non possa legittimare la 'caccia' ai corrotti attraverso una normativa speciale, che ciclicamente ritorna con i consueti tratti dell'approssimazione, del rigorismo repressivo e della simbolicità, a detrimento dei diritti inviolabili