Vertigo and dizziness in children: An update

Background: Vertigo and dizziness are relatively infrequent in paediatric patients, but specific data on the prevalence of these disorders are limited and influenced by various factors, including the age of the examined population. These conditions often have a significant impact on patients’ and parents’ quality of life. The aim of this paper is to investigate the prevalence of different aetiologies of vertigo in the paediatric population through a systematic review. Methods: According to PRISMA guidelines, a systematic review of the literature was performed. Medline and Embase were searched from January 2011 through to 10 September 2021. The search yielded 1094 manuscripts, which were reduced to 7 upon the application of inclusion criteria. Results: A total of 2470 paediatric patients were evaluated by the selected papers. Vestibular Migraine was the most frequently diagnosed condition, occurring alone or in association with other diseases. Overall, audio-vestibular disorders represented the second cause of vertigo, and the prevalence appears to increase according to age growth. Over the years, even though we assisted in the amelioration of diagnostic rates, partially related to an improvement in diagnostic tools, the aetiology of vertigo remains still unclear in a variable percentage of patients. Conclusion: Vertigo in children, despite being an uncommon symptom, requires a multidisciplinary approach, often involving Paediatricians, Neurologists and Otorhinolaryngologists. A comprehensive evaluation of children suffering from vertigo is crucial for establishing a successful therapy and reducing parental worries

Capability-wise walkability evaluation as an indicator of urban peripherality

Urban peripherality is a multidimensional phenomenon, requiring operational tools for analysis and policy design. In this paper, we explore if and how the concept of walkability can be employed as an indicator of peripherality. For this purpose, we employ the capability-wise walkability score (CAWS) to assess neighbourhoods of two case study cities to classify them into four classes (periphery, semi-periphery, semi-core, core). In comparing neighbourhoods on both walkability and a set of neighbourhood-level socioeconomic variables, we argue that walkability should be incorporated as part of a comprehensive framework for the analysis of processes of peripherilisation, since walkability should be seen as one relevant factor of urban capabilities, and hence the lack thereof fits into the definition of urban periphery

Use of ICT for More Efficient Port Operations: The Experience of the EASYLOG Project

The 4.0 revolution in the shipping industry is growing fast and ports are requested to constantly innovate and evolve. Ports need to become not only smarter to implement more efficient, sustainable, and safer operations but also interconnected with each other. This paper presents the experience of the Easylog Project – Optimized logistics for ports and intermodal transport – funded under the Interreg IT-FR Maritime 2014–2020 program. Easylog aims to improve the mobility of rolling cargo between Italian and French regions by taking advantage of ICT technologies to increase the performance of intermodal transport chains and the overall quality of the services offered by ports. The project involves five ports in the upper Tyrrhenian area for which it proposes the shared adoption of integrated ICT devices for optimized and secure management of port operations between the operators involved in the cross-border (trans)port chain. The driving idea is to move from a non-integrated and fragmented management and control system of port events and flows to a common and connected ICT system. Easylog may represent a useful case study potentially replicable in many port contexts

The evaluation of Vertigo in children: which role for parental-camera recording and telemedicine?

Sir, At this time, the management of pediatric patients affected by vertigo remains a challenge that requires a multidisciplinary approach and the collaboration of many specialists, such as otorhinolaryngologists, audiologists, pediatricians, and neurologists. Vertigo in children is a condition often difficult to assess since the little patients are frequently incapable to provide a complete description of their complaints, and parents can be inaccurate or incomplete, in describing or recognizing crucial clinical signs. Many disorders, including neurological and audio-vestibular diseases, can manifest with vertigo, which in children can occur alone or in association to other symptoms such as visual disturbances, migraine, or learning disabilities. It can severely affect the quality of life of both, children and their families, especially if persisting, enhancing parental concerns and anxieties. A careful collection of medical history, with a detailed description of symptoms, is crucial in the diagnostic process. However, parents/caregivers may omit important data since they are not trained to recognize red flags or specific signs. Thus, during the first consultation, otolaryngologists should alert parents/caregivers for assessing specific vertigo features, in the case of future episodes. Timing, frequency, triggers, and associated manifestations can be helpful details to report. Among specific diagnostic tools, the video Head Impulse Test (vHIT) is a valuable instrument for assessing the vestibular-ocular reflex (VOR), even if it can present a higher percentage of artefacts in children, mainly due to technical issues (i.e., higher gain and blinking eyes). Furthermore, while teenagers can undergo different investigations, including specific vestibular testing, the cooperation of younger children, for a full clinical and instrumental testing, can be tricky. Currently, the use of patients’ self-recorded videos is not common among the audio-vestibular practice. However, according to Gedik-Soyuyuce et al, their application can be valuable for observing children’s behaviors during acute vertigo attacks. Nowadays, smartphone high-definition cameras could be useful for recording the dizzy children during a crisis. Therefore, detailed features (i.e., eyes and body movements) could be documented, as already proposed for the adults affected by Meniere’s disease

Linfoma gastrico sanguinante: descrizione di due casi clinici

Two cases of bleeding gastric lymphoma are reported. The stomach is the most common site of primary extranodal Non-Hodgkin's Lymphomas. The best treatment for primary gastric lymphoma has not yet been defined. For many years the treatment of choice has been the gastric resection. Helicobacter Pylori (H. pylori) has been associated with many gastric pathologies, including gastric lymphoma. Eradication of H. pylori is now considered essential for the treatment of this pathology, and usually consists of antibiotic therapy, combined with acid suppression by a proton pump inhibitor. This simple treatment in patients with low grade histology and tumor confined to the stomach can often obviate the need for surgical intervention. Surgery is a necessary treatment independently of the grading and the staging of lymphoma in the bleeding complication as the cases we showed

[Bleeding gastric lymphoma: report of two cases].

Abstract We report two cases of bleeding gastric lymphoma. The stomach is the most common site of primary extranodal Non-Hodgkins Lymphomas. The best treatment for primary gastric lymphoma has not yet been defined. For many years the treatment of choice has been the gastric resection. Helicobacter pylori (H. pylori) has been associated with many gastric pathologies, including gastric lymphoma. Eradication of H. pylori is now considered essential for the treatment of this pathology, and usually consists of antibiotic therapy, combined with acid suppression by a proton pump inhibitor. This simple treatment in patients with low grade histology and tumor confined to the stomach can often obviate the need for surgical intervention. Surgery is a necessary treatment, independently of the grading and the staging of lymphoma, in the bleeding complication as the cases we showed

Simple extension of Lemaitre's elastoplastic damage model to account for hydrolytic degradation

Being motivated by the technological applications of bioabsorbable polymeric materials in the fields of biomechanics and medicine, this paper presents a simple but efficient extension of Lemaitre's elastoplastic damage model by incorporating a chemical-based (hydrolysis) degradation term. The aim is to allow the simulation of devices subjected to both mechanical and chemical environments. The model applicability is tested by a set of numerical finite-element examples. The encouraging results show expected adequate coupling between the elastoplastic and chemical damages. Although the model is presently restricted to linear kinematics, the basic idea can be extended to finite strains