Stretching stenoses of the external auditory canal: a report of four cases and brief review of the literature

Acquired stenosis of the external auditory canal may be caused by a variety of insults, all sharing a common pathogenesis, namely a cascade of inflammatory changes leading to medial canal fibrosis. Previous surgery (canaloplasty or meatoplasty) and radiotherapy, especially if associated with a history of parotid surgery extended to the external auditory canal, have been implicated as possible causes. The literature offers advice on the management of stenosis consequent to otosurgery for congenital and acquired defects, but nothing on forms secondary to radiotherapy to the head and neck region. The proposed solutions are often cumbersome and difficult to fabricate, and therefore expensive. The aim of this paper, in which the cases of four patients are reported, is to present a new technique initially used for the most severe form - i.e. external auditory canal stenosis after surgery and radiotherapy - and then extended to forms due to different causes. This new technique involves the use of a series of surgical steel tubes of increasing dimension commonly used for tissue expansion in a body piercing practice called stretching and known as ear stretching tunnels or ear stretchers. This innovative approach proved effective in solving external auditory canal stenosis in our patients, with the least discomfort for the patient and the lowest cost. We consider this new solution to be feasible and practical and are convinced that it provides a new approach to an old problem. Further studies are needed to increase the number of clinical cases to verify how long the ear stretcher should be kept in place for the stenosis to stabilise, and to establish whether surgery is always necessary after ear stretcher application and, if so, the best timing for surgery

Development of a HPLC method for the simultaneous analysis of riboflavin and other flavin compounds in liquid milk and milk products

A high-performance liquid chromatography method with fluorescence detection was developed for the quantification of riboflavin (RF), flavin mononucleotide (FMN), flavin adenine dinucleotide (FAD) and their photodegradation products, lumichrome (LC) and lumiflavin (LF), in liquid milk and milk products. Both sample preparation and chromatographic separation were studied to avoid acidic conditions that proved to affect flavin stability and degrade FAD into FMN. The sample preparation includes centrifugal skimming and ultrafiltration steps and is suitable for routine application. Linear response was obtained for individual flavins in the respective concentration ranges of interest and relative standard deviation (RSD) was lower than 5%, except for FAD (RSD 11%). The recovery ranged between 80\u2013100%. The proposed method proved to be suitable for assessing flavins in commercial liquid milk and fermented milk products, and for monitoring the degradation of FAD, FMN and RF and the formation of LF and LC in bottled milk exposed to light during shelf storage

CD44 targeted delivery of siRNA by using HA-decorated nanotechnologies for KRAS silencing in cancer treatment

KRAS is a small GTPase that regulates cell proliferation and survival. In tumors, the KRAS gene is mutated, and leading to unregulated tumor growth. Despite the recognized importance of KRAS in cancer, attempts to develop small molecule inhibitors have proved unsuccessful. An alternative strategy is gene silencing and the use of small nucleic acid sequences (e.g. siRNA, shRNA), has been reported to successfully downregulate KRAS. In this study we developed ternary nanocomplexes to deliver an anti-KRAS siRNA to colorectal cancer cells, exploiting the interaction of hyaluronic acid (HA) with CD44 as a means to achieve selective targeting of CD44-positive cancer cells. Two different polycations, poly(hexamethylene biguanide) and chitosan, were complexed with siRNA and coated with HA. Physico-chemical properties and stability of nanoparticles were characterized, including size, surface charge, and degree of siRNA protection. We demonstrate nanoparticle internalization (flow cytometry), siRNA cytosolic release (confocal microscopy) and KRAS silencing (RT-qPCR) in CD44+/KRAS+ colorectal cancer cell line, HCT-116. Further we demonstrate that the uptake of HA-decorated nanoparticles in cancer cells is higher when co-cultured with fibroblasts

Evaluation of the antioxidant/antimicrobial performance of Posidonia oceanica in comparison with three commercial natural extracts and as a treatment on fresh-cut peaches (Prunus persica Batsch)

This research aimed at extending the choice of natural antimicrobials/antioxidants for food applications. Four plant extracts, Posidonia oceanica (PO), Green Tea (GT), Grape seeds (GS) and Grape skin (GK), were analyzed to determine their total phenolic content, antioxidant activity and in vitro antimicrobial performance. PO extract showed the highest total phenolic content (711 mg gallic acid/g extract) and antifungal activity against Aspergillus niger and Penicillium chrysogenum. The highest antioxidant (3.81 mg/L EC50) and antibacterial activities (bactericidal against Gram positives and bacteriostatic against Gram negatives) were found for GT extract. The best performing extracts (PO and GT) were applied by dipping on peach slices in storage trials. Microbiological and pomological parameters were evaluated during 7 d storage. Total aerobic count, Pseudomonas as well as yeasts and moulds populations, were reduced by about 0.5 log cfu/g, mainly up to 5 d in all treated samples compared to the control. Total soluble solids, titratable acidity and colour (L*a*b*) changes were also delayed in treated fruit

Vitamin D deficiency and infertility : insights from in vitro fertilization cycles

Context: Vitamin D deficiency has been proven to affect fertility in mammals, but data in human is less convincing. In particular, data on in vitro fertilization (IVF), an attractive model to draw information on this topic, are sparse and conflicting.Objective: Our objective was to investigate IVF outcome in women with deficient 25-hydroxyvitamin D [25 (OH)D] serum levels (30 ng/mL) had the highest chances of pregnancy.Conclusions: VitaminDis an emerging factor influencing female fertility and IVF outcome. Additional studies are pressingly needed to confirm a causal relationship and to investigate the potential therapeutic benefits of vitamin D supplementation

An investigation of grand battement devant at barre, centre, and in motion using kinematics and electromyography

The purpose of this study was to examine grand battement devant in three conditions: at the barre, in the centre, and traveling. The primary focus was to consider weight transfer in the three conditions, and to examine utilisation of the trunk and lower extremity muscles. An extensive review was done in the dance science literature to determine what previous research had been done related to this subject, and to establish what preliminary work might be needed. As indicated by the literature, in order to achieve this research, it was necessary to develop a dance-specific method for the normalisation of surface electromyography data. In phase one of the research, a dance-specific portable anchored dynamometer was developed and tested. The PAD allowed for the collection of maximum voluntary isometric contractions (MVICs), which could then be used to normalise the sEMG data. In phase two of the research, the grand battement was tested in the three conditions, at the barre, in the centre, and traveling. Forty female dancers volunteered (mean age 30.0 ± 13.0 yrs, mean height 1.63 ± 0.06 m, mean mass 59.0 ± 7.4 kg, and 13.9 ± 13.3 yrs of training in ballet and/or modern dance) and were placed in three groups (Training level): beginner (n = 12), intermediate (n = 14) and advanced (n = 14). Dancers executed five grand battement devant in each of the three conditions (Condition) in randomized order. Data were collected with a 7-camera Vicon motion capture system, two Kistler forceplates, and surface electromyography (EMG), using eight muscles bilaterally. Kinematic data were analysed in three intervals: stance to battement initiation, initiation to battement peak, and peak to end. Four variables were investigated: centre of gravity of the full trunk, centre of gravity of the pelvis, centre of gravity of the upper trunk, and centre of mass. EMG data were analysed in four events: stance, initiation, peak, and end. For weight transfer, the main effect of Condition was significant for all four variables in both the x-axis and the y-axis (p < .001). There were no significant differences for Training and no significant Condition x Training interactions. Muscle use varied according to the combination of event and condition that was executed, and these differences were also influenced by the level of training of the dancer and the side of the body used. It is recommended that dance educators consider the importance of allocating sufficient time to each of the three conditions (barre, centre, and traveling), to ensure development of a variety of motor strategies and muscle activation patterns for dance practice.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Il difetto di luce nel vino bianco : Effetto ed evoluzione nel corso della conservazione = The light-struck taste in white wine : Effect and evolution during the storage

L\u2019esposizione del vino bianco ad una radiazione luminosa impatta negativamente sulle caratteristiche sensoriali. Tale condizione pu`o causare la comparsa di un\u2019alterazione, nota come difetto di luce, causata dalla formazione di composti solforati, quali metantiolo (MeSH) e dimetildisolfuro (DMDS). Le reazioni indotte dalla luce originano dalla riboflavina (RF), un composto fotosensibile, e dalla metionina (MET). I trattamenti del vino bianco con bentonite o carbone attivo sono efficaci per rimuovere parte della RF e l\u2019aggiunta al vino di tannini idrolizzabili limita la comparsa del difetto di luce in soluzione modello. Non `e stata ancora chiarita l\u2019evoluzione del difetto di luce nel vino bianco durante la shelf-life. In questo studio sono stati valutati gli effetti dei fenomeni foto-indotti in vino bianco dopo 24 mesi di conservazione. Il vino `e stato addizionato di RF, MET e antiossidanti, quali glutatione, anidride solforosa e tannino di castagno, singolarmente ed in combinazione, esposto alla luce e conservato al buio. Come atteso, la RF `e degradata in seguito all\u2019esposizione alla fonte luminosa in tutte le condizioni saggiate. La diminuzione di MET `e compresa nel range 21\u201338% in funzione degli antiossidanti aggiunti che, quando aggiunti singolarmente, limitano la formazione del difetto di luce come dimostra il minore livello di MeSH e DMDS presenti. I dati ottenuti suggeriscono che l\u2019impiego di tannini da legno pu`o essere un efficace strumento per limitare la comparsa del difetto di luce anche nel vino bianco.The light exposure of white wine has a detrimental impact on its sensory characteristics. In these conditions, a fault, known as light-struck taste, can appear due to the formation of sulfur compounds, namely methane thiol (MeSH) and dimethyl disulfide (DMDS). The occurrence of photo-induced reactions is strictly related to the presence of riboflavin (RF), a photosensitive compound, and methionine (MET).Wine treatment with bentonite or active charcoal is effective for RF removal, as well as the addition of wood tannins effectively limits the appearance of the defect in model wine. However, the evolution of this fault is not clear during the shelf-life of white wine. In this research, the effects of a light treatment were evaluated in white wine added with RF, MET and antioxidants including sulfur dioxide, glutathione and chestnut tannins, as single or combined addition, and exposed to light followed by the storage in the dark, after 24 months of storage. As expected, the light induced the degradation of RF in all the conditions assayed. MET also decreased by 21\u201338% depending on the antioxidants added. The investigated antioxidants limited the formation of lightstruck taste as lower amounts of MeSH and DMDS were found when the antioxidants were used singularly. Our data suggest the hydrolysable tannins can be an effective tool to prevent the appearance of light-struck taste in white wine

pT3 N0 Laryngeal Squamous Cell Carcinoma: Oncologic Outcomes and Prognostic Factors of Surgically Treated Patients

Objectives/Hypothesis: To assess the disease control, survival rates, and prognostic factors of exclusive surgical treatment for patients with pT3 N0 laryngeal squamous cell carcinoma (LSCC). Study Design: Multicentric retrospective cohort study. Methods: Multicentric retrospective case series of previously untreated patients with pT3 R0N0 LSCC, who received exclusive surgery between 2011 and 2019. Tumor location; subsite involvement; grading; and lymphatic, vascular, and perineural invasion were reported. Overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were measured. Results: Fifty-four patients (mean age 67.1; male sex 83.3%; mean follow-up period 37 months) underwent total laryngectomy (48.1%) or partial laryngectomy (51.9%). Ipsilateral or bilateral neck dissection was performed in 46 (85.2%) cases. Perineural invasion was more frequent in case of supraglottic involvement than glottic involvement (85.7% vs. 14.3%, P&nbsp;=.03). Five (9.3%) patients experienced recurrence (3 local recurrences, 1 nodal recurrence, 1 distant recurrence). Rate of recurrence differed between glottic (0%), supraglottic (80%), and transglottic (20%) tumors (P&nbsp;=.01), with a lower risk yielded by glottic involvement (odds ratio [OR], 0.05, 95% confidence interval [95% CI], 0.01–0.56, P&nbsp;=.01). A higher risk was recorded in case of perineural invasion (OR, 66.0, 95% CI, 1.41–3085.3, P&nbsp;=.03). The OS, DSS, and DFS were 79.6%, 96.3%, and 90.7%, without differences regarding the type of surgery. The DFS was lower in case of supraglottic involvement when compared to purely glottic LSCC (83.9% vs. 100%, P&nbsp;=&nbsp;0.02). Conclusions: Exclusive surgery is a safe option for patients with pT3 R0N0 LSCC. Adjuvant treatments or closer follow-up monitoring might be considered in case of supraglottic involvement or perineural invasion. Level of Evidence: 4 Laryngoscope, 131:2262–2268, 2021

Use of complementary and alternative medicine (CAM) in cancer patients. An italian multicenter survey

INTRODUCTION: Complementary and Alternative Medicine (CAM) include a wide range of products (herbs, vitamins, minerals, and probiotics) and medical practices, developed outside of the mainstream Western medicine. Patients with cancer are more likely to resort to CAM first or then in their disease history; the potential side effects as well as the costs of such practices are largely underestimated. PATIENTS AND METHOD: We conducted a descriptive survey in five Italian hospitals involving 468 patients with different malignancies. The survey consisted of a forty-two question questionnaire, patients were eligible if they were Italian-speaking and receiving an anticancer treatment at the time of the survey or had received an anticancer treatment no more than three years before participating in the survey. RESULTS: Of our patients, 48.9% said they use or have recently used CAM. The univariate analysis showed that female gender, high education, receiving treatment in a highly specialized institute and receiving chemotherapy are associated with CAM use; at the multivariate analysis high education (Odds Ratio, (OR): 1.96 95% Confidence Interval, CI, 1.27-3.05) and receiving treatment in a specialized cancer center (OR: 2.75 95% CI, 1.53-4.94) were confirmed as risk factors for CAM use. CONCLUSION: Roughly half of our patients receiving treatment for cancer use CAM. It is necessary that health professional explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision

Antiblastic Treatment, for Solid Tumors, during Pregnancy: A Crucial Decision:

Cancer is the second leading cause of death during the reproductive years complicating between 0.02% and 0.1% of pregnancies. The incidence is expected to rise with the increase in age of childbearing. The most common types of pregnancy-associated cancers are: cervical cancer, breast cancer, malignant melanoma, Hodgkin's lymphoma, non-Hodgkin's lymphoma and ovarian cancer. The relatively rare occurrence of pregnancy-associated cancer precludes conducting large, prospective studies to examine diagnostic, management and outcome issues. The treatment of pregnancy-associated cancer is complex since it may be associated with adverse fatal effects. In pregnant patients diagnosed with cancer during the first trimester, treatment with multidrug anti-cancer chemotherapy is associated with an increased risk of congenital malformations, spontaneous abortions or fetal death, and therefore, should follow a strong recommendation for pregnancy termination. Second and third trimester exposure is not associated with teratogenic effect but increases the risk of intrauterine growth retardation and low birth weight. There are no sufficient data regarding the teratogenicity of most cytotoxic drugs. Almost all chemotherapeutic agents were found to be teratogenic in animals and for some drugs only experimental data exist. Moreover, no pharmacokinetic studies have been conducted in pregnant women receiving chemotherapy in order to understand whether pregnant women should be treated with different doses of chemotherapy. This article reviews the available data regarding the different aspects of the treatment of cancer during pregnancy