Otoneurological and Postural Assessment in Blind Scuba Divers

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an unusual combined parotideal and neck abscess case report

Abstract Cervical and parotideal abscess is a rare finding in all populations and even more so in the paediatric population. The antibiotic resistance of the bacteria that cause these diseases can make it very dangerous. We present a paediatric case in which there is a combined left-cervical and parotideal abscess in a female 3-month-old baby who presented fever, pain and cervical swelling

Teaching in schools of specialization: problems and the possible solutions

Teaching of anatomy in post-graduate schools that request it is particularly difficult for the number of hours available, the need not to repeat arguments already addressed in the degree course in medicine, to stimulate the interest of doctors in training and provide anatomical knowledge which are not detached from the clinical practice. To overcome these difficulties we have used in the teaching of anatomy of the post-graduate schools of the neurological-neurosurgical areas and of laryngology-phoniatry a didactic approach, which illustrate, verified for its effectiveness with an evaluation questionnaire submitted to the doctors in training at the end of the course. The essential points of the teaching are: monographic lectures on topics of anatomy related to the clinical field of specific specialization. Treatment of the subjects starting from neurological syndromes or complex brain functions of clinical relevance the understanding of which involves learning of a set of anatomical structures (eg language and cranial nerve, paralytic syndromes associated of the cranial nerves etc).The educational cycle is completed inviting the doctors to present to colleagues and to the professor the anatomical correlates of a published case report, provided to them at the end of the lesson. The teaching of the anatomy that we have illustrated is different from that which is evident from the texts available of clinical neuroanatomy, which treated anatomy of brain regions or of functional systems and reported medical cases that seek to exercise the clinical reasoning ,which purpose is not relevant to the teaching of anatomy .In conclusion even if our didactic approach is limited to some medical specializations and tested on a small number of doctors in training we suggest it as an alternative way to teach anatomy in postgraduate schools

Correlation Between Dysphagia and Malocclusion in Rett Syndrome: A preliminary study

Objectives: Rett syndrome (RS) is a severe neurological developmental disorder characterised by stereotypical hand movements, epileptic seizures, craniofacial dysmorphism and digestive dysfunction. This study aimed to examine the correlation between the severity of malocclusion and dysphagia in patients with RS. Methods: This preliminary study was conducted at the Ear, Nose & Throat Clinic of the University Hospital of Siena, Siena, Italy, from January 2014 to December 2017. A total of 56 patients with RS were examined and grouped according to the severity of dysphagia (absent, mild, moderate or severe) and malocclusion (4 mm). Results: All of the patients were female and the mean age was 11.3 years. Eight (14.3%) patients had mild, 18 (32.1%) had moderate and 30 (53.6%) had severe dysphagia. Four (7.1%) patients had 4 mm occlusion. Mild dysphagia was observed in 100% and 40% of patients with 4 mm malocclusion, respectively. There was a significant correlation between dysphagia and malocclusion severity (P <0.001). Conclusion: A higher degree of malocclusion was associated with more severe dysphagia among a cohort of patients with RS. Keywords: X-Linked Mental Retardation; Rett Syndrome; Dysphagia; Malocclusion; Feeding and Eating Disorders of Childhood

Giant acquired tracheocele in a syndromic child: Case report and review of the literature

We report a case of acquired tracheocele in a child with multiple congenital anomalies of the face, limbs, kidneys, and heart, to share our experience with international scientific community, considering the rarity of the disease especially in the pediatric population. Patientâs history reported a tracheotomy at one month of life that was closed at 3 years old. Ten years later, the patient come to us for an anterior cervical mass swelling during respiratory effort and chronic productive cough. The diagnosis was made by high resolution Computed Tomography scan of the neck and chest and an elective surgical resection of the lesion under general anesthesia was done

Determinants of frontline tyrosine kinase inhibitor choice for patients with chronic-phase chronic myeloid leukemia: A study from the Registro Italiano LMC and Campus CML

Background: Imatinib, dasatinib, and nilotinib are tyrosine kinase inhibitors (TKIs) approved in Italy for frontline treatment of chronic-phase chronic myeloid leukemia (CP-CML). The choice of TKI is based on a combined evaluation of the patient's and the disease characteristics. The aim of this study was to analyze the use of frontline TKI therapy in an unselected cohort of Italian patients with CP-CML to correlate the choice with the patient's features. Methods: A total of 1967 patients with CP-CML diagnosed between 2012 and 2019 at 36 centers throughout Italy were retrospectively evaluated; 1089 patients (55.4%) received imatinib and 878 patients (44.6%) received a second-generation (2G) TKI. Results: Second-generation TKIs were chosen for most patients aged &lt;45 years (69.2%), whereas imatinib was used in 76.7% of patients aged &gt;65 years (p&nbsp;&lt;&nbsp;.001). There was a predominant use of imatinib in intermediate/high European long-term survival risk patients (60.0%/66.0% vs. 49.7% in low-risk patients) and a limited use of 2G-TKIs in patients with comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease, previous neoplasms, ischemic heart disease, or stroke and in those with &gt;3 concomitant drugs. We observed a greater use of imatinib (61.1%) in patients diagnosed in 2018-2019 compared to 2012-2017 (53.2%; p&nbsp;=&nbsp;.002). In multivariable analysis, factors correlated with imatinib use were age &gt; 65 years, spleen size, the presence of comorbidities, and ≥3 concomitant medications. Conclusions: This observational study of almost 2000 cases of CML shows that imatinib is the frontline drug of choice in 55% of Italian patients with CP-CML, with 2G-TKIs prevalently used in younger patients and in those with no concomitant clinical conditions. Introduction of the generic formulation in 2018 seems to have fostered imatinib use

Analysis of Early Events during the First Year of Tyrosine Kinase Inhibitor Therapy in Patients with Chronic Phase - Chronic Myeloid Leukemia: A "Campus CML" Study

Tyrosine kinase inhibitors (TKIs) revolutionized treatment of chronic myeloid leukemia (CML). However, the rst months of therapy are crucial, as optimal response is dened as the achievement of molecular milestones at 3, 6 and 12 months (mo.) and as many toxicities, also causing a TKI switch, are more frequent in the 1st yea

La proteina TAU nel secreto nasale dei pazienti anosmici con malattia di Alzheimer: primi risultati e possibili nuove prospettive.

Introduzione: Negli ultimi anni sono descritti disturbi olfattivi In una vasta gamma di disturbi neurologici come il morbo di Alzheimer. Le placche neurofibrillari, uno dei segni patognomonici del morbo di Alzheimer sono stati identificati all'interno del bulbo olfattivo, del nucleo olfattivo anteriore della corteccia entorinale e dell’amigdala. La gravità della demenza è stata correlata con il numero di placche neurofibrillari presenti all'interno di tali siti. Materiali e metodi: Sono stati arruolati 25 soggetti adulti (17 maschi e 8 femmine) con età media di 72,3 anni aventi una precedente diagnosi neurologica di malattia di Alzheimer in sbase ai criteri della Stroke-Alzheimer’s Disease and Related Disorders Association. Come gruppo di controllo, sono stati arruolati 13 soggetti adulti (8 maschi e 5 femmine) con età media di 26,1 anni con nessuna storia di malattia nasale, deficit dell’olfatto e patologia neurologica. Ogni soggetto ha firmato un consenso informato e si è quindi sottoposto alla valutazione ORL mediante anamnesi, esame obiettivo mediante rinoscopia anteriore e fibroscopia nasale, rinomanometria anteriore attiva con test di decongestione nasale, olfattometria eseguita mediante Sniffin’ Sticks®. Infine ogni soggetto è stato poi sottoposto a lavaggio nasale eseguito con dispositivo Rinowash© per doccia nasale micronizzata. Sono state dosate le proteine TAU presenti nei lavaggi nasali utilizzando due differenti test: INNOTEST® hTAU Ag e INNOTEST® PHOSPHO-TAU (181P). Risultati: Livelli significativamente elevati di proteina tau e tau fosforilata sono stati rilevati in quasi tutti i pazienti anosmici. Tutti i controlli erano negativi nel dosaggio della proteina tau tranne uno, il cui livello di proteina tau fosforilata era di 70-90 pg/ml. Conclusioni: I nostri dati, pur trattandosi di primi risultati, danno una prova sulla presenza di proteine tau e tau fosforilate nella secrezione nasale ottenuta da pazienti con malattia di Alzheimer. Uno studio multicentrico internazionale è auspicabile, naturalmente, per aumentare la serie di soggetti e per confermare i nostri risultati; tuttavia il modo semplice per testare i livelli di proteina TAU e la produzione di proteine TAU fosforilate e i risultati che abbiamo ottenuto, rende possibile mettere in evidenza il possibile ruolo, come strumento diagnostico precoce, del dosaggio della proteina TAU nel lavaggio nasale combinato con olfattometria clinica