Observational study on risk factors determining residual dizziness after successful benign paroxysmal positional vertigo treatment: The role of subclinical BPPV

After successful treatment for benign paroxysmal positional vertigo, many patients may complain of residual dizziness. Possible explanations may be the persistence of otolith into canal insufficient to provoke noticeable nystagmus, utricular dysfunction and undiagnosed coexisting vestibular disorder. We conducted a prospective observational case-control study, focusing on the role of risk factors in determining residual dizziness after BPPV treatment. In the present study, 148 patients were recruited and residual dizziness was documented in the 57.5% of the cohort. Among patients with residual dizziness 36 had subclinical BPPV and after retreatment, although nystagmus was not clinically evident, there was resolution of dizziness. We conclude that residual otoliths may play a role in determining post-maneuver residual dizziness that is often linked to subclinical BPPV; this conclusion is also supported by the high prevalence of BPPV recurrence in patients with residual dizziness, as confirmed by our analysis. The main cause appears to be linked with dispersed otolith in semicircular canals

VALUE-BASED EVIDENCES TO FACE THE NEW CHALLENGES OF HEALTH PROMOTION IN A SUSTAINABLE HEALTHCARE SYSTEM

Thirty years ago, starting from a new awareness of the limits of biomedical power and healthcare services to solve all population\u201f health problems, the Ottawa Conference coined a New Public Health by defining Health Promotion (HP) as \u201cthe process of enabling people to increase control over and to improve their health and well-being\u201d. Since then and over the next 30 years, several programs have been developed all over the world to translate HP concepts into practical actions and many health successes have been achieved as well. Nowadays, even if the global health context has strongly changed, the original principles of HP still provide a solid ground for action, being the community engagement and empowerment of women and men still at the heart of any health strategy, in a shared responsibility of all society\u201fs sectors approach. However, since now HP promotion efforts have been directed toward priority health problems in a issue- settings-based approach, but in a sustainable and ethical prospective this will be not enough now: a deeper attention on effectiveness is request and an evidence- and value-based HP approach is needed to support the Public Health community and the policy-making, including the new challenges related to Public Health Genomics

Night-time shift work and related stress responses: A study on security guards

Work-related stress can induce a break in homeostasis by placing demands on the body that are met by the activation of two different systems, the hypothalamic\u2013pituitary\u2013adrenal axis and the sympathetic nervous system. Night-shift work alters the body\u2019s exposure to the natural light\u2013 dark schedule and disrupts circadian (daily) rhythms. The greatest effect of night-shift work is the disruption of circadian rhythms. The impact that these disruptions may have on the pathogenesis of many diseases, including cancer, is unknown. This study aims to discover the relationship among three different job activities of security guards and their stress-related responses by evaluating salivary cortisol levels and blood pressure. Methods: Ninety security guards, including night-time workers and night-time and daily-shift workers, were recruited for this study. Each security guard provided two saliva samples before and after three scheduled time points: (i) at 22:00, (ii) at 06:30, and (iii) at 14:00. Results: The results of the study showed a significant alteration in cortisol levels. Night-time shift cortisol levels significantly increased before and after the work shifts. A physiological prevalence of the vagal tone on the cardiocirculatory activity was found during night-shift work. Conclusions: This study indicates that cortisol levels and blood pressure are sensitive markers of biological responses to severe work stress. Shift-change consequences may occur at the end of the night shift when there is a significant increase in the cortisol level and a significant variation in cardiovascular parameters

Funnel plots and choropleth maps in cancer risk communication: a comparison of tools for disseminating population-based incidence data to stakeholders

Background: Population-based cancer registries provide epidemiological cancer information, but the indicators are often too complex to be interpreted by local authorities and communities, due to numeracy and literacy limitations. The aim of this paper is to compare the commonly used visual formats to funnel plots to enable local public health authorities and communities to access valid and understandable cancer incidence data obtained at the municipal level. Methods: A funnel plot representation of standardised incidence ratio (SIR) was generated for the 82 municipalities of the Palermo Province with the 2003 2011 data from the Palermo Province Cancer Registry (Sicily, Italy). The properties of the funnel plot and choropleth map methodologies were compared within the context of disseminating epidemiological data to stakeholders. Results: The SIRs of all the municipalities remained within the control limits, except for Palermo city area (SIR=1.12), which was sited outside the upper control limit line of 99.8%. The Palermo Province SIRs funnel plot representation was congruent with the choropleth map generated from the same data, but the former resulted more informative as shown by the comparisons of the weaknesses and strengths of the 2 visual formats. Conclusions: Funnel plot should be used as a complementary valuable tool to communicate epidemiological data of cancer registries to communities and local authorities, visually conveying an efficient and simple way to interpret cancer incidence data

EUROMEDITERRANEAN BIOMEDICAL JOURNAL: THE RENEWED MANUSCRIPT LAYOUT AND WEB RENDERING FORESHADOW FURTHER JOURNAL IMPROVEMENT

In January 2006, a new journal, Capsula Eburnea, was born into the Italian scientific publishing scene with the initial goal of creating, at the same time, \u201can open scientific forum and a blog\u201d, based on the premise that \u201cin medicine, nothing should be considered stable, immutable or unsusceptible to critical review at any time, by any scientist\u201d. The Editorial Team progressively sought to improve the quality of the manuscripts published, introducing the requirement for all articles to be written in English, and changed the Journal\u2019s name to EuroMediterranean Biomedical Journal in 2012. Over the last five years, approximately 125 articles by young doctors (including original articles, reviews, commentaries, notes, and abstract books) have been published. The editorial board are confident that the new publishing layout and the renewed web-portal of the journal, introduced in this editorial, represent an essential upgrade after over 10 years of editorial activity, and that these improvements will be appreciated by our authors and, especially, our readers

Illicit drugs consumption evaluation by wastewater-based epidemiology in the urban area of Palermo city (Italy)

Introduction. A wastewater-based epidemiology approach was performed to estimate the drug consumption in Palermo city, the fifth largest city of Italy with a population of 671 696 inhabitants, and to investigate the monthly variability of drug loads in wastewater from different areas of the city. A seven-months detection campaign was conducted at the two wastewater treatment plants of the city. Methods. Following a pre-treatment, 32 samples of wastewater were analyzed by liquid chromatography-tandem mass spectrometry. Results. We estimated a mean cocaine use in Palermo of 0.19 g/day/1000 people, corresponding to 1.90 doses/1000 people and cannabinoids use of 2.85 g/day/1000 people, corresponding to 35.62 doses/1000 people. Amphetamines residues in wastewater were always recovered in concentrations lower than the limit of quantification. Conclusion. Our findings showed that drugs consumption in Palermo is in line with those of other Italian cities and that no significant differences on prevalence on cocaine and cannabinoids consumption were recorded in the different months of the survey, except for the summer period in a wastewater treatment plant of the city