Nasolacrimal duct obstruction: the relationship with nasal allergy

Abstract Nasolacrimal duct obstruction (NLDO) is a common event in clinical practice. The authors, all members of the Italian Society of Rhinology, analysed 100 cases from different ENT Departments. The causes of NLDO, according to the etiology, can be divided into two classes: idiopathic primary acquired nasolacrimal duct obstruction and secondary. The aim of the study was to describe an association between the sign and symptoms of chronic rhinosinusitis and a complaint of epiphora

Risk of falls, vestibular multimodal processing, and multisensory integration decline in the elderly-Predictive role of the functional head impulse test

Age-related degeneration of the vestibular system, also known as presbyastasis, leads to unstable gait and higher risk of falls. These conditions affect lifestyle and may have non-negligible social repercussions due to fear-related states of anxiety and depression. In order to develop a model for predicting risk of falls, we assessed vestibulo-ocular function by video and functional Head Impulse Tests (vHIT and fHIT) and their possible correlations with Tinetti Balance Test score. Thirty-one patients over 65 years of age admitted with trauma due to falls were recruited. Vestibular evaluation (complete otoneurological assessment, vHIT, fHIT), cognitive tests (Mini Mental State Examination), anxiety and depression evaluation and Tinetti Balance Test were performed. The possibility of a correlation between the head impulse tests (vHIT, fHIT) and the Tinetti Balance Test was investigated by logistic regression analysis (Nagelkerke r(2) and Wald test). A linear correlation was found between the Tinetti Balance Test score and fHIT, whereas no correlation was found for vHIT. Functional HIT is an effective test for predicting the risk of falls in elderly patients

Il ruolo del functional HIT nella diagnosi della presbiastasia

La presbiastasia può essere definita come l’instabilità, statica o dinamica, secondaria all’invecchiamento degli organi centrali e periferici, responsabili del mantenimento dell’equilibrio. Il disequilibrio è un problema comune nell’anziano. In molti studi è stato dimostrato che un disturbo dell’equilibrio, tale da richiedere l’intervento medico, è presente in 1/3 dei pazienti sopra i 60 anni, fino ad arrivare a ½ nei pazienti sopra gli 85 anni. I problemi dell’equilibrio, infatti, rappresentano, soprattutto nell’anziano un importante problema sociale, in quanto sono correlati ad un aumento del rischio cadute e fratture, con limitazioni dell’attività fisica, importanti ripercussioni psicosociali ed elevati costi sanitari. Spesso le cause di vertigine sono multifattoriali e specialmente nell’anziano i sintomi non sono specifici rispetto ai pazienti giovani. Alla base del fenomeno, non c’è solo la perdita di funzione vestibolare, visiva e propriocettiva, ma anche l’alterazione delle vie integrative nervose centrali. In letteratura il rischio caduta dell’anziano è stato correlato a numerosi fattori di rischio quali: storia di precedenti cadute; paura di cadere; polifarmacoterapie e assunzione di farmaci particolari (quali sedativi e ipnotici, narcotici, anticonvulsivanti, antidepressivi, psicotropi, cardiovascolari, diuretici, antiipertensivi); alterazione della mobilità; alterazione della vista; rischi domestici; isolamento sociale. Ancora poco studiato è il ruolo dell’apparato vestibolare sulle cadute. I tests ideali per valutare il rischio di caduta dovrebbero essere semplici, brevi e ripetibili per permettere il follow-up. Tra questi, il Tinetti Balance Test può essere considerato uno tra i miglior strumenti per valutare il rischio caduta nell’anziano. Prevede di assegnare un punteggio all’equilibrio statico del soggetto, prima seduto e poi in piedi, e all'andatura. Allo stato attuale, nello studio dei pazienti con disequilibrio, rimane centrale lo studio del riflesso vestibolo-oculare (ocular vestibular reflex: VOR) La valutazione del riflesso vestibolo-oculare può essere effettuata con alcuni test strumentali, tra i quali i principali sono: il video HIT (vHIT) e il functional HIT (fHIT). Abbiamo esaminato un campione di pazienti sopra i 65 anni, suddividendoli in due gruppi in base a riferite cadute negli ultimi 5 anni, tali da richiedere l’intervento medico. Abbiamo escluso pazienti con patologie vestibolari acute in atto quali neuriti vestibolari, malattia di Ménière e vertigini parossistiche benigne. In tutti i pazienti abbiamo eseguito il Tinetti Balance Test, il fHIT e il vHIT. Inoltre abbiamo somministrato dei questionari quali i Dizzness Handicap Inventory (DHI) e lo Hospital Ansiety and Depression Scale (HADS) per valutare la disabilità indotta dalle vertigini, dall’ansia e dalla depressione sul rischio caduta. La compromissione cognitiva è stata valutata con il Mini-Mental Test. Abbiamo trovato una correlazione diretta tra rischio cadute, punteggi al Tinetti Balance Test < 24 e punteggi al fHIT≤80%. Il rischio caduta non è correlato ad alterazioni del vHIT, del DHI, dello HADS e del Mini-Mental Test. Il fHIT si è dimostrato un utile test diagnostico, di semplice esecuzione, nello studio del paziente anziano a rischio caduta e apre la strada a nuovi trattamenti riabilitativi e preventivi

Managing turbinate hypertrophy: coblation vs. radiofrequency treatment

The role of inferior turbinate hypertrophy in the reduction of nasal airflow is well established. Although chronic nasal obstruction is not life- threatening, it significantly impairs patients\u2019 quality of life, affecting many aspects of daily activities; therefore, patients seek medical intervention. 40 patients were selected (27 males and 13 females) between 27 and 64\ua0years of age with a symptom of nasal obstruction. The patients were divided in two groups: Group 1: coblation, 25 patients (18 males and 7 females); Group 2: radiofrequency, 15 patients (7 males and 6 females). These 40 patients were followed for 3\ua0years. Patients were analyzed using both subjective and objective methods. The visual analog scale (VAS) subjective data and objective data including both active anterior rhinomanometry and acoustic rhinometry were recorded and analyzed. Data were collected pre-operatively and at 1 and 3\ua0years post-operatively. According to our data, both coblation and radiofrequency turbinate reduction benefit patients with good results. The complications, found during the follow-up, are limited to minimal bleeding and crusting. Coblation and radiofrequency were significantly less painful than others procedures during the early post-operative period. In our study, both coblation and radiofrequency provide an improvement in nasal airflow with a reduction in nasal obstructive symptoms in the short term, but their efficacy tended to decrease within 3\ua0years

Manganês na nutrição e na produção de massa seca do capim-mombaça

There are few studies that relate the micronutrient manganese nutritional status and production of fodder. The objective was to evaluate the application of manganese in the nutrition and growth of Mombaca grass. The completely randomized design was used with five manganese levels (0, 15, 30, 60, 120 mg dm(-3)) and four replicates. Each experimental unit consisted of a pot filled with 3.5 dm(-3) of soil from Oxisol (Mn = 0.6 mg dm(-3)), containing four plants. Two harvests were set, the first 44 days after sowing and the second 38 days after the first cut. The concentration of manganese in the soils, the manganese content of leaves, number of tillers, plant height, shoot dry mass in each slice and the root system of Mombaca grass were evaluated. The applied rates of manganese resulted in increased accumulation of Mn in the plant, and there was an increase in dry mass of Mombaca grass, with maximum production, obtained from derivation, of 5.9 and 6.3 g plant(-1) for levels of 121 and 71 mg dm(-3) of Mn in the first and second cut respectively. The Mombaca grass has showed high manganese's tolerance, the critical level of toxicity was 841 mg kg(-1) in the second cut.São poucos os estudos que relacionam o micronutriente manganês com o estado nutricional e a produção de forrageiras. Objetivou-se avaliar o efeito da aplicação de manganês na nutrição e no crescimento do capim Mombaça durante dois ciclos de produção. O delineamento experimental foi inteiramente casualizado, constituídos de cinco doses de manganês (0, 15, 30, 60, 120 mg dm-3) e quatro repetições. Cada unidade experimental foi constituída de um vaso preenchido com 3,5 dm3 de terra proveniente de um Latossolo Vermelho distrófico (Mn = 0,6 mg dm-3), contendo quatro plantas. Realizou-se dois cortes, o primeiro aos 44 dias após a semeadura e o segundo 38 dias após o primeiro corte. Avaliaram-se a concentração de manganês no solo, o teor de manganês foliar, o número de perfilhos, altura de plantas, massa seca da parte aérea em cada corte e do sistema radicular. As doses de manganês aplicadas proporcionaram aumento no acúmulo de Mn na planta, bem como houve incremento na produção de massa seca do capim Mombaça, com produção máxima de 5,9 e 6,3 g planta-1, para as doses de 121 e 71 mg dm-3 de Mn, nos primeiro e segundo cortes respectivamente. O capim Mombaça apresentou alta tolerância ao manganês, tendo como nível crítico de toxicidade 841 mg kg-1, ocorrido apenas no segundo corte da forrageira

Investigation of an international water polo tournament in Czechia as a potential source for early introduction of the SARS-CoV-2 Omicron variant into Belgium, Switzerland and Germany, November 2021.

BackgroundThe earliest recognised infections by the SARS-CoV-2 Omicron variant (Pango lineage B.1.1.529) in Belgium and Switzerland suggested a connection to an international water polo tournament, held 12-14 November 2021 in Brno, Czechia.AimTo study the arrival and subsequent spread of the Omicron variant in Belgium and Switzerland, and understand the overall importance of this international sporting event on the number of infections in the two countries.MethodsWe performed intensive forward and backward contact tracing in both countries, supplemented by phylogenetic investigations using virus sequences of the suspected infection chain archived in public databases.ResultsThrough contact tracing, we identified two and one infected athletes of the Belgian and Swiss water polo teams, respectively, and subsequently also three athletes from Germany. In Belgium and Switzerland, four and three secondary infections, and three and one confirmed tertiary infections were identified. Phylogenetic investigation demonstrated that this sporting event played a role as the source of infection, but without a direct link with infections from South Africa and not as a superspreading event; the virus was found to already be circulating at that time in the countries involved.ConclusionThe SARS-CoV-2 Omicron variant started to circulate in Europe several weeks before its identification in South Africa on 24 November 2021. Accordingly, it can be assumed that travel restrictions are usually implemented too late to prevent the spread of newly detected SARS-CoV-2 variants to other regions. Phylogenetic analysis may modify the perception of an apparently clear result of intensive contact tracing.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Influência de métodos de debicagem e do tipo de bebedouro no desempenho e na qualidade dos ovos de codornas japonesas Beak trimming method and drinking system and a their effect on the performance and egg quality of japanese quails

Com o objetivo de avaliar o efeito da debicagem e do tipo de bebedouro sobre o desempenho produtivo de codornas japonesas, 672 fêmeas de codornas de um dia foram usadas em um delineamento inteiramente casualizado e distribuídas em um dos três tratamentos como não-debicagem; debicagem até 1/3 dos bicos; e cauterização, com oito repetições de 28 aves na fase de cria. As aves foram debicadas aos 21 dias de idade e, no 35 dia, foram avaliados o ganho de peso, o consumo de ração, a conversão alimentar e a taxa de mortalidade. Aos 39 dias, 576 codornas foram remanejadas para gaiolas de postura, distribuídas em esquema fatorial 3 × 2, composto de três tipos de debicagem e dois tipos de bebedouro (taça e nipple), de modo que cada combinação foi avaliada com quatro repetições de 24 aves. A fase de produção teve início quando as aves atingiram 50% de produção de ovos, aos 60 dias de idade. As codornas submetidas a debicagem por cauterização apresentaram menor ganho de peso e menor consumo de ração na fase de cria. O estresse pela dor com a debicagem por cauterização pode justificar não só o menor consumo e o menor ganho de peso, como também a maior mortalidade. Infere-se que este método, por ser mais demorado, tenha provocado mais dor e maior nível de estresse, piorando o desempenho das aves. A debicagem de 1/3 dos bicos cortados pode ter ocasionado estresse menos intenso às aves, não interferindo no desempenho. Não se observaram diferenças no desempenho das aves e na qualidade de ovos entre os tipos de bebedouro e métodos de debicagem utilizado na fase de produção. O método de debicagem por cauterização influencia o desempenho de codornas na fase de cria, mas, na fase de produção, assim como o tipo de bebedouro utilizado, não interfere no desempenho das aves nem na qualidade de ovos.<br>A total of 672 one day old- female quails was allotted to a completely randomized experimental design, with three treatments (non-trimmed birds; 1/3 of the beak trimmed and cauterized beak), 8 replicates of 28 birds to evaluate the effect of beak trimming and drinking system on productive performance. The birds were beak trimmed at 21 days of age, and at day 35 the weight gain, feed intake, feed conversion and mortality were evaluated. At day 39, 576 quails were transfered to laying cages, and assigned to a 3x2 factorial arrangement, to evaluate three beak trimming methods and two drinking systems (cup and nipple) by using four replicates of 24 birds each. The production phase started when the birds reached 50% egg production, at 60 days of age. The quails submitted to beak trimming by cauterization showed smaller weight and lower feed intake during the initial period. Stress pain due to the cauterized beak can justify not only lower feed intake and lower weight gain, but also increased mortality. It can be inferred that once this method takes more time it has caused more pain and higher levels of stress, worsening the performance of birds. The trimmed to 1/3 of the beaks cut can have caused stress to the birds less intense, without effect on performance. No differences on bird performance and egg quality were observed between drinking systems and beak trimming during the laying phase. In the initial phase, beak trimming system reduced performance, however, during the production phase, both drinking and beak trimming systems do not affect performance and egg quality of Japanese quails