Inflammation, underweight, malignancy and a marked catabolic state as predictors for worse outcomes in COVID-19 patients with moderate-to-severe disease admitted to Internal Medicine Unit

Introduction: During COVID-19 pandemic, Internal Medicine Units (IMUs) accounted for about 70% of patients hospitalized. Although a large body of data has been published regarding the so-called first wave of the pandemic, little is known about the characteristics and predictors of worse outcomes of patients managed in IMUs during the second wave. Methods: We prospectively assessed demographics, comorbidities, treatment and outcomes, including ventilation support (VS) and death, in patients admitted to our IMU for SARS-CoV-2 between October 13th, 2020 and January 21st, 2021. Clinical evolution and biochemical testing 1, 7 and 14 days after COVID-19 diagnosis were recorded. Results: We studied 120 patients (M/F 56/64, age 71±14.5 years) admitted to our IMU. Most of them had at least one comorbidity (80%). Patients who died were older, more frequently underweight, affected by malignant neoplasms and on statin therapy compared to patients eventually discharged. Both worse outcome groups (VS and death) presented higher neutrophils, ferritin, IL-6 and lower total proteins levels than controls. Age was significantly associated with mortality but not with VS need. The multivariate analysis showed age and gender independent association of mortality with underweight, malignancy and antibiotics use at the admission. With regard to biochemical parameters, both unfavourable outcomes were positively associated with high WBC count, neutrophils, blood urea nitrogen and low serum total proteins. Conclusions: Our study identified inflammation, underweight, malignancy and a marked catabolic state as the main predictors for worse outcomes in COVID-19 patients admitted to IMU during the so-called second wave of the pandemic

LACK OF AN ASSOCIATION BETWEEN INHERITED THROMBOPHILIC RISK FACTORS AND IDIOPATIC SUDDEN SENSORINEURAL HEARING LOSS IN ITALIAN PATIENTS

Objectives: We investigated the presence of congenital thrombophilic risk factors in a population of consecutive Italian patients affected by idiopathic sudden sensorineural hearing loss (SSNHL). Methods: We investigated 48 patients with idiopathic SSNHL for the presence of congenital thrombophilic risk factors. The factor V Leiden G1691A, the prothrombin G20210A allele, and methylenetetrahydrofolate reductase (MTHFR) C677T genotypes were investigated. Allele frequencies and genotype distribution of all factors found in patients were compared to those of 48 healthy subjects of the same ethnic background by Chi2 and odds-ratio analysis. Odds ratios and 95% confidence intervals were calculated for allele and genotype frequencies of all thrombophilia variants. Statistical significance was accepted with a p value of less than .05. We also performed the following blood tests: hemacytometric analysis including platelet count, prothrombin time, activated partial thromboplastin time, fibrinogen, erythrocyte sedimentation rate, C-reactive protein, protein S, protein C, antithrombin III, and activated protein C resistance. Results: In our series, we did not find an association between SSNHL and abnormal levels of antithrombin III, protein C, protein S, D-dimer, or fibrinogen; activated protein C resistance; or factor V G1691A, prothrombin G20210A, or MTHFR C677T mutations. Conclusions: At present, the few studies regarding genetic polymorphisms of congenital thrombophilic factors in SSNHL are not conclusive. According to our data, factor V G1691A, prothrombin G20210A, and MTHFR C677T variants should be not considered risk factors for SSNHL. Further large prospective studies are needed to provide currently lacking information and to improve our knowledge in the field before we recommend the determination of genetic polymorphism in SSNHL as routine practice

Coenzyme Q 10 and Cardiovascular Risk Factors in Idiopathic Sudden Sensorineural Hearing Loss Patients.

OBJECTIVES:: We investigated the association of idiopathic sudden sensorineural hearing loss (ISSNHL) with coenzyme Q (CoQ) and cardiovascular risk factors. STUDY DESIGN:: A prospective study. SETTING:: Hospital center. PATIENTS:: Thirty Italian patients with ISSNHL and 60 healthy Italian subjects. INTERVENTION:: Diagnostic. MAIN OUTCOME MEASURE:: Evaluation of serum CoQ levels and cardiovascular risk factors (total cholesterol, low-density lipoprotein [LDL], homocysteine [HCY]). The results were compared with variance analysis and Student's t test. Univariate and multivariate analysis were used to evaluate the association between ISSNHL and CoQ, total cholesterol, LDL, and HCY levels. RESULTS:: In our series, we found a significant association between ISSNHL and high total cholesterol (p < 0.05), high LDL (p = 0.021), and low CoQ (p < 0.05) levels. We did not find a significant association between ISSNHL and HCY levels. In the univariate analysis, low levels of CoQ, high levels of total cholesterol, and LDL were found to be significantly associated with ISSNHL. In the multivariate analysis, only high levels of total cholesterol and low levels of CoQ remained significantly associated with a high risk of sudden sensorineural hearing loss. CONCLUSION:: The studies regarding the role of cardiovascular risk factors in ISSNHL are not conclusive. This is the first report regarding the association of ISSNHL and low serum levels of the antioxidant CoQ. Further studies are needed toinvestigate the role of antioxidants, including CoQ, in ISSNHL

Glutathione s-transferase gene polymorphisms in italian patients with sudden sensorineural hearing loss.

HYPOTHESIS: To investigate the association between glutathione S-transferase (GST) gene polymorphisms and sudden sensorineural hearing loss (SSNHL) in a population of consecutive Italian patients. Assuming that reactive oxygen species formation may play a role in inner ear damage, we investigated whether profiles of GSTs antioxidant enzymes M1 and T1 genotypes may be associated with the risk of SSNHL. STUDY DESIGN: A prospective study in patients with SSNHL. PATIENTS AND METHODS: We investigated 80 Italian patients with SSNHL for the frequency of GSTT1 and GSTM1 polymorphisms. Genotype distribution of all factors found in patients were compared with those of 80 healthy control subjects of the same ethnic background using chi and odds-ratio analysis. Statistical significance was accepted at a level of p < 0.05. RESULTS: In our series, the frequencies of GSTM1 and GSTT1 null genotypes did not differ from those of the control subjects. CONCLUSION: The few studies regarding genetic polymorphisms of GSTs in SSNHL are not conclusive. Further studies are needed to investigate the role of antioxidants including GSTs in SSNHL and to provide the lacking information to improve our knowledge in the field before implementing the use of genetic polymorphism in the SSNHL medicine daily practice

Coeliac disease and hearing loss: Preliminary data on a new possible association.

Objective. Coeliac disease (CD), an autoimmune gluten-dependent enteropathy, can be associated with several extra-intestinal manifestations, including neurological disorders. At present, no data are available on the presence of hearing loss disorder in coeliac patients. The aim of the present study was to investigate the prevalence of hearing loss in coeliac patients compared with that in healthy controls. Material and methods. Twenty-four adult coeliac patients and 24 healthy subjects matched for gender, age, smoking and drinking habits were enrolled in the study. Among the coeliac patients, 6 were newly diagnosed and 18 patients were on a gluten-free diet for at least one year. Results. A hearing loss was found in 10 (47.1%) coeliac patients and 2 (9.1%) healthy controls. All CD patients with hearing loss presented a sensorineural hearing loss. The prevalence of hearing loss was significantly higher in coeliac patients than in healthy controls (p=0.01) but it was not significantly different between untreated (33.3%) and treated (44.4%) coeliac patients (p: NS). Conclusions. Despite the low number of subjects evaluated, the present study showed a higher prevalence of hearing loss in coeliac patients than in healthy controls, suggesting an association between CD and hearing loss. Immunological processes such as ear-specific and non-specific autoantibodies and vasculitis could be the basis of this association. Further longitudinal investigations on a larger sample size will be necessary to confirm the present data

Educazione, scuola e pedagogia nei giornali quotidiani dell'Italia di oggi: sentieri spesso interrotti

Il file esamina il modo in cui sono trattati i temi dell'educazione e dlela scuola in tre quotidiani di rilevanza nazionale

Sudden cochlear hearing loss as presenting symptom of arachnoid cyst of the cranial posterior fossa

Arachnoid cysts account for almost 1% of neoformations located in the cerebellopontine angle. The aetiopathogenesis is unknown. Arachnoid cysts of the cranial posterior fossa may produce symptoms typical of a tumour such as headache, dizziness, tinnitus and progressive sensorineural hearing loss. Management of these lesions is still controversial; if the arachnoid cyst is symptomatic, surgical treatment is usually recommended. The case is described of an adult female with sudden unilateral cochlear hearing loss as presenting symptom of an arachnoid cyst in the cranial posterior fossa

SUDDEN SENSORINEURAL HEARING LOSS AS PRESENTING SYMPTOM OF MULTIPLE SCLEROSIS IN A 15 YEAR-OLD GIRL

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I-Media-Cities: A Digital Ecosystem Enriching A Searchable Treasure Trove Of Audio Visual Assets

Abstract of paper 0108 presented at the Digital Humanities Conference 2019 (DH2019), Utrecht , the Netherlands 9-12 July, 2019

LOW SERUM FOLATE LEVELS: A RISK FACTOR FOR SUDDEN SENSORINEURAL HEARING LOSS?

OBJECTIVE: Ischemic vascular damage of the inner ear is one of the known causes of sensorineural sudden hearing loss (SSHL). Folate is an emerging risk factor associated with an increased risk of vascular damage. The aim of this study was to investigate whether low serum folate levels are associated with SSHL. MATERIAL AND METHODS: Serum folate levels were determined in 43 patients with SSHL and in 24 controls. RESULTS: Folate levels were found to be significantly lower in SSHL patients than in controls (mean difference -1.96 ng/ml; 95% CI -3.31, -0.59 ng/ml; p = 0.006). No significant relationship between folate levels and either sex, age, cigarette smoking, alcohol consumption or hypertension was observed, while a significant relationship was found between low folate levels and high homocysteine (HCY) levels in all 43 patients (p < 0.01). The potential influence of low folate levels on hearing impairment in SSHL patients can be explained by the effects on HCY metabolism and the diminution of folate antioxidant capacity. CONCLUSION: Further studies are needed to elucidate whether low folate levels can be considered a risk factor for SSHL