Standardised surface electromyography allows effective submental muscles assessment

The aims of this pilot study were to evaluate: (i) the reproducibility and variability of an electromyographical protocol developed for the assessment of submental muscles (SM) (ii) to apply the new protocol to maximal teeth clenching, a simple and largely studied static task in order to quantify the relative contribution of submental muscles. In 20 healthy subjects, aged 19-35years, surface electromyography of SM, masseter (MM) and anterior temporalis (TA) muscles was performed during maximal voluntary clenching (MVC) with and without cotton rolls and the pushing of the tongue against the palate. Clenching on cotton rolls and pushing the tongue against the palate were used to standardise respectively MM and TA, and SM muscular potentials. The exercises were repeated in two appointments (T1-T2); submental muscles standardisation was also repeated twice (A-B) in each session to assess repeatability. Symmetry and activity were calculated for each couple of muscles. A two-way analysis of variance was computed for SM: no Factor 1 (T1 vs T2) or Factor 2 (A vs B) or F1 7F2 significant effects were found. SM recruitment was 31% of the maximal activity, with symmetry values larger than 80%. In conclusion, standardised electromyography allows a reliable assessment of Submental muscles activity

Influence of energy cost and physical fitness on the preferred walking speed and gait variability in elderly women

Typically gait speed decreases and gait variability increases in elderly. The aim of this study was to define the influence of energy cost of walking on gait speed and of health-related physical fitness on gait variability. Thirty healthy young and older women were recruited in the study. Energy cost of walking (NetCW) was analyzed with indirect calorimetry while a kinematic analysis was performed with an optoelectronic system to calculate gait variability (GV) during treadmill walking at different speeds. Gait speed was defined as the preferred walking speed (PWS) of the subject and health related physical fitness (HRPF) comprised body fat, strength, flexibility, and cardiorespiratory fitness. In healthy elderly women, the coefficient of variation of step width was found to be a better indicator of GV than stride time, stride length and double support coefficients of variation. GV was not affected by age allowing a high PWS. Furthermore, significant associations, adjusted for age, body mass index and number of falls, were identified neither between NetCW and the PWS, nor between HRPF and GV; only a significant association was found between hand-grip strength and gait stability. Findings highlighted the importance to evaluate hand-grip strength as an indicator of gait efficiency

Effectiveness of omalizumab in a patient with severe asthma and atopic dermatitis

The anti-IgE antibody omalizumab is currently indicated in severe asthma not controlled by standard drug therapy. Recently, new indications for omalizumab were suggested, which include atopic dermatitis (AD), a skin disorder characterized by elevated levels of IgE. We report the case of a 39-year old woman with severe asthma and severe AD, both resistant to conventional drug treatment. The patient had a IgE level of 1304 kU/L, which exceeded the recommended maximum level for treating asthma with omalizumab (stated in 700 Ku/L) but was far lower than previously reported in cases of AD treated with anti-IgE. The treatment consisted of a dose of omalizumab 375 mg every two weeks, and induced a rapid improvement of asthma, with no need of other drugs after three months, along with a progressive decline of severity of AD, which after five months was completely cured. These findings suggest the usefulness of omalizumab in patients with concomitant severe asthma and AD, also considering the pharmaco-economic balance obtained by withdrawing the multiple drugs used to treat both diseases

Minilaparoscopic Versus Open Pyeloplasty in Children Less Than 1 Year

Purpose: The aim of this study is to compare minilaparoscopic (MLS) and open pyeloplasty (OP) in children <1 year in terms of intra- and perioperative outcomes and esthetic results. Materials and Methods: Patients <1 year of age, with prenatal hydronephrosis, who underwent Anderson-Hynes pyeloplasty for monolateral ureteropelvic junction obstruction (UPJO) at our center from January 2016 to August 2017 were enrolled in the study. Outcomes evaluated were as follows: operative time, length of hospital stay, and postoperative pain anterior-posterior pelvic diameter (APD) reduction. The Vancouver Scar Scale (VSS) was utilized to evaluate esthetic results. Mean follow-up was 26.5 months. Results: Eighteen patients (11M, 7F) of mean age 8.1 months (range 4-12) and mean weight 8.5 kg (range 7-10) underwent Anderson-Hynes pyeloplasty in the study period. Nine of eighteen underwent OP, and 9/18 underwent MLS. Mean operative time was 167 minutes for MLS versus 153 minutes for OP (P = .14). Mean hospital stay was 3.9 days for MLS versus 5.3 days for OP (P = .11). Mean APD reduction was 13.6 mm for MLS and 16.5 mm for OP procedures (P = .63). Mean VSS score was 1.3 for VLS versus 3.4 for OP (P = .04). Conclusions: MLS pyeloplasty is feasible and safe, and reported equivalent results as open procedure for management of UPJO also in toddlers and infants. We found that the only significant difference between the two approaches in children <1 year was represented by the esthetic outcome in the short follow-up period

Kinematic evaluation of physical impairments of an elite Paralympic karateka

Karate is a Japanese martial art that counts millions of practitioners worldwide and that is spreading also in Paralympic competitions, requiring accurate categories definition for disabled athletes. The aim of the study is to present kinematic data of an elite Paralympic karateka, in comparison with able-bodied athletes. The authors also aim to promote a better classification within the discipline, based on objective biomechanical evaluations of physical impairments. A male black belt Paralympic karateka (age: 36 y; body weight: 75.5 kg; height: 173 cm) with lower limbs impairments was evaluated. The athlete had been performing high level karate for 20 years before the disability took place. After the post-operative rehabilitation, he attended 3/4 sessions of para- karate training per week. He performed a standardized sequence of movements, involving a sequence of offensive and defensive techniques, (kata) from traditional Shotokan karate. Joints and body Center of Mass (CoM) kinematics were collected with an optoelectronic motion capture system and compared with those obtained in two groups of able-bodied (elite and amateurs) athletes from a previous study1. Knee angular range of motion (RoM) and peak angular velocity were obtained. Coordinates of CoM were estimated, using the Segmental Centroid Method2, along with CoM average velocity and acceleration. To assess differences between Paralympic karateka and able-bodied groups, the one-sample t-test was performed. The sequence performed by the karateka lasted more than in both able-bodied groups. CoM average velocity and acceleration decreased in comparison with elite karateka. Knees range of movement and peak angular velocity were similar to amateur but lower than elite athletes. Results show that the physical impairments negatively affected the function of lower limbs in the Paralympic athlete. Fundamental skills in karate elite performance (dynamic balance control and joint RoM and angular velocity) were reduced

Influence of biological maturation on postural control in young soccer players

Biological maturation does not follow a linear development path; the process presents inter- individual differences concerning the timing of psychophysical development. The nonlinear nature of the biological maturation process often results in sudden and rapid modifications that can influence the sensorimotor functions, in particular when the peak height velocity (PHV) is approaching. Static standing balance and postural control are fundamental skills, both for daily living and sport performance, that can be strongly affected by PHV. We examined the influence of biological maturation on the performance of static standing balance, an index for sensorimotor control. Two-hundred and 38 young healthy soccer players (U9 to U17), playing in a sub-\ue9lite club (at least two training sessions and an official match per week), were evaluated. After anthropometric measurement, standing balance was assessed using a baropodometric platform (BTS P-Walk, Italy). Subjects stood barefooted on the platform and were recorded at 20 Hz during two 30-s tests, the first with eyes open and the second keeping eyes closed. Participants were split into six groups based on the Maturity Offset (MO), representing the estimated time to/from the PHV and calculated according to Mirwald et al1. The body center of pressure (CoP) sway area and velocity were calculated. Differences between MO groups were tested using a 2-factor (MO and condition) ANOVA with repeated measures on the condition factor (eyes open/closed). The sway area showed a decreasing trend as the MO increased, in particular in MO&lt;-1.5 was higher than in MO&gt;0.5 (p&lt;0.001). Likewise, CoP velocity presented a similar pattern (p&lt;0.001), with a marked decline in groups with MO&gt;0.5. The results suggest that biological maturation is associated with changes in standing balance control. The reduction of CoP sway area and velocity as the MO increase represents the improved efficiency of the postural control system

Anatomical variants of sphenoid sinuses pneumatisation: a CT scan study on a Northern Italian population

Sphenoid bone may be affected by different variants of pneumatisation, which have a relevant importance from a clinical and surgical point of view. The description of such variants in different populations may give useful information. However, few articles describe the variability of sphenoid pneumatised structures and none of them focuses on Northern Italian population. Variants of pneumatisation of sphenoid bone were described in a sample of 300 Northern Italian patients who underwent a CT scan. More than fifty-seven percent of patients showed a form of anatomical variant: the most common form was the pneumatised pterygoid processes (39.6%), followed by dorsum sellae (32.9%) and clinoid processes (20.3%), without statistically significant differences between males and females (p\ua0>\ua00.01). In 26.3% of patients, a combined pneumatisation of these three structures was observed, being the combination pterygoid processes-dorsum sellae the most frequent (11.3%). In 9.3%, all the three sphenoid structures were affected. This article is the first description of the prevalence of different variants of pneumatisation in a Northern Italian population: the occurrence of such forms has to be acknowledged for their possible clinical and surgical consequences

Anatomical Characteristics Of Intrapetrous Carotid Artery : A 3d Segmentation Study On Head Ct-Scan

The intrapetrous portion of internal carotid artery (IPCA) is one of the most unexplored anatomical regions, and its three-dimensional reconstruction in living subjects is still missing. The present study aims at describing IPCA on 3D models extracted from head CT-scans. The intrapetrous carotid artery was manually segmented on head CT-scans of 100 healthy patients free from vascular and neurological pathologies (50 males and 50 females aged between 18 and 91 years). Angles of the posterior and anterior genu, diameter and length of the horizontal portion, and volume of the entire canal were calculated through VAM\uae software. Statistically significant differences according to sex and side were assessed through two-way ANOVA test (p&lt;0.05). Correlation of each measurement with age was calculated as well. On average the angles of the posterior and anterior genu were 120.1\ub110.4\ub0 and 118.0\ub110.0\ub0 in males, 119.5\ub19.2\ub0 and 117.6\ub110.3\ub0 in females, respectively, without statistically significant differences according to sex or side (p&gt;0.05). Average length and diameter of the horizontal part were respectively 25.5\ub12.9 mm and 5.8\ub10.8 mm in males, 24.0\ub12.3 mm and 5.3\ub10.8 mm in females. The volume of IPCA was 0.941\ub10.215 cm3 in males, and 0.752\ub10.159 cm3 in females. Length and diameter of horizontal portion, and volume of IPCA showed statistically significant differences according to sex (p&lt;0.05). No correlation with age was found. This study first provided data concerning not only linear and angular measurements, but also volumes of IPCA, useful in planning surgical interventions of the cranial base