Oxidative stress neuroinflammation and cellular stress response in sensorineural hearing loss: novel nutritional therapeutical approaches

This study is intended to validate the hypothesis that changes in the redox state of glutathione, the major endogenous antioxidant, associated with the abnormal expression and activity of cytoprotective vitagenes, which in normal conditions are expressed only at low level may represent a critical factor, involved in the physiopathological changes associated to degenerative damage occurring in cochlear diseases. Moreover modulation of stress responsive vitagenes by nutritional antioxidants can be an effective therapeutic strategy to minimize consequences of oxidative stress associated to the pathogenesis and course of sensorineural hearing loss. One therapeutic approach can be antioxidant substances, as cisteina and superoxide dismutase supplementation to burst vitagenes and confer neuroprotection. The damage caused in the inner ear by oxidative stress can induce apoptosis and necrosis of both the hair cells as neurons of the spiral ganglion. Reactive oxygen species (ROS) and free radicals are formed not only as by-products of various metabolic pathways but also for exposure to ototoxic substances such as aminoglycosides and cisplatin, for hypoxia/ischemia and to exposure to noise. Although the mechanism of production of ROS within the cochlea has not yet been precisely identified, it is conceivable that mitochondrial dysfunction and consequent burst in oxidative stress are major causative factors. Consistent with this notion, it is known that the base of the cochlea is more vulnerable to oxidative damage resulted from exposure to ototoxic substances than the apical portions. The difference in survival between the basal outer hair cells and the apical ones appear to be due to a significantly lower level of glutathione in the basal outer hair cells than the apical, a phenomenon that makes it easier basal cells vulnerable to damage from free radicals. © Mattioli 188

Adaptive psychological structure in childhood hearing impairment: audiological correlations

La presente ricerca affronta i problemi clinici e sociali che riguardano lo sviluppo linguistico e cognitivo nei bambini sordi. Attualmente, lo sviluppo della Teoria della mente rappresenta un importante campo di ricerca nello studio della sordità. Questi studi internazionali hanno evidenziato nei bambini sordi una significativa alterazione nello sviluppo della Teoria della Mente, soprattutto in caso di perdita congenita o preverbale delludito. In particolare, la ricerca si concentra sulle competenze dei bambini sordi nel riconoscere emozioni e desideri, attraverso metodi sia cognitivi che percettivi, per la valutazione delle capacità psico-cognitiva attraverso una serie di domande composte da alcuni test adeguati, da somministrare ai pazienti con perdita uditiva. Lesperimento è stato condotto su un gruppo composto da 10 bambini (5 maschi e 5 femmine), di età compresa tra 4 e 9 anni e tra 54 e 108 mesi), affetti da perdita uditiva congenita bilaterale (da grave a cofosi), o da perdita uditiva preverbale sviluppata sia in bambini che attendono lultimo anno prima di frequentare la scuola elementare, sia in quelli che frequentano il quarto anno di scuola elementare. I criteri di selezione sono stati basati su: valutazione audiologica, somministrazione di test neuropsicologici al fine di valutare, in generale, le capacità cognitive e percettive e osservazioni cliniche effettuate, al fine di valutare la psicopatologia del campione, attraverso dei test che valutano più facilmente lo sviluppo sia della percettività visiva (Coloured Progressive Matrices), sia della rappresentazione grafica (Test di disegno sulla figura umana e il Test di disegno sulla famiglia). Lo strumento di misurazione cognitiva è stato il Deaf Children Series, test strutturato da noi, che consiste in un esame dello stato mentale (MSE), capace di valutare: il livello di capacità cognitiva (conoscenza-correlato), lumore e modelli di discorso e di pensiero di un paziente al momento della valutazione. I bambini sordi mostrano sul lato percettivo una sensibilità ridotta alle espressioni di tristezza. Nel test possiamo osservare un meccanismo di difesa psicodinamico per quanto riguarda la prestazione percettiva. Al contrario, per quanto riguarda i bambini normoudenti, la paura è lemozione più difficile da identificare. I bambini sordi sembrano essere maggiormente predisposti al riconoscimento di emozioni visive. Inoltre, i bambini sordi presentano notevoli capacità di problem solving, capacità di riconoscimento emotivo, probabilmente a causa del loro problema

Therapeutical innovations and medical responsibility: What's new in oto-laryngology

On one hand the incessant and constant technological and instrumental progress in the medical fieldhas allowed to increase knowledge and to reach new objectives. On the other hand, however, it has also raised the risk linked to professional responsibility, regarding informed consent and law 24/2017 of the Italian Republic, better known as Gelli Bianco. In this work an analysis of relevant literature will be presented, followed by a study on the role of new devices on responsibility profiles in otolaryngology. According to the analysis of the Italian law and considering the weaknesses ofthe above mentioned guidelines, pending legal administrative clarifications, we believe an operational protocol can be proposed in case of application of therapeutical innovations, especially about experimental introductions. Consequently, in our opinion, the risk of incrimination persists in case of use of innovative procedures in the absence of a formal shared opinion expressed in guidelines or in good practices, which still need a satisfactory definition

The European Association for the Study of Obesity (EASO) Endorses the Milan Charter on Urban Obesity

The Milan Charter on Urban Obesity highlights the challenges of urban environments as a battleground for human health, as cities are often organized to subvert public health goals, and promote rather than prevent the development of obesity and consequent non-communicable diseases. The Charter articulates ten principles which detail actions and strategies through which general practitioners, diverse medical specialists, related healthcare professionals, administrators and healthcare practice managers, policy actors - within health systems and at a national level - along with experts across disciplines, and citizens, can work in cooperation to meet this challenge and improve publichealth. The Charter urges the adoption of decisions that deliver the following: (i) policies which enable our cities to become healthier and less obesogenic, more supportive of well-being and less health-disruptive in general, and (ii) policies that fully support primary prevention strategies, that address social stigma, and that ensure fair access to treatment for people living with obesity. The Milan Charter on Urban Obesity aims to raise awareness of our shared responsibility for the health of all citizens, and focuses on addressing the health of people living with obesity - not only as a challenge in its own right, but a gateway to other major non-communicable diseases, including cardiovascular diseases, type 2 diabetes, and some cancers

The secretory senescence in otorhinolaryngology: Principles of treatment

Atrophy or hypofunction of the salivary gland because of aging, radiotherapy or disease causes hyposalivation and impairs the quality of life of patients by compromising mastication, swallowing and speech and by leading to a loss of taste. Moreover, hyposalivation exacerbates dental caries and induces periodontal disease, and oral candidiasis. Currently, no satisfactory therapies have been established to solve salivary hypofunction. Current treatment options for atrophy or hypofunction of the salivary glands in clinical practice are only symptomatic and include saliva substitutes and parasympathetic agonists, such as pilocarpine, to stimulate salivary flow. However, parasympathomimetics have systemic side effects, so different treatment options are necessary, and research has recently focused on this. The main strategies that have been proposed to restore salivary gland atrophy and hypofunction are gene therapy by gene activation/silencing during stem cell differentiation and by the use of viral vectors, such as adenoviruses; cell-based therapy with salivary gland cells, stem cells and non-salivary gland and/ or non-epithelial cells to regenerate damaged salivary gland cells; replacement with tissue bioengineering in which organoids from pluripotent stem cells are used in the development of organ replacement regenerative therapy. Remarkable progression in this research field has been made in the last decade, but a definitive therapy for salivary gland hypofunction has not been developed due to intrinsic challenges that come with each approach. However, with research efforts in the future, a range of precision medicine therapies may become available individualized to each patient

Re‐Thinking the Environment, Cities, and Living Spaces for Public Health Purposes, According with the COVID‐19 Lesson: The LVII Erice Charter

Urban planning is a key tool to promote health in cities. The COVID-19 emergency accelerated several social, environmental, and digital challenges, stressing the importance of some issues regarding housing, urban mobility, green areas, and health service networks, urban health policies, and actions. These issues were the subject of an intensive residential course (the 57th) held in Erice, Sicily, in June 2021 in the “International School of Epidemiology and Preventive Medicine G. D’Alessandro”, and the main findings are described here. Methods. Lectures presented the topics, subsequently developed them, and argued them in parallel practical sessions using the World Café technique, since it is well suited for the interaction of participants and the involvement of groups. Results. The World Café provides new insights into how to improve the livability and health of urban spaces, and a set of strategies and actions were proposed for each topic. Discussion and Conclusions. All attendees agreed on the importance of participation in the planning processes, but also on the need for strong political support to ensure the resources needed and a full integration of health with other local policies. A multidisciplinary approach to developing systemic operational capacities and health literacy is considered pivotal to raising awareness and participation

A new histological method to study oral soft tissue penetrability to iodine and optimize oral use of iodine solutions

The aim of this work is to establish a histological method to fix iodine inside slides of treated oral mucosa more permanently in order to allow section counterstaining and facilitate improved clinical and experimental studies on iodine penetration. Transforming iodine into a stable histological formation inside tissues is particularly useful for histological analysis of clinical and experimental iodine treatments. In the field of oncology, this method can be applied to povidone-iodine-treated (human or animal) mucosa or skin, to organs treated with iodine tincture or Lugol’s solution, to oral lesion detection and to mucogingival junction identification