Early assessment of vestibular function after unilateral cochlear implant surgery

Introduction : Cochlear implantation (CI) has been reported to negatively effect on the vestibular function. The study of the vestibular function has variably been conducted by different types of diagnostic tools. The combined use of modern, rapidly performable diagnostic tools could reveal useful for standardizing the evaluation protocol. Methods: In a group of 28 subjects undergoing CI, the video Head Impulse Test (vHIT), the cervical Vestibular Evoked Myogenic Potentials (cVEMPS) and the short-form of Dizziness Handicap Inventory (DHI) questionnaire were investigated pre-operatively and post-operatively (implant on and off) in both the implanted and the contralateral, non-implanted ear. All surgeries were performed with a round window approach (RWA), except for three otosclerosis cases were the extended RWA (eRWA) was used. Results: The vHIT of the lateral semicircular canal showed a pre-operative vestibular involvement in nearly 50% of the cases, whilst the three canals were contemporarily affected in only 14% of them. In all the hypo-functional subjects, cVEMPs were absent. A low VOR gain in all the investigated SSCC was found in 4 subjects (14%). In those subjects, (21.7%) in whom cVEMPs were pre-operatively present and normal in the operated side, absence of response was post-operatives recorded. Discussion/Conclusion: The vestibular protocol applied for the study showed to be appropriate for distinguishing between the CI operated and the non-operated ear. In this regard, cVEMPs showed to be more sensitive than vHIT for revealing a vestibular sufferance after CI, although without statistical significance. Finally, the use of the RWA surgery was apparently not avoiding signs of vestibular impairment to occur

Quality of life and psychological impact in patients with atopic dermatitis

Atopic dermatitis (AD) is a dermatological disorder that affects patients' mental health and psychological state in complex ways. The importance of understanding the entire scope of this burden is well recognized, but there is limited comprehensive information about the resulting stress on adult patients with AD. This study aimed to determine the degree of psychological stress in patients with AD compared to healthy participants. A total of 352 adult patients participated in this cross-sectional study-174 with AD and 178 healthy participants. Demographic and clinical data were collected. Itch and sleep disturbance were assessed using a numeric rating scale and a visual analogue scale. The 20-item Toronto Alexithymia Scale (TAS-20) and Beck Depression Inventory (BDI) questionnaires were administered to assess the symptoms of alexithymia and depression. Quality of life (QOL) was assessed in AD patients using the Dermatology Quality Index. In our study, we found high TAS-20 and BDI scores among patients with AD. The prevalence of alexithymic personality features was 56.3% in patients with AD versus 21.3% in healthy controls (p < 0.001). Based on BDI scoring (BDI-21 > 13), depression was suspected in a significantly higher number of patients with AD than in the control group (56.9% (99/174) vs. 15.7% (28/178); p < 0.0001). Eczema Area and Severity Index (EASI) score did not show any significant correlations with psychological parameters. Among clinical parameters, only sleep disturbance was positively correlated with depression (R = 0.307, p < 0.005). Our data show that the severity index score as a representative factor of skin involvement has a limited role in predicting the effect of skin diseases on mental status. Screening and assessment for psychiatric disorders, QOL, and sleep disturbance in patients with atopic dermatitis cannot be neglected by physicians and they should be treated in clinical practice with the consideration of psychosomatic approaches

Factors associated with dog behavioral problems referred to a behavior clinic

Undesirable behaviors are common in the domestic dog population. This study aimed to identify similarities and differences in characteristics underlying 2 major groups of behavioral problems, and their treatment outcome. The study focused on 335 dogs that visited a Behavioral Clinic in northern Italy between 2013 and 2016. These cases were categorized into 2 broad groups based on the diagnosis: an \u201caggressive\u201d group (behavioral pathologies involving aggression) and an \u201canxious\u201d group (behavioral pathologies not primarily involving aggression). Each dog underwent a behavior consultation made by a veterinary specialist who used a basic history questionnaire focused on all aspects of dog's behavior, management, and health issue. Several variables were selected from the questionnaires collected. We found a statistical association of the behavioral problem with factors such as size, sex, age, time of onset, dogs' resting place, family composition, and mounting behaviors involving people (P 64 0.05). Small- and medium-sized dogs were mainly \u201canxious\u201d instead of \u201caggressive\u201d; male dogs were mostly \u201caggressive\u201d and female dogs (neutered and intact) were mainly \u201canxious\u201d; dogs adopted from pet shops were all anxious. On average, \u201caggressive\u201d dogs exhibited the problem 4 months after adoption. \u201cAnxious\u201d dogs exhibited the problem within 1 week of adoption. The resting place and diagnosis were statistically related (P 64 0.05): the 20% of dogs that slept on owners' bed were mainly \u201canxious\u201d dogs (78% of these). Sixty-five percent of \u201canxious\u201d dogs and 33% of \u201caggressive\u201d dogs showed mounting behaviors toward people. Most (72.3%) (N = 242/335) of the dogs improved after behavior treatment. \u201cAggressive\u201d dogs (96%, N = 232/242) improved more than \u201canxious\u201d ones (4%; N = 10/242) (P 64 0.05). Moreover, owners of dogs with anxiety problems were significantly more prone to surrender the dog to a shelter or other people (P 64 0.05). Our work supports some previous findings and suggests some new information regarding factors associated with broad scale aggression and anxiety in domestic dogs. Anxiety problems appear more difficult and demanding for dog owners. A referral population is not likely representative of the entire population of dogs. To understand patterns of behavioral problems, we need more complete population data and we need data from dogs across their lifetime

Methods and advanced Equipment for Simulation and Treatment in Radiation Oncology: programa MAESTRO

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Allelic Variants of HLA-C Upstream Region, PSORS1C3, MICA, TNFA and Genes Involved in Epidermal Homeostasis and Barrier Function Influence the Clinical Response to Anti-IL-12/IL-23 Treatment of Patients with Psoriasis

Several biologic therapies have been developed to treat moderate-to-severe psoriasis, with patients exhibiting different clinical benefits, possibly due to the heterogeneity of pathogenic processes underlying their conditions. Ustekinumab targets the IL-12/IL-23-p40 subunit and inhibits type-1 and type-17 T-cell responses. Although ustekinumab is effective as both short- and long-term treatment, therapeutic response varies considerably among patients. Ustekinumab biosimilars will be commercialized in the very next future, likely broadening the use of this drug in the treatment of psoriasis patients. Our pharmacogenomic study evaluated the influence of 417 single-nucleotide polymorphisms (SNPs) in psoriasis-risk alleles on the clinical response to ustekinumab in a cohort of 152 patients affected by moderate-to-severe plaque-type psoriasis. Differences in SNP pattern characterizing HLA-Cw6(+) or HLA-Cw6(-) patients, showing high or low responses to ustekinumab, were also analysed. We identified twelve SNPs in HLA-C upstream region (rs12189871, rs4406273, rs9348862 and rs9368670), PSORS1C3 (rs1265181), MICA (rs2523497), LCE3A-B intergenic region (rs12030223, rs6701730), CDSN (rs1042127, rs4713436), CCHCR1 (rs2073719) and in TNFA (rs1800610) genes associated with excellent response to ustekinumab. We also found that HLA-Cw6(+) and HLA-Cw6(-) patients carried out distinct patterns of SNPs associated with different clinical responses. The assessment of HLA-C alleles, together with other genetic variants, could be helpful for defining patients who better benefit from anti-IL-12/IL-23 therapy

Guselkumab for treatment of moderate-to-severe plaque psoriasis: real-life effectiveness and drug-survival for up to 148 weeks

Background: Real-world data are useful to guide the management of psoriasis. Here, we present data on the effectiveness and survival of guselkumab in moderate-to-severe chronic plaque psoriasis for up to 148 weeks. Research design and methods: Cross-sectional study of 122 patients receiving guselkumab (100 mg at weeks 0 and 4, and then every 8 weeks thereafter) for>12 weeks, from November 2018 to April 2022. Main outcome measures: Clinical features and drug survival were analyzed up to 148 weeks. Results: Obese patients (32.8%) and those receiving prior biologics (64.8%) were included. Guselkumab treatment was associated with a rapid decrease in PASI, from 16.2 to 3.2 at week 12, and long-term improvements in all subgroups (97.6%, 82.9%, and 63.4% of patients, respectively, achieved PASI 75, 90, and 100 after 148 weeks). More non-obese than obese patients achieved PASI 100 at week 148 (86.4% vs 38.9%), as did bio-naïve vs bio-experienced patients (86.7% vs 50.0%). Previous biologic therapy was a negative prognostic factor for achieving PASI 100 over the long-term by multivariate analysis (p = 0.005). Overall, 96% of patients were on treatment after 2 years. Conclusions: Real-world data confirm the long-term effectiveness of guselkumab in patients with psoriasis

Proton imaging apparatus for protontherapy application

Radiotherapy with protons, due to the physical properties of these particles, offers several advantages for cancer therapy as compared to the traditional radiotherapy with photons. In the clinical use of proton beams, a pCT (proton Computed Tomography) apparatus can contribute to improve the accuracy of the patient positioning and dose distribution calculation. In this paper a pCT apparatus built by the PRIMA (PRoton IMAging) Italian Collaboration will be presented and the preliminary results will be discussed