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

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

Evaluation of Clinical and Ultrasonographic Parameters in Psoriatic Arthritis Patients Treated with Adalimumab: A Retrospective Study

Objectives. The aim of this study was to evaluate clinical and US-PD parameters in PsA during adalimumab treatment. Methods. A retrospective study has been conducted in forty patients affected by moderate-to-severe peripheral PsA. Clinical, laboratory, and US-PD evaluations were performed at baseline, after 4, 12, and 24 weeks of treatment. They included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analogue scale (VAS), Health Assessment Questionnaire (HAQ) modified for Spondyloarthritis, Psoriasis Area Severity Index (PASI) score, the 28-joint Disease Activity Score (DAS 28), and US-PD assessment. US-PD findings were scored according to a semiquantitative scale (ranging 0–3) for synovial proliferation (SP), joint effusion (SE), bone erosions (BE), and PD. Results. Data obtained for clinical, laboratory findings and US-PD evaluation showed statistical significant improvement in all the measures performed except for BE. A significant parallel decrease in SE, SP, and PD values were demonstrated. Conclusion. This study demonstrated that US-PD is a valid technique in monitoring the response to adalimumab in moderate-to-severe PsA

Efalizumab

Introduction: Conventional systemic therapies for psoriasis are associated with serious toxicities that can limit long-term use. In recent years, biological therapies have offered the possibility of long-term therapy with improved safety and efficacy for the treatment of psoriasis. Biological therapies can be classified into three categories: the T-cell modulating agents (alefacept and efalizumab), the inhibitors of TNF-alpha (adalimumab, etanercept, infliximab) and the inhibitors of IL-12 and -23 (ustekinumab). Efalizumab is a humanized recombinant monoclonal IgG1 antibody. It targets multiple stages in the immunopathogenesis of psoriasis: initial T-cell activation, migration of T-cells into dermal and epidermal tissues, and T-cell reactivation. On 19 February 2009, the Committee for Medicinal Products for Human Use (CHMP) recommended the suspension of the marketing authorisation for efalizumab.Areas covered: Numerous clinical trials have demonstrated the efficacy, safety and health-related quality of life benefits of efalizumab in patients with moderate-to-severe chronic plaque psoriasis. Efalizumab was approved by the FDA in November 2003 and by the European Medicines Evaluation Agency in September 2004 for the treatment of adult patients with moderate-to-severe chronic plaque psoriasis. Recently, three cases of progressive multifocal leukoencephalopathy were described in patients on long-term (> 3 years) efalizumab therapy, leading to its withdrawal from the market.Expert opinion: Although initially favorable, the safety profile of efalizumab revealed the appearance of severe adverse events in long-term treated patients. Therefore, post-marketing surveillance is essential for correct evaluation of drug potential

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

Effect of Felisept spray® on signs of travel anxiety in cats

Car transport can be stressful for cats. Most frequently reported symptoms are vocalisations, restlessness, panting, trembling, salivation and vomiting1. These symptoms could be fear induced as a result of insufficient or bad experiences with car transport, but they could also result from motion sickness. However, the distinction between these two diagnosis is not very clear. Little research has been published on this area2,3. This study aims to evaluate the effects of the Felisept spray\uae on signs of travel-related problems in cats. 10 cats (6 males and 4 females) of different breeds, aged between 2 and 13 years, referred for problems when transported by car, were recruited. Owners were asked to fill in a questionnaire in order to understand cat behaviour during travel. Each cat was then filmed during two car transports of 15 min. The first transport was a routine transportation (baseline trial), in the second one Felisept\uae was sprayed in the pet carrier 10 minutes before the travel (treatment trial). An additional questionnaire was used to investigate cat behaviour during the treatment trial. The questionnaires analysis showed that vocalizations, tail close to body and mydriasis decreased after the administration of Felisept spray\uae (Wilcoxon, p<0.05), while panting and swallowing tend to decrease (Wilcoxon, p=0.66). Video analysis showed that restlessness, crouched position and mydriasis decreased after the administration of Felisept spray\uae (Wilcoxon, p<0.05). These results suggest that the use of Felisept\uae spray in the pet carrier 10 minutes before the transport could decrease transport-related signs of stress in cats

Erythrodermic psoriasis treated with ustekinumab: An Italian multicenter retrospective analysis

Erythrodermic psoriasis (EP) is one of the most severe cutaneous conditions which may lead to serious morbidity and even mortality. This condition is often difficult to manage and, due to its rarity (estimated prevalence 1–2.25% of psoriatic patients) there is a lack of high-quality medical literature examining treatment options [1]

PRIMA+: A proton Computed Tomography apparatus

The proton Computed Tomography (pCT) is a medical imaging method, based on the use of proton beams with kinetic energy of the order of 250 MeV, aimed to directly measure the stopping power distribution of tissues thus improving the present accuracy of treatment planning in hadron therapy. A pCT system should be capable to measure tissue electron density with an accuracy better than 1% and a spatial resolution better than 1 mm. The blurring effect due to multiple Coulomb scattering can be mitigated by single proton tracking technique. As a first step towards pCT the PRIMA+ Collaboration built a prototype capable to carry out a single radiography and a tomographic image of a rotating object. This apparatus includes a silicon microstrip tracker to identify the proton trajectory and a YAG:Ce calorimeter to measure the particle residual energy