Somatic tinnitus

Modulation of tinnitus characteristics such as pitch and loudness has been extensively described following movements of the head, neck and limbs, vertical or horizontal eye gaze, pressure on myofascial trigger points, cutaneous stimulation of the hands, electrical stimulation of the median nerve, and transcranial direct current stimulation. Modulation of tinnitus follows complex interactions between auditory and somatosensory afferents and can be favored by underlying somatic disorders. When tinnitus appears to be preceded or strictly linked to a somatic disorder, and therefore related to problems of the musculoskeletal system rather than of the ear, it is defined somatic tinnitus. A correct diagnosis and treatment of somatic disorders underlying tinnitus play a central role for a correct management of somatic tinnitus. However, the identification of somatic tinnitus may be complex in some cases. In this paper, after a general review of the current evidences for somatic tinnitus available in the literature, we present and discuss some cases of patients in which somatic modulation of tinnitus played a role - although different from case to case - in their tinnitus, describing the diagnostic and therapeutic approaches followed in each individual case and the results obtained, also highlighting unexpected findings and pitfalls that may be encountered when approaching somatic tinnitus patients

Locally advanced leiomyosarcoma of the spleen. A case report and review of the literature

<p>Abstract</p> <p>Background</p> <p>Leiomyosarcomas are rare tumours, predominantly localized in the stomach, small intestine and retroperitoneum. Only one case of primary leiomyosarcoma of the spleen is described in human beings in literature.</p> <p>Case presentation</p> <p>We report a case of locally advanced primary leiomyosarcoma of the spleen in a 54 year-old woman, diagnosed only after splenectomy, performed with the suspicion of splenic haematoma.</p> <p>Conclusion</p> <p>Due to the lack of cases, no specific chemotherapy regimen has been tested to provide a longer survival.</p

CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

Systematic Review and meta-analysis of the prevalence of overweight and obesity among school-age children in Italy

Objective: the objective of the study was to obtain reliable data from recent surveys carried out in Italy on the prevalence of overweight (OW) and obesity (OB) in children. Design: we searched in MEDLINE/Pubmed and Scopus. The keywords included "over-weight", "obesity", "children", "aged 6-11 years", "Italy", associated to the boolean operators AND/OR. The limits applied to the research were: English AND/OR Italian language, publication time period January 2000-September 2010, target of 6-11 years; Body Mass Index assessed according to IOTF criteria. StatsDirect 2.7.8 was utilized to perform statistical analysis. Results: 25 studies have been select, the percentage of overweight varied between 18% and 33,7% and obesity between 5,5% and 21,9%. The highest values were in Southern Italy (OW: 25,6%, CI95% 24,8-26,3; OB: 15,2%, CI95 % 13-17,5) vs Central Italy (OW: 22,6%, CI95% 21-24,1; OB: 9,3%, CI95% 7,9-10,7) vs Northern Italy (OW: 21%, CI95% 19,6-22,3; OB: 8,2%, CI95% 6,8-9,7). Conclusion: a relevant prevalence of overweight and obesity was found In Italian children; the excess weight concerns one child out of four. There are significant differences in the prevalence of overweight and obesity in relation to geographical distribution (Northern, Central and Southern Italy), the high prevalence of overweight and obesity resulted statistically significant in the Southern compared to Central and Northern Italy. These differences are likely linked to different geographical areas in relation to socioeconomic and environmental condition that must be further investigated. There is a need of promoting better eating habits in young children in Italy, above all in areas with highest prevalence.OBJECTIVE: The objective of the study was to obtain reliable data from recent surveys carried out in Italy on the prevalence of overweight (OW) and obesity (OB) in children. DESIGN: We searched in MEDLINE/Pubmed and Scopus. The keywords included "overweight ", "obesity", "children", "aged 6-11 years", "Italy", associated to the boolean operators AND/OR. The limits applied to the research were: English AND/OR Italian language, publication time period January 2000-September 2010, target of 6-11 years; Body Mass Index assessed according to IOTF criteria. StatsDirect 2.7.8 was utilized to perform statistical analysis. RESULTS: 25 studies have been select, the percentage of overweight varied between 18% and 33,7% and obesity between 5,5% and 21,9%. The highest values were in Southern Italy (OW: 25,6%, CI95% 24,8-26,3; OB: 15,2%, CI95% 13-17,5) vs Central Italy (OW: 22,6%, CI95% 21-24,1; OB: 9,3%, CI95% 7,9-10,7) vs Northern Italy (OW: 21%, CI95% 19,6-22,3; OB: 8,2%, CI95% 6,8-9,7). CONC

Qualità della vita e attività fisica nei trapiantati di fegato: risultati di uno studio pilota caso-controllo.

OBBIETTIVI: Il trapianto epatico è diventato un trattamento comunemente utilizzato per la malattia epatica in fase terminale e dell’insufficienza epatica acuta. La maggior parte della letteratura nazionale e internazionale riporta un miglioramento della vita dopo il trapianto. Tuttavia, i pazienti possono presentare una limitazione delle attività fisiche, sociali e disagi della sfera emotiva con una conseguente qualità di vita inferiore rispetto alla popolazione generale. L’obiettivo dello studio è la valutazione della qualità della vita e dell’attività fisica dei trapiantati di fegato in confronto con la popolazione generale. MATERIALI E METODI: Lo studio pilota con disegno caso-controllo è stato realizzato tramite la somministrazione di due questionari (SF-36, IPAQ) a un campione di 54 pazienti sottoposti a trapianto di fegato con tecnica Piggyback tra il 2002 ed il 2009. Il gruppo di controllo è stato estratto dalla popolazione generale afferente agli ambulatori di ortopedia del policlinico “Umberto I” di Roma. RISULTATI: Sono stati intervistati 54 pazienti sottoposti a trapianto di fegato e 108 controlli, per un totale di 162 responders con un’età media di 55 anni. Il livello d’istruzione del gruppo di controllo è notevolmente superiore rispetto ai casi (25% dei controlli ha conseguito la laurea rispetto all’1.9% dei casi). Il livello educativo è decisivo per il PCS (punteggio per la salute fisica), che risulta più basso nei trapiantati (x=46.02 vs x=47.27 dei controlli). L’analisi univariata mette in evidenza differenze significative per alcune scale del questionario SF-36. In particolare, i trapiantati di fegato, rispetto ai controlli, presentano valori più bassi per PF (attività fisica; p=<0.001), RP (limitazioni di ruolo dovute alla salute fisica; p=0.029), RE (limitazioni di ruolo dovute allo stato emotivo; p=0.043) e MH (salute mentale; p=0.03). Le scale dello SF-36 sono influenzate, soprattutto, dal dispendio energetico totale (Met_totale) e dall’essere “caso”. CONCLUSIONI: Dalla presente indagine emerge una minor indipendenza dei soggetti trapiantati (81.5% non vive da solo vs 77.8% del gruppo di controllo), un basso livello d’istruzione, valori inferiori di MCS (punteggio per la salute mentale) e PCS. Tali risultati sono alla base di una valutazione negativa della qualità di vita dei trapiantati rispetto alla popolazione generale. Il trapianto di fegato determina una serie di benefici, ma i problemi di natura fisica e sociale persistono per alcuni pazienti. Interventi volti a migliorare i programmi di riabilitazione, un regolare supporto psico-sociale e follow-up in tutte le fasi della terapia possono consentire ai pazienti uno stile di vita post-trapianto più soddisfacente

Quality of life and physical activity in liver transplantation patients: results of a case-control study in Italy.

The aim of the study was to assess the quality of life (QOL) and the physical activity of liver transplant recipients compared with the general population. The case-controlled pilot study was accomplished through the administration of 2 questionnaires: 36-item Medical Outcomes Study, Short-Form General Health Survey (SF-36) for quality of life (10 scores) and International Physical Activity Questionnaire (IPAQ) to estimate the physical activity (metabolic equivalent score). Fifty-four patients who underwent liver transplantation using the piggyback technique and 108 controls from the general population at the orthopedic ambulatories were enrolled between 2002 and 2009. Participants had a mean age of 55 years (range, 41-73). The multivariate analysis showed significant differences for some scales of the SF-36: liver transplant recipients displayed lower values for "Mental Composite Score" (P = .043), "physical activity" (P = .001), "role limitations due to physical health" (P = .006), "role limitations due to the emotional state" (P = .006), and "mental health" (P = .010). The metabolic equivalent positively associated with all examined SF-36 scales. The present study focused on the QOL and physical activity of liver transplant recipients, demonstrating that transplant recipients scored lower than the general population. Liver transplantation may allow full recovery of health status, but the physical and social problems persist in some patients. Interventions aimed at improving rehabilitation programs, regular psychosocial support, and follow-up in all phases of treatment may give patients a more satisfying lifestyle after transplantation. © 2012 Elsevier Inc

Cardiopulmonary Exercise Testing in Repaired Tetralogy of Fallot: Multiparametric Overview and Correlation with Cardiac Magnetic Resonance and Physical Activity Level

Patients with repaired Tetralogy of Fallot (rToF) typically report having preserved subjective exercise tolerance. Chronic pulmonary regurgitation (PR) with varying degrees of right ventricular (RV) dilation as assessed by cardiac magnetic resonance imaging (MRI) is prevalent in rToF and may contribute to clinical compromise. Cardiopulmonary exercise testing (CPET) provides an objective assessment of functional capacity, and the International Physical Activity Questionnaire (IPAQ) can provide additional data on physical activity (PA) achieved. Our aim was to assess the association between CPET values, IPAQ measures, and MRI parameters. All rToF patients who had both an MRI and CPET performed within one year between March 2019 and June 2021 were selected. Clinical data were extracted from electronic records (including demographic, surgical history, New York Heart Association (NYHA) functional class, QRS duration, arrhythmia, MRI parameters, and CPET data). PA level, based on the IPAQ, was assessed at the time of CPET. Eighty-four patients (22.8 &plusmn; 8.4 years) showed a reduction in exercise capacity (median peak VO2 30 mL/kg/min (range 25&ndash;33); median percent predicted peak VO2 68% (range 61&ndash;78)). Peak VO2, correlated with biventricular stroke volumes (RVSV: &beta; = 6.11 (95%CI, 2.38 to 9.85), p = 0.002; LVSV: &beta; = 15.69 (95% CI 10.16 to 21.21), p &lt; 0.0001) and LVEDVi (&beta; = 8.74 (95%CI, 0.66 to 16.83), p = 0.04) on multivariate analysis adjusted for age, gender, and PA level. Other parameters which correlated with stroke volumes included oxygen uptake efficiency slope (OUES) (RVSV: &beta; = 6.88 (95%CI, 1.93 to 11.84), p = 0.008; LVSV: &beta; = 17.86 (95% CI 10.31 to 25.42), p &lt; 0.0001) and peak O2 pulse (RVSV: &beta; = 0.03 (95%CI, 0.01 to 0.05), p = 0.007; LVSV: &beta; = 0.08 (95% CI 0.05 to 0.11), p &lt; 0.0001). On multivariate analysis adjusted for age and gender, PA level correlated significantly with peak VO2/kg (&beta; = 0.02, 95% CI 0.003 to 0.04; p = 0.019). We observed a reduction in objective exercise tolerance in rToF patients. Biventricular stroke volumes and LVEDVi were associated with peak VO2 irrespective of RV size. OUES and peak O2 pulse were also associated with biventricular stroke volumes. While PA level was associated with peak VO2, the incremental value of this parameter should be the focus of future studies

Preliminary Evaluation of Sedentary Lifestyle in Italian Children after Solid Transplant: What Role Could Physical Activity Play in Health? It Is Time to Move

Background: Advances in the medical–surgical field have significantly increased survival after solid organ transplantation in the pediatric population. However, these patients are predisposed to the development of long-term complications (e.g., cardiovascular disease). The therapeutic role of physical activity (PA) to counteract these complications is well known. The purpose of the study was to investigate the level of PA in a pediatric population after solid organ transplantation. Methods: In the first 4 weeks at the beginning of the school year, the Physical Activity Questionnaire for Older Children and Adolescents was administered to young patients who had previously undergone solid transplants at our institute. Results: Questionnaires of 49 patients (57.1% female, mean age 13.2 ± 3.5 years) were analyzed and 32.7% of subjects did not perform any exercise during school physical education classes. Only 24% practiced a moderate quantity of exercise in the previous week (2–3 times/week) and 72% engaged in sedentary behaviors during weekends. Conclusions: Preliminary data confirmed that young recipients are still far from meeting the minimum indications of the World Health Organization on PA and sedentary behavior. It will be necessary to increase their involvement in PA programs in order not only to increase their life expectancy but also to improve their quality of life