Unusual symptomatology in eagle syndrome

A 20-year-old female presented a history of isolate left external ear pain. ENT valuation showed no alteration of the district, but an aberrant styloid process was tender to palpation in the left tonsillar fossa. Computer tomography was performed and confirmed it. Thereafter, the diagnosis of Eagle syndrome was made. The auricular branch of the vagal nerve (ABVN) was pressed by the styloid process causing the pain. This case pointed out the importance to consider anatomical alteration as elongated styloid process as a possible cause of external ear pain

Eustachian tube dysfunction in children with adenoid hypertrophy: the role of adenoidectomy for improving ear ventilation

Introduction: To our knowledge, few papers have addressed preoperative evaluation of the impact of adenoid hypertrophy (AH) on the pathogenesis of eustachian tube dysfunction (ETD) in children with otitis media with effusion (OME). Aim: The aim of this study was 2-fold: first, to evaluate ETD using tubomanometry and Eustachian Tube Score 7 (ETS-7), in a group of children having AH; second, to assess the clinical impact of adenoidectomy on the ETD of these patients. Methods: Fifty patients, aged 4 to 15 years, underwent adenoidectomy based on various parameters: size of the adenoids causing canal obstruction (grades 1-4), the presence of OME, and recurrent episodes of rhinosinusitis. The function of the eustachian tube was evaluated using ETS-7 before and after surgical treatment. The patients were followed up for 6 months. Results: Forty children presented ETD. Of these, 36 had a grade 4 AH. The preoperative mean value for ETS-7 was 6.62. The mean postoperative ETS-7 score showed a value of 9.60 with a statistical difference compared to the preoperative value (P =.0015). Conclusions: Adenoid hypertrophy has a high impact on the frequency of ETD. In the patients observed in the present study, the ETS-7 score appeared to be a valid tool for assessing ETD both preoperatively and postoperatively. Adenoidectomy seemed to be effective in improving ETD as well as middle ear ventilation

Effects of irrigation on n2o emissions in a maize crop grown on different soil types in two contrasting seasons

Crop management and soil properties affect greenhouse gas (GHG) emissions from cropping systems. Irrigation is one of the agronomical management practices that deeply affects soil nitrous oxide (N2O) emissions. Careful management of irrigation, also concerning to soil type, might mitigate the emissions of this powerful GHG from agricultural soils. In the Mediterranean area, despite the relevance of the agricultural sector to the overall economy and sustainable development, the topic of N2O emissions does not have the same importance as N2O fluxes in temperate agricultural areas. Only some research has discussed N2O emissions from Mediterranean cropping systems. Therefore, in this study, N2O emissions from different soil types (sandy‐loam and clay soils) were analyzed in relation to the irrigation of a maize crop grown in two contrasting seasons (2009–2010). The irrigation was done using a center pivot irrigation system about twice a week. The N2O emissions were monitored throughout the two‐years of maize crop growth. The emissions were measured with the accumulation technique using eight static chambers (four chambers per site). Nitrogen fertilizer was applied in the form of ammonium sulphate and urea with 3,4 dimethylpyrazole phosphate (DMPP) nitrification inhibitors. In 2009, the N2O emissions and crop biomass measured in both soil types were lower than those measured in 2010. This situation was a lower amount of water and nitrogen (N) available to the crop. In 2010, the N2O fluxes were higher in the clay site than those in the sandy‐loam site after the first fertilization, whereas an opposite trend was found after the second fertilization. The soil temperature, N content, and soil humidity were the main drivers for N2O emission during 2009, whereas during 2010, only the N content and soil humidity affected the nitrous oxide emissions. The research has demonstrated that crop water management deeply affects soil N2O emissions, acting differently for denitrification and nitrification. The soil properties affect N2O emission by influencing the microclimate conditions in the root zone, conditioning the N2O production

Tympanic cholesterol granuloma and exclusive endoscopic approach

Objective: Background: Case Report: Conclusions: Unusual or unexpected effect of treatment Cholesterol granuloma is a histological entity containing cholesterol crystals surrounded by foreign-body giant cells and chronic inflammation. Tympanic cholesterol granuloma is a rare disease, while petrous bone cholesterol granuloma is more common. Surgery consists of elective management in most cases of CGs. There are several types of surgery described to treat cholesterol granuloma; however, a case treated by primary endoscopic ear surgery has not yet been described. The aim of this case report is to present the endoscopic characteristics of cholesterol granulomas and show how endoscopic ear surgery is possible in isolated and selected cases with this pathology. We report the case of a 65-year-old patient affected by a cholesterol granuloma of the middle ear, with progressive hearing impairment and fullness of the left ear. The granuloma was diagnosed via medical imaging using magnetic resonance imaging, which identified the typical high signal intensity in T1-and T2-weighted images. In this case, cholesterol granuloma was limited to the epitympanic and mesotympanic regions. For small cholesterol granulomas confined to the middle ear, a canal wall-up or wall-down tympanoplasty plus ventilation tube insertion are usually performed. In this case, primary endoscopic surgery was performed under general anaesthesia to remove the presumed cholesterol granuloma. It was completely removed by this approach, without facial nerve injuries or postoperative complications. The patient had no disease recurrence at clinical and radiological investigation at 1-year follow-up. An exclusive endoscopic approach to remove cholesterol granuloma is feasible. However, it should only be performed in selected cases

Facial nerve dehiscence and cholesteatoma: a comparison between decades

OBJECTIVES: To evaluate the incidence of facial canal dehiscence (FCD) and other intraoperative findings over the last 20 years as well as correlation with the Japanese Otological Society/European Academy of Otology and Neurotology classification in patients with cholesteatoma. MATERIALS and METHODS: A total of 469 patients operated from 1998 to 2018 were selected and divided into 2 groups of 10 years each. RESULTS: Dehiscence was significantly higher in patients with a history of pathology longer than 5 years (22.7%). Higher values were observed in revision surgery, 44.4% in the first period and 41.7% in the second. The tympanic segment was the one most frequently involved, affecting 92% of patients in the first period and 97% of patients in the second. Dehiscence occurred significantly more often in patients with a semicircular canal fistula, 14.8% in the first decade and 8.8% in the second. The incidence of FCD was significantly higher in patients with primary cholesteatoma (especially in those with combined pars tensa-flaccida) than in those with a secondary acquired one, 31.5% vs 7.4% in the first period, 21.1% vs 7.4% in the second, and in those with a stage III disease, 42% in the first period, 33.3% in the second. CONCLUSION: Patients with a shorter history of cholesteatoma as well as those not previously operated had a lower incidence of FCD. The tym-panic tract of the facial nerve remains the most frequent site of dehiscence, while the association between dehiscence and fistula of the semicircular canal remains strong. Patients with combined pars tensa-pars flaccida and stage III cholesteatoma have a higher incidence of FCD

Fertilizer type influences tomato yield and soil N2O emissions

Improvements in crop management for a more sustainable agriculture are fundamental to reduce environmental impacts of cropland and to mitigate effects on global climate change. In this study three fertilization types – ammonium nitrate (control); mineral fertilizer added with a nitrification inhibitor (3,4-dimethylpyrazole phosphate (DMPP)), and an organo-mineral fertilizer (OM) – were tested on a tomato crop in order to evaluate effects both on crop production and soil N2O emissions. Plants grown under OM fertilization had a greater relative growth rate compared to mineral fertilization, due to a higher net assimilation rate, which was related to a greater light interception rather than to a higher photosynthetic efficiency. OM fertilization determined the highest fruit production and lower soil N2O fluxes compared to NH4NO3, although the lowest soil N2O fluxes were found in response to mineral fertilizer added with a nitrification inhibitor. It can be concluded that organo-mineral fertilizer is a better nutrient source compared to mineral fertilizers able to improve crop yield and to mitigate soil N2O emission

Assessing the ability of MODIS EVI to estimate terrestrial ecosystem gross primary production of multiple land cover types

© 2016 Elsevier Ltd Terrestrial ecosystem gross primary production (GPP) is the largest component in the global carbon cycle. The enhanced vegetation index (EVI) has been proven to be strongly correlated with annual GPP within several biomes. However, the annual GPP-EVI relationship and associated environmental regulations have not yet been comprehensively investigated across biomes at the global scale. Here we explored relationships between annual integrated EVI (iEVI) and annual GPP observed at 155 flux sites, where GPP was predicted with a log-log model: ln(GPP)=a×ln(iEVI)+b. iEVI was computed from MODIS monthly EVI products following removal of values affected by snow or cold temperature and without calculating growing season duration. Through categorisation of flux sites into 12 land cover types, the ability of iEVI to estimate GPP was considerably improved (R2 from 0.62 to 0.74, RMSE from 454.7 to 368.2 g C m−2 yr−1). The biome-specific GPP-iEVI formulae generally showed a consistent performance in comparison to a global benchmarking dataset (R2 = 0.79, RMSE = 387.8 g C m−2 yr−1). Specifically, iEVI performed better in cropland regions with high productivity but poorer in forests. The ability of iEVI in estimating GPP was better in deciduous biomes (except deciduous broadleaf forest) than in evergreen due to the large seasonal signal in iEVI in deciduous biomes. Likewise, GPP estimated from iEVI was in a closer agreement to global benchmarks at mid and high-latitudes, where deciduous biomes are more common and cloud cover has a smaller effect on remote sensing retrievals. Across biomes, a significant and negative correlation (R2 = 0.37, p < 0.05) was observed between the strength (R2) of GPP-iEVI relationships and mean annual maximum leaf area index (LAImax), and the relationship between the strength and mean annual precipitation followed a similar trend. LAImax also revealed a scaling effect on GPP-iEVI relationships. Our results suggest that iEVI provides a very simple but robust approach to estimate spatial patterns of global annual GPP whereas its effect is comparable to various light-use-efficiency and data-driven models. The impact of vegetation structure on accuracy and sensitivity of EVI in estimating spatial GPP provides valuable clues to improve EVI-based models

Physical activity in the prevention of peripheral artery disease in the elderly

Aging is a well-known cardiovascular risk factor and cardiovascular diseases (CVD) are estimated to be the most common cause of death in the elderly. Peripheral arterial disease (PAD) represents an important clinical manifestation of CVD leading to increase morbidity and mortality, especially in elderly population. The correct management of PAD population includes the prevention of cardiovascular events and relief of symptoms, most commonly intermittent claudication. Progressive physical activity is an effective treatment to improve walking distance and to reduce mortality and cardiovascular events in patients with PAD, however the ability to effectively engage in physical activity often declines with increasing age. The maintenance and increase of reserve functional capacity are important concepts in the elderly population. Ultimately, the goal in participation of physical activity in the healthy elderly population is maintenance and development of physical functional reserve capacity. Therefore, for individuals suffering of PAD, appropriate physical activity in the form of supervised exercise may serve as a primary therapy. Although there are few direct comparisons of therapeutic exercise programs vs. pharmacological or surgical interventions, these increases in walking distance are greater than those reported for the most widely used agents for claudication, pentoxyphylline, and cilostazol. Despite a reduction in mortality and improvement of quality of life caused by physical activity in the PAD population, the molecular, cellular, and functional changes that occur during physical activity are not completely understood. Therefore, this review article aims at presenting an overview of recent established clinical and molecular findings addressing the role of physical activity on PAD in the older population