Delayed recurrent nerve paralysis following post-traumatic aortic pseudoaneurysm

Blunt trauma to the neck or to the chest are increasingly observed in the emergency clinical practice. They usually follow motor vehicle accidents or may be work or sports related. A wide pattern of clinical presentation can be potentially encountered. We report the uncommon case of a patient who was referred to our observation presenting with hoarseness and disphagia. Twenty days before he had sustained a car accident with trauma to the chest, neck and the mandible. Laryngoscopy showed a left recurrent laryngeal nerve palsy. Further otolaryngo-logical examination showed no other abnormality. At CT and MR imaging a post-traumatic aortic pseudoaneurysm was revealed. The aortic pseudoaneurysm was consequently repaired by implantation of an endovascular stent graft under local anesthesia. The patient was discharged 10 days later. At 30-days follow-up laryngoscopy the left vocal cord palsy was completely resolved. Hoarseness associated with a dilated left atrium in a patient with mitral valve stenosis was initially described by Ortner more than a century ago. Since then several non malignant, cardiovascular, intrathoracic disease that results in embarrassment from recurrent laryngeal nerve palsy usually by stretching, pulling or compression; thus, the correlations of these pathologies was termed as cardiovocal syndrome or Ortner's syndrome. The reported case illustrates that life-threatening cardiovascular comorbidities can cause hoarseness and that an impaired recurrent laryngeal nerve might be correctable

A quality evaluation framework for the statistical register Frame-SBS

In 2013, Istat implemented the new statistical register “Frame-SBS” for the annual production of economic accounts statistics based on the integrated use of administrative and survey data, overcoming most of the limits of the traditional survey-based estimation strategy. The transition to a production strategy essentially based on the use of administrative data required the development of innovative methodological approaches, and determined the need of new tools for quality evaluation of both the data and the statistical process. In this paper we propose a first scheme of indicators for measuring and documenting the quality of the FrameSBS. The final goal is to implement a quality control system to regularly monitor the register, by the identification of possible process and data weaknesses, and supporting quality improvements

La vegetazione del Parco Regionale del Taburno-Camposauro (Campania)

Lo studio della vegetazione del Parco Regionale del Taburno-Camposauro ha prodotto una carta della vegetazione a livello fisionomico e una mappa con valenza fito-climatica ottenuta a partire da 6 immagini riprese dal satellite Landsat-5, utilizzando un modello matematico di tipo sinusoidale

Orchids in Campania (Italy): a first progress report of knowledge.

Gli autori presentano lo stato delle conoscenze sulla distribuzione delle orchidee in Campania. Circa 5100 Km2 dei 13595 Km2 dell’area totale della Campania sono stati indagati e sono stati raccolti 6960 dati distributivi con coordinate UTM. Attualmente sono state trovate 75 entità (inclusi 10 ibridi) appartenenti a 19 generi. Le entità più frequenti sono Dactylorhiza maculata subsp. saccifera e Orchis provincialis mentre le più rare sono Pseudorchis albida, prima segnalazione per la regione, Ophrys insectifera Ophrys promontorii, Orchis palustris ed Epipogium aphyllum

Delayed recurrent nerve paralysis following post-traumatic aortic pseudoaneurysm

Blunt trauma to the neck or to the chest are increasingly observed in the emergency clinical practice. They usually follow motor vehicle accidents or may be work or sports related. A wide pattern of clinical presentation can be potentially encountered. We report the uncommon case of a patient who was referred to our observation presenting with hoarseness and disphagia. Twenty days before he had sustained a car accident with trauma to the chest, neck and the mandible. Laryngoscopy showed a left recurrent laryngeal nerve palsy. Further otolaryngo-logical examination showed no other abnormality. At CT and MR imaging a post-traumatic aortic pseudoaneurysm was revealed. The aortic pseudoaneurysm was consequently repaired by implantation of an endovascular stent graft under local anesthesia. The patient was discharged 10 days later. At 30-days follow-up laryngoscopy the left vocal cord palsy was completely resolved

Recovery of Carotenoids from Tomato Pomace Using a Hydrofluorocarbon Solvent in Sub-Critical Conditions

The enrichment of oils with nutraceutical bioactive phytomolecules allows the achievement of functional oil-based products of great interest in the food, pharmaceutical, and cosmetic fields. Carotenoids, such as lycopene and β-carotene, are available at a high concentration in tomatoes and tomato waste products, as peels, seeds, and pulp; their recovery is recently attracting growing interest and economic importance in the food industry, and also in consideration of the huge amount of industrial waste produced. The aim of this work is to study the production of an oil functionalized with carotenoids from tomato peels. The extractions were carried out using an innovative process based on the use of commercial Norflurane as solvent in subcritical conditions. Extraction trials were performed on dried tomato peels, with the addition of tomato seeds or wheat germ flour as sources of oily co-solvents, capable of also preserving the biological characteristics of the carotenoids extracted. Although lycopene solubility in Norflurane is quite low, the solvent recirculation and regeneration were allowed to reach a concentration in the oily extracts of approximately 0.3 mg/goil after 2 h of the process. The enrichment in β-carotene was more pronounced, and concentrations of 0.733 mg/goil and 0.952 mg/goil were observed in wheat germ and tomato seed oils, respectively. The results obtained in this study were compared with those obtained by traditional and supercritical CO2 extraction methods

Recovery of Carotenoids from Tomato Pomace Using a Hydrofluorocarbon Solvent in Sub-Critical Conditions

The enrichment of oils with nutraceutical bioactive phytomolecules allows the achievement of functional oil-based products of great interest in the food, pharmaceutical, and cosmetic fields. Carotenoids, such as lycopene and β-carotene, are available at a high concentration in tomatoes and tomato waste products, as peels, seeds, and pulp; their recovery is recently attracting growing interest and economic importance in the food industry, and also in consideration of the huge amount of industrial waste produced. The aim of this work is to study the production of an oil functionalized with carotenoids from tomato peels. The extractions were carried out using an innovative process based on the use of commercial Norflurane as solvent in subcritical conditions. Extraction trials were performed on dried tomato peels, with the addition of tomato seeds or wheat germ flour as sources of oily co-solvents, capable of also preserving the biological characteristics of the carotenoids extracted. Although lycopene solubility in Norflurane is quite low, the solvent recirculation and regeneration were allowed to reach a concentration in the oily extracts of approximately 0.3 mg/goil after 2 h of the process. The enrichment in β-carotene was more pronounced, and concentrations of 0.733 mg/goil and 0.952 mg/goil were observed in wheat germ and tomato seed oils, respectively. The results obtained in this study were compared with those obtained by traditional and supercritical CO2 extraction methods

Can a Surgical Technique Be a Risk for Post-tonsillectomy Haemorrhage? Our Point of View

Objectives: Controversies have recently arisen regarding post-operative haemorrhagic complications in relation to the surgical procedures ad- opted for tonsillectomy. The authors set out to verify the relationship between surgical techniques and post-operative haemorrhage based on the analysis of data derived from multi-centric studies. Results: Eight multi-centric studies were analysed. The mean frequency of post-tonsillectomy haemorrhage was: 1.13% for primary haemorrhage, 5.37% for secondary haemorrhage, and 6.5% as overall for cold dissection with cold haemostasis; 0.99% for primary haemorrhage, 2.91% for secondary haemorrhage, and 3.9% as overall for cold dissection with hot haemostasis; 1.31% for primary haemorrhage, 7.38% for secondary haemorrhage, and 8.69% as overall for hot dissection with hot haemostasis. The statistical comparison did not show significant differences between the frequencies of post-tonsillectomy primary, secondary, and total haemorrhage in relation to the surgical techniques employed. Conclusion: A great variability in the frequency of haemorrhagic complications reported in the selected articles was found, regardless of the surgical technique. These findings, together with the lack of a statistically significant difference in post-tonsillectomy haemorrhage between the techniques employed, must be carefully considered by professionals involved in health organizations in clinical wards and the relative problems linked to medical liability