The impact of Coronavirus (COVID-19) on head and neck cancer patients' care

The impact of Coronavirus (COVID-19) on head and neck cancer patients' care

Freight distribution with electric vehicles: A case study in Sicily. RES, infrastructures and vehicle routing

Abstract This paper deals with the issue of the production of electricity required for an electric delivery van to carry out its daily mission. In particular, the technical solutions adopted for the generation and management of energy from renewable energy sources will be illustrated. Subsequently a vehicle routing problem with time windows is formulated in order to optimize the freight distribution at urban level completing the exploration of two aspects, infrastructures and management of the service, considered fundamental for dealing with the distribution of freight in a system scenario. The article describes a case study for the delivery of freight within the last mile in which the installation of renewable energy production plants is proposed in the same place where the urban distribution center has been planned. The area dedicated to freight handling is thus proposed in the work as an energy platform as well as logistics. The optimization of a freight delivery service is performed in order to reduce the energy used by the vehicle in its daily travels and some aspects related to the governance (i.e. time windows allowed for the delivery/pick-up operations) are included in the problem constraints. A test application, considering a set of 84 retailers, has been carried out as case study in the Capo d'Orlando municipality (Sicily, Italy)

Freight distribution with electric vehicles: A case study in Sicily. Delivery van development

Abstract A change in the logistics sector in terms of environmental sustainability is necessary to support the achievement of the social challenges associated with freight transport. Unfortunately, the policy responses to solving congestion and emissions issues are mainly dedicated to the movement of people. The most valued opportunities to reduce the negative effects of freight delivery (the goal of EU policy is CO2 free urban logistics by 2030) regards both the use of electric vehicles to perform the distribution and the introduction of distribution centres that encourage the use of light commercial vehicles. However, the combination of zero emission vehicles in logistic and transportation activities requires some additional challenges from the organizational and operational point of view. In order to avoid the delocalization of polluting emissions it is necessary that the production of electricity related to the new needs comes from renewable sources preferably distributed throughout the territory. This paper explores the integration of electric vehicles in logistics operations executed through light commercial vehicles, taking into consideration, during the design phase of a new concept delivery van, the technical connections with the production systems and its possible applications also in areas other than urban. The results of the case study presented encourage the development of a type of vehicle with features not yet covered by the market and which are of particular relevance for sustainable logistics applied to small towns or small islands, which are widespread in Italy

Subtyping patients with somatic tinnitus: modulation of tinnitus and history for somatic dysfunction help identify tinnitus patients with temporomandibular joint disorders

Objective: Determine in a cohort of patients with normal hearing and chronic tinnitus if self-reported history for temporomandibular joint (TMJ) dysfunction and a positive modulation of tinnitus in the TMJ region could be suggestive of an underlying TMJ disorder. Patients and Methods: The study included 226 patients presenting to the Head and Neck Service of our University Hospital. Following audiological and somatic tinnitus evaluation, patients were divided into two groups. The study group (n= 134) included subjects that met both the following criteria: A) a self-reported history for TMJ dysfunction and B) a positive modulation of tinnitus following somatic maneuvers in the TMJ region. The control group (n=92) included patients with similar demographic and tinnitus characteristics that did not meet the proposed criteria for somatic tinnitus. Afterwards, patients underwent clinical TMJ evaluation in the Service of Clinical Gnathology of our University. Results: One hundred thirty-one patients (57.9%) received a clinical diagnosis of TMJ disorder according to DC/TMD Axis I; 79.1% in the study group and 27.2% in the control group. Ninety-five (42.1%) patients were negative for TMJ disorders; 20.9% in the study group and 72.8% in the control group. A significantly higher number of TMJ disorders was found in patients in the study group compared to the control group (p<0.0001). Most patients had joint disorders (67.2%), followed by other (29.8%) and pain disorders (29%). Logistic regression analysis in the study group showed that female gender was more prevalent in patients with TMJ disorders. Conclusion: Our findings in patients with chronic tinnitus and normal hearing suggest that self-reported history for somatic dysfunction and modulation of tinnitus, when occurring simultaneously in the TMJ region, can be useful to preliminarily identify patients with TMJ disorders

Efficacy of safety catheter devices in the prevention of occupational needlestick injuries: applied research in Liguria Region (Italy)

Health care workers who use or may be exposed to needles are at increased risk of needlestick injuries which can lead to serious infections with bloodborne pathogens. These injuries can be avoided by eliminating the unnecessary use of needles, using safety devices. The present study was aimed at evaluating the impact of a safety-engineered device, with passive fully automatic needlestick protection, on the reduction of needlestick injuries among health care workers. The setting of the study was a network of five public health care institutions situated in a Northern Italian Region. Data about the type of device, the number of employees and the amount of catheter devices used per year were collected through regular meetings with health care workers over a period of five years.The most remarkable result of this study was represented by the huge risk reduction estimated for safety devices. Indeed, the risk of needlestick injuries due to conventional devices was found to be 25 fold higher than that observed for safety devices. However, it is noteworthy that a discernible part of this excess can be explained by the different background amount of devices used. Moreover, the descriptive analysis suggested that individuals with a poor/moderate training level showed a lower risk, albeit not statistically significant, than those with a good/high training.In conclusion, there is a convincing evidence of a causal connection between the introduction of safety devices and reduction in the occurrence of needlestick injuries. This consideration pushes to introduce safety devices into daily clinical practice

Tobacco, alcohol and family history of cancer as risk factors of oral squamous cell carcinoma: case-control retrospective study

The aim of the study is to observe retrospectively the correlation between Oral Squamous Cell Carcinoma (OSCC) and risk factors; including tobacco, alcohol and Family History of Cancer (FHC). A total of 478 patients were included retrospectively from the database of the Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome. A Test Group (TG) consisted of 239 patients with a confirmed diagnosis of OSCC. A Control Group (CG) consisted of 239 patients without history and/or diagnosis of oral cancer. The logistic regression models were used to calculate the adjusted Odd Ratios (ORs) associated with alcohol, tobacco and FHC; including the General Family History of Cancer (GFHC) and Family History of Head and Neck Cancer (FHHNC) and their 95% Confidence Intervals (CI). The high rate of tobacco consumption was associated with an OR of 1.035 (95% CI 1.001–1.070) and a statistical significance (p = 0.041). Drinker patients showed a significant risk of developing OSCC (p = 0.05) and the OR was 1.035 (95% CI 1.010–1.061). The GFHC was associated with a marginal risk of OSCC with an OR of 1.095 (95% CI 0.953–1.259), without significance (p = 0.199). The FHHNC showed a notable risk increase with an OR of 1.871 (95% CI 0.902–3.882), without significance (p = 0.092). Alcohol and tobacco may be associated with an increase in the risk of OSCC

Scoliosis and dental occlusion: a review of the literature

<p>Abstract</p> <p>Background</p> <p>Idiopathic scoliosis is a deformity without clear etiology. It is unclear wether there is an association between malocclusion and scoliosis. Several types of occlusion were described in subjects with scoliosis, mostly case-reports.</p> <p>Objectives</p> <p>The aim of this review was to evaluate the type of occluslins more prevalent in subjects with scoliosis</p> <p>Search strategy</p> <p>All randomised and controlled clinical trials identified from the Cochrane Oral Health Group Trials Register, a MEDLINE search using the Mesh term scoliosis, malocclusion, and relevant free text words, and the bibliographies of papers and review articles which reported the outcome of orthodontic treatment in subjects with scoliosis that were published as abstracts or papers between 1970 and 2010.</p> <p>Selection criteria</p> <p>All randomised and controlled clinical trials published as full papers or abstracts which reported quantitative data on the outcomes malocclusion in subjects with scoliosis.</p> <p>Data collection and analysis</p> <p>Data were extracted without blinding to the authors, age of patients or type of occlusion.</p> <p>Main results</p> <p>Using the search strategy eleven observational longitudinal studies were identified. No randomized clinical trials were recorded. Twenty-three cross-sectional studies were recorderd, and the others studies were reviews, editorials, case-reports, or opinions. The clinical trials were often not controlled and were about the cephalometric evaluation after treatment with the modified Milwuakee brace, followed by the orthodontic treatment of the class II relationship with a functional appliance. Clinical trials also included the study of the associations between scoliosis and unilateral crossbite, in children with asymmetry of the upper cervical spine. This association was also investigated in rats, pigs and rabbits in clinical trials. The other associations between scoliosis and occlusion seems to be based only on cross-sectional studies, case-reports, opinions.</p> <p>Authors' conclusions</p> <p>Based on selected studies, this review concludes that there is plausible evidence for an increased prevalence of unilateral Angle Class II malocclusions associated with scoliosis, and an increased risk of lateral crossbite, midline deviation in children affected by scoliosis. Also, documentation of associations between reduced range of lateral movements and scoliosis seem convincing. Data are also mentioned about the association between plagiocephaly and scoliosis.</p

Serum Albumin Is Inversely Associated With Portal Vein Thrombosis in Cirrhosis

We analyzed whether serum albumin is independently associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) and if a biologic plausibility exists. This study was divided into three parts. In part 1 (retrospective analysis), 753 consecutive patients with LC with ultrasound-detected PVT were retrospectively analyzed. In part 2, 112 patients with LC and 56 matched controls were entered in the cross-sectional study. In part 3, 5 patients with cirrhosis were entered in the in vivo study and 4 healthy subjects (HSs) were entered in the in vitro study to explore if albumin may affect platelet activation by modulating oxidative stress. In the 753 patients with LC, the prevalence of PVT was 16.7%; logistic analysis showed that only age (odds ratio [OR], 1.024; P = 0.012) and serum albumin (OR, -0.422; P = 0.0001) significantly predicted patients with PVT. Analyzing the 112 patients with LC and controls, soluble clusters of differentiation (CD)40-ligand (P = 0.0238), soluble Nox2-derived peptide (sNox2-dp; P &lt; 0.0001), and urinary excretion of isoprostanes (P = 0.0078) were higher in patients with LC. In LC, albumin was correlated with sCD4OL (Spearman's rank correlation coefficient [r(s)], -0.33; P &lt; 0.001), sNox2-dp (r(s), -0.57; P &lt; 0.0001), and urinary excretion of isoprostanes (r(s), -0.48; P &lt; 0.0001) levels. The in vivo study showed a progressive decrease in platelet aggregation, sNox2-dp, and urinary 8-iso prostaglandin F2 alpha-III formation 2 hours and 3 days after albumin infusion. Finally, platelet aggregation, sNox2-dp, and isoprostane formation significantly decreased in platelets from HSs incubated with scalar concentrations of albumin. Conclusion: Low serum albumin in LC is associated with PVT, suggesting that albumin could be a modulator of the hemostatic system through interference with mechanisms regulating platelet activation

Radiation therapy and mandibular osteoradionecrosis: state of the art

Purpose of review: This article aims to provide an update on literature data related to mandibular osteoradionecrosis (MORN) secondary to the irradiation of the head and neck region. Recent findings: Radiotherapy (RT) plays a crucial role in the contemporary management of head and neck cancer (HNC) patients and, despite intensity-modulated technique (IMRT), mandibular osteoradionecrosis (MORN) remains a significant RT-related complication. Based on its clinical manifestation, MORN can negatively affect patients' quality of life. Preventive interventions should be prioritized. This manuscript is expected to represent an opportunity to guide a clear proposal for clinical measures in the individual MORN situations