371 research outputs found
Effects of omalizumab therapy on allergic rhinitis: a pilot study
The use of omalizumab, a humanized monoclonal antibody able to binding Ig-E, is currently authorized only for treatment of severe bronchial asthma. The use of omalizumab in other Ig-E related diseases is off-label, although some studies have provided promising results about it. The aim of this study was to evaluate if therapy with omalizumab in patients affected by asthma and allergic rhinitis has an impact also on allergic rhinitis-related symptoms
Hearing loss, tinnitus, hyperacusis, and diplacusis in professional musicians: a systematic review
Professional musicians (PMs) are at high risk of developing hearing loss (HL) and other audiological symptoms such as tinnitus, hyperacusis, and diplacusis. The aim of this systematic review is to (A) assess the risk of developing HL and audiological symptoms in PMs and (B) evaluate if different music genres (Pop/Rock Music-PR; Classical Music-CL) expose PMs to different levels of risk of developing such conditions. Forty-one articles including 4618 PMs were included in the study. HL was found in 38.6% PMs; prevalence was significantly higher among PR (63.5%) than CL (32.8%) PMs; HL mainly affected the high frequencies in the 3000-6000 Hz range and was symmetric in 68% PR PMs and in 44.5% CL PMs. Tinnitus was the most common audiological symptom, followed by hyperacusis and diplacusis. Tinnitus was almost equally distributed between PR and CL PMs; diplacusis was more common in CL than in PR PMs, while prevalence of hyperacusis was higher among PR PMs. Our review showed that PR musicians have a higher risk of developing HL compared to CL PMs; exposure to sounds of high frequency and intensity and absence of ear protection may justify these results. Difference in HL symmetry could be explained by the type of instruments used and consequent single-sided exposure
Use of balloon catheter dilation and steroid-eluting stent in light and severe rhinosinusitis of frontal sinus: a multicenter retrospective randomized study
OBJECTIVE: Frontal sinus surgery has an increased rate of re-stenosis, if compared to other sinuses, that mainly depends on recurrent inflammation and abnormal scarring at the frontal recess; its reduction represents one of the keys of therapeutic success. Balloon catheter dilation (BCD) and implantable sinus stents/spacers represent strategies to improve sinus ventilation respecting the integrity of mucosa and reducing abnormal post-surgical scarring. The purpose of this study is to evaluate the effectiveness, safety and correct indication for the use of BCD and a non-absorbable stent (Relieva Stratus™ MicroFlow spacer) in the management of chronic rhinosinusitis (CRS) of the frontal sinus. PATIENTS AND METHODS: In this multicentric retrospective study we included a population of 76 frontal sinuses with non-polypoid CRS. Forty-one frontal sinuses were treated with BCD alone and 35 with BCD + Spacer. We analysed both radiological (Lund-McKay CT scoring modified by Zienrich) and symptomatologic results (SNOT-20 questionnaire) before surgery and after 12 months, dividing patients in two main groups: group “L” (light/mild frontal CRS) and group “S” (moderate/severe frontal CRS). RESULTS: Our results confirm a good safety and effectiveness of BCD in management of frontal CRS and show a good safety, although without significant effectiveness, of Relieva Stratus™ MicroFlow spacer when added to BCD in the management of light and severe frontal CRS. CONCLUSIONS: BCD is an option in management of frontal CRS; the use of stents/spacers could become a new and effective tool in management of CSR, both in addition to standard therapies and in patients where the use of systemic drugs is contraindicated
Effects of COVID-19 pandemic on otolaryngology surgery in Italy: the experience of our university hospital
Otolaryngology and head and neck surgery underwent drastic changes during the COVID-19 pandemic. Since March 10, the first day of the lockdown in Italy, diagnostic and therapeutic procedures were limited to emergency and oncology cases, while outpatient procedures and clinical examinations were temporarily suspended to limit virus diffusion and to reallocate personnel into wards dedicated to COVID-19. In our otolaryngology unit, between March 10 and April 28, 2020, we performed 96 surgical procedures; they mainly consisted in diagnosis and treatment of malignant tumors of the head and neck (77%), management of acute upper airway obstruction in adults and children (14.7%), drainage of abscesses of the head and neck (6.2%), and treatment of nasal bone fractures (2.1%). When comparing these data with those of the same period in 2019 for emergency and oncology procedures, we noticed a drastic reduction of head and neck abscesses and nasal bone fractures, while oncology surgery remained stable
Localizzazione inusuale di cisti del dotto tireoglosso
nglish version
Summary: An unusual localization of thyroglossal duct cyst.
M. Barbaro, A. Di Mario, D. De Seta, G. Rispoli, E. Covelli, G.A. Bertoli, A. Minni
Thyroglossal duct cysts are most common neck masses after benign lymphonodes. They originate from primitive thiroglossal duct, so they could be locate along its course. Every mass in the middle line of the neck can be considerated as a thyroglossal cyst. Best treatment is surgery (Sistrunk procedure).
We present a case of unusual localization at floor of the mouth of thyroglossal in a 34 years old woman. To our knowledge in literature, only two cases, have been reported both
Resting state functional thalamic connectivity abnormalities in patients with post-stroke sleep apnoea: a pilot case-control study
OBJECTIVE: Sleep apnoea is common
after stroke, and has adverse effects on the
clinical outcome of affected cases. Its pathophysiological
mechanisms are only partially known. Increases
in brain connectivity after stroke might influence
networks involved in arousal modulation
and breathing control. The aim of this study was to
investigate the resting state functional MRI thalamic
hyper connectivity of stroke patients affected
by sleep apnoea (SA) with respect to cases not
affected, and to healthy controls (HC).
PATIENTS AND METHODS: A series of stabilized
strokes were submitted to 3T resting state
functional MRI imaging and full polysomnography.
The ventral-posterior-lateral thalamic nucleus was
used as seed.
RESULTS: At the between groups comparison
analysis, in SA cases versus HC, the regions significantly
hyper-connected with the seed were
those encoding noxious threats (frontal eye
field, somatosensory association, secondary visual
cortices). Comparisons between SA cases
versus those without SA, revealed in the former
group significantly increased connectivity with
regions modulating the response to stimuli independently
to their potentiality of threat (prefrontal,
primary and somatosensory association, superolateral
and medial-inferior temporal, associative
and secondary occipital ones). Further
significantly functionally hyper connections were
documented with regions involved also in the modulation
of breathing during sleep (pons, midbrain,
cerebellum, posterior cingulate cortices), and in
the modulation of breathing response to chemical
variations (anterior, posterior and para-hippocampal
cingulate cortices).
CONCLUSIONS: Our preliminary data support
the presence of functional hyper connectivity in
thalamic circuits modulating sensorial stimuli, in
patients with post-stroke sleep apnoea, possibly
influencing both their arousal ability and breathing
modulation during sleep
Lessons learned from COVID-19 pandemic in Italy
Since the COVID-19 outbreak, Italy has been one of the most affected countries in Europe and the second for number of deaths. In this commentary, we discuss some lessons that we learned as healthcare providers working in a large public hospital during the pandemic, with a special focus on the importance of infection containment and early diagnosis, the role of swab, serological tests, home isolation and individual protection devices, and the available therapies and management indications to better face a possible new outbreak in the near future. These comments should stimulate a more diffused, efficient and efficacious management of COVID-19 patients, also reducing the number of accesses to hospital emergency departments and the related spread of the infection
Pathophysiology and therapy of systemic vasculitides
Systemic vasculitides represent uncommon conditions characterized by the inflammation of blood vessels that can lead to different complex disorders limited to one organ or potentially involving multiple organs and systems. Systemic vasculitides are classified according to the diameter of the vessel that they mainly affect (small, medium, large, or variable). The pathogenetic mechanisms of systemic vasculitides are still partly unknown, as well as their genetic basis. For most of the primary systemic vasculitides, a single gold standard test is not available, and diagnosis is often made after having ruled out other mimicking conditions. Current research has focused on new management protocol and therapeutic strategies aimed at improving long-term patient outcomes and avoiding progression to multiorgan failure with irreversible damage. In this narrative review, authors describe different forms of systemic vasculitides through a review of the literature, with the aim of highlighting the current knowledge and recent findings on etiopathogenesis, diagnosis and therapy
Trophic and neurotrophic factors in human pituitary adenomas (Review)
The pituitary gland is an organ that functionally connects the hypothalamus with the peripheral organs. The pituitary gland is an important regulator of body homeostasis during development, stress, and other processes. Pituitary adenomas are a group of tumors arising from the pituitary gland: they may be subdivided in functional or non-functional, depending on their hormonal activity. Some trophic and neurotrophic factors seem to play a key role in the development and maintenance of the pituitary function and in the regulation of hypothalamo-pituitary-adrenocortical axis activity. Several lines of evidence suggest that trophic and neurotrophic factors may be involved in pituitary function, thus suggesting a possible role of the trophic and neurotrophic factors in the normal development of pituitary gland and in the progression of pituitary adenomas. Additional studies might be necessary to better explain the biological role of these molecules in the development and progression of this type of tumor. In this review, in light of the available literature, data on the following neurotrophic factors are discussed: ciliary neurotrophic factor (CNTF), transforming growth factors β (TGF‑β), glial cell line-derived neurotrophic factor (GDNF), nerve growth factor (NGF), vascular endothelial growth factor (VEGF), vascular endothelial growth inhibitor (VEGI), fibroblast growth factors (FGFs) and epidermal growth factor (EGF) which influence the proliferation and growth of pituitary adenomas
Endoscopic Resection of Sinonasal Inverted Papilloma: A Multivariate Retrospective Analysis of Factors Affecting Recurrence and Persistence.
Sinonasal inverted papilloma (IP) is the most common benign epithelial tumor in the nasal cavity and paranasal sinuses, with a worldwide incidence between 0.6 and 1.5/100 000 persons per year. However, only a few studies have investigated patient-dependent factors related to IP recurrence and persistence. According to available evidence, these factors are still debated, and results are contradictory. In this multicenter retrospective study, we analyzed the clinical records of 130 patients who were surgically treated for sinonasal IP to evaluate the factors affecting recurrence and persistence of IP and compared the curative rates of different surgical approaches. Our analysis showed that IP recurrence is strongly related to specific risk factors including incomplete surgical removal, stage of disease, site of the lesion, surgical technique, and malignancy rate. In conclusion, the recurrence of IP may be affected by several risk factors; these factors must be carefully considered during clinical evaluation and especially during the follow-up of patients with IP
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