Benign paroxysmal positional vertigo following whiplash injury: a myth or a reality?

Objective: The aim of the study was to evaluate the true incidence, diagnosis, and treatment of benign paroxysmal positional vertigo (BPPV) arising after whiplash injury and to distinguish this type of posttraumatic vertigo from other types of dizziness complained after trauma. Methods: This was a retrospective study comprising patients referred to our center after whiplash injury. The patients were evaluated with neurotologic examination including bedside and instrumental tests. A Dizziness Handicap Inventory evaluating the symptoms of patients was submitted before and after treatment and was evaluated. The BPPV patients were separately evaluated from those with cervicogenic vertigo, and a comparison between our data about idiopathic BPPV was done. Results: Eighteen patients of whiplash who had BPPV were evaluated. The mean age was 38.2 years. BPPV was the cause of vertigo in 33.9% of total whiplash patients. In 16 cases, the posterior semicircular canal was involved; the lateral semicircular canal was involved in 2 cases. The instrumental neurotologic assessment did not show any alteration of either vestibulospinal reflexes or dynamic ocular movements. Duration of symptoms before treatment ranged from 3 to 26 days. A total of 55.5% of patients had relief from their symptoms after first repositioning maneuver. The Dizziness Handicap Inventory score improved in all patients treated with repositioning maneuvers, but no difference emerged with idiopathic BPPV data. Conclusion: BPPV after whiplash injury could be unveiled with a simple bedside examination of peripheral vestibular system, and a treatment could be done in the same session. The diagnosis of posttraumatic BPPV is not different from the idiopathic form, but the treatment may require more maneuvers to achieve satisfactory results

Localisation of mediterranean Kaposi's sarcoma in Morgagni's ventricle

Objective: Head and neck involvement in Kaposi\u2019s Sarcoma (KS) is not unusual . However, laryngeal involvement is a relatively infrequent manifestation and ENT specialists should consider it in differential diagnosis in laryngeal lesions of AIDS patients and/or subjects from the Mediterranean area. Methods: Case report and review of the literature in English Clinical Case: Male patient presenting with a three- month history of cough and acute dispnoea. Laryngoscopy identified a laryngeal mass occluding the glottic plane. Tracheotomy was then performed and the laryngeal lesion was removed. Histopathology showed neoplastic spindle cells that were positive to immunostain with CD-31 and CD-34, and immunoreactivity for HHV-8 was present. A diagnosis of KS was then suspected and confirmed after dermatological inspection. Conclusions: Purple vascular mass lesions should lead in ENT to a high index of suspicion to exclude systemic diseases. Laryngeal KS must be included in the differential diagnosis of pigmented laryngeal lesions to plan correct managemen

Bipolar Quantum Molecular Resonance versus Blunt Dissection tonsillectomy

Bipolar Quantum Molecular Resonance versus Blunt Dissection tonsillectomy. Objectives: This study compared a quantum molecular resonance tonsillectomy (QMRT) to a standard blunt dissection tonsillectomy (BDT) for effectiveness and safety. Methodology: From January 2011 to September 2012, we recruited 80 children (ages 3 to 16 y) with paediatric obstructive sleep apnoea syndrome and/or recurrent tonsillitis. Patients were randomly assigned to receive QMRT (N = 40) or BDT (N = 40). The operating time and blood loss during surgery were evaluated. During the first postoperative week, the patients' parents completed a questionnaire to evaluate bleeding, ear and neck pain, nausea, vomiting, interrupted sleep, oral liquid intake or discomfort in fluid assumption, and analgesic consumption. Results: The average tonsillectomy duration was significantly shorter in the QMRT group (22.07 min \ub1 9.05) than in the BDT group (35.12 min \ub1 13.32; p < 0.000005). The average blood loss during tonsillectomy was significantly lower for the QMRT group (5.62 ml \ub1 7.44) than for the BDT group (43 ml \ub1 33.20; p < 000000001). However, the BDT group reported significantly lower pain scores than the QMRT group on days 2 (p < 0.05), 5 (p < 0.05), and 6 (p < 0.05); on other days, the groups were not significantly different. The BDT group reported two early and one late bleeding episodes; the QMRT group recorded only two late bleeding episodes. Conclusions: QMRT significantly reduced the operating time and intra-operative blood loss. No significant differences were found between the two techniques in postoperative pain or bleeding

Physicochemical parameters and antibiotics residuals in Algerian honey

The aim of the present study was to evaluate the quality of 36 samples of different honey type supplied by local producers from Algeria in order to verify its compliance with the standards of Codex Alimentarius and  European Union (EU). For that, five physicochemical parameters were  analyzed using the HPLC method: hydroxyl-methyl furfural (HMF), sugars, diastase activity and search of antibiotic contamination with streptomycin and tetracycline. The physicochemical analyses of the Algerian honeys show that 56% of samples correspond to Codex standards and 44% not in  conformity with the standards required by the Codex Alimentarius and EU, because part of the samples had one or more defects. The percentage not in conformity was due to the high rates of hydroxyl-methyl furfural, sucroseand also to the low enzyme level. Analysis performed by the laboratory to detect residues of tetracycline and streptomycin in honey have revealed insignificant traces of oxytetracycline in two samples of honey (0.03 ppb). From the present study, it is observed that the Algerian honey samples is not completely in agreement with the requirements of international honey standards which could be caused by inappropriate actions during processing and storage steps.Key words: Honey quality, sugar, diastase activity, hydroxymethylfurfural, antibiotic residues

Treatment of sudden sensorineural hearing loss with transtympanic injection of steroids as single therapy: a randomized clinical study.

The aim of this study was to verify the efficacy and the safety of transtympanic dexamethasone to treat sudden sensorineural hearing loss as first and single drug method. Considering ethical implication of performing a mininvasive procedure on middle ear, we matched such proposed treatment with systemic prednisone administration that represents the widest adopted protocol. Randomized prospective study was conducted. The inclusion criterion was a sudden sensorineural hearing loss of at least 30 dB across three contiguous frequencies over a period of 24 h. Group A received transtympanic steroid injections; Group B received oral administration of steroids. 25 patients were treated with transtympanic therapy whereas 21 underwent systemic treatment. The mean of initial PTA was 59 dB for the whole series: 65 dB for group A and 51 dB for group B. The recovery better than 10 dB was obtained in 80% of patients of group A and in 17 81% of patients of group B, with a total of 80.5%. The mean relative gain in PTA was 41.16% in the group A and 44.7% in the group B. In the frequencies tested (0.5, 1, 2, and 4 kHz) PTA improvements after transtympanic treatment were higher than after systemic treatment, but these differences were not statistically significant (P = 0.61). Both transtympanic and systemic treatment had similar clinical recovery times. This prospective randomized clinical study showed good result in terms of hearing recovery, better than the expected results of the simple observation without treatment. We can consider transtympanic administration as a first line treatment, because of the statistical analysis confirmed similar results with systemic therapy, reducing possible side effects of systemic drug administration. The delay of treatment does not influence the outcome, allowing treating patients within 10 days of onset

Genome-wide mapping of i-motifs reveals their association with transcription regulation in live human cells

Lay Summary Among the secondary structures alternative to the DNA double helix, i-Motifs (iMs) and G-quadruplexes (G4s) are four-stranded non-canonical nucleic acid structures that form in cytosine- and guanine-rich regions, respectively. Because iMs fold in vitro under acidic conditions, they were long thought to form only in vitro. We now show that iMs, like G4s, form in live human cells mainly at gene promoters in open chromatin. iMs that are unstable in vitro still form in cells. iMs and G4s are cell-type specific and associated with increased transcription; however, transcript levels are remarkably different: low for iMs and high for G4s, indicating their distinct activity as regulators of the cell transcriptome. The iM/G4 interplay may represent a novel therapeutic target in disease.i-Motifs (iMs) are four-stranded DNA structures that form at cytosine (C)-rich sequences in acidic conditions in vitro. Their formation in cells is still under debate. We performed CUT & Tag sequencing using the anti-iM antibody iMab and showed that iMs form within the human genome in live cells. We mapped iMs in two human cell lines and recovered C-rich sequences that were confirmed to fold into iMs in vitro. We found that iMs in cells are mainly present at actively transcribing gene promoters, in open chromatin regions, they overlap with R-loops, and their abundance and distribution are specific to each cell type. iMs with both long and short C-tracts were recovered, further extending the relevance of iMs. By simultaneously mapping G-quadruplexes (G4s), which form at guanine-rich regions, and comparing the results with iMs, we proved that the two structures can form in independent regions; however, when both iMs and G4s are present in the same genomic tract, their formation is enhanced. iMs and G4s were mainly found at genes with low and high transcription rates, respectively. Our findings support the in vivo formation of iM structures and provide new insights into their interplay with G4s as new regulatory elements in the human genome

Influence of knee joint position and sex on vastus medialis regional architecture

Ultrasound imaging was used to investigate vastus medialis (VM) architecture in 10 males and 10 females at different knee angles. Increase in muscle thickness occurs predominantly when the knee angle is changed from 0° (full extension) and 45° (p &lt; 0.05); increases in VM pennation angle can be predominantly observed between 45° and 90° (p &lt; 0.05). Sex differences in the VM architecture can be observed in the distal (p &lt; 0.01) but not in the proximal region of the muscle (p &gt; 0.11). </jats:p