67 research outputs found
Sialendoscopic management of autoimmune sialadenitis: a review of literature
Autoimmune diseases of major salivary glands include Sjögren's syndrome and a complex of disorders classified as immunoglobulin G4-related diseases. These pathologies are characterised by an autoimmune reaction mediated by T-helper lymphocytes that targets the ducts of exocrine glands in Sjögren's syndrome and glandular parenchyma in immunoglobulin G4-related diseases. Immunoglobulin G4-related diseases represent recently introduced multi-organ diseases that also involve the salivary glands. However, the morbid conditions once known as Mikulicz's disease and Kuttner's tumour were recently considered as two variants of immunoglobulin G4-related diseases affecting the major salivary glands ( immunoglobulin G4-related sialadenitis). This review briefly summarises the pathogenesis and clinical features of autoimmune diseases of the major salivary glands, focusing on the diagnostic and therapeutic role of sialendoscopy
Myringotomy and ventilation tube insertion with endoscopic or microscopic technique in adults: a pilot study
The purpose of this study is to assess the feasibility of endoscopic-assisted myringotomy and ventilation tube insertion in adults affected by chronic otitis media with effusion, comparing the outcomes of this approach with those obtained with the traditional microscopic technique. Twenty-four patients were enrolled in this trial and alternately assigned to 2 groups of 12 subjects each. In group A, patients underwent myringotomy and ventilation tube insertion under endoscopic view, whereas in group B, the same procedure was performed traditionally using a microscope. All cases were evaluated 1 week after surgery and then monthly until tube extrusion. Type A tympanogram was achieved in 10 of 13 ears in both groups (76.92%). No significant difference in operative times or complication rates was observed (P > .05). Endoscopic technique could be a viable alternative to the microscopic approach for myringotomy and ventilation tube positioning in adults affected by chronic otitis media with effusion
Use of irrigation device for duct dilatation during sialendoscopy
Background: Continuous irrigation of the duct with isotonic saline is one of the fundamental stages of a successful sialendoscopic procedure. It allows for an adequate luminal distension for the removal of debris and mucous plugs and for the conservative treatment of strictures. This procedure, which commonly involves the use of a medical syringe, can be laborious, and it is often necessary to interrupt irrigation during surgery due to the high resistance to saline. Setting: Academic university hospital. Method: We propose the use of an irrigation device which consists of a high-pressure syringe barrel, an ergonomic piston handle, and a gauge used to monitor the inflation and deflation of balloon catheters. The system allows for a simple and safe dilation, ensuring good visualization of the salivary duct lumen during sialendoscopy. Conclusions: The irrigation system described can be widely used to perform a diagnostic or interventional sialendoscopy more effectively than with a typical manual irrigation procedure
Intraconal tumor-like mass as first manifestation of IgG4-related disease
A great variety of tumors and tumor-like lesions can involve the orbit. Benign and malignant neoplasms, inflammatory diseases, vascular and congenital lesions take part of this heterogeneous group that creates many challenges for diagnosis, management, and treatment.
Obviously, symptoms and clinical history are fundamental to establish a differential diagnosis, and imaging is mandatory to distinguish between lesions that have similar clinical presentations in most cases. With this report, the authors highlight the diagnostic difficulties and the importance to include not only tumors but also vascular inflammatory process into the differential diagnosis of this unilateral orbital lesion type
Upright BPPV Protocol: Feasibility of a New Diagnostic Paradigm for Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo Compared to Standard Diagnostic Maneuvers
Bollettino Sismico Italiano: Analisys of Early Aftershocks of the 2016 MW 6.0 Amatrice, MW 5.9 Visso and MW 6.5 Norcia earthquakes in Central Italy
The Amatrice-Visso-Norcia seismic sequence is the most important of the last 30 years in Italy. The seismic sequence started on 24 August, 2016 and still is ongoing in central Apennines. At the end of February 2017 more than 57,000 events were located, 80,000 events up to the end of September 2017 (Fig. 1). The mainshocks of the sequence occurred on 24 August 2016 (Mw 6.0 and Mw 5.4), 26 October 2016 (Mw 5.4 and Mw 5.9), 30 October 2016 (Mw 6.5), 18 January 2017 (four earthquakes Mwâ„ 5.0).
In this seismic sequence, all the waveforms recorded by temporary stations deployed by the SISMIKO emergency group (stations T12**; Moretti et al., 2016) where available in real- time at the surveillance room of INGV. Because of the high level of seismicity and the dense seismic network installed in the region, more than 150 events per day were located at the end of February 2017; still 60 events per day were located up to the end of August 2017.The Amatrice-Visso-Norcia is the most important seismic sequence since 2015, the time when the analysis procedures of the BSI group (Bollettino Sismico Italiano) were revised (Nardi et al., 2015). BSI is now available every four months on the web: bulletins contain revised earthquakes (location and magnitude) with MLâ„ 1.5, quasi-real time revision of MLâ„ 3.5 earthquakes and phase arrivals from waveforms recorded on seismic stations available from the European Integrated Data Archive (EIDA), (Mazza et al., 2012).
These last procedures allow the integration of signals from temporary seismic stations (Moretti et al., 2014) installed by the emergency group SISMIKO (Moretti and Sismiko working group, 2016), even when they are not in real time transmission, if they are rapidly archived in EIDA, together with real time signals from the seismic stations of the permanent INGV network.
The analysis strategy of the BSI group for the Amatrice -Visso - Norcia seismic sequence (AVN.s.s in the following) was to select the earthquakes located in the box with min/max latitude: 42.2/43.2 - and min/max longitude: 12.4/14.1 to prepare a special volume of BSI on the seismic sequence.PublishedTrieste, Italy1SR. TERREMOTI - Servizi e ricerca per la Societ
Dupilumab in the treatment of severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP): A multicentric observational Phase IV real-life study (DUPIREAL)
Background
Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with significant morbidity and reduced health-related quality of life. Findings from clinical trials have demonstrated the effectiveness of dupilumab in CRSwNP, although real-world evidence is still limited.
Methods
This Phase IV real-life, observational, multicenter study assessed the effectiveness and safety of dupilumab in patients with severe uncontrolled CRSwNP (nâ=â648) over the first year of treatment. We collected data at baseline and after 1, 3, 6, 9, and 12âmonths of follow-up. We focused on nasal polyps score (NPS), symptoms, and olfactory function. We stratified outcomes by comorbidities, previous surgery, and adherence to intranasal corticosteroids, and examined the success rates based on current guidelines, as well as potential predictors of response at each timepoint.
Results
We observed a significant decrease in NPS from a median value of 6 (IQR 5â6) at baseline to 1.0 (IQR 0.0â2.0) at 12âmonths (pâ<â.001), and a significant decrease in Sino-Nasal Outcomes Test-22 (SNOT-22) from a median score of 58 (IQR 49â70) at baseline to 11 (IQR 6â21; pâ<â.001) at 12âmonths. Sniffin' Sticks scores showed a significant increase over 12âmonths (pâ<â.001) compared to baseline. The results were unaffected by concomitant diseases, number of previous surgeries, and adherence to topical steroids, except for minor differences in rapidity of action. An excellent-moderate response was observed in 96.9% of patients at 12âmonths based on EPOS 2020 criteria.
Conclusions
Our findings from this large-scale real-life study support the effectiveness of dupilumab as an add-on therapy in patients with severe uncontrolled CRSwNP in reducing polyp size and improving the quality of life, severity of symptoms, nasal congestion, and smell
Analisi Del Bollettino Sismico Italiano A Seguito Del Terremoto Di Amatrice Mw 6.0 (24 Agosto 2016, Italia Centrale)
La sequenza sismica che ha seguito il terremoto di magnitudo momento MW= 6.0 di Amatrice del 24 agosto 2016 Ăš la prima sequenza rilevante che avviene da quando, allâinizio del 2015, le modalitĂ di analisi del Bollettino Sismico Italiano (BSI) sono state aggiornate (Nardi et al., 2015). Queste modalitĂ prevedono la pubblicazione del BSI ogni quattro mesi, la revisione solo degli eventi con MLâ„ 1.5, la revisione rapida degli eventi con MLâ„ 3.5 e lâintegrazione allâinterno del BSI di tutte le stazioni i cui dati sono archiviati nello European Integrated Data Archive (EIDA). Questâultima procedura permette di integrare nel BSI anche le stazioni temporanee (Moretti et al., 2014) installate dal gruppo di emergenza SISMIKO (Sismiko working group, 2016), le cui registrazioni vengono archiviate, in tempi brevi, in EIDA (Mazza et al., 2012) insieme alle stazioni trasmesse in real-time. I quadrimestri del BSI 2015 e il primo del 2016 sono attualmente disponibili (http://cnt.rm.ingv.it/bsi) in formato QuakeML; tale formato contiene le localizzazioni con la stima degli errori, le magnitudo (MW, ML, Md), le letture delle fasi P ed S e i Time Domain Moment Tensor (TDMT). Sono stati inoltre sviluppati alcuni webservices (http://webservices.rm.ingv.it/ws_fdsn.php) per facilitare la lettura dei QuakeML e per rendere il bollettino fruibile alla comunitĂ scientifica. Il terremoto di MW 6.0, avvenuto nella notte del 24 agosto 2016, alle ore 01:36 UTC, nellâarea al confine tra lâUmbria, il Lazio, lâAbruzzo e le Marche, ha dato inizio a una sequenza sismica che al 23 settembre 2016 contava circa 11000 eventi.PublishedLecce, Italy4IT. Banche dat
Bollettino Sismico Italiano: gennaio - aprile 2015
Nel primo quadrimestre 2015 si sono verificati 5 eventi di magnitudo superiore a 4: il 23 gennaio un Mw 4.3 Ăš stato localizzato tra le province di Bologna e Prato, seguito da una sequenza di alcune centinaia di eventi; il 6 febbraio un Mw 4.7 al largo delle Isole Eolie, ad oltre 270 km di profonditĂ ; il 28 febbraio un Mw 4.1 nella Piana del Fucino; il 15 aprile un evento di magnitudo Mw 4.3 nel Mar Tirreno, al largo della costa calabra occidentale, ad una profonditĂ di oltre 250 km e il 24 aprile un terremoto di magnitudo ML 4.0 tra le province di Ravenna e ForlĂŹ-Cesena,seguito da una sequenza di oltre 80 repliche.Istituto Nazionale di Geofisica e Vulcanologia e Dipartimento Protezione CivilePublished4IT. Banche dat
Bollettino Sismico Italiano: maggio - agosto 2015
Nel secondo quadrimestre 2015 si sono verificati 7 eventi di magnitudo superiore a 4: il 9 maggio un evento di ML 4.5 Ăš stato localizzato nel basso Tirreno ad una profonditĂ di circa 217 km; lâ11 maggio un terremoto di
Mw 4.4 nel Mar Ionio a circa 47 km di profonditĂ ; il 29 maggio un Mw 4.2 nel Mar Adriatico di fronte a San Benedetto del Tronto; il 2 agosto un evento di magnitudo ML4.0 nel Mar Tirreno, al largo della costa calabra occidentale, ad una profonditĂ di circa 247 km e il 3 agosto un terremoto di magnitudo ML 4.0 tra le province di Cosenza e Catanzaro a sud della Sila, seguito da una sequenza di oltre 80 repliche di piccola magnitudo.
Lâ8 agosto 2015 si Ăš verificato un terremoto di ML 4.1 alle Isole Eolie, ed infine il 29 agosto un evento di Mw
4.0 vicino al confine della Slovenia con il Friuli Venezia Giulia, seguito da una sequenza sismica che Ăš continuata anche dopo il 31 agosto.Istituto Nazionale di Geofisica e Vulcanologia - Dipartimento di Protezione CivilePublished4IT. Banche dat
- âŠ