Unilateral vocal fold paralysis post-thyroidectomy: does early intervention allow for better voice recovery?

Objective: Thyroidectomy is the primary cause of unilateral vocal fold paralysis (UVFP). A delay in rehabilitation may cause dysfunctional phenomena and worsen dysphonia. The main aim is to investigate the impact of early Speech Therapy (ST) on voice recovery in UVFP post-thyroidectomy and propose an appropriate treatment schedule. Patients and methods: 93 patients with UVFP were analysed. 72 presented transient paralysis and 21 permanent ones. Individuals with permanent paralysis were retrospectively divided in two groups. Group A was composed of 11 patients (8 F, 3 M; mean age: 50.5 ± 8.6) who received ST within 8 weeks; Group B comprised 10 patients (7 F, 3 M; mean age: 57 ± 11.5) treated after more than 8 weeks. Videolaryngostroboscopy (VLS) was assessed and both objective and subjective voice parameters were collected. The non-parametric Wilcoxon test was applied to the sample. Results: The resolution of supraglottic compensations was observed in 91% of cases in Group A, whereas in only 40% of cases in Group B. A functional glottal closure occurred in 73% of patients in group A, while it was completely absent in group B. Group A showed a statistically significant difference between the values of Jitter, NHR, TMF and VHI collected pre-ST compared to that collected after 1 year. Conversely, a statistically significant difference was found only for VHI values in group B. Conclusions: Early ST brings benefits to patients with permanent UVFP, both on voice recovery and on quality of life. A ST protocol should be applied both before and after thyroidectomy. The ST treatment should start early after surgery

Gender differences in internet addiction: A study on variables related to its possible development

Internet addiction and its related variables (i.e., internet gaming addiction, social media addiction, fear of missing out, phubbing) have mostly been investigated in the general population without considering possible gender differences. The present study aimed to investigate the specific characteristics of men and women in the possible development of pathological behaviors related to internet addiction. A total of 276 participants (of ages ranging from 18 to 30 years old) were recruited in the study (46.7% were males) and responded to online questionnaires on variables related to internet addiction and psychological traits. The results showed that gender represents a key factor in explaining why individuals are addicted to the internet in different ways. Stepwise linear regression analyses showed that both genders shared social media addiction as the primary predictor of internet addiction but also exclusive predictors for each gender. Knowing the variables underlying the development of internet Addiction can be useful for both prevention and treatment and tailoring intervention for this addictive behavior

Prevalenza dei sintomi vertigine e instabilità in un campione di 2672 soggetti e correlazione con il sintomo cefalea

La vertigine e l’instabilità sono sintomi molto comuni nella popolazione la cui prevalenza è stimata tra il 20 e il 56%. L’obiettivo del nostro lavoro è stato quello di determinare la prevalenza di questi sintomi in una popolazione di 2672 soggetti. È stato somministrato loro loro un questionario; nella prima parte sono stati richiesti i dati demografici e se avessero mai sofferto di vertigine o instabilità nella loro vita. L’età media del campione è stata di 48,3 ± 15 anni, il 46,7% erano maschi. Sul totale della popolazione 1077 (40,3%) hanno riferito di aver sofferto di vertigine o instabilità nella loro vita, con un primo episodio occorso all’età di 39,2 ± 15,4 anni. Nella seconda parte del questionario sono state indagate le caratteristiche delle vertigini (età del primo episodio, il tipo di vertigine, presenza di più episodi, esacerbazione posizionale della vertigine, presenza di sintomi cocleari infine la presenza di cefalea da moderata o severa nel corso della vita e le sue caratteristiche cliniche (riferita a un emicrania, pulsante, associata a fono o fotofobia, peggiore con l’attività fisica). È stata osservata una correlazione della vertigine con l’età e con il sesso, essendo la prima 4,4 volte più frequente nelle donne e 1,8 volte nei soggetti con oltre 50 anni. Sul campione complessivo di 2672 soggetti, 13,7% hanno riferito vertigine rotatoria, 26,3% episodi recidivanti, 12,9% esacerbazione correlata alla posizione e il 4,8% presenza sintomi cocleari; il 34,8% ha lamentato cefalea nel corso della loro vita. I soggetti affetti da cefalea presentavano un’incidenza aumentata di vertigini recidivanti, di esacerbazione correlata alla posizione, di sintomi cocleari e un’età più giovane di comparsa del primo episodio di vertigine/instabilità. Nella discussione i nostri dati sono stati confrontati con quelli di precedenti studi. Gli autori sottolineano la correlazione tra vertigine/instabilità da un lato e cefalea con caratteristiche emicraniche dall’altro

Genome-wide analyses identify common variants associated with macular telangiectasia type 2

Idiopathic juxtafoveal retinal telangiectasis type 2 (macular telangiectasia type 2; MacTel) is a rare neurovascular degenerative retinal disease. To identify genetic susceptibility loci for MacTel, we performed a genome-wide association study (GWAS) with 476 cases and 1,733 controls of European ancestry. Genome-wide significant associations (P < 5 × 10−8) were identified at three independent loci (rs73171800 at 5q14.3, P = 7.74 × 10−17; rs715 at 2q34, P = 9.97 × 10−14; rs477992 at 1p12, P = 2.60 × 10−12) and then replicated (P < 0.01) in an independent cohort of 172 cases and 1,134 controls. The 5q14.3 locus is known to associate with variation in retinal vascular diameter, and the 2q34 and 1p12 loci have been implicated in the glycine/serine metabolic pathway. We subsequently found significant differences in blood serum levels of glycine (P = 4.04 × 10−6) and serine (P = 2.48 × 10−4) between MacTel cases and controls

La vertigine: sintomo non malattia : i disturbi vestibolo-posturali

I disturbi dell\u2019equilibrio, in generale, e le vertigini in particolare sono un sintomo cardine in tutta la clinica medica. Obiettivo di questa presentazione \ue8 chiarire alcuni aspetti diagnostici e terapeutici, frutto della esperienza clinica. Il primo step nella valutazione di un paziente vertiginoso \ue8 definire il sintomo. Le descrizioni dei sintomi da parte del paziente sono spesso vaghe e inconsistenti. Le vertigini sono illusioni di movimento o rotazione del corpo rispetto all\u2019ambiente o dell\u2019ambiente rispetto al corpo. Sono l' espressione di un malfunzionamento del sistema vestibolare, centrale o periferico, complesso sistema che realizza la funzione dell\u2019equilibrio. Il sistema dell\u2019equilibrio \ue8 complesso sistema senso-psico-motorio finalizzato a: stabilizzare lo sguardo durante i movimenti; attivare la muscolatura tonica antigravitaria necessaria per mantenere la stazione eretta e per consentire il movimento armonico e coordinato; orientare il soggetto nello spazio; regolare funzioni neurovegetative come la pressione arteriosa. Tale funzione \ue8 il risultato dell' elaborazione a livello del tronco encefalico (nuclei vestibolari e sostanza reticolare principalmente) delle afferenze vestibolari, visive, propriocettive e uditive; tale elaborazione \ue8 modulata dalla attivit\ue0 del cervelletto, della corteccia cerebrale e del sistema extrapiramidale. La complessit\ue0 delle informazioni sensoriali e delle regolazioni motorie e neurovegetative in cui il sistema \ue8 interessato giustifica la frequenza della sintomatologia vertiginosa, la molteplicit\ue0 delle possibili cause coinvolte ed anche le difficolt\ue0 di un approccio terapeutico unitario. Le cause dei disturbi dell'equilibrio vanno da disturbi assolutamente benigni a patologie che mettono a repentaglio la vita, Nonostante patologie centrali pericolose non si manifestino comunemente con vertigini o dizziness isolati, l\u2019ictus e altre malattie neurologiche possono iniziare nello stesso modo. Le caratteristiche che le distinguono possono essere molto sottili. Identificare le pi\uf9 comuni patologie periferiche \ue8 una priorit\ue0. Nella presentazione saranno illustrati gli strumenti per riconoscere e trattare le principali forme di vertigine periferica: ruolo dell\u2019anamnesi, ruolo dell\u2019esame clinico, ruolo degli esami strumentali Inoltre verranno definiti i criteri per distinguere la vertigine periferica da quella centrale

Energy Efficiency of Error Control for High Data Rate WPAN

This paper addresses the issue of energy efficiency for error control mechanisms over WPAN systems. An analytical formulation has been developed to study the trade-off between link layer performance and energy consumption for two types of error control schemes: pure ARQ and type II hybrid ARQ protocol. An MC-CDMA-based system is considered. First of all, the analysis has been used to compare different error recovery schemes from the energy efficiency point of view. Moreover, it has been found that, for any channel conditions, there exists an optimal value of the transmit power that maximizes the energy efficiency. The paper also shows how this result can be used to design the power control of an energy efficient CDMA-based communication system

Sinus infection in intensive care patients.

Sinusitis is a complication known to accompany nasotracheal intubation, but its frequency has not been well established. During a two-year-period, 1,126 patients in an intensive care unit have been studied. Twenty-seven of them (2%) developed a bacterial sinusitis. The diagnosis is established on the basis of an unexplained clinical sepsis, imaging evidence of fluid in the maxillary sinus, and antral puncture. Microbiological samples showed Gram-negative micro-organisms, in particular Pseudomonas aeruginosa, and an elevated percentage of Staphylococcus aureus and Escherichia coli. The likely predisposing factors (nasogastric and/or nasotracheal tubes) are discussed. Aetiology, diagnosis and management of the disease are discussed in detail. The importance of prompt removal of nasal instrumentation and of early sinus drainage, in addition to broad-spectrum antibiotic therapy, is emphasized

Musculoskeletal pain in Europe: the role of personal, occupational, and social risk factors

ObjectivesThe prevalence of musculoskeletal pain in European countries varies considerably. We analyzed data from the fifth European Working Conditions Survey (EWCS) to explore the role of personal, occupational, and social risk factors in determining the national prevalence of musculoskeletal pain.MethodsOver the course of 2010, 43 816 subjects from 34 countries were interviewed. We analyzed the one-year prevalence of back and neck/upper-limb pain. Individual-level risk factors studied included: sex; age; educational level; socioeconomic status; housework or cooking; gardening and repairs; somatizing tendency; job demand–control; six physical occupational exposures; and occupational group. Data on national socioeconomic variables were obtained from Eurostat and were available for 28 countries. We fitted Poisson regression models with random intercept by country.ResultsThe main analysis comprised 35 550 workers. Among individual-level risk factors, somatizing tendency was the strongest predictor of the symptoms. Major differences were observed by country with back pain more than twice as common in Portugal (63.8%) than Ireland (25.7%), and prevalence rates of neck/upper-limb pain ranging from 26.6% in Ireland to 67.7% in Finland. Adjustment for individual-level risk factors slightly reduced the large variation in prevalence between countries. For back pain, the rates were more homogenous after adjustment for national socioeconomic variables.ConclusionsOur analysis indicates substantial variation between European countries in the prevalence of back and neck/upper-limb pain. This variation is unexplained by established individual risk factors. It may be attributable in part to socioeconomic differences between countries, with higher prevalence where there is less risk of poverty or social exclusion

Residual dizziness after successful repositioning maneuvers for idiopathic benign paroxysmal positional vertigo.

To establish a possible causal factor for residual dizziness (RD) after successful repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV).Ninety consecutive patients with idiopathic BPPV were treated with repositioning maneuvers, and the rate of RD was assessed as well as clinical data. Posturography and assessment of anxiety levels were performed on patients reporting RD. Results were compared with a control group of BPPV patients of the sample after repositioning maneuvers and without RD.Twenty-eight subjects (31.1\%) reported RD on the second day after successful repositioning maneuvers. The mean duration of RD was 11.6 ± 3.9 days. Patients with RD presented a higher duration of BPPV (14.1 vs. 10.9 days, p = 0.01). A correlation was demonstrated between the duration of BPPV and duration of RD (p < 0.01). Subjects with RD presented increased body sways, above all in eyes-closed conditions.RD is mainly correlated with duration of vertigo in BPPV patients. Anxiety was demonstrated to play a role in increased body sways

Performance and energy efficiency of hybrid ARQ over ground-HAP links

In HAP systems, the on-board power is a limited resource and each HAP-based communication system should use it as effectively as possible. In this paper we address the issue of the energy efficiency of a HAP-based communication system at link layer. An analytical formulation is carried out in order to investigate the trade-off between performance and energy consumption of different error recovery mechanisms, namely, pure-ARQ and type II hybrid ARQ protocols. The results are then used to optimize physical layer parameters, such as the transmission power. A Multicarrier Code Division Multiple Access based air interface is considered. After the definitions of energy efficiency of link level error control schemes, the optimum value of the transmission power in terms of energy efficiency will be computed