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Sub-Clinical Effects of Chronic Noise Exposure on Vestibular System. 慢性噪声暴露对前庭系统的亚临床影响。
IF 1.5 Pub Date : 2020-05-31 eCollection Date: 2020-05-01
P Viola, A Scarpa, D Pisani, C Petrolo, T Aragona, L Spadera, P De Luca, F M Gioacchini, M Ralli, E Cassandro, C Cassandro, G Chiarella

Aim: to investigate the effect of chronic noise exposure on vestibular function of subjects without clinical evidence of vestibular disorders and with documented cochlear damage from noise.

Subjects and methods: 25 patients with chronic noise-induced hearing loss (NIHL) and without vestibular complaints (group A) and 25 matched controls with sensorineural hearing loss without noise exposure (group B), underwent audiological and vestibular test including caloric and cervical vestibular-evoked myogenic potentials tests (cVEMPs).

Results: In subjects chronically exposed to noise, similarly to that of the auditory threshold, an increase in the evocation threshold of VEMPs has been documented, statistically significant (p<0,05) and independent of the performance of the auditory threshold. p1-n1 amplitude values showed a significant difference between group A and group B. No significant difference for p1-n1 latencies between the two groups was found.

Conclusion: We have documented the possibility of vestibular lesion, along with cochlear damage, related to chronic acoustic trauma.

目的:探讨慢性噪声暴露对无前庭功能障碍临床证据和有耳蜗噪声损伤记录的受试者前庭功能的影响。对象和方法:25例无前庭不适的慢性噪声性听力损失(NIHL)患者(A组)和25例无噪声暴露的感音神经性听力损失患者(B组)进行听力学和前庭测试,包括热量和颈前庭诱发肌电位测试(cvemp)。结果:在长期暴露于噪音的受试者中,与听觉阈值相似,vemp的唤起阈值增加,具有统计学意义(结论:我们已经记录了与慢性听觉创伤相关的前庭病变以及耳蜗损伤的可能性。
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引用次数: 0
Laparoscopic Repair of Paediatric Indirect Inguinal Hernia: Modified Flip Flap Technique. 腹腔镜下小儿腹股沟斜疝修补术:改良翻转瓣技术。
IF 1.5 Pub Date : 2020-05-31 eCollection Date: 2020-05-01
A Garzi, M Prestipino, E Calabrò, R M Di Crescenzo, M S Rubino

In paediatric age, indirect inguinal hernia represents more than 95% of the hernial disease. It is a congenital type, in contrast with adulthood in which acquired forms are more frequently found (1). The laparoscopic correction of indirect inguinal hernia is one of the most common surgeries performed in paediatric age. In recent years, various techniques have been introduced for the videolaparoscopic correction of this disease. The aim of this study is to provide an assessment of the efficacy and safety of the execution of a modified Flip-Flap technique, using tissue glue for filling of Peritoneal-vaginal duct (DPV), performed in order to ensure greater suture tightness and reduce the incidence of postoperative hydrocele. author1, author2, author 2, author1, author1, author 2 The Authors present a retrospective review of their record of cases, considering a total of 187 patients aged between 18 months and 14 years. For the correction of the hernial defect, the modified VLS Flip-Flap technique was carried out. The evaluation of safety, efficacy, operating time, relapse rate and development of short-term complications (such as postoperative hydrocele, scrotal hematoma or ecchymosis, atrophy or iatrogenic testicle ascension) was considered in a mean follow-up of 6 months. The Authors suggest that this variant of the peritoneal Flip-Flap technique is simple to perform; its safety, reproducibility and effectiveness is proven and has a percentage of relapses and complications overlapping with the "open" approach and superior to other laparoscopic techniques.

在儿科年龄,腹股沟间接疝占疝病的95%以上。这是一种先天性的类型,而成人期的获得性形式更常见(1)。腹腔镜矫正腹股沟斜疝是儿科年龄最常见的手术之一。近年来,各种技术已被介绍为腹腔镜矫正这种疾病。本研究的目的是评估一种改良的Flip-Flap技术的有效性和安全性,该技术使用组织胶填充腹膜-阴道导管(DPV),以确保更大的缝合严密性并减少术后鞘膜积液的发生率。作者1,作者2,作者2,作者1,作者1,作者2作者对他们的病例记录进行了回顾性回顾,考虑了187例年龄在18个月至14岁之间的患者。为了矫正疝缺损,采用改良的VLS Flip-Flap技术。平均随访6个月,评估安全性、有效性、手术时间、复发率和短期并发症(如术后鞘膜积液、阴囊血肿或瘀斑、萎缩或医源性睾丸升高)的发生情况。作者认为这种腹膜Flip-Flap技术的变体操作简单;其安全性、可重复性和有效性已得到证实,其复发和并发症的比例与“开放式”入路重叠,优于其他腹腔镜技术。
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引用次数: 0
Minimally Invasive Treatment of Urolithiasis in Children: Evaluation of the Use of Flexible Ureterorenoscopy and Laser Lithotripsy 儿童尿石症的微创治疗:软性输尿管镜和激光碎石术的应用评价
IF 1.5 Pub Date : 2020-05-01 DOI: 10.14273/UNISA-2816
A. Garzi, M. Prestipino, E. Calabró, R. D. Di Crescenzo, M. Rubino
Urolithiasis is a multifactorial disease; in recent years, its incidence has gradually increased in pediatric age. Among the factors involved in urolithiasis pathophysiology, urinary tract anomalies and metabolic diseases are the most relevant, although ethnicity and environmental factors may have an important role. The advances in technology and miniaturization of endoscopic devices have permitted the use of Retrograde Intrarenal Surgery (RIRS) to treat kidney and ureteral stones. Nowadays, flexible ureterorenoscopy and laser lithotripsy, which are techniques that have been applied in the management of adult upper urinary tract disorders, are also used in children as a minimally invasive treatment of urolithiasis with encouraging, effective and safe results. The Authors report a retrospective review of their record of cases considering 21 pediatric urolithiasis treatment procedures performed between October 2017 and April 2019 in a total of 17 patients (10 males and 7 females). Six procedures involved the use of the flexible ureterorenoscope (FURS) while in 15 procedures the application of the laser fiber was used (FURSL). A case of laser lithotripsy for bladder stone was included. The average age of patients was 10.5 years (2–18 years). The renal pelvis dilatation pretreatment was evaluated in post-operative follow-up. From the evaluation of the sample in analysis, the use of RIRS has good results in the treatment of paediatric urolithiasis, emerging as a valid option in the management of the paediatric population in terms of efficacy and safety, with an improvement in patient outcomes.
泌尿系结石是一种多因素疾病;近年来,其发病率在儿科年龄段逐渐增加。在尿石症病理生理学的相关因素中,尿路异常和代谢性疾病是最相关的,尽管种族和环境因素可能起着重要作用。技术的进步和内窥镜设备的小型化允许使用逆行肾内手术(RIRS)治疗肾和输尿管结石。如今,柔性输尿管肾镜和激光碎石术已被应用于成人上尿路疾病的治疗,也被用于儿童尿路结石的微创治疗,取得了令人鼓舞、有效和安全的结果。作者报告了对2017年10月至2019年4月期间共17名患者(10名男性和7名女性)进行的21次儿童尿石症治疗的病例记录的回顾性审查。6个手术涉及使用柔性输尿管肾镜(FURS),而在15个手术中使用了激光纤维(FURSL)。包括一例膀胱结石激光碎石术。患者的平均年龄为10.5岁(2-18岁)。在术后随访中评估肾盂扩张预处理。从分析样本的评估来看,RIRS的使用在治疗儿童尿石症方面取得了良好的效果,在疗效和安全性方面成为管理儿科人群的有效选择,并改善了患者的预后。
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引用次数: 2
Pleomorphic Adenoma of the Parotid Gland and Ipsilateral Thyroid Incidentaloma: Report of A Rare Case With Review of Literature 腮腺多形性腺瘤及同侧甲状腺偶发瘤1例报告并文献复习
IF 1.5 Pub Date : 2020-05-01 DOI: 10.14273/UNISA-2822
F. Candelori, A. Minni, A. Greco, A. Scarpa, C. Cassandro, M. Cavaliere, M. Bisognox, E. Cassandro, M. de Vincentiis, M. Ralli
Background Pleomorphic adenomas are benign tumors of the salivary glands that mainly affect the lower pole of the superficial lobe of the parotid gland. The term “pleomorphic” refers to the epithelial and connective origin of the mass. The clinical presentation is typically that of asymptomatic swelling which increases in volume. Therapy consists in surgical removal of the tumor mass by parotidectomy with nerve preservation. Case details This clinical case describes an interesting case of pleomorphic adenoma of the parotid gland in a 62-year-old patient. The patient presented with a long history of an asymptomatic mildly worsening swelling of the left parotid region. The peculiarity of the clinical case is the dimension of the adenoma (9x5x9 cm) and the presence of a thyroid incidentaloma (TI), consisting of a thyroid multinodular goiter composed of nodules, the largest of which measured 8 cm in diameter. This mass dislocated the laryngotracheal axis, compressed the larynx and caused the reduction of the respiratory space, making orotracheal intubation difficult and determining the need to perform a tracheotomy. Conclusion Benign pleomorphic adenomas can potentially reach large sizes if untreated. Socio-economic problems may be the reason for late diagnosis.
背景多形性腺瘤是唾液腺的良性肿瘤,主要影响腮腺浅叶下极。术语“多形性”是指肿块的上皮和结缔组织来源。临床表现通常是体积增加的无症状肿胀。治疗包括通过保留神经的腮腺切除术切除肿瘤块。病例详情本临床病例描述了一例62岁患者的腮腺多形性腺瘤。患者有长期无症状轻度恶化的左腮腺肿胀病史。临床病例的特点是腺瘤的大小(9x5x9厘米)和甲状腺偶发瘤(TI)的存在,该瘤由结节组成的甲状腺多结节性甲状腺肿组成,其中最大的结节直径为8厘米。这种肿块使喉气管轴错位,压迫喉部,导致呼吸间隙缩小,使经口气管插管困难,并决定是否需要进行气管切开。结论如果不治疗,良性多形性腺瘤可能会达到较大的大小。社会经济问题可能是诊断延迟的原因。
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引用次数: 1
Surgical VLS Therapy of Oesophageal Achalasia in Pediatric Age 小儿食管失弛缓症的VLS手术治疗
IF 1.5 Pub Date : 2020-05-01 DOI: 10.14273/UNISA-2817
A. Garzi, M. Prestipino, M. Rubino, E. Calabró
The Authors present a retrospective review of their record of cases, characterized by 4 cases of achalasia in which it was performed a Heller myotomy with front fundoplication (Thall) in laparoscopic approach in the period from 2012 to 2019. In paediatric achalasia, the laparoscopic Heller myotomy seems to be the best treatment because of its multiple advantages offered by the minimally invasive technique. First of all, thanks to the video-technique, which allows a complete and extended myotomy, the accuracy of this operation is maximized; moreover, the post-operative pain is widely reduced, thanks to the minimal dissection and traction of the tissues; finally, but not negligible, this approach ensures a better aesthetic result than the classic open technique. With regard to the front fundoplication, the Authors suggest that it is mandatory because, even if it extends the operating time, it ensures a natural protection to the myotomy herniated mucosa and avoids gastro-oesophageal reflux, which often occurs after the surgical correction, thus obliging to perform a reoperation.
作者对他们的病例记录进行了回顾性审查,以2012年至2019年期间4例贲门失弛缓症为特征,其中在腹腔镜入路中进行了Heller肌切开术和前底折叠术(Thall)。在儿科贲门失弛缓症中,腹腔镜Heller肌切开术似乎是最好的治疗方法,因为微创技术具有多种优势。首先,得益于视频技术,可以进行完整和扩展的肌切开术,该手术的准确性最大化;此外,由于组织的剥离和牵引最小,术后疼痛大大减轻;最后,但不能忽略的是,这种方法确保了比经典的开放技术更好的美学效果。关于前胃底折叠术,作者建议它是强制性的,因为即使它延长了手术时间,它也能确保对肌切开术后突出的粘膜的自然保护,并避免胃食管反流,这通常发生在手术矫正后,因此有必要进行再次手术。
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引用次数: 0
Mozart’s or Ambient Music do not Affect Autoalgometric Pain Threshold 莫扎特或环境音乐不会影响自动算法疼痛阈值
IF 1.5 Pub Date : 2020-05-01 DOI: 10.14273/UNISA-2825
N. Vecchione, L. Lorusso, A. Viggiano
Nowadays, researchers and clinicians are increasingly interested in alternative non-pharmacological treatments, and music therapy seems to have additional and powerful effects on different pathologies and pain. However, since pain is a subjective perception, it is difficult to evaluate if and which effect music has on it. In this study, a new device and method have been introduced to objectively estimate pain threshold and its changes related to external stimuli. The above-mentioned device, called autoalgometer, allows to evaluate pain threshold changes while listening to music or other sounds. In this experiment, the pain threshold was evaluated in twenty-seven volunteers after listening to one out of three different soundtracks: white noise, Mozart’s sonata K448 or Brian Eno’s ambient music. Compared to staying in silence, listening to the recordings had no significant effect on pain threshold, and the results did not show any significant difference between the experimental groups. Probably, the positive effect of music described in other studies can be ascribed to a psychological effect, meaning that music can improve subjective mood and, thus, modify pain perception.
如今,研究人员和临床医生对替代性非药物治疗越来越感兴趣,音乐治疗似乎对不同的病理和疼痛有着额外而强大的影响。然而,由于疼痛是一种主观感知,因此很难评估音乐是否对其产生影响以及对其产生何种影响。在本研究中,引入了一种新的设备和方法来客观估计疼痛阈值及其与外部刺激相关的变化。上述设备被称为自动算法仪,可以在听音乐或其他声音时评估疼痛阈值的变化。在这个实验中,27名志愿者在听了三种不同音轨中的一种后评估了疼痛阈值:白噪音、莫扎特的奏鸣曲K448或布莱恩·伊诺的环境音乐。与保持沉默相比,听录音对疼痛阈值没有显著影响,实验组之间的结果也没有任何显著差异。也许,其他研究中描述的音乐的积极影响可以归因于心理影响,这意味着音乐可以改善主观情绪,从而改变疼痛感知。
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引用次数: 1
Effects of Polyurethane Foam Dressings as an Add-on Therapy in the Management of Digital Ulcers in Scleroderma Patients 聚氨酯泡沫敷料在硬皮病患者指溃疡治疗中的作用
IF 1.5 Pub Date : 2020-05-01 DOI: 10.14273/UNISA-2823
F. Rossi, F. Rivellese, F. Napolitano, F. Mosella, C. Selleri, N. Montuori, A. de Paulis
Digital ulcers (DUs) represent a severe and common complication occurring in patients affected by Systemic Sclerosis (SSc), with a consistent impact on the quality of life and often resulting in longer hospitalization than unaffected patients. Conventional treatment of SSc ulcers consists of both topical and systemic (oral or intravenous) pharmacological therapies. Several surgical options are also available, but there is overall a lack of official guidelines or recommendations. The aim of this study was to evaluate the efficacy of a novel local therapy based on polyurethane foam dressings, namely the Highly Hydrophilic Polyurethane Foam (HPF), in addition to the conventional pharmacological treatment, in a cohort of 41 SSc patients with at least one active ulcer. Our results showed that the addition of HPF to the conventional treatment based on systemic drugs induced i) a significant reduction in the number of active DUs (p=0.0034); ii) a significant reduction of the mean duration of ulcer-related hospitalization as compared with standard therapy (p=0.0001); iii) a significant improvement of patients’ Quality of Life, as evaluated through the Scleroderma Health Assessment Questionnaire (SHAQ) (p=0.00011). Therefore, in our experience, the combined management of DUs can improve both the onset of new DUs and DU’s healing thus leading to a better outcome.
指溃疡(DU)是发生在系统性硬化症(SSc)患者中的一种严重而常见的并发症,对生活质量有持续的影响,通常导致住院时间比未受影响的患者更长。SSc溃疡的常规治疗包括局部和全身(口服或静脉)药物治疗。也有几种手术选择,但总体上缺乏官方指南或建议。本研究的目的是评估一种基于聚氨酯泡沫敷料的新型局部治疗方法,即高亲水性聚氨酯泡沫(HPF),以及常规药物治疗的疗效,该方法对41名至少有一例活动性溃疡的SSc患者进行了队列研究。我们的结果表明,在基于全身药物的常规治疗中添加HPF诱导i)活性DU数量显著减少(p=0.0034);ii)与标准治疗相比,溃疡相关住院的平均持续时间显著缩短(p=0.0001);iii)通过硬皮病健康评估问卷(SHAQ)评估,患者的生活质量显著改善(p=0.000011)。因此,根据我们的经验,对DU的联合治疗可以改善新DU的发作和DU的愈合,从而获得更好的结果。
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引用次数: 3
Dietary Restriction for The Treatment of Meniere’s Disease 梅尼埃病的饮食限制治疗
IF 1.5 Pub Date : 2020-05-01 DOI: 10.14273/UNISA-2824
P. Luca, C. Cassandro, M. Ralli, F. Gioacchini, R. Turchetta, M. P. Orlando, I. Iaccarino, M. Cavaliere, E. Cassandro, A. Scarpa
Meniere’s disease (MD) is an idiopathic inner ear disorder characterized by spontaneous recurrent vertigo, fluctuating sensorineural hearing loss (SNHL), aural fullness and tinnitus. Endolymphatic hydrops (EH) of the inner ear is currently considered the pathophysiological mechanisms that underlies typical symptoms of MD. MD diagnosis is based on the criteria of the Baràny Society. There are many therapeutic options for MD, but none is considered effective by the scientific community. The first-line treatment commonly includes dietary modification, as low salt diet and reduction of alcohol and caffeine daily intake. Although some studies showed a positive effect of these dietary restrictions, even in the prevention of recurrences, currently there is no uniform consensus on their usefulness. New dietary approach, such SPC-flakes, are being evaluated: further assessments will be needed to validate their use in clinical practice.
梅尼埃病(MD)是一种特发性内耳疾病,其特征是自发性复发性眩晕、波动性感音神经性听力损失(SNHL)、听觉饱胀和耳鸣。内耳内淋巴积水(EH)目前被认为是MD典型症状的病理生理机制。MD的诊断基于Baràny协会的标准。MD有很多治疗选择,但科学界认为没有一种是有效的。一线治疗通常包括改变饮食,如低盐饮食和减少每日酒精和咖啡因摄入。尽管一些研究表明,这些饮食限制有积极作用,即使在预防复发方面也是如此,但目前对其有用性还没有达成一致意见。正在评估新的饮食方法,如SPC薄片:需要进一步评估,以验证其在临床实践中的应用。
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引用次数: 12
A New Strategy for a High Tumour Burden Region: The Campania Oncological Network. 高肿瘤负担地区的新策略:坎帕尼亚肿瘤网络。
IF 1.5 Pub Date : 2020-02-20 eCollection Date: 2020-01-01
S De Placido, U Bracale, R Pacelli, M Sodo, G Merola, V Silvestri, F Corcione
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引用次数: 0
Evidence on the Need for an Integrated Approach to the Management of Diabetes: The Diagnostic Perspective if Osteomyelitis is Suspected 糖尿病综合治疗的必要性证据:怀疑骨髓炎的诊断视角
IF 1.5 Pub Date : 2020-02-20 DOI: 10.14273/UNISA-2808
B. Saleem
19 Università degli Studi di Salerno Background According to the International Diabetes Federation 9.3% of adults aged 20–79 years (463 million people worldwide) are living with diabetes and the number is still raising: this will lead to an increased number of expected complications, including infections. Besides, at least half of all amputations occur in people with diabetes, most commonly because of an infected diabetic foot ulcer. Diabetic foot osteomyelitis (DFO) remain the most frequent diabetic complication, associated with substantial morbidities, requiring hospitalization, daily wound care, antimicrobial therapy and is the most common precipitating event leading to lower extremity amputation. DFO is associated with high health care costs.
19萨莱诺大学背景根据国际糖尿病联合会的数据,9.3%的20-79岁成年人(全球4.63亿人)患有糖尿病,而且这个数字还在上升:这将导致包括感染在内的预期并发症的增加。此外,至少一半的截肢手术发生在糖尿病患者身上,最常见的原因是糖尿病足溃疡。糖尿病足骨髓炎(DFO)仍然是最常见的糖尿病并发症,与大量疾病相关,需要住院治疗、日常伤口护理和抗菌治疗,是导致下肢截肢的最常见的诱因。DFO与高昂的医疗保健成本有关。
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引用次数: 1
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