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Canzonieri Cecilia; Ornati Federica; Matti Elina; Chu Francesco; Manfredi Guido; Olivieri Carla; Buscarini Elisabetta; Pagella Fabio; Cesare Danesino.
No full textCommentary: "Sagittal Crest": Definition, Stepwise Dissection, and Clinical Implication From a Transorbital Perspective
No full textMedical education and attitudes about acute otitis media guidelines: a survey of Italian pediatricians and otolaryngologists.
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Medical Education and Attitudes About Acute Otitis Media Guidelines A Survey of Italian Pediatricians and Otolaryngologists
Author(s): Marchisio, P (Marchisio, Paola); Mira, E (Mira, Eugenio)2; Klersy, C (Klersy, Catherine)3; Pagella, F (Pagella, Fabio)2; Esposito, S (Esposito, Susanna); Bianchini, S (Bianchini, Sonia); Di Mauro, G (Di Mauro, Giuseppe)4; Fusi, M (Fusi, Michela); Nazzari, E (Nazzari, Erica); Tagliabue, M (Tagliabue, Marta)2; Bellussi, L (Bellussi, Luisa)5; Principi, N (Principi, Nicola)1
Source: PEDIATRIC INFECTIOUS DISEASE JOURNAL Volume: 28 Issue: 1 Pages: 1-4 DOI: 10.1097/INF.0b013e318184ef02 Published: JAN 2009
Times Cited: 7 (from Web of Science)
Cited References: 36 [ view related records ] Citation Map
Abstract: Background: Medical education and guidelines have been advocated as major means of improving the managernent of otitis media. Limited data are available concerning medical education in acute otitis media (AOM), and the association between medical education and attitudes about AOM guidelines has never been explored.
Objectives: To assess the prevalence of medical education concerning AOM, of a Positive attitude toward AOM guidelines and of appropriate diagnostic methods in a large sample of Italian pediatricians (PEDs) and otolaryngologist (ENTs) and to look for possible associations between them.
Subjects and Methods: This cross-sectional survey was based on the responses of 2012 physicians (1160 PEDs and 852 ENTs) to a mailed anonymous questionnaire.
Results: Very few (9%) of the responders had received any AOM medical education during Medical school, but the number increased (hiring residency (38%) and peaked in the postresidency period (53%) with slight differences between PEDs and ENTs. Forty percent reported a positive attitude toward AOM guidelines, with PEDs having a better attitude than ENTs (46% vs. 32%, P < 0.001), An appropriate diagnostic method for AOM was reported by only 21% of the physicians (PEDs 11% vs. ENTs 35%, P < 0.001). AOM Medical education during postresidency and reporting the use of appropriate diagnostic methods were significantly associated With a positive attitude about AOM guidelines.
Conclusions: Specific educational programs concerning AOM should be implemented and rigorously evaluated, before physicians become fully trained PEDs and ENTs, and maintained during postresidency. Evidence-based guidelines should be further incorporated into everyday practice of both PEDs and ENTs
Evolution in the treatment of sinonasal inverted papilloma: Pedicle-oriented endoscopic surgery
No full textBACKGROUND:
In the literature, the global endoscopic sinus surgery (ESS) success in the treatment of sinonasal inverted papilloma (IP) is 95%. This study was designed to describe a conservative endoscopic approach, based on research of the tumor's pedicle and treatment concentrated on its site of attachment, and to compare the results of this technique with the outcome of standard endoscopic treatment.
METHODS:
Retrospective analysis of the patients treated in our institution for paranasal inverted papilloma (IP), between 2002 and 2011 with a minimum of 18 months follow-up was performed. Group A received a standard ESS including whole sinus demucosization (maxillary, ethmoid, frontal, or sphenoid sinus) and bony wall drilling. Group B patients instead underwent pedicle-oriented endoscopic surgery (POES); in this group, bony demucosization and drilling were selectively conducted around the site of pedicle attachment of the tumor.
RESULTS:
The cohort included 73 patients (median age, 60.5 years; median follow-up, 58 months). Group A/group B consisted of 37/36 patients. IP persistence-recurrence for group A/group B was 0/1 cases. Oncological success for global endoscopic/group A/group B was 98.6% (72/73)/100% (37/37)/97.2% (35/36). We noticed a significant difference in surgical operative time and postoperative complication rate among the groups, in favor of POES technique.
CONCLUSION:
Our data confirm the efficacy of the endonasal endoscopic treatment for sinonasal IP. Moreover, the even more conservative endoscopic treatment proposed (POES) seems to offer good control of the disease, shorter operating times, avoidance of unnecessary surgery with respect to uninvolved structures, and permits a follow-up aimed at the site of the pedicle attachment
Merkel cell carcinoma of the auriche.
No full textAbstract: Merkel cell carcinoma is a rare malignant tumor of the skin. The face and extremities are the most common locations. We present a case of Merkel cell carcinoma of the auricle in a 93-year-old man subsequently treated with surgery and radiotherapy. The clinical features, prognosis, and treatment of the Merkel cell carcinoma are discussed. (c) 2005 Elsevier Inc. All rights reserve
Antibiotic treatment alone for acute rhinosinusitis gives a poor response in allergic children
Full text linkAcute rhinosinusitis (ARS) is frequent in children. Patients with allergic rhinitis show signs of more impaired paranasal sinus functioning than normal subjects during viral colds. This study evaluated the effectiveness of administering antibiotics alone to treat ARS in both allergic and non-allergic children. The results showed that antibiotic therapy alone in the treatment of ARS may be generally insufficient to resolve symptoms, mainly endoscopic signs. Moreover, in allergic children this issue appears to be more evident
A novel device for intraoperative cauterization of bleeding points in endoscopic sinus surgery
No full textHemostasis is a critical point in endoscopic sinus and skull base surgery. A variety of techniques are presently available for reducing intraoperative bleeding; however, several limitations of the classical instruments should be stated. For example, reaching bleeding points in an anatomically angled site with straightforward bipolar devices could be quite difficult. With the aim of solving this problem, we developed a simple system using a standard curved suction tube, a rubber catheter and a monopolar system. This device provides an integrated suction function and is able to reach all paranasal and skull base areas, making it extremely useful in gaining precise access to the site of bleeding while providing excellent endoscopic vision. The described monopolar suction tube has proven to be a valid instrument for intraoperative hemostasis in endoscopic procedures; moreover, it does not add any further cost, making it applicable in particular healthcare settings, such as those in developing countries
An alternative way to perform diagnostic nasopharyngeal swab for SARS-CoV-2 infection
No full textOn March 11, 2020, WHO has defined the novel coronavirus disease SARS-CoV-2 (COVID-19) outbreak as a pandemic and still today continues to affect much of the world. Among the reasons for the rapid spread of SARS-CoV-2 infection, there is not only the high transmissibility of the virus, but also the role of asymptomatic or minimally symptomatic carriers. Therefore diagnostic testing is central to contain the global pandemic. Up to now real-time reverse transcriptase polymerase chain reaction (RT-PCR)-based molecular assays for detecting SARSCoV-2 in respiratory specimens is the current reference standard for COVID-19 diagnosis. Nasopharyngeal swab is the preferred choice for SARS-CoV-2 testing; however is not always a free of complications procedure. In patients with severe coagulopathies or diseases such as HHT, the risk of nosebleeding may be high. As in all those conditions like advanced stage sinonasal neoplasms or unfavorable anatomical characteristics, the nasopharyngeal swab may not be feasible. This work reports a safe and effective procedure of nasopharyngeal swab collection for COVID-19 testing, through the transoral way, in patients with contraindication to perform it transnasally. The procedure proved feasible and well tolerated. The discomfort for the patient is comparable with the execution of an oropharyngeal swab without exposing him to additional complications. In selected cases, the procedure described represents a valid alternative to nasopharyngeal swab performed transnasally. In particular, it allows reaching the area with the highest diagnostic sensitivity. Moreover it can be performed by Otolaryngology and, with adequate training, also by non-specialist staff
Modelling of ALK1 ectodomain and ALK1-ActRIIA-BMP9 receptor complex: hints from Type 2 Hereditary Haemorrhagic Telangiectasia
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