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Erratum to: Oculo-auriculo-vertebral spectrum: going beyond the first and second pharyngeal arch involvement (Neuroradiology, (2017), 59, 3, (305-316), 10.1007/s00234-017-1795-1)
No full textIn the article “Oculo-auriculo-vertebral spectrum: going beyond the first and second pharyngeal arch involvement”, the list of author names was incorrect. Author names were inverted with the surname preceding first name. Davide Brotto 1, Renzo Manara 2, Sara Ghiselli 1, Elisa Lovo 1, Rodica Mardari 3, Irene Toldo 4 , Alessandro Castiglione 1, Giovanni Schifano 1, Valentina Stritoni 1, Roberto Bovo 1, Patrizia Trevisi 1, Alessandro Martini 1
Dalle note alla terapia intensiva pediatrica del nostro dipartimento: "possibile ruolo della musica come terapia non farmacologica"
No full textWorking Hypothesis
In the literature there are few and often conflicting evidence about the role of music in improving the comfort of patients admitted to intensive care units, especially in children. These studies are focused in particular on neonatal age, while, as regards as the child, studies are rare and limited to the assessment of a few outcomes.
This study aimed to investigate whether music, in a setting such as the Pediatric Intensive Care Unit of our Department, could help in reducing the stress related to hospitalization of our young patients and improving their neurological status, endocrine and hemodynamic status, with a better adaptation, for instance, to mechanical ventilation.
Materials and Methods
In the period between March and December 2012, we enrolled 20 patients admitted to the Pediatric Intensive Care of the Department of Pediatrics of the University Hospital of Padua, with different pathologies and different degrees of sedation. After a first phase of 30 minutes observation we exposed the children to the first two movements of the 6th Symphony of Beethoven, the "Pastoral", for a period of 45 min, using special headsets and adjusting the volume according to the indications of the American Academy of Pediatrics (<50 db).
Different variables were compared during the two phases: continuous electroencephalographic monitoring was performed followed by qualitative, quantitative and spectral maps analysis; sedation was assessed using Comfort Behavior Scale and FLACC scale was utilized for pain evaluation; plasma and salivary cortisol level was measured as an endocrinolgical marker of stress; heart rate, systolic and diastolic blood pressure, mixed venous oxi-hemoglobin saturation, urine output were recorded as indices of hemodynamic status; continuous transcutaneous arterial oxygen saturation, arterial pCO2 levels from emogasanalysis samples and respiratory rate were measured in the two phases without any changes in mechanical ventilation settings.
Results
The qualitative analysis of EEG showed a transition phase toward drowsiness/sleep in 12 out of 16 patients, with a depth of sleep in patients who were already in that state (4/4) . Moreover, by means of spectral maps and quantitative analysis of the EEG recordings, we highlighted possible areas of brain activation that underwent major changes during music listening and the activation of the frontal regions devoted to the "management" of emotions. The comparison between the sedation and pain evaluation scales obtained by independent operators showed in all cases a reduction of the values obtained before and during music listening that was statistically significant for both the FLACC (Prob> | z | = 0.0003 p-value) and the Comfort Scale (Prob> | z | = p-value 0.0014). The comparison of cortisol levels obtained before and after music listening has shown a reduction of the values in almost all cases (16/18 in the plasma, 13/14 level in salivary). As regards as the vital parameters, the statistical analysis performed showed an evolution of outcomes, in relation to time, significant for the heart rate (p = 0.03), for the average arterial pressure (p = 0064), for diastolic blood pressure ( p = 0.028) and for the respiratory rate (p = 0.086). PaCO2 and mixed venous O2 saturation improved after listening to the music, with a significant effect for PaCO2 (the average value fell from 48.5 to 42 mm Hg). Also urine output significantly improved during music listening (Prob> | z | p-value = 0.001).
Conclusions
Almost all of the variables investigated in the present study showed a marked improvement in the course of music, with a benefit that was highlighted at neurological level, sedation and pain level, endocrine, hemodynamic and respiratory systems. From the analysis of spectral maps and quantitative EEG data it has been shown that sedation does not seem to prevent the acquisition of the musical stimulus and that music is capable of activate the anterior cortical areas involved in the perception of emotions
[The distribution and activities of hemodynamic laboratories in Italy: the implications for the quality of services].
No full text
Temporal bone squamous cell carcinoma: Analyzing prognosis with univariate and multivariate models.
No full textOBJECTIVES/HYPOTHESIS:
Temporal bone squamous cell carcinoma (SCC) is an uncommon malignancy accounting for less than 0.2% of head and neck cancers. Despite advances in its early diagnosis, skull base microsurgery, radiotherapy, and integrated treatments, prognosis in advanced SCCs remains dismal. The present study aimed to analyze the clinicopathological variables potentially influencing outcome in a series of temporal bone SCCs.
STUDY DESIGN:
The prognosis of 41 patients with temporal bone SCC was assessed retrospectively using univariate and multivariate statistical approaches.
PATIENTS AND METHODS:
Twenty-two women and 19 men consecutively operated for primary temporal bone SCC with a curative intent at a tertiary referral center between 1980 and 2008.
RESULTS:
On univariate analysis, cT stage correlated with disease-free survival in months (DFS) (P = 0.037), and pT stage correlated with recurrence rate (P = 0.038), DFS (P = 0.013), and disease-specific survival (DSS) (P = 0.025). Lymph node status (cN0 or pN0 vs. pN+) was associated with DFS (P = 0.025). SCC grading correlated significantly with recurrence rate (P = 0.005), DFS (P = 0.004), and DSS (P = 0.0036). Dura mater involvement was significantly associated with a higher recurrence rate (P = 0.001), a shorter DFS (P = 0.00001), and a lower DSS (P = 0.0001). On multivariate analysis, only dura mater involvement (P = 0.001) and N status (P = 0.012) remained independently prognostic of DFS.
CONCLUSION:
Recurrences occurred despite obtaining block resections according to the tumor's clinical stage and pathologically free margins in all cases. Further analyses are mandatory to investigate hidden microscopic pathways of tumor diffusion, particularly in bone. Multi-institutional protocols are needed to facilitate comparisons between studies and enable meaningful meta-analyses
Confronto tra approccio anatomico ed approccio integrato nell'ablazione della fibrillazione atriale
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