Guidelines of the French Society of Otorhinolaryngology. Role of the ENT specialist in the diagnosis of childhood obstructive sleep apnea-hypopnea syndrome (OSAHS). Part 1: Interview and physical examination

ObjectivesTo present the 2017 Clinical Practice Guidelines of the French Society of Otorhinolaryngology concerning the role of the ENT specialist in the diagnosis of pediatric obstructive sleep apnea-hypopnea syndrome. This article focuses specifically on medical history and physical examination.MethodsA multidisciplinary work-group drew up a first version of the guidelines, graded according to level of evidence following the GRADE grading system. The final version was obtained by including the suggestions and comments from the editorial group.ResultsAt the end of the process, guidelines were established and graded regarding the following points: interview and analysis of the various interview scores recommended in the literature; clinical examination with awake upper-airway endoscopy; and indications for referral to non-ENT specialists.     

Are plain-language summaries included in published reports of evidence about physiotherapy interventions? Analysis of 4421 randomised trials,systematic reviews and guidelines on the Physiotherapy Evidence Database (PEDro)

BackgroundA plain-language summary is a short and clearly stated version of a study’s results using non-scientific vocabulary that provide many advantages for patients and clinicians in the process of shared decision-making.ObjectivesThe primary objective was to investigate the extent to which published reports of physiotherapy interventions provide plain-language summaries. We investigate as the secondary objectives if the available plain-language summaries are at a suitable reading level for a lay person and if inclusion of plain-language summaries in these reports is increasing over time and is associated with trial quality (i.e. PEDro score).Data sourcesAll 4421 randomised controlled trials (RCT), systematic reviews and clinical practice guidelines that included plain-language summaries indexed on Physiotherapy Evidence Database (PEDro) were included.Main outcome measuresProportion of published reports with plain-language summaries, Flesch Reading Ease Score (FRES) and the Flesch–Kincaid Grade Level (FKGL).ResultsThe number of published reports with a plain-language summary doubled in the last 6 years. From a total of 34,444 reports indexed on PEDro, only 4421 reports had English plain-language summaries. RCTs with plain-language summaries had higher PEDro scores than RCTs without plain-language summaries (mean difference = 0.8 points, 95%CI 0.7 to 0.8). Only 2% of reports were considered at a suitable reading level by the FKGL formula and 0.1% by the FRES formula.ConclusionsAlthough the publication of plain-language summaries is increasing over time, the current number corresponds to only 13% of all published reports. In addition the majority of plain-language summaries are written at an advanced reading level.     

Clinical presentation of young people (10–24 years old) with brain tumors: results from the international MOBI-Kids study

Journal of Neuro-Oncology - We used data from MOBI-Kids, a 14-country international collaborative case–control study of brain tumors (BTs), to study clinical characteristics of the tumors in...     

Cytologic and histologic samples from patients infected by the novel coronavirus 2019 SARS-CoV-2: An Italian institutional experience focusing on biosafety procedures

The 2019 coronavirus pandemic, which started in Wuhan, China, spread around the globe with dramatic and lethal effects. From the initial Chinese epicenter, the European diaspora taxed the resources of several countries and especially those of Italy, which was forced into a complete social and economic shutdown. Infection by droplets contaminating hands and surfaces represents the main vehicle of diffusion of the virus. The common and strong efforts to contain the pandemic have relevant effects on the management of samples from histopathology laboratories. The current commentary reports and focuses on the protocols and guidelines in use at a large tertiary Italian hospital that accordingly are proposed for adoption in Italian laboratories as a potential model for national guidelines for the coronavirus emergency.     

Posterior reversible encephalopathy syndrome associated with Guillain-Barré syndrome: Case report and clinical management considerations

Around half of the patients with Guillain-Barré syndrome (GBS) present autonomic dysfunction requiring admission to intensive care unit in up to a quarter of patients. Treatment of GBS consists of plasma exchange (PE) and intravenous immunoglobulins (IVIG). Posterior reversible encephalopathy syndrome (PRES) consists in a reversible subcortical vasogenic brain edema caused by endothelial damage triggered by abrupt blood pressure changes. We report on a woman who presented with PRES in the course of GBS treated first with IVIG, and then with PE. The present report underlines the challenge that the clinicians face when these two rare syndromes concur. The literature is not helpful considering that both blood pressure fluctuations and IVIG are reported to be involved in the pathogenesis of PRES. In the present letter, both pathogenic mechanisms and clinical management considerations are discussed.