Asymptomatic Lacrimal Flow Abnormalities in Patients with Septal Deviations and Turbinate Hypertrophy

Background: This study aimed to investigate the lacrimal flow in patients affected by septal deviations and turbinate hypertrophy and to evaluate changes after rhinoseptoplasty with dacryocystography (DCT) and computed tomographic dacryocystography (CT-DCT). Methods: The study prospectively recruited patients having septal deviations with or without turbinate hypertrophy who underwent surgical evaluation for correction of their respiratory symptoms and were not referred for epiphora. Patients were excluded if they had undergone surgery for cranial vault defects or had experienced septal deviations after traumatic accidents. All patients were studied with DCT and CT-DCT preoperatively and postoperatively. Results: A total of 24 patients (10 men and 14 women) were recruited for the study. Of these patients, 11 (45.8%) had a reduced flow of the medium contrast due to a partial obstruction at the level of the internal ostium. All 11 patients had septal deviations and turbinate hypertrophy, whereas 8 patients had a unilateral obstruction (72.7%), and 3 patients had a bilateral obstruction (27.3%). All flows were corrected after surgery. Conclusions: The safe and well-tolerated radiologic techniques performed in this study provided detailed imaging of the lacrimal outflow system. A high incidence of partial obstruction to the internal ostium was found in patients with septal deviations, turbinate hypertrophy, and no lacrimal symptoms, suggesting a frequent presymptomatic condition.     

Analysis of prognostic indexes and other parameters to predict the length of hospitalization in thermally burned patients

BACKGROUND: In a retrospective study the influence of several clinical data and prognostic indexes on the length of hospital stay in burned patients was investigated. METHODS: We recorded all admitted patients from January 2004 to December 2005 except for electrical and chemical injuries or patients that died during recovery. Age, gender, weight, height, body surface area, fluid, caloric and protein delivery, Total Burn Surface Area, full thickness burn surface area, Roi index, Baux score, Unit Burn Standard index, Abbreviated Burn Severity Index and the length of hospitalization were registered. A univariate and multivariate analysis was performed to look for correlations between these parameters and the length of hospitalization. RESULTS: We recorded eligible 233 patients. The univariate analysis showed that age, protein and caloric delivery, Roi index and ABSI were significantly related with the length of hospitalization while, at the multivariate analysis, only Roi index was related (p<0.05). However, Roi index was able to predict only 5.5-6% of cases. CONCLUSIONS: A correlation exists between the length of hospital stays and the Roi index in burned patients but does not explain the bulk of evidence. Further studies are required to investigate this relation, to screen other parameters and to correlate them with measures of outcome, i.e. functional (the range of motion of articulations) or aesthetic (patient's self assessment of his body image).     

Cross-reactivities of 41 new amphetamine designer drugs to EMIT® immunoassays

Amphetamine designer drugs are central nervous system stimulants, and are widely diffused in illegal markets. Monitoring of drugs of abuse in biological fluids is successfully used for clinical and forensic applications. In particular, the urine matrix allows the verification of drug intake in the short and medium term. In a forensic toxicology laboratory, typical analysis for these drugs involves an immunoassay screening method. Here we describe the cross-reactivity profiles of 41 new amphetamine designer drugs to the urine drug tests EMIT^® II Plus (Amphetamines assay and Ecstasy assay).     

Prevention of corticosteroid-induced osteoporosis with salmon calcitonin in sarcoid patients

Summary The aim of this study was to evaluate the usefulness of salmon calcitonin (sCT) in preventing corticosteroid-induced osteoporosis. Three groups of patients with sarcoidosis requiring long-term steroid therapy were followed for 2 years with yearly evaluations of vertebral cancellous mineral content (VCMC) by quantitative computed tomography. The first group (n=18) was treated with intramuscular (i.m.) sCT for the 2-year study period; the second (n=11) with i.m. sCT for the first 4 months and then with sCT nasal spray for 20 months; the third (n=35) received no sCT. We observed a large mineral loss in the third group but a very slight drop of VCMC in the two groups receiving sCT. SCT nasal spray was better tolerated and as effective as i.m. injections. The action of sCT appeared extremely useful, especially in the first year of steroid therapy when corticosteroid-induced mineral loss was maximal. We conclude that sCT nasal spray is a good tool for preventing corticosteroid-induced osteoporosis.     

Radiation-induced brain tumours after central nervous system irradiation in childhood: a review

OBJECTS: Radiation-induced cerebral tumours constitute a significant risk for subjects undergoing radiotherapy for the management of cerebral neoplasms. Age-related cerebral vulnerability could be a specific factor in the genesis of these complications. METHODS: The pertinent literature of both paediatric and adult series has been reviewed. Three personal cases were added. RESULTS: One hundred forty-two paediatric second brain tumours were evaluated. Out of them, 69 were malignant gliomas, 33 meningiomas, 8 sarcomatous lesions and 13 low-grade astrocytomas. The average latency period for the appearance of the second tumour was 8 years. Among the second tumours occurring in adults, meningioma is the most common. In this subgroup, the latency period ranged between 16 and 30 years. CONCLUSION: Paediatric radiation-induced brain tumours differ from the adult counterpart for both the histological subtypes. These figures indicate a specific vulnerability of the infantile brain demonstrated by the most frequent occurrence of highly malignant lesions.     

Differentiation of monocytes into CD1a- dendritic cells correlates with disease progression in HIV-infected patients

Monocyte differentiation into dendritic cells (DCs) depends on microenvironmental conditions. In this study, the capacity of human monocytes to differentiate into mature DCs and their ability to induce an antiviral immune response was investigated in HIV-infected patients. In healthy subjects, monocytes differentiate into CD1a+ DCs in the presence of granulocyte macrophage colony-stimulating factor and interleukin (IL)-4 and matured in the presence of lipopolysaccharide. Here, we found that in 30% and 45% of HIV-infected white and African subjects, respectively, monocytes gave rise to a homogeneous CD1a* DC population. In the patients who gave rise only to the CD1a* DCs, this population spontaneously produced IL-10 but not IL-12, and induced a T helper 2-like immune response when cultured with human T cells isolated from cord blood mononuclear cells. In patients with monocytes differentiated into CD1a* DCs, a high percentage of HIV-specific CD4 T cells producing IL-4 were seen in the peripheral blood. Furthermore, differentiation of monocytes into DCs with CD1a* phenotype correlated with low CD4 T-cell counts and high viral loads in HIV-infected subjects. These results suggest that the differentiation of monocytes into CD1a* DCs may be a phenotypic marker associated with progression of the disease.