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To determine whether submucosal mesna (2-mercaptoethane sodium sulfonate) infiltration is superior to normal saline or adrenaline + lidocaine in mucoperichondrial hydrodissection.

Twenty-one rabbits were administered adrenaline + lidocaine, saline or mesna. Bilateral septal mucoperichondrial flap elevations were performed following submucosal infiltration. The intraoperative bleeding amount, operation time, accessibility of the surgical plane, field quality and degree of mucoperichondrial injury were recorded. The three groups were compared histopathologically.

The amount of bleeding and duration of the operation were significantly higher and the accessibility of the surgical plane score was significantly lower in the saline group vs. the other groups (p < 0.05). The mucosal damage rate was significantly higher in the saline group compared with adrenaline + lidocaine (p < 0.05). The surgical field quality was significantly lower in the saline group compared with adrenaline + lidocaine (p < 0.05 mesna instead of normal saline or adrenaline + lidocaine in septoplasty was not more advantageous in terms of intraoperative parameters. The adrenaline + lidocaine group was superior to normal saline for all intraoperative parameters. In conclusion, the use of adrenaline may be more advantageous in facilitating septal mucoperichondrium elevation due to its widespread use, low cost and superiority to physiological saline.

The purpose of this study was to correlate acute invasive fungal rhinosinusitis (AIFRS) and chronic invasive fungal rhinosinusitis with underlying diseases, aetiological microorganisms, clinical symptoms, radiological findings, and surgical and medical treatment to determine the subset of patients who require more accurate diagnostic investigation and to prevent irreversible complications.

This retrospective monocentric study included 17 patients who underwent endoscopic sinus surgery evaluated by paranasal computed tomography and magnetic resonance imaging. Age, sex and symptoms, and location of the invasive fungal infection and the causative fungus were analysed.

In total, 4 patients were affected by the AIFRS form, and 13 by the chronic form. this website Diabetes mellitus was reported in 41.17% of cases, and haematological diseases in 23.52%. The maxillary sinuses were involved in 47.05% of cases and sphenoidal sinuses in 52.94%; Aspergillus fumigatus was the fungus in 76.47% of cases, and Zygomycetes in 23.53%.

An understanding of the different types of fungal sinusitis and knowledge of their features play a crucial role in reaching prompt diagnosis and initiation of appropriate therapy, which is essential to avoid a protracted or fatal outcome.

An understanding of the different types of fungal sinusitis and knowledge of their features play a crucial role in reaching prompt diagnosis and initiation of appropriate therapy, which is essential to avoid a protracted or fatal outcome.

With the introduction of remote access thyroidectomy questions regarding patient satisfaction after trans-cervical thyroidectomy has been raised in several publications. As far as neck scars are concerned, patient satisfaction in the early post-operative period and long term are different. This study assessed patient satisfaction regarding their neck scar in the early post-operative period and at long term follow-up.

Retrospective study. Patients underwent total thyroidectomy by single surgeon. Scar satisfaction scores assessed at different time intervals (< 6 weeks, 6 months, 2 years and 5 years after procedure). Scores of patients aged < 35 years and > 35 years were compared. Patient and observer scar assessment scales (PSAS, OSAS) and patient satisfaction score (PSS) were used.

595 patients were included (443 females and 152 males, age 19-77 years). Improvement was observed in the PSAS (13.5 ± 2.3 at 6 weeks; to 4.32 ± 1.37 at 5 years; p < 0.05) and OSAS (7.32 ± 1.35 to 4.18 ± 1.51; p < 0.05). PSS improved over time from 1.8 ± 0.8 to 0.92 ± 0.66 (p < 0.05). The satisfaction scores were higher in patients < 35 years (p = 0.003). The scores indicated excellent patient satisfaction and are similar to those published in the literature regarding minimally invasive surgery (MIS).

Proper incision placement and suturing resulted in excellent patient satisfaction regarding scars after conventional thyroidectomy.

Proper incision placement and suturing resulted in excellent patient satisfaction regarding scars after conventional thyroidectomy.

Inflammation and nutritional status play an important role in the prognosis of cancer. Lymphocyte-to monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and prognostic nutritional index (PNI) are independent prognostic scores in numerous cancers. However, any study showed their prognostic role in low-risk differentiated thyroid carcinoma (DTC). We aimed to clarify and identify the prognostic value of inflammation indices in low-risk DTC patients.

We analysed data from 116 patients, dividing the population into two groups, according to AJCC staging system (8

edition). The LMR, NLR, PLR and PNI cut-off value were determined using receiver operating characteristic (ROC) curve. Disease-free survival (DFS) was calculated with Kaplan-Meyer and Log-Rank tests and the risk of recurrence was calculated with univariate and multivariate Cox regression. Statistical significance was p < 0.05.

We found a baseline NLR value ≥ 1.750 (75% sensitivity, 40.2% specificity) and a baseline LMR value of 3.83 (66.7% sensitivity, 48.9% specificity). Overall DFS was 74.995 ± 3.236 with a p value of 0.678. NLR showed a hazard ratio for recurrence with almost twice the risk of recurrence (Adjusted Hazard Ratio /HR

) 1.828, p-value = 0.019).

NLR can be considered a prognostic score with twice the risk of recurrence in low-risk DTC patients with NLR < 1.750.

NLR can be considered a prognostic score with twice the risk of recurrence in low-risk DTC patients with NLR less then 1.750.

This prospective, non-randomised study documents our initial experience using the Flex

Surgical System for transoral surgery in Italy.

All patients who underwent transoral robotic surgery using the Medrobotics

Flex

Robotic System (Raynham, MA, USA) between March 2018 and April 2019 were reviewed. Rates of successful surgery, surgical time and complications were evaluated. 43 surgical procedures were performed in the study. The average age was 62.56 years (range 36-90 years). The Flex

system was used successfully in surgery of the base of the tongue, palatine tonsils, supraglottis, hypopharynx and glottis, which was the most frequent target.

All procedures were successfully completed. There were no intraoperative or serious postoperative complications, with no cases of intraoperative haemorrhage.

This is the first study in Italy evaluating the use of the Flex

system to safely resect lesions in the oral cavity, larynx and pharynx.

This is the first study in Italy evaluating the use of the Flex® system to safely resect lesions in the oral cavity, larynx and pharynx.

While inorganic mercury is being gradually withdrawn from industry, environmental exposure to mercury is recognized as one of the greatest present toxicological problems. link2 The aim of this study was to evaluate the effect of polyunsaturated fatty acids (PUFAs) supplementation on selected cardiovascular risk factors and the urinary mercury (Hg-U) concentration in workers occupationally exposed to mercury vapor.

Overall, 38 workers of an electrolyzer hall (Hg-U 46.6±35.7 μg/g creatinine) and a control group of 60 employees not exposed to Hg (Hg-U 4.3±15.5 μg/g creatinine) were included in a clinical cross-over study. Clinical and laboratory tests were carried out 4 times before and after a 3-month period of PUFAs supplementation (1000 mg daily), then after a 3-month break, and then after another 3-month period of PUFAs supplementation.

The baseline heart rate (HR) and serum triglyceride levels were higher in the Hg-exposed workers than in the controls, whereas systolic blood pressure (SBP) and cholesterol (upplementation was associated with a decrease in Hg-U in which HDL3 metabolism probably plays an important role.

In addition to physical damage, COVID-19 also has a serious impact on the mental health of society. link3 For many people, this involves the necessity of adapting to new conditions, uncertainty about the future and a tremendous mental burden. It was investigated whether there were any differences between the 2 measures (before and during the COVID-19 pandemic) in the levels of perceived stress, anxiety, life satisfaction and experienced emotions.

The study, conducted in Poland and the Netherlands, involved 168 people. The metric, the Positive and

, the

, the and the

were used. The subjects were divided into 3 groups non-immigrants living in Poland (N = 50), Dutch citizens (N = 56), and Polish immigrants living in the Netherlands (N = 62).

The level of stress and negative emotions was higher in the groups of Poles living in Poland and Poles living in the Netherlands than in the group of Dutch citizens. Therefore, access to psychological care should be improved during the pandemic, especially for immigrants, due to the increased risk of developing stress-induced mental disorders.

In the groups of Poles, there was an increase in perceived stress and trait anxiety during the COVID-19 pandemic. The group of Dutch citizens experienced a reduction in the anxiety level during the COVID-19 pandemic. In the group of Polish immigrants, there was an increase in life satisfaction during the COVID-19 pandemic. Int J Occup Med Environ Health. 2021;34(2)177-88.

In the groups of Poles, there was an increase in perceived stress and trait anxiety during the COVID-19 pandemic. The group of Dutch citizens experienced a reduction in the anxiety level during the COVID-19 pandemic. In the group of Polish immigrants, there was an increase in life satisfaction during the COVID-19 pandemic. Int J Occup Med Environ Health. 2021;34(2)177-88.

Dysregulated lipid metabolism is associated with more aggressive pathology and poorer prognosis in prostate cancer (PC). The primary aim of the study is to assess the relationship between the plasma lipidome and clinical outcomes in localised and metastatic PC. The secondary aim is to validate a prognostic circulating 3-lipid signature specific to metastatic castration-resistant PC (mCRPC).

Comprehensive lipidomic analysis was performed on pre-treatment plasma samples from men with localised PC (N = 389), metastatic hormone-sensitive PC (mHSPC)(N = 44), or mCRPC (validation cohort, N = 137). Clinical outcomes from our previously published mCRPC cohort (N = 159) that was used to derive the prognostic circulating 3-lipid signature, were updated. Associations between circulating lipids and clinical outcomes were examined by Cox regression and latent class analysis.

Circulating lipid profiles featuring elevated levels of ceramide species were associated with metastatic relapse in localised PC (HR 5.80, 95% CI 3.04-11.1, P = 1 × 10

), earlier testosterone suppression failure in mHSPC (HR 3.70, 95% CI 1.37-10.0, P = 0.01), and shorter overall survival in mCRPC (HR 2.54, 95% CI 1.73-3.72, P = 1 × 10

). The prognostic significance of circulating lipid profiles in localised PC was independent of standard clinicopathological and metabolic factors (P < 0.0002). The 3-lipid signature was verified in the mCRPC validation cohort (HR 2.39, 95% CI 1.63-3.51, P = 1 × 10

).

Elevated circulating ceramide species are associated with poorer clinical outcomes across the natural history of PC. These clinically actionable lipid profiles could be therapeutically targeted in prospective clinical trials to potentially improve PC outcomes.

Elevated circulating ceramide species are associated with poorer clinical outcomes across the natural history of PC. These clinically actionable lipid profiles could be therapeutically targeted in prospective clinical trials to potentially improve PC outcomes.