Predicting of the current and future geographical distribution of Laurus nobilis L. under the effects of climate change.

Today, climate change affects all living things on earth. It also leads to serious losses in terms of biodiversity, ecosystem services, and human welfare. In this context, Laurus nobilis L. is a very important species for Turkey, and the Mediterranean countries. This research aimed to simulate the current distribution of the suitable habitat for L. nobilis in Turkey and to predict its possible range shifts in future climate scenarios. To predict the geographical distribution of L. nobilis, the study used the maximum-entropy algorithm-based MaxEnt 3.4.1 with seven bioclimatic variables created using the Community Climate System Model 4.0 (CCSM4) and the prediction models RCP4.5-8.5 for the years 2050-2070. The results indicated that the most important bioclimatic variables that shape the distribution of L. nobilis are BIO11-mean temperature of coldest quarter, and BIO7-annual temperature range. Two climate change scenarios predicted that the geographical distribution of L. nobilis would increase slightly and then decrease in the future. However, the spatial change analysis showed that the general geographical distribution area of L. nobilis did not change significantly, but the "moderate," "high," and "very high" suitable habitats changed towards "low" suitable habitats. These changes were particularly effective in Turkey's Mediterranean region, which shows that climate change is instrumental in determining the future of the Mediterranean ecosystem. Therefore, suitability mapping and change analysis of potential future bioclimatic habitats can help in planning for land use, conservation, and ecological restoration of L. nobilis.

Maternal serum fructosamine levels and stillbirth: a case-control study of the Stillbirth Collaborative Research Network.

OBJECTIVE: To evaluate the association between maternal fructosamine levels at the time of delivery and stillbirth. DESIGN: Secondary analysis of a case-control study. SETTING: Multicentre study of five geographic catchment areas in the USA. POPULATION: All singleton stillbirths with known diabetes status and fructosamine measurement, and representative live birth controls. MAIN OUTCOME MEASURES: Fructosamine levels in stillbirths and live births among groups were adjusted for potential confounding factors, including diabetes. Optimal thresholds of fructosamine to discriminate stillbirth and live birth. RESULTS: A total of 529 women with a stillbirth and 1499 women with a live birth were included in the analysis. Mean fructosamine levels were significantly higher in women with a stillbirth than in women with a live birth after adjustment (177 ± 3.05 versus 165 ± 2.89 µmol/L, P < 0.001). The difference in fructosamine levels between stillbirths and live births was greater among women with diabetes (194 ± 8.54 versus 162 ± 3.21 µmol/L), compared with women without diabetes (171 ± 2.50 versus 162 ± 2.56 µmol/L). The area under the curve (AUC) for fructosamine level and stillbirth was 0.634 (0.605-0.663) overall, 0.713 (0.624-0.802) with diabetes and 0.625 (0.595-0.656) with no diabetes. CONCLUSIONS: Maternal fructosamine levels at the time of delivery were higher in women with stillbirth compared with women with live birth. Differences were substantial in women with diabetes, suggesting a potential benefit of glycaemic control in women with diabetes during pregnancy. The small differences noted in women without diabetes are not likely to justify routine screening in all cases of stillbirth. TWEETABLE ABSTRACT: Maternal serum fructosamine levels are higher in women with stillbirth than in women with live birth, especially in women with diabetes.

Early Endoscopy Decrease the Length of Hospital Stay and the Costs in Patients with Upper Gastrointestinal Bleeding.

BACKGROUND: Acute gastrointestinal (GI) bleeding is a common cause of hospitalization. There are conflicting results regarding the effectiveness of early endoscopy in patients with upper GI bleeding. OBJECTIVE: The study aimed to determine the benefit of early endoscopy and the epidemiological characteristics of patients presenting to the emergency department with non-variceal acute upper GI bleeding. METHODS: Patients over 18 years of age who presented to the emergency department with upper GI between 2015 and 2016 and underwent endoscopy were included in the study. The patients were divided into two groups: early endoscopy group (endoscopy within the 24 h) and late endoscopy group (endoscopy after 24 h). RESULTS: Of 104 patients, 57.7% were man, and the mean age was 66.27 ± 17.64 years. Of the patients who underwent endoscopy, 80 (76.9%) were in the early endoscopy group. There was no difference in blood transfusion needs (P = 0.388), re-bleeding (P = 0.137), the need for surgery, and mortality rates with regard to the timing of endoscopy. The results of the receiver-operating characteristics curve analysis revealed patients with a GBS ≥ 9 were taken as high-risk, and a prognosis analysis was performed accordingly. However, in patients undergoing early endoscopy, a difference was detected with respect to the length of hospital stay (P = 0.011) and treatment costs (P = 0.030). In the comparison with the admission time (working/non-working h) and variables, there were no significant differences in the length of hospital stay (P = 0.230), transfusion needs (P = 0.348), re-bleeding frequency (P = 0.905), and treatment costs (P = 0.094). CONCLUSION: Endoscopy within 24 h in the setting of acute upper non-variceal GI bleeding is associated with an increase in the length of hospital stay and treatment costs, but is not associated with re-bleeding, transfusion needs, need for surgery, and mortality.

Two Different Manifestations of Neonatal Vascular Injury: Dyke-Davidoff-Masson Syndrome and Crossed Cerebellar Atrophy.

Dyke-Davidoff-Masson syndrome (DDMS) was first described in 1933 as a clinical condition characterized by hemiatrophy, hyperpneumatization of paranasal sinuses, contralateral hemiparesis, facial asymmetry, seizures, and mental retardation.1 DDMS can be of 2 types: congenital and acquired. The congenital type can be caused by various conditions experienced during fetal or early childhood development, including ischemia, infarction, trauma, infections, and hemorrhage. The acquired type is mostly associated with hemorrhage, trauma, and infections experienced after 1 month of age. DDMS can manifest alone or can be accompanied by crossed cerebellar atrophy (CCA) which is a newly discovered radiological marker characterized by prominent cortical sulci and loss of cerebellar parenchyma. The congenital type of DDMS is known to be accompanied by ipsilateral cerebellar atrophy and the acquired type is known to be accompanied by contralateral cerebellar atrophy.2,3 Supratentorial events may lead to destruction in the cortico-ponto-cerebellar pathways, mostly in the contralateral side of the body (80%) due to decussation.4 In this report, we present 2 cases of DDMS accompanied by CCA to emphasize the possibility that the DDMS cases with severe intrauterine hemorrhage can be accompanied by contralateral CCA and migratory abnormalities rather than ipsilateral CCA and clinical survey.

Is ceftriaxone effective in experimental brain ischemia/reperfusion injury?

OBJECTIVE: The aim of the present study was to investigate the neuroprotective effect of ceftriaxone in a rat brain ischemia/reperfusion injury model. METHODS: The oxidative stress parameter, malondialdehyde (MDA) levels with or without ceftriaxone treatment in brain ischemia/reperfusion injured rats as well as in controls were measured in serum and brain tissue. Motor examinations of the rats were also performed. One-way Analysis of Variance (ANOVA) test was used for analysis. Duncan's Multiple Range Test was performed in multiple comparisons. p < 0.05 were considered statistically significant.  RESULTS: The data of this study showed that ceftriaxone treatment reduced the MDA levels in brain tissues in ischemia/reperfusion injured rats. Moreover, Bederson motor scores were higher in the ceftriaxone treated group as compared to the ischemia group (p = 0.092). CONCLUSION: These results suggest that ceftriaxone could be beneficial for the prevention of brain ischemia/reperfusion injury caused by acute arterial occlusion through reducing the tissue MDA level (Tab. 2, Fig. 5, Ref. 24).

The investigation of the antitumoral effect of Cornus mas L in mice with ehrlich solid tumor.

AIM: Cornus mas L is commonly used due to its anti-inflammatory, anti-carcinogenic and anti-oxidant properties. In the study, the effects of C. mas L extract on a solid tumor were examined in the Ehrlich solid tumor model developed in Balb/C type mice. METHODS: Ehrlich acid tumor (EAT) cells (1x106 EAT cell) from the stock animal were injected subcutaneously (s.c.) through the nape of the mice. Treatment groups of solid tumor-induced animals received 100 mg/kg and 200 mg/kg of C. mas L extract intraperitoneally (i.p.) for 14 days. RESULTS: Tumor volumes and animal weights were found to be statistically significant compared to the control group (p < 0.05). AgNOR staining was performed in tumor tissues. Statistically significant differences were observed between the groups in terms of TAA/NA ratio (p < 0.05). Immunohistochemical and biochemical parameters were also evaluated. An estimation of tumor proliferation of the lung, liver, brain, kidney, testis and tumor antioxidant parameters viz. lipid peroxidation, reduced glutathione (GSH), glutathione S-transferase (GST), superoxide dismutase (SOD) and catalase (CAT) was made. CONCLUSIONS: Our study showed that the anti-tumor effect of C. mas L in assisted tumor development with EAT cells, was mediated by the enhancement of oxidative stress with multiple mechanisms (Tab. 6, Fig. 12, Ref. 38).

Frequency of psychiatric disorders in nonemergent admissions to emergency department.

OBJECTIVES: Repeated admissions of patients with undiagnosed psychiatric problems in emergency departments (ED) is a major contributor to patient unsatisfaction and overcrowding in EDs. We evaluated the presence of psychiatric disorders in non-emergent admissions in the ED of a tertiary care hospital. MATERIALS AND METHODS: This cross-sectional study was carried out in Eskisehir Osmangazi University Hospital between December 2015 and March 2016. The study group consists of 4320 non-emergent patients (31% of all admissions to non-emergent ED). Psychiatric assessments of patients were done using the Primary Care Evaluation of Mental Disorders (PRIME-MD) scale prior to their discharge from the ED. The Mann-Whitney U, Kruskal-Wallis and Chi-square tests, as well as multivariate logistic regression, were performed for statistical analysis. RESULTS: The mean age was 30 ± 11.7 years years ranging from 18 to 78 years. Among non-emergent cases, 44% had at least one psychiatric disorder. The most frequent psychiatric disorder was mood disorder (major and minor depression). Females with a comorbid disease and lower education level had increased risk for mood disorders, anxiety disorders, and somatoform disorders. Single males with a comorbid disease had increased risk for alcohol dependence. CONCLUSIONS: Undiagnosed patients with psychiatric disorders appear to be frequent users of medical emergency department services. These results might be helpful in developing more effective strategies to serve the mental health needs of the undiagnosed. People's awareness of psychiatric disorders should be increased.

Carinal sleeve pneumonectomy for lung cancer.

BACKGROUND: Here, we present our experience of 12 lung cancer cases operated with carinal sleeve pneumonectomy (CSP) from 2001 to 2011. METHODS: 12 cases who had undergone CSP in our department from 2001 to 2011 were retrospectively evaluated and presented by taking into account their demographical and clinical features, the surgical technique that was used, the complications that developed and the latest conditions of these patients. RESULTS: Of the 12 cases, 11 were male and 1 was female with a mean age of 58.6 years (40-71 years). 11 cases had right and 1 had left CSP. The ethiology for resection was lung cancer in all cases. 10 cases had carinal invasion of the lung cancer, 1 had bronchopleural fistula developing after right pneumonectomy, 1 had distal tracheal rupture due to intubation tube placed during pneumonectomy; these all resulted in performing CSP. Five patients developed complications during the postoperative period. Three cases developed recurrences/metastases during the follow-up. Nine patients died, 3 patients were alive and were followed-up by our department. For all the cases, the median survival was 9 months, the estimated survival rate of 2-years was 33%, and 5-year survival rate was 22%. Survival for 2-4 years was 71%. CONCLUSIONS: We think that with increasing surgical experience better results are obtained in these technically demanding procedures.

Comparison of sperm carnitine profiles of normospermic, oligospermic and azospermic individuals.

OBJECTIVE: The World Health Organization recognizes infertility as a public health issue. An estimated 48.5 million couples worldwide grapple with infertility. Infertility and spermatogenesis dysfunction arise from diverse genetic factors, including single-gene mutations and chromosomal abnormalities. Current research continues to explore other potential causes of infertility, leveraging both proteomic and metabolomic analyses. The primary aim of this study is to underscore the significance of investigating male infertility from a metabolomic perspective. PATIENTS AND METHODS: This study aimed to identify new markers for diagnosing and treating male infertility by examining the carnitine profiles in seminal fluids of individuals diagnosed with the normospermic group, oligospermic group, and azospermic group, employing the LC/MS-MS method. RESULTS: The first three L-carnitines C2 (Acetylcarnitine), C8:1 (Octenoylcarnitine), and C16:1 (Palmitoleylcarnitine), emerged as potential novel markers for diagnosis and treatment. CONCLUSIONS: Based on these findings, we posit that the results obtained in this study will aid in diagnosing, treating, and monitoring systemic diseases, and provide a foundation for more comprehensive future molecular studies aimed at enhancing prevention and treatment strategies for infertility.

Metabolomic analysis of seminal fluids in infertile individuals.

OBJECTIVE: Infertility impacts a substantial number of couples worldwide, and about 50% of cases are linked to male factors. The analysis of seminal fluid composition can improve diagnostic accuracy and offer deeper insights into the pathophysiology of male factor infertility. This study seeks to identify novel markers for diagnosing and treating male infertility by comparing organic acid profiles in the seminal fluid of individuals with normospermia, oligospermia, and azoospermia. PATIENTS AND METHODS: Semen samples were collected from men with normospermia, oligospermia, and azoospermia. The organic acid profile in the seminal fluid was analyzed using liquid chromatography-mass spectrometry/mass spectrometry (LC/MS-MS). Data analysis was performed using SPSS and MetaboAnalyst. RESULTS: The study revealed significant differences in metabolite levels among normospermic, oligospermic, and azoospermic individuals. In groups with oligospermia, there were significant decreases in the levels of 2-OH-Isovaleric Acid, 3-Methyl-2-Oxovaleric Acid, Ethyl-Malonic Acid, Citric Acid, Oxoproline, Malic Acid, N-Acetyl-Aspartic Acid, Suberic Acid, Glutaconic Acid, and Succinic Acid. Similarly, individuals with azoospermia exhibited a notable reduction in the levels of Citric Acid, Malic Acid, and Suberic Acid. Furthermore, according to the Variable Importance in the Projection (VIP) score analysis, Ethyl-Malonic Acid, Glycolic Acid, and 3-Methyl-2-Oxovaleric Acid were identified as crucial factors for diagnosis and potential treatment strategies. CONCLUSIONS: The data obtained from the study highlights the significant potential of metabolites in assessing infertility and gaining a more in-depth understanding of the underlying pathological mechanisms.

Hand ischemia caused by solitary humeral exostosis irritating the brachial artery.

A 39-year-old woman presented with ischemia of the left hand. Angiography revealed thrombosis of forearm arteries. Surgical intervention was unsuccessful. CT angiography revealed an exostosis on the distal humerus close to the brachial artery which we believe was the cause of repetitive minor trauma to the brachial artery leading to embolic occlusion of the radial and ulnar arteries. Early diagnosis of the underlying cause is the key to successful treatment of hand ischemia. For patients without risk factors for arterial occlusive disease, imaging of bony structures must be performed in order not to miss the likely cause of an insidious repetitive vascular trauma.

Sphenoid sinus mucocele presenting with unilateral visual loss: a case report.

OBJECTIVE: Mucoceles of the sphenoid sinus are rare and may remain undiagnosed until symptoms arise due to the compression of surrounding structures. Because of its close proximity to the sphenoid sinus, the optic nerve may be compressed and visual impairment may result. CASE REPORT: We report on a case of sphenoid sinus mucocele presenting with unilateral visual loss as the only symptom in a 72-year-old patient. Physical examination, computerised tomography, magnetic resonance imaging, bacteriological cultures and histopathological evaluation were used to make the diagnosis. The patient underwent endoscopic sinus surgery for drainage and marsupialisation of the mucocele. Intravenous ceftriaxone was administered over the following three days, and the patient was discharged on the third post-operative day. In the post-operative period, a slight improvement in vision was observed. CONCLUSION: Early diagnosis and prompt surgical intervention are imperative in patients with sphenoid sinus mucoceles presenting with acute visual loss.

Reliability and validity of Turkish version of pediatric balance scale.

Assessment tool is a key point to evaluate balance disturbances in children. The aim of this study was to analyze reliability and validity of Turkish version of pediatric balance scale. The present study included 34 children (13 girls; 21 boys) with balance impairments. The scale consists of 14 items. Eight observers assessed the video records of the participants for interrater agreement. One observer evaluated the records twice in 2 weeks for intrarater agreement. Intraclass correlation coefficient was used for the interobserver and intraobserver agreement. The Functional Reach Test was used to calculate concurrent validity. Mean age of the sample was 11.68 ± 3.53 years. The Turkish version of the scale was found to be reliable, perfectly (intraclass correlation coefficient for interobserver agreement = 0.915). Intraobserver agreement was also reliable, perfectly (ICC = 0.927). The strong correlation between pediatric balance scale and functional reach test was found (r = 0.692; p < 0.001). The Turkish version of the scale is a valid and reliable tool to evaluate children with balance impairments. Moreover, it is easy to use for health providers working with disabled children.

Evaluation of the Ocular Surface, Conjunctival Impression Cytology and Meibomian Gland Dropout in Patients with Familial Mediterranean Fever.

PURPOSE: Familial Mediterranean fever (FMF) is an idiopathic disease with chronic inflammation. We aimed to determine the changes caused by the chronic inflammatory nature of FMF on the ocular surface, meibomian glands (MG), and conjunctiva via conjunctival impression cytology (CIC). MATERIAL-METHOD: Forty-two FMF patients with a mean age of 11.93±3.92 years and 36 control patients with a mean age of 11.83±3.38 years were included in the study. Ocular surface anomalies of the patients were evaluated using Schirmer II, TBUT and OSDI. MG function (meibum quality), morphology (meiboography), and CIC were evaluated. RESULTS: Although there was a significant difference between the groups in terms of Schirmer II and TBUT, OSDI scores did not significantly differ (P=0.022, 0.010, and 0.099 respectively), and no significant dry eye sign was observed in either group. There was significant difference between the groups in terms of the percent area of MG dropout, MG density, meiboscore (P=0.020, 0.023, and 0.031 respectively), but no significant difference was observed in relation to MG quality (P=0.650). Although conjunctival impression cytology was of a higher grade in the patients with FMF according to Nelson's classification, no significant difference was observed between the groups (P=0.109). CONCLUSION: Although there was a decrease in the number of MGs in FMF patients, no significant deterioration was observed in conjunctival cytology. In these patients, tear film stability may deteriorate in particular. Clinicians should be aware of the possibility of ocular surface disease secondary to MG dropout in patients with FMF.

Elephantiasis nostras verrucosa on the abdomen of a Turkish female patient caused by morbid obesity.

Elephantiasis Nostras Verrucosa is a rare disorder of an extremity or a body region, which is associated with chronic lymphedema. There are 7 reported cases of abdominal elephantiasis in the medical literature. Here we report a morbidly obese female patient with elephantiasis nostras verrucosa on the abdominal wall.

Plasma visfatin concentrations in subjects with type 1 diabetes mellitus.

BACKGROUND/AIMS: Visfatin is a recently discovered adipokine, and its circulating concentrations have not been adequately studied in type 1 diabetes mellitus (DM). Therefore, this study was designed to examine plasma visfatin levels in type 1 diabetic patients and to determine the relationships between visfatin and duration of diabetes, body mass index, glycemic control, insulin dosage and lipid profile. METHODS: Forty-eight patients with type 1 DM and 26 healthy controls were investigated. RESULTS: Type 1 diabetic patients had significantly low visfatin levels compared with controls (18.8 +/- 1.7 vs. 20.2 +/- 0.3 ng/ml; p < 0.0001). Visfatin levels were comparable between patients with a short duration of diabetes (<10 years) and patients with a long duration of diabetes (>or=10 years) (18.9 +/- 1.7 vs. 18.2 +/- 2.0 ng/ml; p > 0.05). There was a significant correlation between visfatin and hemoglobin A1c (HbA1c) even after the adjustment for age, sex, body mass index and duration of diabetes (r = -0.48, p = 0.005) in the patient group. Multivariate analysis showed that significant determinants of visfatin concentrations were HbA1c and duration of diabetes (r(2) = 0.27). CONCLUSION: These data emphasize that plasma visfatin concentrations are lower in patients with type 1 DM and related to glycemic control reflected by HbA1c.

Resection via median sternotomy in patients with lung cancer invading the main pulmonary artery.

BACKGROUND: Conventional pneumonectomy via posterolateral thoracotomy is not always possible in cases with T4 tumour with widespread pulmonary artery invasion. Our objective is to present our surgical experiments in cases with a hilar mass who were thought to have pulmonary artery invasion, in whom we performed intrapericardial pneumonectomy through median sternotomy. METHOD: Nine cases who had undergone intrapericardial pneumonectomy via median sternotomy were included in this study and evaluated retrospectively. These cases were thought to have right or left pulmonary artery invasion in preoperative evaluation. RESULTS: Two cases had right and seven cases left pneumonectomy. Based on TNM classification, two patients were Stage IIB, two Stage IIIA and five Stage IIIB in postoperative histopathological examination. Either right or left main pulmonary artery invasion was seen in IIIB cases while invasion was limited to the pericardium in the others. Lymph node involvement was detected in seven cases while six cases were N1, and one case was N2. There was no operative mortality. CONCLUSION: Standard posterolateral thoracotomy might not be possible in all cases, particularly in patients with hilar tumours invading the main pulmonary artery. In such patients an intrapericardial approach with median sternotomy provides an easier and safer alternative while making it possible to have wider lymph node dissection. Furthermore, if necessary, hemi-clamshell incision can easily be added to this approach.

Diagnostic impact of 18F-FDG PET/CT on the management of rare breast carcinomas: Apocrine and neuroendocrine carcinomas. / Impacto diagnóstico de la PET/TC con 18F-FDG en el tratamiento de carcinomas de mama raros: carcinomas apocrinos y neuroendocrinos.

OBJECTIVE: We aimed to evaluate the diagnostic impact of 18F-FDG PET/CT in staging apocrine breast carcinoma (ABC) and primary breast neuroendocrine carcinoma (PBNEC) and to demonstrate possible alterations of the 18F-FDG uptake in these histopathologic subtypes. In addition, we aimed to compare 18F-FDG PET/CT findings between ABC, PBNEC and invasive ductal carcinoma. MATERIAL AND METHODS: A total of 570 patients and 585 breast lesions were retrospectively included in this study. After patients were classified into molecular subtypes according to the histopathological analysis, 18F-FDG PET/CT imaging was performed. The SUVmax findings of primary tumors obtained from 18F-FDG PET/CT were compared between the groups. RESULTS: Invasive ductal carcinoma was the most prevalent breast carcinoma (77.7%, n=446), with a low proportion of ABC (4.1%, n=24) and PBNEC (2.4%; n=14) diagnosed. The highest mean SUVmax was calculated in HER2 subtype of ABC and 18F-FDG uptake ratio in HER2 and TN subtypes were found statistically higher than Luminal B type of ABC (p=0.038 and p=0.019, respectively). Although 18F-FDG uptake in Luminal B subtype of PBNEC was higher than Luminal A subtype, difference was not statistically significant. Additionally, the axillary metastasis rate was significantly higher in the ABC group (p=0.015). CONCLUSIONS: The histopathological ABC subtype group showed different 18F-FDG uptake than the invasive ductal carcinoma group. Even if 18F-FDG uptake was lower in the PBNEC group than in the other groups, PET/CT showed and adequate performance in detecting primary tumors and metastases. The 18F-FDG PET/CT scan results may contribute to the initial staging and management of ABC and PBNEC patients.

Validity of the Italian adaptation of the Tinnitus Handicap Inventory; focus on quality of life and psychological distress in tinnitus-sufferers.

The aim of this study was to determine the validity of the Italian translation of the Tinnitus Handicap Inventory (THI) by Newman et al. in order to make this self-report measure of perceived tinnitus handicap available both for clinical and research purposes in our country and to contribute to its cross-cultural validation as a self-report measure of perceived severity of tinnitus. The Italian translation of the Tinnitus Handicap Inventory (THI) was administered to 100 outpatients suffering from chronic tinnitus, aged between 20 and 82 years, who attended the audiological tertiary centres of the University Hospital of Modena and the Regional Hospital of Treviso. No segregation of cases was made on audiometric results; patients suffering from vertigo and neurological diseases were excluded. Pyschoacoustic characteristics of tinnitus (loudness and pitch) were determined and all patients also completed the MOS 36-Item Short Form Health Survey to assess self-perceived quality of life and the Hospital Anxiety and Depression Scale as a measure of self-perceived levels of anxiety and depression. The THI-I showed a robust internal consistency reliability (Cronbach's alpha = 0.91) that was only slightly lower than the original version (Tinnitus Handicap Inventory-US; Cronbach's alpha = 0.93) and its Danish (Cronbach's alpha = 0.93) and Portuguese (Cronbach's alpha = 0.94) translations. Also its two subscales (Functional and Emotional) showed a good internal consistency reliability (Cronbach's alpha = 0.85 and 0.86, respectively). On the other hand, the Catastrophic subscale showed an unacceptable internal consistency reliability as it is too short in length (5 items). A confirmatory factor analysis failed to demonstrate that the 3 subscales of the THI-I correspond to 3 different factors. Close correlations were found between the total score of the Italian translation of the Tinnitus Handicap Inventory and all the subscales of the MOS 36-Item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale scores indicating a good construct validity. Moreover, these statistically significant correlations (p < 0.005) confirmed that the self-report tinnitus handicap is largely related to psychological distress and a deterioration in the quality of life. On the other hand, it was confirmed that the tinnitus perceived handicap is totally independent (p > 0.05) from its audiometrically-derived measures of loudness and pitch thus supporting previous studies that focused on the importance of non-auditory factors, namely somatic attention, psychological distress and coping strategies, in the generation of tinnitus annoyance. Finally the results of the present study suggest that the THI-I maintains its original validity and should be incorporated, together with other adequate psychometric questionnaires, in the audiological examination of patients suffering from tinnitus and that psychiatric counselling should be recommended for the suspected co-morbidity between tinnitus annoyance and psychological distress.