SARS-CoV-2 RNA viability on high-touch surfaces and evaluation of a continuous-flow ozonation treatment.

Background: The COVID-19 emergency has highlighted the importance of prevention systems and environ-mental microbiological monitoring as fundamental elements in the response to epidemics and other such threats to individual and collective health. The use of automated "No-touch" room disinfection systems eliminates or reduces the dependence on operators, thus allowing an improvement in the effectiveness of terminal disinfection. Study design: In the present study, we focused on possible SARS-CoV-2 contamination of surfaces of com-mercial services, and the effectiveness of ozone treatment on the virus. Methods: Analyses were conducted on 4-7 October and 27-30 December 2021 in four supermarkets in an Apulian city; supermarkets A and B were equipped with an ozonisation system, while C and D were without any environmental remediation. Results: SARS-CoV-2 RNA was detected by real-time RT-PCR only in December, in 6% of the surfaces tested, and all examined samples were found to be negative after viral culture, since no cytopathic effect was observed. A statistically significant difference emerged from the comparison of October vs. December (p = 0.0289), but no statistically significant difference (p = 0.6777) emerged from the comparison between supermarkets with and without the ozonisation system. Conclusions: Although no important changes were observed by treating the environments with ozonisation systems, further studies are needed to validate the effectiveness of environmental treatments with airborne disinfectants.

Endometriosis: seeking optimal management in women approaching menopause.

The incidence of endometriosis in middle-aged women is not minimal compared to that in the reproductive age group. The treatment of affected women after childbearing age to the natural transition toward menopause has received considerably poor attention. Disease management is problematic for these women due to increased contraindications regarding hormonal treatment and the possibility for malignant transformation, considering the increased cancer risk in patients with a long-standing history of the disease. This state-of-the-art review aims for the first time to assess the benefits of the available therapies to help guide treatment decisions for the care of endometriosis in women approaching menopause. Progestins are proven effective in reducing pain and should be preferred in these women. According to the international guidelines that lack precise recommendations, hysterectomy with bilateral salpingo-oophorectomy should be the definitive therapy in women who have completed their reproductive arc, if medical therapy has failed. Strict surveillance or surgery with removal of affected gonads should be considered in cases of long-standing or recurrent endometriomas, especially in the presence of modifications of ultrasonographic cyst patterns. Although rare, malignant transformation of various tissues in endometriosis patients has been described, and management is herein discussed.

Official controls regarding artisanal ice cream shops: public health policies and consumer protection in the Italian and European legislative frameworks.

Ice cream is a widely enjoyed food that is especially popular during summer. To ensure it is safe and ready-to-eat for consumers, legislation imposes a series of obligations for food business operators, and for competent authorities that have to carry out official controls, including official sampling. This article reviews the general and specific requirements applicable to the premises where ice cream is produced, concerning aspects related to health notification obligations and to implementing and maintaining procedures based on the principles of the Hazard Analysis and Critical Control Point system. The review extends to results stemming from the most recent official control activities conducted in Italy, and to future perspectives on control methods that will have to be compliant with the provisions of the new EU Regulation 625/2017 applicable from 2019.

Effect of myo-inositol and alpha-lipoic acid on oocyte quality in polycystic ovary syndrome non-obese women undergoing in vitro fertilization: a pilot study.

The aim of the present study was to evaluate the effectiveness of the combined administration of myo-inositol and α-lipoic acid in polycystic ovary syndrome (PCOS) patients with normal body mass index (BMI), who had previously undergone intracytoplasmic sperm injection (ICSI) and received myo-inositol alone. Thirty-six of 65 normal-weight patients affected by PCOS who did not achieve pregnancy and one patient who had a spontaneous abortion were re-enrolled and given a cycle of treatment with myo-inositol and α-lipoic acid. For all female partners of the treated couples, the endocrine-metabolic and ultrasound parameters, ovarian volume, oocyte and embryo quality, and pregnancy rates were assessed before and after three months of treatment and compared with those of previous in vitro fertilization (IVF) cycle(s). After supplementation of myo-inositol with α-lipoic acid, insulin levels, BMI and ovarian volume were significantly reduced compared with myo-inositol alone. No differences were found in the fertilization and cleavage rate or in the mean number of transferred embryos between the two different treatments, whereas the number of grade 1 embryos was significantly increased, with a significant reduction in the number of grade 2 embryos treated with myo-inositol plus α-lipoic acid. Clinical pregnancy was not significantly different with a trend for a higher percentage for of myo-inositol and α-lipoic acid compared to the myo-inositol alone group. Our preliminary data suggest that the supplementation of myo-inositol and α-lipoic acid in PCOS patients undergoing an IVF cycle can help to improve their reproductive outcome and also their metabolic profiles, opening potential for their use in long-term prevention of PCOS.

Isthmocele in a retroflexed uterus: a report of an unrecognized case.

The term "isthmocele" refers to a niche on the anterior wall of the uterine isthmus or of the cervical canal at the site of a previous cesarean delivery scar. Such anatomic defect can cause many gynecologic sequelae that only recently have being identified and described. Hysteroscopy is commonly considered the gold standard for the diagnosis and also for the treatment, at least in the case of defects of small size. The authors described the case of a 37-year-old woman who underwent a cesarean section (CS) seven years before, with a long lasting history of menstrual irregularities, and pelvic pain increasing during menstruation at the hypogastric level. Magnetic resonance imaging (MRI) showed an exceptionally large isthmocele on the anterior wall of a retroflexed uterus which was otherwise misinterpreted as the uterine cavity filled with menstrual blood during a previous hysteroscopy (HSC). Although exceptional, this case highlights the possibility that a large sized isthmocele in a retroflexed uterus could be misinterpreted as the uterine cavity filled by menstrual blood at HSC. In this case MRI definitely clarified the diagnosis.

MRI in the assessment of prolapsed pedunculated submucous leiomyomas: two case reports.

Uterine leiomyomas are the most common benign gynecological tumors affecting 20-30% of women in reproductive age. Despite their benignity, in some cases several symptoms may require surgical intervention. Submucosal leiomyomas are less frequent (5-10%), but are usually symptomatic. Approximately 2.5% of the myomas are pedunculated and can protrude in the cervical canal. Symptomatic leiomyomas can be treated either by hysterectomy or myomectomy, and these procedures can be performed with several techniques. Whenever possible, hysteroscopic myomectomy is better because it has many advantages, as it also preserves future fertility. Two interesting cases of prolapsed pedunculated submucous leiomyomas are reported in order to prove that magnetic resonance imaging (MRI) is essential to choose the most appropriate treatment and to perform an adequate presurgical planning, which must be based on an overall assessment of the leiomyoma's characteristics (number, location, size and presence or absence of a stalk) and the patient's characteristics.

Biochar reduces short-term nitrate leaching from a horizon in an apple orchard.

Nitrogen leaching in croplands is a worldwide problem with implications both on human health and on the environment. Efforts should be taken to increase nutrient use efficiency and minimize N losses from terrestrial to water ecosystems. Soil-applied biochar has been reported to increase soil fertility and decrease nutrient leaching in tropical soils and under laboratory conditions. Our objective was to evaluate the effect of biochar addition on short-term N leaching from A soil horizon in a mature apple orchard growing on subalkaline soils located in the Po Valley (Italy). In spring 2009, 10 Mg of biochar per hectare was incorporated into the surface 20-cm soil layer by soil plowing. Cumulative nitrate (NO) and ammonium (NH) leaching was measured in treated and control plots 4 mo after the addition of biochar and the following year by using ion-exchange resin lysimeters installed below the plowed soil layer. Cumulative NO leaching was not affected by biochar after 4 mo, whereas in the following year it was significantly ( < 0.05) reduced by 75% over the control (from 5.5 to 1.4 kg ha). Conversely, NH leaching was very low and unaffected by soil biochar treatment. The present study shows that soil biochar addition can significantly decrease short-term nitrate leaching from the surface layer of a subalkaline soil under temperate climatic conditions.

Effect of compost application on the dynamics of carbon in a nectarine orchard ecosystem.

The aim of the present study was to compare the quantity and the type of carbon (C) stored during the 14-year lifetime of a commercial nectarine orchard ecosystem fertilized with mineral or organic fertilizers. The study was carried out in the Po valley, Italy, in a nectarine orchard of the variety Stark RedGold, grafted on GF677 hybrid peach × almond. Since orchard planting in August 2001, the following treatments were applied in a randomized complete block design with four replicates per block and compared: 1. unfertilized control; 2. mineral fertilization (including P and K at planting and N applied as NO3NH4 yearly at the rate of 70-130 kg ha-1); 3. compost application at a rate of 5 Mg DW ha-1 yr-1; 4. compost application at a rate of 10 Mg DW ha-1 yr-1. Compost was obtained from domestic organic wastes mixed with pruning material from urban ornamental trees and garden management after a 3-month stabilization period. Application of compost at the highest rate increased C in the soil; the amount of C sequestered was approximately 60% from amendment source and 40% from the net primary production of trees and grasses with a net increase of C compared to mineral fertilization. Compost application was found to be a win-win strategy to increase C storage in soil and, at the same time, to promote plant growth and yield to levels similar to those obtained with mineral fertilization. The rate of C application is crucial, indicated by the fact that compost supply at the rate of 10 Mg ha-1 yr-1 was the only fertilization strategy of the ones tested that resulted in higher C sequestration. This shows that compost amendment may stimulate an increase in the net primary production of plants.

Meta-analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro-oesophageal reflux disease.

BACKGROUND: Many investigators have proposed an association between gastro-oesophageal reflux disease and laryngo-pharyngeal symptoms, suggesting that medical or surgical therapy for reflux may be useful. AIM: To perform a meta-analysis assessing the effectiveness of medical or surgical therapy for reflux disease in adult patients with laryngeal or pharyngeal symptoms presumed to be due to gastro-oesophageal reflux disease. METHODS: Randomized controlled trials comparing medical or surgical treatments for gastro-oesophageal reflux disease against placebo were identified by searching MEDLINE (1966-September 2005), EMBASE (1974-September 2005), the CCRCT (until September 2005) and abstracts from gastroenterology and ENT meetings. The relative risks of reporting symptomatic improvement or resolution of symptoms was evaluated using a random-effects model. RESULTS: Five studies using high-dose proton pump inhibitor as intervention met the inclusion criteria and were included in the meta-analysis. No surgical studies met inclusion criteria. The pooled relative risk was 1.18 (95% confidence interval: 0.81-1.74). There was no heterogeneity between studies but evidence of significant publication bias. Sub-group analysis performed evaluating Jadad scores and symptom type, did not change the relative risk. CONCLUSIONS: Therapy with a high-dose proton pump inhibitor is no more effective than placebo in producing symptomatic improvement or resolution of laryngo-pharyngeal symptoms. Further studies are necessary to identify the characteristics of patients that may respond to proton pump inhibitor therapy.

Lipid, lipoprotein, and apolipoprotein assessment during an 8-wk very-low-calorie diet.

The influence of a very-low-calorie diet (VLCD) on lipid pattern is controversial. To evaluate the long-term effect of semistarvation on lipid patterns, a group of severely obese patients [aged 37 +/- 12 y, body mass index (BMI) 40.0 +/- 0.9] underwent a VLCD for 8 wk. Total cholesterol (TC), LDL cholesterol (LDL-C), and HDL cholesterol (HDL-C), triglycerides (TGs), apolipoproteins A1 (apo A1) and B (apo B) were analyzed every week. TC (6.07 +/- 0.23 vs 5.53 +/- 0.25 mmol/L, P less than 0.0008), HDL-C (mmol/L 1.26 +/- 0.06 vs 1.04 +/- 0.05 mmol/L, P less than 0.0001), TGs (1.46 +/- 0.19 vs 1.06 +/- 0.10 mmol/L, P less than 0.0008), and apo A1 (1.57 +/- 0.06 vs 1.32 +/- 0.06 g/L, P less than 0.0002) decreased, whereas LDL-C and apo B showed a biphasic behavior: they significantly fell during the first 3 wk, but during the last weeks returned to their initial values.

Epilepsy with bilateral occipital calcifications: a benign onset with progressive severity.

We studied four patients with a focal epilepsy and bilateral occipital corticosubcortical calcifications without any sign of phakomatosis. The clinical course of the disease was similar in all the patients and evolved from a benign onset to a severe encephalopathy with progressive mental impairment. The question of whether these patients have an incomplete and atypical form of Sturge-Weber syndrome or a previously undescribed disorder is addressed.

[Comparison of three methods for the rapid determination of body composition]. / Tre metodiche a confronto per una rapida determinazione della composizione corporea.

The study of body composition is becoming increasingly important in the field of nutritional medicine. The possibility of assessing body composition easily and economically has therefore raised considerable interest. Using straightforward correlations, we have compared the data obtained from the assessment of BF% using plicometry, impedance analysis and the interactivity of close-infrared rays; in addition, we studied the possible influence of the distribution of fatty tissue, expressed as W/H, on the results obtained using these methods. One hundred and forty-eight subjects (51 M and 97 F) were studied aged between 13 and 76 years old, with BMI ranging between 16.8 and 56.4; subjects were divided into three groups according to BMI and W/H. The three methods proved to be well correlated in patients with BMI less than 30 (r between 0.92 and 0.74), whereas correlations were less marked and less significant in groups with BMI greater than 30. W/H seemed capable of influencing results obtained using these methods and this was more evident in results obtained using impedance analysis (p less than 0.0001). The three methods studied were comparable in normal weight and slightly overweight patients, whereas contrasting findings were obtained in patients with moderate and severe obesity. Extreme caution must therefore be used in interpreting the data obtained in these subjects.

Glycosaminoglycans as a possible tool for micro- and macroalbuminuria in diabetic patients. A pilot study.

The aim was to investigate sulodexide as a possible therapeutic tool for treating micro- and macroalbuminuria in diabetic patients. Fifteen patients (13 micro- and 2 macroalbuminuric) with Type II diabetes, were treated with 600 lipoprotein-lipase releasing units of sulodexide by the intramuscular route, daily for 28 days, and followed up for 2 months. The main evaluation parameter was the albumin excretion rate. At the end of treatment, six of the 13 microalbuminuric patients showed a decrease in the albumin excretion rate, which increased again in three of the six during follow-up. In the two macroalbuminuric patients the albumin excretion rate decreased at the end of treatment and remained unchanged after a further 2 months. Overall analysis (15 patients) showed a significant decrease (P < 0.05) in the albumin excretion rate compared with baseline. Metabolic control and blood pressure remained unchanged during the entire period of study. No adverse events were registered. It is concluded that sulodexide administration has a favourable effect in reducing the albumin excretion rate in Type II diabetic patients with micro- and macroalbuminuria.

[A.R.G.U.S. A model for an interactive visual field and visual pathway atlas]. / A.R.G.U.S. Modell für einen interaktiven Gesichtsfeld- und Sehbahnatlas.

A.R.G.U.S. is a data base that connects visual field defects directly with possible lesion sites that are presented graphically. By means of a touch screen or "mouse," scotomata can be depicted on a VDU, while on a second monitor the computer program simultaneously shows the resulting defects in the visual pathway. It is possible to page through different sections of the visual pathway; the lesion is probably located in the section where the affected fibers lie the closest to each other and where the non-affected fibers are the farthest apart. Additionally, the VDU depicting the visual pathway can show the surrounding anatomic structures in the form of brain sections. Even in these sections, lesions can be superimposed interactively; the resulting scotomata are simultaneously depicted on the "visual field VDU." Anatomic and functional details can be displayed by touching the structure of interest. If necessary, a video clip can be activated in the same way. New anatomic findings can be considered by modifying the course of the fibers of the visual pathway. This new technique is especially helpful in distributing comprehensive neuro-ophthalmological knowledge.

Carcinoid tumours of the larynx: report of two cases.

Carcinoid tumour of the larynx is extremely rare. The increasing number of these lesions reported is due to the application of ultrastructural and immunological methods in the diagnosis. Two new cases of this malignant neoplasm are presented and discussed with particular reference to the difficulty in distinguishing carcinoids from other tumours of the larynx. The accurate pathological identification of the tumour is essential for treatment and prognosis.

Laryngeal metastasis from colonic adenocarcinoma.

Metastases to the larynx from distant primaries are very rare. Usually the secondary lesion comes from an hypernephroma or malignant melanoma. A case of metastatic laryngeal tumour from a colonic adenocarcinoma, occurring in a 59-year-old woman, is presented and the routes for laryngeal spread are discussed. The poor survival-rate of these patients justified only conservative surgery.

Arterial anomalies of the middle ear associated with stapes ankylosis.

An aberrant internal carotid artery in a young woman complaining of pulsatile tinnitus and conductive hearing loss was diagnosed pre-operatively by CT scan and angiographic findings. An exploratory tympanotomy was performed in order to evaluate the cause of the severe conductive hearing loss. It was possible to detect a large persistent stapedial artery associated with a stapedial fixation of unknown cause. Despite these vascular anomalies a stapedotomy was performed successfully.

[Acute epiglottitis in adults: a rare cause of acute respiratory insufficiency]. / L'epiglottite acuta nell'adulto: una rara causa di insufficienza respiratoria acuta.

Acute epiglottitis is an infective disease which may have a rapid and aggressive course to total upper airway obstruction. Due to its rarity (mostly in adults) and aspecific initial clinical features, it may present diagnostic problems to less experienced medical personnel. This is the principal reason why the mortality rate is still unacceptably high. Indirect or direct laryngoscopy is mandatory for diagnosis: as this might be difficult for non-specialist physicians, their awareness of the potentially severe consequences of epiglottic infections is fundamental to minimizing diagnostic delay. In fact, early involvement of experienced ENT and anaesthesiological staff is essential for diagnosis, which must be as prompt as possible and followed by thorough clinical monitoring to avoid fatal outcome.

[Papillary carcinoma arising in thyroglossal duct cyst: a case report and review of the literature]. / Carcinoma papillifero insorto su cisti del dotto tireoglosso: presentazione di un caso e revisione della letteratura.

While thyroglossal duct cysts are a frequent cause of cervical masses, carcinomas arising in thyroglossal duct remnants are rare. In this paper the Authors report a new case, which occurred in a young woman. The diagnosis of carcinomas in thyroglossal duct cysts almost always comes as a surprise upon pathologic examination. The type of neoplasia most frequently described in Literature is that of the papillary carcinoma (82%). Other types of carcinomas are also reported in Literature: mixed follicular-papillary carcinomas (9 cases), squamous cell carcinomas (10 cases) and follicular carcinomas (3 cases). There are different theories regarding the origin of and therapy for these malignancies. In the sixties some Authors thought that these carcinomas were metastases of thyroid carcinomas. Now, following demonstration of normal thyroid tissue occurrence in the wall of thyroglossal duct cysts, it is almost universally accepted that a carcinoma may arise from thyroglossal remnants. The foci of cancer found in the thyroid reported only infrequently in Literature are a result of the plurifocality of papillary carcinoma. The Authors suggest that the Sistrunk procedure is an adequate, sufficient treatment if the carcinoma is limited to the cyst's walls. They also recommend postoperative administration of substitution therapy of thyroid hormones. Indications for thyroidectomy are then discussed.