Recurrence of benign paroxysmal positional vertigo: experience in 3042 patients.

OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is a disorder of the inner ear with a high rate of recurrence. Vascular disorders, migraine and autoimmune disorders have been considered facilitating factors for relapsing episodes. Our aim was to assess the role of vascular disorders, migraine and anti-thyroid antibodies in patients with recurrences. METHODS: We retrospectively analysed records of 3042 patients treated for BPPV without other lifetime vertigo. Clinical data included previous vascular disorders of the central nervous system, heart disorders, migraine and recent head trauma. The presence of anti-thyroid autoantibodies was assessed in all patients. RESULTS: Mean age of the first BPPV was 52.8 ± 14.5 years; there were 2339 females (76.9%), while 2048 (67.3%) of patients presented recurrences within two years of follow-up. Previous disorders of the central nervous system, presence of anti-thyroid antibodies, head trauma and migraine showed an association with recurrences. Above all, in subjects having the first BPPV while aged between 40 and 60 years, anti-thyroid antibodies were predictive for recurrences. CONCLUSIONS: Our data are consistent with the hypothesis that anti-thyroid autoantibodies may play a role in recurrences in subjects with initial manifestations between 40 and 60 years.

Environmental Impact of Food Preparations Enriched with Phenolic Extracts from Olive Oil Mill Waste.

Reducing food waste as well as converting waste products into second-life products are global challenges to promote the circular economy business model. In this context, the aim of this study is to quantify the environmental impact of lab-scale food preparations enriched with phenolic extracts from olive oil mill waste, i.e., wastewater and olive leaves. Technological (oxidation induction time) and nutritional (total phenols content) parameters were considered to assess the environmental performance based on benefits deriving by adding the extracts in vegan mayonnaise, salad dressing, biscuits, and gluten-free breadsticks. Phenolic extraction, encapsulation, and addiction to the four food preparations were analyzed, and the input and output processes were identified in order to apply the life cycle assessment to quantify the potential environmental impact of the system analyzed. Extraction and encapsulation processes characterized by low production yields, energy-intensive and complex operations, and the partial use of chemical reagents have a non-negligible environmental impact contribution on the food preparation, ranging from 0.71% to 73.51%. Considering technological and nutritional aspects, the extraction/encapsulation process contributions tend to cancel out. Impacts could be reduced approaching to a scale-up process.

Pneumolabyrinth and Recurrent Paroxysmal Positional Vertigo After Traumatic Stapes Fracture.

OBJECTIVES:: The development of pneumolabyrinth without previous head trauma is a rare event; the associated symptoms may be nonspecific, and they can simulate various cochleo-vestibular pathological entities. The aim of the present study is to describe one of these rare occurrences, characterized by a peculiar onset. METHODS:: We report a case of stapes fracture secondary to ear pick penetration into the middle ear with a pneumolabyrinth that caused a recurrent paroxysmal positional vertigo (PPV) mimicking a canalolithiasis. RESULTS:: The patient developed a profound left sensorineural hearing loss and an intractable PPV with "migrant" features. A pneumolabyrinth was visualized with high-resolution computed tomography. A perilymphatic fistula (PLF) with stapes fracture was found while performing an explorative tympanotomy. After the surgical treatment of the PLF, the patient no longer complained of vestibular symptoms. CONCLUSIONS:: To our knowledge, this is the fifth case of traumatic pneumolabyrinth simulating a canalolithiasis without previous history of temporal bone trauma and/or middle ear surgery. A pneumolabyrinth should be suspected in case of patients presenting recurrent intractable PPV after ear trauma.

Shelf life extension as solution for environmental impact mitigation: A case study for bakery products.

Over the last years, increasing attention has been paid to environmental concerns related to food production and potential solutions to this issue. Among the different strategies being considered to reduce the impact food production has on the environment, only moderate has been paid to the extension of shelf life; a longer shelf life can reduce food losses as well as the economic and environmental impacts of the distribution logistics. The aim of this study is to assess the environmental performance of whole-wheat breadsticks with extended shelf lives and to evaluate whether the shelf-life extension is an effective mitigation solution from an environmental point of view. To this purpose, the life cycle assessment (LCA) approach was applied from a "cradle-to-grave" perspective. Rosmarinic acid was used as an antioxidant to extend the shelf life. To test the robustness of the results and to investigate the influence of the choices made in the modelling phase, a sensitivity and uncertainty analysis were carried out. The achieved results highlighted how, for 10 of the 12 evaluated impact categories, the shelf-life extension is a proper mitigation solution, and its effectiveness depends on the magnitude of product loss reduction that is achieved. The shelf-life extension doesn't allow for the reduction of environmental impact in the categories of human toxicity, cancer effects and freshwater eutrophication.