Quail egg homogenate with zinc as adjunctive therapy in seasonal allergic rhinitis: a randomised, controlled trial.

OBJECTIVE: Because most available treatments for managing seasonal allergic rhinitis show some side effects without reducing recurrence, natural anti-allergic products could represent an interesting treatment addition. This study aimed to analyse the efficacy and tolerance of quail egg as adjunctive therapy in seasonal allergic rhinitis. METHOD: In a Consolidated Standards of Reporting Trials compliant framework, patients with seasonal allergic rhinitis were prospectively randomised to receive mometasone nasal spray for four weeks or the same topical corticosteroid therapy plus commercially available oral quail egg and zinc tablets. RESULTS: Forty patients were enrolled. The mometasone + quail egg and zinc tablets group showed a greater reduction in nasal itching, sneezing and total nasal symptom scores than the mometasone nasal spray only group. A higher proportion of participants in the mometasone + quail egg and zinc tablets group had good rhinitis control than in the mometasone nasal spray only group, with no need for rescue medications. CONCLUSION: Despite the need for a further larger study, quail egg preliminarily appears to be an effective adjunct to topical steroid therapy in seasonal allergic rhinitis.

An unusual case of melanoma metastasis in the buccal space: learning by mistakes to distinguish it from salivary neoplasms.

BACKGROUND: The buccal space is an unusual location of malignancies. We report here the case of a woman with a melanoma metastasis in buccal fat pad, to evaluate the imaging features which might lead to the correct, although uncommon, diagnosis. CASE PRESENTATION: A 71-year-old woman presented with a painless visible swelling of the left cheek. MRI revealed the presence of a solid lesion located in the buccal fat pad with features suggestive of malignancy. It showed T1 hyperintensity and T2 hypointensity, and restriction of diffusion. Histological examination showed neoplastic cells compatible with melanoma. DISCUSSION: The lesion features (T1 hyperintensity and T2 hypointensity) initially lead our team to believe that there was a hemorrhagic component, possibly a residue of the biopsy. However, when associated with other malignancy features, such as low apparent diffusion coefficient (ADC) values and contrast enhancement, they should evoke the suspect of melanoma, provided that no biopsy was performed and no trauma occurred in the 3-7 days before.

Olfactory disorders in coronavirus disease 2019 patients: a systematic literature review.

OBJECTIVE: Recent scientific literature has widely described a possible major role of smell dysfunction as a specific symptom of coronavirus disease 2019. This systematic review may provide a more holistic approach to current knowledge of the disease. METHODS: A systematic review was completed using Embase, PubMed and Web of Science databases that considered original articles focused on olfactory evaluation in coronavirus disease 2019 patients, published between March and May 2020, in English language. RESULTS: From the 483 research papers initially identified, 32 original studies were selected, comprising a total of 17 306 subjects with a laboratory confirmed diagnosis of coronavirus disease 2019. Individual study sample sizes ranged from 6 to 6452 patients. This comprehensive analysis confirmed that olfactory disorders represent an important clinical feature in coronavirus disease 2019, with a prevalence of 11-100 per cent in included patients, although there was heterogeneity in terms of assessment tools and population selection criteria. CONCLUSION: The results indicate that an accurate clinical evaluation should be carried out using structured questionnaires and tests with olfactory substances.

The role of narrow-band imaging in parathyroid surgery: a preliminary evaluation in five parathyroid adenoma cases.

BACKGROUND: Narrow-band imaging uses selective haemoglobin light absorption to emphasise vascular visualisation and capillary networks. OBJECTIVE: This study aimed to evaluate the application of this technique to parathyroid surgery. METHOD: This preliminary evaluation was carried out on five consecutive patients with single parathyroid adenoma being considered for minimally invasive video-assisted parathyroidectomy. The adenomas were checked for narrow-band imaging vascular patterns. Minimally invasive video-assisted parathyroidectomy was then carried out in accordance with our standard protocol. RESULTS: In four out of the five cases, narrow-band imaging integrated the white endoscopic light and direct vision, but in one case narrow-band imaging allowed distinction between the hidden neoplastic tissue and the surrounding structures thanks to the different vascular patterns. CONCLUSION: Narrow-band imaging was helpful in properly identifying adenoma. It is suggested that this technique be considered as a means for surgeons to improve their confidence in selected surgical treatments and to improve treatment quality.

Nasal cytology in children: scraping or swabbing?

Nasal cytology has become a valuable tool in the assessment of a multitude of nasal pathologies in children. Collection methods differ significantly and even though the use of the nasal curette is regarded as the most reliable in adults, most practitioners use the nasal swab in children. However, no studies have validated the reliability and supposed better tolerability of the latter. We have compared these two sampling methods regarding their tolerability and analysed the diagnostic accuracy of the cotton nasal swab (NSW) to identify nasal cytotypes and rhinitis phenotypes, using nasal scraping (NSC) for comparison. In a multicentric prospective study we recruited 208 children and performed nasal cytology by means of NSW and NSC. Microscopic evaluating of the nasal cytotypes was performed and tolerability of NSW and NSC was tested. Our data revealed a significantly inferior diagnostic accuracy of NSW compared to NSC regarding reliability and cell counts. Our study is the first to shed light on the role of the sampling tools for pediatric nasal cytology. We documented a poor diagnostic accuracy of NSW, thus suggesting using only the nasal curette in clinical practice. Furthermore, tolerability did not differ between the two, refuting the common thesis that swabs are to be preferred when doing nasal cytology in children.

Transnasal endoscopic microfractured fat injection in glottic insufficiency.

OBJECTIVE: We evaluated a novel treatment for glottic insufficiency involving the injection of autologous material with direct glottic visualisation in an outpatient setting. METHODS: Three patients with vocal cord palsy underwent laryngoplasty under local anaesthesia using only a flexible endoscope with a working canal for Microfractured Fat Fibre-endoscopic Injection (MFFI). Adipose tissue was processed using the Lipogems device, which allows optimal purity, fluidity, and mesenchymal stem cell content in the resultant emulsion. RESULTS: According to the preliminary data, MFFI was well tolerated and no complications were observed. During the 12-month follow-up period, voice improvement was constant in all three patients, hinting at the stem cell-related regenerative potential of the procedure. CONCLUSIONS: MFFI was proven to be a useful and straightforward tool, combining all of the relevant advantages of other known treatments for glottic insufficiency, and is an efficacious and innovative treatment that can be performed on an outpatient basis using only autologous material.

Radical modified surgery in breast carcinoma. Our experience.

A retrospective study of 541 patients portraying breast carcinoma in different evolutive stages is presented and analyzed according to their distribution in stages, their treatment, follow-up and evolution. The surgical procedure of choice, Radical vs. Modified Radical (Merola - Madden) has been discriminated in two periods. There exists a trend of preference towards the modified radical which is advised for the early stages. The survival rate for either procedure selected according to stage is promising, and the local complications, recurrences and metastasis have been low enough to permit to evaluate the conducts held somehow optimistically.