Explore the vast range of titles available.

Background Acute mastoiditis (AM) is the most common complication of acute otitis media (AOM) and could lead to serious complications if not diagnosed early and treated appropriately. Nowadays, there is no definitive consensus about the diagnostic algorithm and the optimal therapeutic management for patients with AM. The purpose of this study is to analyze the management of children admitted for AM and complicated AM (CAM) in a referral children’s hospital, evaluating differences in clinical presentation and management to outline a diagnostic and therapeutic pathway. Moreover, the incidence over time was assessed. Methods Retrospective study of children admitted for AM at Meyer University Hospital– IRCCS, Florence from January 2016 to December 2023. Results Eighty-five patients were included in the study (60% male, median age 4 years), the microbiological examinations were carried out in 68% of them. The most frequent isolated pathogens were Pseudomonas aeruginosa in AM and Streptococcus pyogenes in CAM. Seventeen patients developed a CAM. An elevated CRP value is associated with an increased risk of CAM ( p  = 0.043). Management of patients with AM was mainly medical with intravenous antibiotics. Surgical intervention was required only in one case (1 out of 68). In contrast, surgical intervention was required in 76% of CAM cases (13 out of 17). The most common procedure was mastoidectomy combined to abscess drainage, according to the predominance of this complication in our study group. Only one patient had a recurrence leading to a second surgery. No significant statistical correlation was found between the occurrence of complications and younger age, personal history of otitis or leukocyte count. A significant increase in AM case was found during the study period. Conclusions AM and CAM are infrequent but potentially life-threatening complications of AOM. A marked rise in AM cases was observed in 2023, likely due to the lifting of pandemic restrictions. A heterogeneous management of mastoiditis was observed, even within a single center. Elevated CRP levels are the only identified parameter associated with the complicated form. Pediatricians should be aware of the importance of a prompt diagnosis and guidelines should be developed to support effective management.

BACKGROUND: The aim of the study is to evaluate the incidence of recurrence of acquired cholesteatoma and functional outcomes in patients who underwent CWD tympanoplasty with cavity obliteration using an inferior-based musculoperiosteal flap. A comparison between children and adults was conducted. METHODS: All surgeries performed by the same expert surgeon from 2016 to 2019 were considered for the study. Patients younger than 18 years old, operated on at Meyer's Children Hospital, formed group A. Patients older than eighteen, operated on at Santo Stefano Hospital, formed group B. Clinical, audiological, and radiological data were collected from medical records. The Air Bone Gap (ABG) was used to assess the audiological results, and outpatient evaluations were considered to detect cases of recurrence. RESULTS: Group A and Group B are composed of 23 and 25 patients, respectively. The postoperative ABG is 30.7 dBHL in group A and 29.5 dBHL in group B. The rate of recurrence is 17.2% in children and 8% in adults. The recurrence of cholesteatoma occurred in five children (21.8%) after an average follow-up of 18 months and in three adults (12%) after an average follow-up of 24 months. CONCLUSION: The surgical approach to CCOM in children aims to be as conservative as possible. The greater extension of the pathology is cor-related with a greater erosion of the ossicular chain. According to our experience, open tympanoplasty with the obliterative technique allows us to obtain good anatomical and audiological outcomes, both in adults and children. KEYWORDS: Children, cholesteatoma, ear surgery, otitis media, tympanoplasty

Abstract Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis, with multisystem manifestation such as bone pain, being the most common presenting symptom, cardiovascular or central nervous system involvement, interstitial lung disease, skin and orbital lesions, adrenal enlargement, retroperitoneal fibrosis and renal impairment as well fever, and weight loss. The disease is challenging to diagnose due to its rarity and mimicry of other infiltrative processes. Technetium-99 m bone scintigraphy showing pathological bone activity in the long bones is highly suggestive of ECD. However, not all patients have bone complaints. Till now, fluorine-18-fluorodeoxyglucose positron-emission tomography/computed tomography ( 18 F-FDG PET/CT) was especially used after histological diagnosis to determine disease activity and extent, as well as the evaluation of treatment response. With this case, we suggest an additional role for 18 F-FDG PET/CT earlier on in the diagnosis workup as follows: detecting a possible biopsy site to establish the diagnosis of ECD especially in a clinical context without bone pain.

This contribution deals with the ethical challenges arising from the IoT landscape with reference to a specific context, i.e. the realm of agri-food. In this sector, innumerable web-connected tools, platforms and sensors are constantly interacting with consumers/users/citizens, by reshaping and redefining the core elements and functions of machine–human being relationships. By sketching out the main pillars which ethics of the Internet of Food (IoF) is founded on, my argument posits that the civic hybridization of knowledge production mediated by IoT technologies may create breeding ground for the move towards an ‘ethical in-design’ approach to the IoF-driven smart systems.

In today’s innovation-driven agrifood domain, the perspective of using so-called New Breeding Techniques (NBTs) on both non-human animals and plants calls into question the regulatory approach (process/product-based) to be used, while asking for a critical reflection on the potential impact of products on the industrial sector and citizens. A possible reconfiguration of European (EU) discipline will have to grapple with not only agrifood market’s interests and needs, but mostly and primarily with the growing quest for public and participatory discussion on the current dominant vision on life sciences. Only through restoring visibility to the intertwining of knowledge production will it be possible to obtain EU governance of gene editing that is more authoritatively reliable from a scientific stance, as well as more transparently discussed and democratically shared at legal and policy level.

Abstract In a time of structural challenges to the integrity, validity, and reliability of science, the new Regulation 2019/1381 aims to rethink the risk assessment phase for greater transparency and sustainability in the food chain. The novel set of provisions calls, inter alia, for Member States’ and civil society’s involvement in the management structure and scientific panels of the European Food Safety Authority (EFSA). Using the European process of ‘agencification’ as a theoretical background, this analysis addresses which problems the reformed legal framework aims to solve as regards EFSA’s governance and which new questions it simultaneously brings to the forefront.

With the market for alternatives to dairy products growing considerably for reasons of animal ethics, environmental or health considerations, the need for legal clarity in sales denominations is rising among stakeholders. The US legal context, in this regard, oscillates from the courts’ faith in consumers’ reasonableness to the attempt of the Food and Drug Administration (FDA) to strengthen the enforcement of the regulated standards of identity. At the core of those divergent viewpoints stand the issues pertaining to the nutritional status or quality of both dairy and plant-based products, together with evolving consumer perceptions and changing dietary behaviours. This contribution looks at these opposing visions, casting light on the modalities through which the US authorities are divergently upholding their own beliefs and regimes of authority vis-à-vis citizens’ attitudes and knowledge in addressing the ‘legal identity’ of dairy and plant-based products.

Urethrocavernous fistula is a rare complication of penile prosthesis. Literature lacks any materials regarding this complication’s treatment. We report our experience with a 66-year-old man who developed urethrocavernous fistula after penile prosthesis implant. Our technique involves the careful closure of urethral and corpus cavernosum defects with application of TachoSil ® above the sutures. After the salvage procedure, no recurrence of fistula occurred and patient was able to have sexual intercourse. We believe that our technique may be successfully used in case of urethrocavernous fistula after penile prosthesis implant.

By looking at both the EU and US agricultural context, this essay reflects on the implementation of big data into agricultural legal practice, on regulations the implementation may require and on potential changes it brings into the legal realm of agriculture. The first part discusses big data’s potential for agriculture, together with problems and dilemmas arising from it. The second section reviews the main legal problems information exchange poses between farmers and ATPs, by analysing the normative questions on ownership, privacy and security of big farm data. The final part showes the possible perspectives the issue opens in the agricultural sphere, by using the concepts of “open data” and “data philanthropy” as institutional and procedural patterns to follow to achieve more knowledgeable and sustainable agriculture.