Background/Aim: Thyroid dysfunction, both hypoand hyperthyroidism, has been associated with cardiovascular disease. The aim of this study was to evaluate the association between thyroid dysfunction and atherosclerosis measured mostly by carotid intima-media thickness, as well as discuss whether L-T4 replacement is able to reverse or slow down the progression of atherosclerosis. Materials and Methods: The review was conducted according the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We performed on PubMed a literature search from May 2004 to January 2020, using the search terms 'subclinical hypothyroidism' or 'thyroid disorders' and 'carotid artery', 'carotid intima-media thickness (IMT)', 'levothyroxine', and 'atherosclerosis'. Results: Twenty-six studies were eligible and included in the analysis. Overall, the studies encompassed a total of 36.434 patients included in this review. Most studies indicated a proportional correlation between IMT and thyroid dysfunction. Levothyroxine (L-T4) replacement led to significant decrease of IMT after 1 year in most studies. Conclusion: Most studies have concluded that thyroid dysfunction is associated with arterial wall remodeling and, thus, with increased cardiovascular risk. However, the exact mechanistic background of pathological structural changes in the arterial wall is still unsettled. Large randomized controlled studies are required to definitively address the extent to which T4 replacement therapy might benefit patients with subclinical thyroid disorders.The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We performed on PubMed a literature search for the articles published from May 2004 until January 2020, using the 3127 This article is freely accessible online.
It has been suggested that vascular loops in the cerebellopontine angle and internal auditory canal are involved in the etiology of audio-vestibular symptoms. Several studies have focused on the compression of the eighth cranial nerve by vascular loops but have yielded contradictory results regarding their clinical significance. The aim of this study was to investigate whether vascular loops in this region correlate with audio-vestibular symptoms and which loop features – if any – can potentially lead to symptom manifestation. This systematic review was conducted according to the PRISMA guidelines. We performed on PubMed a literature search from November 2005 to October 2020. The search strategy included the following keywords (“vascular loops” OR “AICA loops” OR “vascular compression syndrome”) AND (“hearing loss” OR “tinnitus” OR “vertigo”). Fifteen studies were eligible and included in the analysis. Overall, the studies encompassed a total of 11,788 patients included in this review. The significantly larger group of patients (70%), in which no correlation of symptoms with vascular loops was found, suggests that vascular loops are probably anatomic variations in a substantial majority of cases with an uncommon subset causing some audio-vestibular symptoms. Even within the papers claiming a correlation, there is a multitude of symptoms that did not correlate with vascular loops. It has been suggested by most authors that magnetic resonance imaging should be performed to exclude the role of a vascular loop in the etiology of audio-vestibular symptoms only when vascular compression syndrome is suspected based on clinical indications and not routinely. Further studies would be useful in order to detail the relationship between the vascular structures and the nervous system.
In recent years, pedestrian navigation assistance has been used by an increasing number of people to support wayfinding tasks. Especially in unfamiliar and complex indoor environments such as universities and hospitals, the importance of an effective navigation assistance becomes apparent. This paper investigates the feasibility of the indoor landmark navigation model (ILNM), a method for generating landmark-based routing instructions, by combining it with indoor route maps and conducting a wayfinding experiment with human participants. Within this context, three different cartographic visualization scenarios were designed and evaluated. Two of these scenarios were based on the implementation of the ILNM algorithm, with the concurrent effort to overcome the challenge of representing the semantic navigation instructions in two different ways. In the first scenario, the selected landmarks were visualized as pictograms, while in the second scenario, an axonometric-based design philosophy for the depiction of landmarks was followed. The third scenario was based on the benchmark approach (metric-based routing instructions) for conveying routing instructions to the users. The experiment showed that the implementation of the ILNM was feasible, and, more importantly, it was beneficial in terms of participants' navigation performance during the wayfinding experiment, compared to the metric-based instructions scenario (benchmark for indoor navigation). Valuable results were also obtained, concerning the most suitable cartographic approach for visualizing the selected landmarks, while implementing this specific algorithm (ILNM). Finally, our findings confirm that the existence of landmarks, not only within the routing instructions, but also as cartographic representations on the route map itself, can significantly help users to position themselves correctly within an unfamiliar environment and to improve their navigation performance.The main problem of indoor navigation assistance approaches is the lack of accurate GPS signal, since it can only be used efficiently outside of buildings (radio signals cannot penetrate through walls). Due to this fundamental technical weakness, different approaches to overcome this problem were presented. These approaches can be based on the use of Wi-Fi, Bluetooth, ultra-wideband (UWB), near-field communication (NFC), etc.Traditional static maps have been employed for many years as navigational assistance [2]. Nonetheless, indoor navigation aids nowadays, mainly rely on location-based services (LBS) [3][4][5]. In these approaches, aside from the major challenge of accurate positioning the user, communicating effectively the routing instructions is of great significance as well [6]. So far, several approaches have been proposed, informing the user about the optimal routing decision, facilitating in this manner the wayfinding procedure. Among these techniques, non-map-based approaches are gaining interest, mainly because they offer to the user the possibility of not missing important elements o...
SARS-CoV-2 pandemic is the greatest public health concern of the year 2020. There are several worldwide reports of patients who have managed to recover from SARS-CoV-2 infection with negative PCR test results, that for unknown reasons convert back to positive PCR. We report a case of a patient in our hospital who developed positive PCR test results for SARS-CoV-2, after 4 consecutive results that were negative, along with a full-blown clinical syndrome of SARS-CoV-2 infection.
Introduction Anatomical variations of the nasal cavity and of the paranasal sinuses are frequently encountered and play an important role in dysfunctional drainage of sinuses. However, it is not clear in the literature whether they predispose to sinus pathology. Objectives The aim of the present review is to summarize the understanding of the association between anatomical variations of the sinonasal area and sinus pathology. Data Synthesis The present review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We performed a thorough research on PubMed from October 2004 until May 2020 by using the search terms paranasal sinus anatomical variations and sinus disease, sinusitis, and mucosal disease.Thirty studies were eligible and were included in the analysis. Overall, the studies encompassed a total of 6,999 patients included in the present review. In many studies, it has been statistically established that certain anatomical variations increase the risk of sinus disease. On the other hand, the rest of the collected studies failed to show any statistically significant correlation between anatomical variants and sinus pathology. Conclusion The present study highlights the possible correlation between some anatomical variations of the sinonasal area and pathologies of the paranasal sinuses. Careful assessment and computed tomography (CT) in patients with chronic rhinosinusitis is needed, especially in those undergoing endoscopic surgery, to identify and treat anatomical variations in the paranasal sinuses that may be correlated with rhinosinusitis. Due to contradictory results in the literature, further research is needed to elucidate the effects of anatomical variants of the sinonasal area.
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