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Ethiopia's commitment to achieving universal health coverage (UHC) requires an efficient and equitable health priority-setting practice. The Ministry of Health aims to institutionalize health technology assessment (HTA) to support evidence-based decision making. This commentary highlights key considerations for successful formulation, adoption, and implementation of HTA policies and practices in Ethiopia, based on a review of international evidence and published normative principles and guidelines. Stakeholder engagement, transparent policymaking, sustainable financing, workforce education, and political economy analysis and power dynamics are critical factors that need to be considered when developing a national HTA roadmap and implementation strategy. To ensure ownership and sustainability of HTA, effective stakeholder engagement and transparency are crucial. Regulatory embedding and sustainable financing ensure legitimacy and continuity of HTA production, and workforce education and training are essential for conducting and interpreting HTA. Political economy analysis helps identify opportunities and constraints for effective HTA implementation. By addressing these considerations, Ethiopia can establish a well-designed HTA system to inform evidence-based and equitable resource allocation toward achieving UHC and improving health outcomes.

We reviewed the literature concerning the innate response from nasal and oral epithelial cells and their reaction to hydrogen peroxide (H 2 O 2 ). Hydrogen peroxide is produced physiologically by oral bacteria and plays a significant role in the balance of oral microecology since it is an important antimicrobial agent. In the epithelial cells, the enzyme superoxide dismutase catalyzes a reaction leading from hydrogen peroxide to the ion superoxide. The induced oxidative stress stimulates a local innate response via activation of the toll-like receptors and the NF-κB. Those kinds of reactions are also activated by viral infections. Virus-induced oxidative stress plays an important role in the regulation of the host immune system and the specific oxidant-sensitive pathway is one of the effective strategies against viral infections. Therefore, nose/mouth/throat washing with hydrogen peroxide may enhance those local innate responses to viral infections and help protect against the current coronavirus pandemic. We strongly encourage the rapid development of randomized controlled trials in both SARS-CoV-2 positive and negative subjects to test the preliminary findings from the in-vitro and in-vivo observational studies that we identified., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The authors report the study of a clinical case, which presented eosinophilia both in the secretion of the nasal mucosa and in the blood count. After a careful examination of all the pathologies related to hypereosinophilia, through a clinical study, they have documented the presence of an adenocarcinoma located in the ileocecal junction of the colon. From what has been documented it is clear that only a clinical observation of precision, carried out above all through nasal cytology and colonoscopy, is able to diagnose an important pathology, such as oncology. For the literature review we used the Scopus and PubMed search engines to analyze other authors who were interested in the relationship between eosinophilia and colorectal cancer. Much of the studies analyzed reported a close relationship between the presence of tissue eosinophilia and tumor, and the prognosis of colorectal cancer. KEY WORD: Colorectal cancer, Eosinophils, Hypereosinophilia.

Introduction: The frequency of gastroesophageal reflux disease (GERD) is increasing, in part through easy inspection of the upper digestive tract, but especially for a real spread of the disease as a consequence of modernity, lifestyle, incorrect dietary rules, and stress arising from social norms. It is a common chronic gastrointestinal disorder in Europe and the United States., Materials and Methods: The aim of our study is to highlight a relationship between gastroesophageal reflux disease and salivary pH as evidenced by indicator strips, especially in the outpatient field. Twenty adult subjects (10 males and 10 females) aged between 18 and 50 years (GROUP A)_ were selected. How to control a homogeneous group of 20 patients without GERD, or from any type of allergies (GROUP B) was enlisted., Results: This method has provided excellent results showing no difference in the measured values compared with the traditional instrumental measurement., Conclusion: Our study has allowed us to observe a strong correlation between the saliva pH, nasal cavities and the interaction between the two districts, and could be the basis for a diagnosis of GERD especially in primary health care clinics and in the initial stage of the disease., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest.

Although several therapeutic approaches are available at present for the treatment of chronic pharyngitis, new therapeutic strategies acting on pharyngeal mucous function should be investigated in order to improve symptoms and quality of life. High-molecular weight hyaluronate performs important functions on mucociliary clearance, tissues hydration, defense against micro-organisms, and on tissue repair as well, but at present there is no clinical evidence of its exogenous use in patients with chronic pharyngitis. Our open, randomized controlled study was carried out to investigate efficacy, and tolerability of exogenous high molecular weight sodium hyaluronate (SH) at the dosage of 9 mg three times a day for a period of 30 days, in patients with chronic pharyngitis. Results show significant improvements of symptoms and cytology in active group (A, n = 10) vs. control group (B, n = 10). Good compliance and no adverse events were reported in group A. In conclusion, SH was effective and safe in patients with chronic pharyngitis., (© The Author(s) 2015.)

Dehydroepiandrosterone (DHEA) and its sulfated ester DHEAS are the most abundant circulating adrenal steroids but their function remains to be elucidated. DHEAS secretion and serum levels decrease with age and this is parallel to the development of a number of the problems of ageing (immunosenescence, increased incidence of osteoporosis, atherosclerosis and cancer, decrease of cognitive functions and/or well-being). For these reasons a growing interest in replacement of DHEA in elderly people has been developed. The findings from recent studies of replacement of DHEA in elderly are reviewed here. Although we have some positive data about benefit results of this therapy on muscle, bone and well-being, at present it is premature to recommend the routine use of DHEA replacement because most of its aspects remains controversial.

The effects of type 2 diabetes on evoked otoacoustic emissions (e-OAEs) elicited by clicks in subjects with normal hearing and the involvement of the central (CNS) and peripheral nervous system and acute hyperglycemia were investigated. In study 1, 110 type 2 diabetic patients and 106 control subjects matched for age and gender were investigated by e-OAEs. Central and peripheral neuropathy were evaluated respectively by auditory brainstem responses (ABRs) and according to San Antonio Consensus Conference criteria. In study 2, 10 healthy and 10 type 2 diabetic men matched for age, all with normal e-OAEs, underwent a 5-hour hyperglycemic clamp study. e-OAE tests were performed before and during the hyperglycemic clamp. In study 1, e-OAEs were impaired in 51.8% (57 of 110) of the diabetic subjects, in comparison to 4.7% (five of 106) of the control group (P < .0001). Diabetics with impaired e-OAEs (e-OAEs-), in comparison to those with normal e-OAEs (e-OAEs+), were older (51.0+/-5.8 v 45.1+/-6.0 years, P < .001), had diabetes longer (11.5+/-4.4 v 7.0+/-3.9 years, P < .001), achieved poorer metabolic control as judged by hemoglobin A1c ([HbA1c] 6.9%+/-0.4% v 6.5%+/-0.3%, P < .001), and had more peripheral neuropathy (46% v 23%, P < .02). No difference was observed between e-OAEs- and e-OAEs+ subjects for retinopathy or nephropathy. Nevertheless, when the duration of diabetes was corrected by multiple regression analysis, the correlation between sensorineural damage and peripheral neuropathy lost significance (P = .12). Diabetic groups (e-OAEs+ and e-OAEs-) showed greater latency in waves I, III, and V and greater interwave latency for waves I to V than the control group, but there was no significant difference in ABRs between e-OAEs+ and e-OAEs- subjects. In study 2, there were no significant changes in e-OAE intensities compared with basal values during the entire hyperglycemic clamp in either type 2 diabetic or control subjects. No difference was observed between the two groups at each time of the clamp. Thus, type 2 diabetic subjects show a higher rate of compromised e-OAEs than healthy individuals. The e-OAE dysfunction does not associate with either an injury to the auditory nervous pathway or diabetic microvasculopathy. The apparent interference of peripheral neuropathy in e-OAEs loses significance when corrected for the duration of diabetes.

Background and Aim: Benign thyroid nodules are a frequent pathology in the general population and in particular in the aged, but their treatment is still controversial. The percentage by which volume and/or the number of nodules is reduced using L-thyroxine treatment reported in the literature varies widely: from 9 to 68%. The aim of this study was to study the therapeutic efficacy of thyroxine treatment in the aged., Methods: A retrospective study was performed in 105 elderly out-patients (mean age 68 +/- 6 years) suffering from thyroid nodules forming part of a population of 7452 thyroid patients from central Italy attending the 2nd Medical Clinic at "La Sapienza" University of Rome from 1986 to 1994. Other diseases which might influence treatment were excluded in all subjects. Thyroid hormones, TSH and antithyroid antibodies were assayed using RIA techniques; patients also underwent ultrasonography of the gland, 131I thyroid captation with scintigraphy and cytological analysis using fine needle aspiration. Patients were treated with L-thyroxine (75-150 micrograms/day) and controlled after 6, 12 and 24 months. No collateral effects were reported., Results: The majority of patients (some 85%) remained stationary; just under 10% improved and only a few showed a deterioration of symptoms., Conclusions: Medical therapy continues, in the authors' opinion, to be the first choice in the treatment of benign thyroid nodules also in elderly patients owing to its easy management, low cost and scarce collateral effects.

Development of spontaneous hemothorax without predisposing conditions is extremely rare. We report a young man with a history of a seizure disorder who presented to the emergency department with spontaneous hemothorax. Exploratory thoracotomy evacuated 2,000 ml of old blood. No source of hemorrhage was identified. To our knowledge, this is the first report of spontaneous hemothorax proved by thoracotomy.