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We present the results of a search for continuous gravitational wave signals (CGWs) in the second data release (DR2) of the European Pulsar Timing Array (EPTA) collaboration. The most significant candidate event from this search has a gravitational wave frequency of 4-5 nHz. Such a signal could be generated by a supermassive black hole binary (SMBHB) in the local Universe. We present the results of a follow-up analysis of this candidate using both Bayesian and frequentist methods. The Bayesian analysis gives a Bayes factor of 4 in favor of the presence of the CGW over a common uncorrelated noise process, while the frequentist analysis estimates the p-value of the candidate to be 1%, also assuming the presence of common uncorrelated red noise. However, comparing a model that includes both a CGW and a gravitational wave background (GWB) to a GWB only, the Bayes factor in favour of the CGW model is only 0.7. Therefore, we cannot conclusively determine the origin of the observed feature, but we cannot rule it out as a CGW source. We present results of simulations that demonstrate that data containing a weak gravitational wave background can be misinterpreted as data including a CGW and vice versa, providing two plausible explanations of the EPTA DR2 data. Further investigations combining data from all PTA collaborations will be needed to reveal the true origin of this feature., 12 figures, 15 pages, to be submitted

Rhinogenic headache (RH) is a headache or facial pain syndrome secondary to mucosal contact points in the sino-nasal cavities, in the absence of inflammatory signs, hyperplastic mucosa, purulent discharge, sino-nasal polyps or masses. It may result from pressure on the nasal mucosa due to anatomical variations among which the pneumatization of the middle turbinate, concha bullosa, a variant of the development of ethmoidal cells, is the most commonly observed. Clinical practice suggests a close correlation between concha bullosa, mucosal contacts and rhinogenic headache, with high impact on the QoL. However diagnostic and therapeutic difficulties still remain. Aim of the present study is to evaluate the impact of medical or surgical care on the QoL of patients suffering from concha bullosa related headache from the patients' perspective.One-hundred-two subjects with concha bullosa and headache anamnesis were randomized into two groups and given medical or surgical treatment. To assess the Quality of life (QoL) we used visual analogue scale and for the first time, the migraine disability score before and after treatment.After treatment the severity of the headache decreased as well as the discomfort in the surgical group compared with medical group.The improvement of symptoms and QoL suggests that the endoscopic surgical plastic may promote the rapid resolution of concha bullosa related headache improving the and reducing health care costs.

Intraparotid facial nerve solitary plexiform neurofibroma: a case report M. Mesolella, E. Cantone, D. De Blasio, I. Ferranti, M. Cimmino, R. Palumbo, A. M. Di Lullo, E. Nigro, M. Iengo INTRODUCTION Intraparotid facial nerve solitary plexiform neurofibromas are extremely rare. These tumours arise from Schwann cells and are classified into two types: schwannomas and neurofibromas. Histologic differentiation between schwannoma and neurofibroma usually presents little difficulty. Schwannomas are well-encapsulated tumours whereas neurofibromas are not. Neurofibromas may also incorporate nerve fibres within their matrix, whereas schwannomas are generally attached to or surrounded by a nerve. The plexiform variant is recognised by the presence tortuous and multinodular gross and microscopic lesions. This variant have a high risk of malignant transformation up to 15% of patient with NF1. We present the first paediatric case of an intraparotid facial nerve solitary plexiform neurofibroma. CASE REPORT A 5-year-old Italian male was referred for evaluation and management of a progressively enlarging right parotid mass of 4 months duration. He haven’t any pain, trismus, facial weakness or previous trauma. There is no stigmata or familial history of von Recklinghausen’s disease or Neurofibromatosis type 1 (NF1). On physical examination, a 2 cmx/2 cm firm, mobile mass was palpable slightly superior to the right angle of the mandible. There was no associated lymphadenopathy or facial nerve weakness. A fine needle aspiration for cytology (FNA) was performed and was conclusive for the presence of “Schwann cells and fibroblast proliferation and myxoid stroma”. A MR with contrast was better able to localise the mass of the parotid gland with variable morphology and central areas of low-signal density. A partial parotidectomy was performed for excision. Intraoperatively, the mass was found to be well-circumscribed and tan coloured. The main trunk of the facial nerve appeared to be adherent to the mass and was carefully dissected off.. The histology reveal a plexiform neufibroma with a characteristic multinodular lesion composed of Schwann cells and fibroblast proliferation and a myxoid stroma with entrapped nerve fibres. DISCUSSION Neurogenic neoplasms of the facial nerve are uncommon with those involving the intraparotid portion of the facial nerve being even less common. Surgery is the only effective option currently available for the treatment of plexiform neurofibroma. These tumours are in fact non-radiosensitive and given their slow growth rates, only limited benefit has been observed with chemotherapy. However, success of surgical intervention is limited by the infiltrating nature of the tumours, resulting in a high rate of tumour re-growth. Facial nerve preservation during surgery is unlikely and significant morbidity can result from their excision. In our case, the tumor could be readily separated from the main trunk, and facial movement was completely preserved owing to the rich neural network around the mass.

valutare le manifestazioni di interesse otorinolaringoiatrico nella mucopolisaccaridosi e il ruolo dell’otorinolaringoiatria nell’approccio terapeutico. La mucopolisaccaridosi è una patologia da accumulo lisosomiale causata da deficit di enzimi deputati alla degradazione dei glicosamminoglicani, con conseguente danno cellulare. Questa patologia si associa a ritardo mentale, bassa statura, facies caratteristica, organomegalia e accumulo di glicosamminoglicani nei tessuti. I soggetti affetti si rivolgono spesso precocemente allo specialista otorinolaringoiatra a causa di manifestazioni patologiche a carico dell’orecchio e del tratto respiratorio superiore. Abbiamo analizzato 20 pazienti ( 13 maschi, età media 17,7) con mucopolisaccaridosi (35% TIPO I, 30% TIPO II, 20% TIPO III, 5% TIPO IV, 10% TIPO VI), focalizzando l’attenzione sulle loro manifestazioni otorinolaringoiatriche e gli effetti della chirurgia otorinolaringoiatrica sul miglioramento della loro qualità di vita. RIASSUNTO DEI RISULTATI: abbiamo riscontrato manifestazioni otorinolaringoiatriche in tutti i tipi di mucopolisaccaridosi; in particolare, si è riscontrata anamnesi positiva per otiti medie ricorrenti nel 30% dei casi, ipoacusia nel 75% ( mista nel 33,33%, trasmissiva nel 33,33%, neurosensoriale ne 13,33% e non specificata nel 20%), ipertrofia adenotonsillare nel 75%, frequenti infezioni delle alte vie aeree nel 75%, sindrome ostruttiva da apnee notturne nel 45%. Nel 50% dei pazienti è stata necessaria la terapia chirurgica otorinolaringoiatria: adenotonsillectomia nel 25%, adenoidectomia nel 15%, apposizione di tubi di ventilazione per l’orecchio medio nel 15%, tonsillectomia nel 10%, tracheotomia nel 5% e exeresi dei polipi delle corde vocali nel 5% la chirurgia otorinolaringoiatrica ha ridotto la frequenza e la severità delle infezioni dell’orecchio e ha alleviato i sintomi ostruttivi delle vie aeree superiori. Le manifestazioni otrinolaringoiatriche della mucopolisaccaridosi richiedono frequenti controlli da parte dello specialista otorinolaringoiatra;la chirurgia otorinolaringoiatrica può migliorare la qualità di vita di questi pazienti.

Commento alle norme del codice di procedura civile che regolano il procedimento sommario di cognizione Commentary on the articles of Italian civil procedure code ruling summary proceeding