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Summary: Paediatric obstructive sleep disordered breathing (OSDB) has a considerable impact on cardiovascular physiology, but the consequences on children's basal metabolism and response to exercise are far from being known. The objective was to propose model estimations for paediatric OSDB metabolism at rest and during exercise. A retrospective case–control analysis of data from children submitted to otorhinolaryngology surgery was performed. The heart rate (HR) was measured, while oxygen consumption (VO2) and energy expenditure (EE) at rest and during exercise were obtained using predictive equations. The results for the patients with OSDB were compared with controls. A total of 1256 children were included. A total of 449 (35.7%) had OSDB. The patients with OSDB showed a significantly higher resting heart rate (94.55 ± 15.061 bpm in OSDB vs. 92.41 ± 15.332 bpm in no‐OSDB, p = 0.041). The children with OSDB showed a higher VO2 at rest (13.49 ± 6.02 mL min−1kg−1 in OSDB vs. 11.55 ± 6.83 mL min−1kg−1 in no‐OSDB, p = 0.004) and a higher EE at rest (67.5 ± 30.10 cal min−1kg−1 in OSDB vs. 57.8 + 34.15 cal min−1kg−1 in no‐OSDB, p = 0.004). At maximal exercise, patients with OSDB showed a lower VO2max (33.25 ± 5.82 mL min−1kg−1 in OSDB vs. 34.28 ± 6.71 in no‐OSDB, p = 0.008) and a lower EE (166.3 ± 29.11 cal min−1kg−1 in OSDB vs. 171.4 ± 33.53 cal min−1kg−1 in no‐OSDB, p = 0.008). The VO2/EE increment with exercise (Δ VO2 and Δ EE) was lower in OSDB for all exercise intensities (p = 0.009). This model unveils the effect of paediatric OSDB on resting and exercise metabolism. Our findings support the higher basal metabolic rates, poorer fitness performance, and cardiovascular impairment found in children with OSDB. [ABSTRACT FROM AUTHOR]

There have been few investigations on the epidemiology, etiology, and medical management of acute unilateral vestibulopathy (AUV). Short-term pharmaceutical resolutions include vestibular symptomatic suppressants, anti-emetics, and some cause-based therapies. Anticholinergics, phenothiazines, antihistamines, antidopaminergics, benzodiazepines, and calcium channel antagonists are examples of vestibular suppressants. Some of these medications may show their effects through multiple mechanisms. In contrast, N-acetyl-L-leucine, Ginkgo biloba, and betahistine improve central vestibular compensation. Currently, AUV pathophysiology is poorly understood. Diverse hypotheses have previously been identified which have brought about some causal treatments presently used. According to some publications, acute administration of anti-inflammatory medications may have a deleterious impact on both post-lesional functional recovery and endogenous adaptive plasticity processes. Thus, some authors do not recommend the use of corticosteroids in AUV. Antivirals are even more contentious in the context of AUV treatment. Although vascular theories have been presented, no verified investigations employing anti-clotting or vasodilator medications have been conducted. There are no standardized treatment protocols for AUV to date, and the pharmacological treatment of AUV is still questionable. This review addresses the most current developments and controversies in AUV medical treatment. [ABSTRACT FROM AUTHOR]

Forensic evaluation reports and judicial outcomes regarding older victims of suspected sexual offenses were retrospectively reviewed. During this period, a total of 14 cases were registered, corresponding to 0.3% of nonfatal crimes against elderly and 0.6% of the total of sexual crimes reported. All the victims were female. The majority lived alone and did not have limitations in communication, orientation, ambulation, or autonomy. The offenders were all male (17 to 81 years old); most were known to the victims and had history of previous disruptive behaviors. The majority of the sexual offenses occurred in the victims’ homes, and the offenders tended to use physical violence. Forensic evaluation was crucial for the identification of physical and biological evidence, and forensic conclusions were positively correlated with the judicial outcome of each case. High prosecution and conviction rates were also observed. [ABSTRACT FROM AUTHOR]

Introduction: To date, little is known about predisposing factors for persistent COVID-19-induced olfactory dysfunction (pCIOD). The objective was to determine whether olfactory cleft (OC) measurements associate with pCIOD risk.Material and Methods: Three subgroups were recruited: group A included patients with pCIOD, group B included patients without olfactory dysfunction following SARS-CoV-2 infection (ntCIOD), and group C consisted in controls without past history of SARS-CoV-2 infection (noCOVID-19). Olfactory perception threshold (OPT) and visual analog scale for olfactory impairment (VAS-olf) were obtained. OC measurements were obtained through computed tomography scans. Results were subsequently compared.Results: A total of 55 patients with a mean age of 39 ± 10 years were included. OPT was significantly lower in pCIOD patients (group A: 4.2 ± 2.1 vs. group B: 12.3 ± 1.8 and group C: 12.2 ± 1.5, p < 0.001). VAS-olf was significantly higher in pCIOD (group A: 6 ± 2.6 vs. group B: 1.7 ± 1.6 and group C: 1.6 ± 1.5, p < 0.001). OC length was significantly higher in group A (42.8 ± 4.6) compared to group B (39.7 ± 3.4, p = 0.047) and C (39.8 ± 4, p = 0.037). The odd of pCIOD occurring after COVID-19 infection increased by 21% (95% CI [0.981, 1.495]) for a one unit (mm) increase in OC length. The odd of pCIOD occurring was 6.9 times higher when OC length >40 mm.Conclusion: Longer OC may be a predisposing factor for pCIOD. This study is expected to encourage further research on OC morphology and its impact on olfactory disorders. [ABSTRACT FROM AUTHOR]

The surgical treatment of children with enlarged inferior turbinates is still controversial. Foundational evidence for indicating turbinoplasty is still scarce, and there is a myriad of proposed techniques. This work aimed to address the midterm nasal obstruction outcomes of pediatric inferior turbinate surgery. A Literature search across PUBMED and Cochrane collaboration databases was undertaken, using the MeSH terms: turbinates, nasal obstruction, surgery, and children. Articles focusing on turbinate surgery with an exclusively pediatric cohort were included. The minimum follow-up time for inclusion was set at four months, and only the latest available follow-up in each study was considered. All the integrated studies used objective instruments to quantify nasal obstruction before and after surgery. A comprehensive review and meta-analysis were performed to assess nasal outcomes after the intervention. The 95% confidence interval of the effect magnitude for each study was calculated to elucidate effect sizes. Seven studies met the inclusion criteria for review, and five were included in the meta-analysis, accounting for a total of 510 patients. The follow-up period ranged from 4 months to 1 year. Pooled results showed that nasal patency was significantly improved after surgery (p < 0.001) in the midterm follow-up. No significant differences were found between bone-sparing and bone-removal procedures (p = 0.38). This is the first meta-analysis to address midterm results of pediatric turbinate surgery. Our results suggest a positive impact of inferior turbinate surgery on nasal patency, irrespective of technique. • Growing evidence suggests that inferior turbinate reduction improves nasal airflow in children with nasal obstruction. • Various surgical techniques may be used and there is a debate about the ideal approach in children. • Pediatric inferior turbinate reduction is effective in improving nasal patency measurements up to one year. • No differences seem to exist between bone sparing and bone removing techniques in the midterm nasal patency. [ABSTRACT FROM AUTHOR]