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Olfactory dysfunction (OD) is one of the most common symptoms of acute and long-COVID-19. QualitativeOD frequently accompanies or follows quantitative olfactory loss . Limited studies to date have combinedboth qualitative and quantitative evaluation of OD . The aim of this study was to estimate the prevalence of qualitative OD and evaluate its functional impact in post-COVID-19 patients by combining a validated questionnaire and a comprehensive olfactory psychophysical evaluation.

Background High inter-individual variability of the anticoagulant plasma levels of the first three direct oral anticoagulants was previously reported. Aims of the present study were to evaluate edoxaban inter and intra-individual variability in patients with non valvular atrial fibrillation and to assess correlation between edoxaban plasma levels and coagulation screening test and renal function. Methods From January 31st 2017 to June 30th 2018, a total of 101 NVAF patients were enrolled: 48 patients were on edoxaban 60 mg and 53 on edoxaban 30 mg, once daily. Blood samples were taken at C-trough and at C-peak within the first month (15–25 days) of treatment and then at C-trough each three months. Prothrombin time (PT), activated partial thromboplastin time (aPTT), specific anti-FXa chromogenic test were performed. Creatinine clearance (CrCl) was calculated using the Cockcroft-Gault formula. Results Mean inter-individual variability expressed as overall coefficient of variation (CV%) values was lower at C-peak (CV% = 49) than at C-trough (CV% = 68). Mean CV% intra-individual variability was 26.5. No significant correlation was found between edoxaban plasma levels and CrCl (C-trough r/r2 = −0.007/0.000; C-peak r/r2 = 0.129/0.017). Correlations (r/r2), at C-trough and C-peak, between edoxaban levels and PT and aPTT, were 0.386/0.149–0.922/0.851 and 0.283/0.080–0.567/0.321, respectively. Significant discrepancies between PT or aPTT and edoxaban levels were found. Conclusions This study confirms also for edoxaban a high inter-individual variability in NVAF patients. PT and aPTT are not useful to measure this drug. As for the other two anti-FXa drugs, the absence of a significant correlation between CrCl and edoxaban plasma levels was observed.

Premesse. L’impiego di contaglobuli automatici per il conteggio dei globuli bianchi (WBC), globuli rossi (RBC) e piastrine (PLT) rappresenta ormai il sistema di analisi piu diffuso nei Laboratori e, nonostante i progressi diagnostici degli ultimi anni, la lettura manuale dello striscio di sangue periferico rimane ancora il riferimento metodologico per una rapida e accurata diagnostica delle malattie ematologiche. Nuovi strumenti automatici sono stati recentemente introdotti per migliorare la diagnostica microscopica, riducendo i tempi di esecuzione e le potenziali variabili analitiche operatore dipendente della metodica manuale. Scopo del presente lavoro e confrontare la metodica manuale in microscopia ottica e il metodo semiautomatizzato Cellavision (Cellavision, Lund, Sweden) nella lettura dello striscio di sangue periferico e nel conteggio delle piastrine.

Negli ultimi anni il numero dei pazienti trattati con farmaci anticoagulanti [eparine e antagonisti della vitamina K (AVK)] per la prevenzione e la cura del tromboembolismo venoso e per la prevenzione dell’ictus cardioembolico e cresciuto in modo esponenziale. A breve, quattro farmaci anticoagulanti orali ad azione diretta (DOA) inibente il fattore X attivato (aXa) e il fattore II attivato (aIIa), gia registrati per la prevenzione del tromboembolismo venoso in ortopedia, saranno disponibili anche in Italia per la prevenzione dell’ictus nei pazienti con fibrillazione atriale. Il Laboratorio, insieme a un adeguato modello gestionale, ha sempre rivestito un ruolo di primaria importanza per garantire l’efficacia e la sicurezza dei trattamenti con i farmaci anticoagulanti convenzionali (AVK ed eparine). Il vantaggio dei DOA e che, a differenza degli AVK, possono essere somministrati a dosi fisse, senza la necessita di un monitoraggio costante. Tuttavia, il Laboratorio manterra comunque un ruolo fondamentale nel management di questi farmaci, soprattutto in particolari categorie di pazienti e in determinate condizioni cliniche, per garantire un trattamento sicuro e ridurre il rischio di gravi complicanze. In questo articolo vengono valutati il ruolo del laboratorio e i test attualmente disponibili, raccomandati per ogni molecola.

Anticoagulation Clinics (ACs) are services specialized in management of patients on anticoagulant treatment. At present, ACs manage patients chiefly on antivitamin K antagonists (AVKs), but patient population has already changed in the last few years, because of an increase of treatments with other anticoagulant drugs, which require different management systems. The strong increase in the number of patients at AC, mainly on long-term treatment, has determined the development of web management, through telemedicine systems, improving the quality of life and maintaining the same clinical quality levels. New oral anticoagulants (NOAs) have shown to be as effective as AVK antagonists in stroke prevention in atrial fibrillation and for treatment of venous thromboembolism in addition to VTE prophylaxis in orthopaedic surgery, when administered at a fixed dose, but patient adherence and compliance are crucial for good quality treatment. At present, lacking data from the real world, an oversimplification of treatment with NOAs could cause unjustified risks for patients and also a possible future underuse of good drugs. For these reasons the vigilance must be high and ACs can have a crucial role in defining which is the best management for NOA patients and how to do it, as it happened for AVKs.

Telemedicine system is defined as the use of tele-communications to support health care with the purpose to facilitate the interaction between patient and health care provider and to achieve improved treatment results and lower treatment costs. This approach, currently spreading, is becoming a useful mean to ensure home health care, remote patient monitoring and disease management. Furthermore, telemedicine can support educational and training programs for patients and health care providers. Technological innovation in medical care and introduction of telecommunication technologies in medical practice have led to the development of telemedicine programs in many medical specialities. The principal aims of a telemedicine system applied to clinical practice are to improve health care and social assistance. The concept of telemedicine in Oral Anticoagulant Therapy (OAT) management grows from the necessity to improve interactions between patients and health care providers and, at the same time, to enhance management system. The increase of communication requests among different subjects can be facilitated through the elaboration of data networks between the Anticoagulation Clinic (AC), general practitioner or other peripheral districts and patients. Telemedicine systems for OAT have been developed during the last few years with the aim to decentralize in the health territorial care units the activity of ACs, improving the quality of life of the patients living far from the AC site and maintaining the same clinical quality levels. A telemedicine system for anticoagulated patients should be structured through net supported programs (intra and internet) to collect and elaborate clinical data, connected among hospital divisions, health care peripheral districts and patients. A digital format to collect clinical data, an electronic medical record, communication tools to connect patients and peripheral health care and a global quality control system are mandatory requirements to set up a telemedicine system. All communications, including clinical data, laboratory controls, alerts, prescriptions and recommendations have to be available in real time through a bi-directional connection. The telematic organization could develop different types of solutions for different types of patients in OAT population. For example:  independent patient, who lives far away from the Clinic but can reach a peripheral district (Hospice, General Practitioner and so on);  home patient not independent

To assess the effect of oral splint therapy on audio-vestibular symptoms in patients with Menière's disease (MD) and temporomandibular disorder (TMD).Retrospective case-control study. Treatment group: 37 patients with MD and TMD who received gnatological treatment.26 patients with MD and TMD who had never received gnatological treatment. The number of vertigo spells in 6 months (primary endpoint), pure-tone audiometry average (PTA), MD stage, functional level, Dizziness handicap Index (DHI), Tinnitus handicap Index (THI) and Aural Fullness Scale (AFS) were compared at baseline and after 24 months according to groups. Analysis of Covariance was used to determine the treatment effect.Groups were comparable for demographic, clinical data, baseline PTAs and the number of vertigo spells. Analysis of covariance showed a significant effect of gnathological treatment on number of vertigo spells ([Formula: see text] = 0.258, p 0.001), PTA ([Formula: see text] = 0.201, p 0.001), MD stage ([Formula: see text] = 0.224, p 0.001), functional level ([Formula: see text] = 0.424, p 0.001), DHI ([Formula: see text] = 0.421, p 0.001), THI ([Formula: see text] = 0.183, p 0.001), but not for AFS ([Formula: see text] = 0.005, p = 0.582). The treatment group showed vertigo control of class A in 86.5% and class B in 13.5% of patients. In the control group, vertigo control was of class A in 19.2% of patients and class B in 11.5%, class C in 30.8%, class D in 11.5%, class E in 19.2% and class F in 7.7%. Classes of vertigo control differed significantly (XOral splint therapy could represent a viable treatment in patients with TMD and uncontrolled MD disease. The effects are maintained at least after 2 years.