Objective: this study seeks to examine the status of female gynecological surgeons in Italy concerning both discriminatory practices and the availability of opportunities of improvement within the operating theatre. Design, setting and population: a National Survey addressed to a group of 3242 female surgeons all over Italy carried out and approved by the members of “Women in Surgery Italia”. Methods: the survey was conducted from November 1 to December 31, 2020, gathering data from 219 female gynecologists out of 3242 surveyed across Italy. The survey focused on various professional aspects, particularly surgical practice. Main outcome measures: we collected data concerning subjective satisfactions by respondents. Satisfaction was evaluated with a 5-points LIKERT scale. Data were described calculating mean, median or frequency. Results: this sub-analysis includes these 207 respondents. Among respondents, 47% reported having children, while 31% opted out of parenthood due to professional reasons. Nearly half of them were trainees (42%). Despite a considerable workload (with a mean workingweek of 45 hours), 96% of the participants reported spending less than half of their worktime in the operating theater. They performed a median of 2 surgical operations per week, compared to 5 for male counterparts. Despite challenges, 65% expressed a commitment to their career path. Conclusions: efforts to address gender bias, promote work-life balance, and enhance female leadership representation are essential. These findings emphasize the need for systemic changes to create a supportive environment for female gynecologists. Further research with broader sampling is warranted to fully understand and address these challenges.

Key points • SARS-CoV-2 is a possible cause of acute severe tracheitis in laryngectomees. • In our series, the clinical picture was characterized by a hemorrhagic tracheitis with a slow resolution pattern. • We observed a histological pattern of erosive inflammation of the respiratory epithelium. • Planned tracheo-bronchoscopy and tracheal toilettes are recommended to prevent critical obstruction of the airway, which can be fatal in patients with associated impairment of lung function caused by SARS-CoV-2 infection. • The present cases highlight the need for close interdisciplinary working and communication in the management of airway complications of COVID-19 infection.

Background: allergic rhinitis is a common childhood disease responsible for a major impact on quality of life and health care resources. Many hypotheses have been proposed to explain the link between allergy and otitis media, although a definitive mechanism has not been identified yet. One of the major critical points is that authors failed in distinguishing among different phenotypes of middle ear inflammation. This review pointed out evidence from the laboratory and clinical experience to link allergy to different phenotypes of otitis media in children. Methods: we performed a systematic review in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process. Our search yielded 3010 articles that were finally screened. This resulted in 20 publications of which the full texts included for the qualitative analysis based on different phenotypes of otitis media. Results: clinical evidences and analyses of biomarkers suggested that allergy may be linked to some phenotypes of otitis media and, in particular, to otitis media with effusion and acute re-exacerbations in children with middle ear effusion. It was not possible to perform the analysis for allergy and acute and chronic otitis media because of paucity and heterogeneity of data. Conclusion: Allergy should be considered in the diagnostic work up of different phenotypes of otitis media. Clinicians should evaluate prompt and accurate treatment of allergy in improving outcomes, although futures studies are required to increase evidence supporting that anti-allergy treatment may be effective in the recovery and outcome of otitis media with effusion.

Background. Irreversible bilateral sensorineural hearing loss is a common side effect of platinum compounds. Because of extended overall survival period of children, a prolonged hearing surveillance and management of hearing impairments are emerging concerns for pediatric oncology. Methods. In this retrospective observational study we enrolled 38 children out of 116 treated at our institution by chemotherapy (cisplatin and/or carboplatin) with or without irradiation between 2007–2014, and submitted to hearing monitoring before every cycle of chemotherapy and that completed a 5 years long-term follow-up. Chemotherapy regimens, demographic findings, cumulative doses and cranial irradiation were compared. Results. At the end of 5-years follow-up ototoxicity was significantly increased compared to that at observed the end of chemotherapy (52.5% vs 39.5%, p<0.001). A late onset of hearing loss was experienced in 13.1% of children while in 26.3% progressive hearing loss was measured. Deafness at the end of chemotherapy and irradiation was significant prognostic factor for late ototoxicity outcomes (Odds Ratio 7.2 – CI:1.67–31.1 – p<0.01 and 5.25 – CI:1.26–21.86 – p<0.01 respectively). No significant differences were found between cisplatin and combined treatment (i.e. cisplatin shifted to carboplatin during monitoring for the onset of ototoxicity) and ototoxicity was not associated with platinum compounds cumulative dose (p>0.05). 13.1% of children needed hearing aids at the end of follow-up. Conclusions. Our study confirms the effectiveness of long-term follow-up in identifying late onset/progressive hearing loss after platinum compound chemotherapy and allows us to avoid the harmful effects of hearing deprivation with hearing aid intervention.

Background: allergic rhinitis is a common childhood disease in industrialized countries that is responsible for a major impact on quality of life and health care resources. The objective of this review was to provide a systemic review of experimental and clinical evidence linking allergy to rhinosinusitis in children including common cold. Furthermore, we questioned if anti-allergy treatment may prevent the occurrence of rhinosinusitis or improve outcomes of its specific management. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process to identify experimental and clinical articles about allergy and acute or chronic rhinosinusitis in children published since January 2000. The research was performed in April 2020 including only English-language peer-reviewed papers. Our search yielded 7103 that were finally screened. This resulted in 30 publications of which the full texts were assessed and included in a qualitative analysis per different phenotypes of rhinosinusitis. Results: The evidence suggests that allergy may lead to overall impairment of mechanical and immunological defense function of the nasal mucosa against viruses and that anti-allergy treatment may significantly decrease the number and severity of upper respiratory tract infections including common colds in children. It was not possible to perform the analysis for allergy and post viral acute rhinosinusitis, bacterial acute rhinosinusitis and recurrent acute rhinosinusitis because of paucity and heterogeneity of data. We found interesting data linking allergy to chronic rhinosinusitis: although there is no definitive proof of causation studies lead to suppose that anti-allergy treatment may improve outcomes of specific CRS treatments. Conclusion: We summarized conclusions in a practical algorithm taking into account different phenotypes of rhinosinusitis in order to elucidate when prompt and accurate diagnosis of allergy is recommended. We lastly focused attention on the needs for future research.