If a patient reports a THI greater than 38, the otolaryngologist should supplement diagnostic studies with a psychological consultation.

Our purpose was to determine the prevalence and features of metabolic syndrome (MS) in a series of long-term hematopoietic stem cell transplantation (HSCT) survivors. We assessed the clinical, metabolic and endocrinological data, and plasma TNF, leptin, resistin and adiponectin levels relating to 85 HSCT recipients. MS was diagnosed on the basis of the National Cholesterol Education Program-Adult Treatment Panel III criteria. Its prevalence was compared with that observed in an Italian population, and its relationship with the clinical and laboratory parameters was assessed univariately and multivariately. Twenty-nine HSCT recipients had MS instead of the 12.8 expected (P<0.0001), with hypertriglyceridemia being the most common feature. Univariate analysis indicated that high insulin and leptin levels, low-adiponectin levels and hypogonadism were significantly related to a diagnosis of MS; multivariate analysis indicated plasma leptin, insulin resistance, age and hypogonadism. We conclude that HSCT recipients are at increased risk of a form of MS that has particular clinical features. Plasma leptin levels are independently related to MS, thus suggesting that leptin resistance may play a role as a pathogenetic clue, as in other conditions in which MS occurs as a secondary phenomenon. MS deserves consideration as a life-threatening complication in patients who are probably cured of their underlying disease.

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It is well known that high intensity sounds modify balance by activating the saccule, which is sensitive to both vestibular and acoustic stimuli. Few studies have examined the effects of music on the postural responses in healthy subjects. The aim of this study was to evaluate the influence of different types of music (Mozart, Köhler, Köhler with a carrier of 12 KHz and subjects' favourite music) on twelve healthy subjects standing on a stabilometric platform. With each type of music, all subjects underwent static posturography with eyes opened and eyes closed, and with and without foam pads. We evaluated the length and the surface of body sway and the correlation between them, and we analyzed the visual, vestibular and somatosensory sub-components. Listening to different types of music did not significantly change the stabilometric variables, with the exception of listening to Mozart's Jupiter, which caused a significant reduction in the visual component with a consequent increase in both the vestibular and somatosensory inputs. Further studies are needed to determine the effect of Mozart's music in modifying the sensory strategy in the rehabilitation of patients with vestibular impairments.