As the Worm Turns-A Rare Cause of Intestinal Obstruction.

BACKGROUND: Anisakiasis, a zoonotic disease caused by the nematode Anisakis, poses a significant concern for public health, particularly in regions with high consumption of raw or undercooked fish. CASE PRESENTATION: We present a case report of a 41-year-old woman who developed severe abdominal symptoms, ultimately diagnosed with intestinal obstruction due to Anisakis infestation, requiring surgery. Despite the absence of prominent eosinophilia or specific radiological findings, the diagnosis was confirmed through histological examination, highlighting the importance of considering anisakiasis in patients with a history of raw seafood consumption. CONCLUSION: The case underscores the diagnostic challenges associated with anisakiasis, emphasizing the need for increased awareness among healthcare professionals and the public regarding the risks of consuming raw or undercooked seafood. Effective management requires a multidisciplinary approach, including clinical assessment, imaging studies, and histological evaluation, to ensure timely diagnosis and appropriate treatment.

Influence of light conditions (colour temperature and illuminance) on the evaluation of root translucency for the application of Lamendin's age-at-death estimation technique.

Estimation of age-at-death represents a central focus in forensic human identification, as it is a key parameter used in the identification of unidentified bodies. In 1992, Lamendin et al. published a simple technique for estimating the age-at-death of adult skeletal remains based on two dental criteria: the gingival regression and the extent of dentine translucency. Although Lamendin's technique is widely used in forensic contexts and the evaluation of root translucency is a key element in the technique, the light conditions for measuring this parameter have not been adequately established. The aim of the present study is to analyse the influence of colour temperature and illuminance level of a LED light source when root translucency is evaluated to optimize the use of Lamendin's technique for age-at-death estimation. The results describe how light settings may affect the visual perception of root translucency by different examiners and, therefore, affect the accuracy of the age-at-death estimation methods and techniques based on this parameter.

Correlation between use of different type protective facemasks and the oral ecosystem.

BACKGROUND: Spread worldwide through droplets, the Virus Sars-Cov-19 has caused a global health emergency alarm. In order to limit its spread, the use of masks has become part of the daily life of the entire population, however, little is known about its constant use and the changes generated in the oral cavity. This work aims to investigate correlations between the continuous use of masks covering the nose and mouth for 3 h and changes in the ecological factors of the oral cavity. METHODS: 34 volunteers were divided into 2 groups: wear only the filtering facepiece code 2 (FFP2) mask (Group A) and wear the FFP2 mask covered by a surgical mask (Group B). Measurement of Volatile Organic Compounds (VOCs), saliva rehydration and consistency test, collection of basal saliva and saliva stimulated with paraffin gum and mucosal swab were collected and analyzed at two times: before using the mask(s) (T0) and 3 h after continuous use of the mask(s) (T1). RESULTS: The results indicated a significant difference between the groups, in which the basal saliva volume and pH and the peaks of VOCs increased for group B between T0 and T1. The rehydration time decreased and the volume and pH of the stimulated saliva increased, but with no significant difference between the groups. Furthermore, group B showed a significant decrease in Candida albicans Colony Forming Units (CFUs) and Total Bacterial Count (TBC) between T0 and T1. CONCLUSION: It is concluded that the prolonged use of the FFP2 mask covered by a surgical mask can generate oral alterations in the user.

Mesenteric Cyst with GI Symptoms: A Fluid Approach to Treatment-Case Report and Literature Review.

Mesenteric cysts are defined as a heterogeneous group of intra-abdominal cystic lesions of the mesentery or omentum that may be found in any portion of the gastrointestinal tract from the duodenum to the rectum. The clinical condition is entirely asymptomatic in many patients, particularly with small cysts. The diagnosis is typically incidental and secondary to imaging performed for other purposes. In symptomatic patients, the clinical picture is characterized by nonspecific gastrointestinal signs and symptoms. Treatment may be surgical or via interventional radiology. We report the case of a 55-year-old female patient complaining of left-sided abdominal discomfort and constipation lasting three months. An abdominal ultrasound showed the presence of a 10 × 14 × 16 cm anechoic cystic mass filling the whole anterior and left abdominal cavity, confirmed by CT and MRI. The cyst, removed laparoscopically, was histologically a simple mesothelial cyst. We reviewed the international literature over the last 10 years of all cases with mesenteric cysts > 10 cm in evaluating gastrointestinal symptoms at diagnosis, histology, performed treatment, and outcome.

Coincidental or Causal? Concurrence of Colorectal Carcinoma with Primary Breast Cancer.

Multiple primary malignant neoplasms (MPMN) represent the occurrence of a second malignancy in the same patient within 6 months after the detection of first primary (synchronous) tumor, or > 6 months after primary detection (metachronous). We present a case of a patient treated for carcinoma of the breast who developed a metachronous primary malignancy in the colorectal tract. These tumors were histologically different with distinct immune-histochemical parameters. The association between breast and colon cancer is well documented in the literature with several studies reporting the coexistence of common extrinsic and genetic predisposing factors. Although rare, MPMN are becoming more common due to the increased number of elderly cancer survivors, improved diagnosis and enhanced awareness. The association between colorectal and breast cancer should not be dismissed merely as metastasis since there is good precedent for the co-occurrence of these primary tumors.

Is Melanoma Progression Affected by Thyroid Diseases?

Clinical and epidemiological evidence indicate a relationship between thyroid diseases and melanoma. In particular, the hypothyroidism condition appears to promote melanoma spread, which suggests a protective role of thyroid hormones against disease progression. In addition, experimental data suggest that, in addition to thyroid hormones, other hormonal players of the hypothalamic-pituitary-thyroid (HPT) axis, namely the thyrotropin releasing hormone and the thyrotropin, are likely to affect melanoma cells behavior. This information warrants further clinical and experimental studies in order to build a precise pattern of action of the HPT hormones on melanoma cells. An improved knowledge of the involved molecular mechanism(s) could lead to a better and possibly personalized clinical management of these patients.

In Vitro and In Vivo Effects of the Urokinase Plasminogen Activator Inhibitor WX-340 on Anaplastic Thyroid Cancer Cell Lines.

Increased expression of the urokinase-type plasminogen activator (uPA) system is associated with tumor invasion, neo-angiogenesis, and metastatic spread, and has been shown to positively correlate with a poor prognosis in several cancer types, including thyroid carcinomas. In recent years, several uPA inhibitors were found to have anticancer effects in preclinical studies and in some phase II clinical trials, which prompted us to evaluate uPA as a potential therapeutic target for the treatment of patients affected by the most aggressive form of thyroid cancer, the anaplastic thyroid carcinoma (ATC). In this study, we evaluated the in vitro and in vivo effects of WX-340, a highly specific and selective uPA inhibitor, on two ATC-derived cell lines, CAL-62 and BHT-101. The results obtained indicated that WX-340 was able to reduce cell adhesion and invasiveness in a dose-dependent manner in both cell lines. In addition, WX-340 increased uPA receptor (uPAR) protein levels without affecting its plasma membrane concentration. However, this compound was unable to significantly reduce ATC growth in a xenograft model, indicating that uPA inhibition alone may not have the expected therapeutic effects.

New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery.

BACKGROUND: In the last decade, two research groups, the French group by Clough et al. (Br J Surg. 97:1659-65, 2010) and the Chinese one by Li et al. (ISRN Oncol 2013:279013, 2013), proposed two types of classification of axillary lymph nodes in breast cancer, identifying novel anatomic landmarks for dividing the axillary space in lymph node dissection. MAIN BODY: Knowledge of the exact location of the sentinel node helps to focus the surgical dissection and to reduce the morbidity of sentinel lymph node biopsy procedures, in particular the risk of arm lymphedema, without compromising sensitivity. CONCLUSION: In this article, we aimed at focusing on the clinical impact that the most recent classifications of axillary lymph nodes have obtained in literature, highlighting the importance of defining new demarcations to preserve the axillary lymph nodes as much as possible in breast surgery.

Microbial Contamination and Disinfection of Sport Mouthguard: In Vitro Study.

Mouthguards in Ethylene Vinyl Acetate (EVA) should be sanitized to prevent alteration of oral microbiota. The present study determined, in vitro and by SEM observation, the decontaminating effect of different substances on EVA mouthguards previously contaminated with saliva and broth culture of Enterococcus faecalis ATCC 29212 and Candida albicans CH 34 (clinically isolated). Subsequently, the mouthguards were subjected to the following treatments: (A) Untreated; (B) 5 min with sterilized distilled water (H2O d); (C) 5 min with H2O2; (D) 5 min with a physiological solution; (E) toothbrush and fluoride toothpaste; (F) 5 min with 0.5% NaOCl; (G) 5 min with Oral Care Foam™; (H) 5 min with Bite Sept™. The highest efficacy against E. faecalis was demonstrated by H2O2 (84.19% bacterial load reduction). H2O2 and Oral Care Foam™ showed a greater reduction of salivary cell load. The highest efficacy against C. albicans was demonstrated by 0.5% NaOCl which caused a 92.95% reduction of cell load. In conclusion, hydrogen peroxide, 0.5% sodium hypochlorite and the solution Oral Care Foam™ allowed to obtain an optimum disinfection of the mouthguard. SEM observation showed that different substances demonstrated a decontaminating effect decreasing the microbial communities on the EVA surface.

Bacterial leakage in external hexagon implants with and without the interposition of a sealing-connector.

PURPOSE: To investigate whether the interposition of a sealing-connector was able to reduce the bacterial leakage in external hexagon implants. METHODS: 20 implants with external hexagon connection were used. Ten Test implant-abutment assemblies were connected with the interposition of a sealing-connector molded in the exact shape of the two opposed surfaces. Ten Control implant-abutment assemblies were connected with no sealing-connector interposed. Two types of bacteria were introduced into the internal portion of the implant, before placing the connector. The study lasted 28 days. RESULTS: All control specimens, seeded with P. aeruginosa (PA) and A. actynomycetemcomitans (AA), showed contamination of the culture medium, indicative of microbial leakage. In the Test specimens, three instances of contaminated specimens were found in the samples seeded with PA and two contaminated specimens in the ones seeded with AA, for a total of five contaminated samples out of 10. The use of the sealing-connector was able to prevent bacterial leakage in half of the samples (50%). The leakage in both groups occurred mainly in the last week of the experiment. Probably, a longer period, under the conditions of this experiment, is necessary for the migration of the bacteria, and, furthermore, an observation period of 7 or 14 days may not be enough to show microbial contamination. CLINICAL SIGNIFICANCE: Using an interface under in vitro non-loading experimental conditions, could sometimes (50%) prevent bacterial microleakage and thus possibly the risk of peri-implant site infection. Moreover, less bone resorption and the maintenance of soft tissues and esthetics might be achieved in those cases where bacterial leakage does not occur.

Bacterial leakage in Morse Cone internal connection implants using different torque values: an in vitro study.

PURPOSE: The aim of this study was to assess whether there was a decrease of bacterial leakage with increasing torque values in conical Morse Cone connection implants. METHODS: A total of 30 Morse Cone conical tapered implants (10 implants per group) were used in this study. The abutments were connected to the implants with 20 N (group 1), 30 N (group 2), and 40 N (group 3) insertion torque values. The inner parts of 5 implants, per group, were inoculated with Pseudomonas aeruginosa suspension and the remaining 5 implants, per group, with Aggregatibacter actinomycetemcomitans. The penetration of bacteria into the surrounding solution was determined by the observation of turbidity of the broth. RESULTS: In groups 1 and 2, bacterial contamination was found in 2 of the 10 implants, only in the specimens seeded with P. aeruginosa. In group 3, no contaminated samples were found. CONCLUSION: This study demonstrated that with increased insertion torque values in Morse Cone connection, the bacterial leakage is reduced.

Implants with internal hexagon and conical implant-abutment connections: an in vitro study of the bacterial contamination.

Prevention of microbial leakage at the implant-abutment junction is a major challenge for the construction of 2-stage implants in order to minimize inflammatory reactions and to maximize bone stability at the implant neck. The aim of the present in vitro study was an evaluation of the leakage observed over a period of 28 days in Cone Morse taper internal connections and in screwed-abutments connections. In the present study 10 specimens of Cone Morse (Group 1) and 10 of internal hexagon (Group 2) implants were used. The inner parts of 5 implants per group were inoculated with Pseudomonas aeruginosa (PS) suspension and 5 implants per group with Aggregatibacter actinomycetemcomitans (AA). The possible penetration of bacterial suspension into the surrounding solution was determined by the observation of turbidity of the broth. In Group 1, bacterial contamination was found in 3 out of 5 implant-abutment assemblies seeded with the PS and in 2 samples out of 5 in the assemblies seeded with AA, with a total of leaked assemblies in this group of 5 out of 10. In Group 2, bacterial contamination was found in 4 out of 5 implant-abutment assemblies seeded with the PS, and in 4 out of 5 samples seeded with AA, with a total of leaked assemblies of 8 out of 10. The present data confirm the reported high permeability to bacterial leakage of screw-retained abutment connections, and the lower infiltration rates-although not significantly-of Cone Morse taper internal connections.

Influence of sport mouthguards on the ecological factors of the children oral cavity.

BACKGROUND: The use of fixed and/or removable dental devices is an attributable factor that may affect the oral cavity homeostasis. The aim of this study was to monitor the oral environmental changes caused by dental devices, as sports mouthguards with the aid of a chair-side test. METHODS: Sixty children with sports-mouthguards were analyzed at baseline (T0), after 6 months of dental devices use (T1), after a year (T2) and after almost 6 months without using it (T3). At T0, a clinical monitoring was performed and the DMFT index was recorded. At each time of observation, the following parameters were recorded: FMPS, FMBS, unstimulated-flow rate, saliva consistency, resting pH, stimulated saliva, buffer capacity, the CFU/ml of Streptococcus mutans. RESULTS: In 60 subjects, mean age 9.9 ± 1.2, mean value of DMFT 1.55 ± 1.29,dmf-t 3.43 ± 1.21, FMPS and FMBS values increased significantly at T2. The values of unstimulated flow rate vary significantly within the observation times. The pH value and the buffering capacity reduced significantly at T2. The tests for the detection of S. mutans were negative in all the subjects in several observation times. All patients regularly used fluoridated toothpaste and comply with normal standards of oral hygiene; but over time the patients lost their initial motivation. CONCLUSIONS: Sport treatment with dental devices dues to changes in oral ecological factors: increases FMPS, FMBS and reduces the buffering capacity and the salivary pH. The use of removable devices increases the retentive plaque surfaces and inhibits the protective effect of saliva.The so-called "chair-side" tests were able to easily monitor patients and to determine the risk of oral disease during sport treatment.

What Is the Impact of Antimicrobial Photodynamic Therapy on Oral Candidiasis? An In Vitro Study.

This study aimed to evaluate the ability of photodynamic therapy, based on the use of a gel containing 5% delta aminolaevulinic acid (ALAD) for 45' followed by irradiation with 630 nm LED (PDT) for 7', to eradicate Candida albicans strains without damaging the gingiva. C. albicans oral strains and gingival fibroblasts (hGFs) were used to achieve these goals. The potential antifungal effects on a clinical resistant C. albicans S5 strain were evaluated in terms of biofilm biomass, colony forming units (CFU/mL) count, cell viability by live/dead analysis, and fluidity membrane changes. Concerning the hGFs, viability assays, morphological analysis (optical, scanning electronic (SEM), and confocal laser scanning (CLSM) microscopes), and assays for reactive oxygen species (ROS) and collagen production were performed. ALAD-mediated aPDT (ALAD-aPDT) treatment showed significant anti-biofilm activity against C. albicans S5, as confirmed by a reduction in both the biofilm biomass and CFUs/mL. The cell viability was strongly affected by the treatment, while on the contrary, the fluidity of the membrane remained unchanged. The results for the hGFs showed an absence of cytotoxicity and no morphological differences in cells subjected to ALAD-aPDT expected for CLSM results that exhibited an increase in the thickening of actin filaments. ROS production was augmented only at 0 h and 3 h, while the collagen appeared enhanced 7 days after the treatment.

Antibody Response after 3-Dose Booster against SARS-CoV-2 mRNA Vaccine in Kidney Transplant Recipients.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a high rate of mortality in kidney transplant recipients (KTRs). Current vaccine strategies for KTRs seem to be unable to provide effective protection against coronavirus disease 2019 (COVID-19), and the occurrence of severe disease in some vaccinated KTRs suggested a lack of immunity. We initially analyzed the antibody response in a group of 32 kidney transplant recipients (KTRs) followed at the nephrology and dialysis unit of the Hospital Pio XI of Desio, ASST-Brianza, Italy. Thus, we studied the differences in antibody levels between subjects who contracted SARS-CoV-2 after the booster (8 individuals) and those who did not contract it (24 individuals). Furthermore, we verified if the antibody response was in any way associated with creatinine and eGFR levels. We observed a significant increase in the antibody response pre-booster compared to post-booster using both a Roche assay and DIAPRO assay. In the latter, through immunotyping, we highlight that the major contribution to this increase is specifically due to IgG S1 IgM S2. We observed a significant increase in IgA S1 and IgA NCP (p = 0.045, 0.02) in the subjects who contracted SARS-CoV-2. We did not find significant associations for the p-value corrected for false discovery rate (FDR) between the antibody response to all assays and creatinine levels. This observation allows us to confirm that patients require additional vaccine boosters due to their immunocompromised status and therapy in order to protect them from infections related to viral variants. This is in line with the data reported in the literature, and it could be worthwhile to deeply explore these phenomena to better understand the role of IgA S1 and IgA NCP antibodies in SARS-CoV-2 infection.

Antibody Response against SARS-CoV-2 after mRNA Vaccine in a Cohort of Hospital Healthy Workers Followed for 17 Months.

The assessment of antibody response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is of critical importance to verify the protective efficacy of available vaccines. Hospital healthcare workers play an essential role in the care and treatment of patients and were particularly at risk of contracting the SARS-CoV-2 infection during the pandemic. The vaccination protocol introduced in our hospital protected the workers and contributed to the containment of the infection' s spread and transmission, although a reduction in vaccine efficacy against symptomatic and breakthrough infections in vaccinated individuals was observed over time. Here, we present the results of a longitudinal and prospective analysis of the anti-SARS-CoV-2 antibodies at multiple time points over a 17-month period to determine how circulating antibody levels change over time following natural infection and vaccination for SARS-CoV-2 before (T0-T4) and after the spread of the omicron variant (T5-T6), analyzing the antibody response of 232 healthy workers at the Pio XI hospital in Desio. A General Estimating Equation model indicated a significant association of the antibody response with time intervals and hospital area, independent of age and sex. Specifically, a similar pattern of antibody response was observed between the surgery and administrative departments, and a different pattern with higher peaks of average antibody response was observed in the emergency and medical departments. Furthermore, using a logistic model, we found no differences in contracting SARS-CoV-2 after the third dose based on the hospital department. Finally, analysis of antibody distribution following the spread of the omicron variant, subdividing the cohort of positive individuals into centiles, highlighted a cut-off of 550 BAU/mL and showed that subjects with antibodies below this are more susceptible to infection than those with a concentration above the established cut-off value.

Abdominoplasty after massive weight loss. Safety preservation fascia technique and clinical outcomes in a large single series-comparative study.

Introduction: Weight loss after bariatric surgery causes very important modifications to the patient's silhouette. Abdominal fat and skin excess reduction are associated with several complications. The most frequent are seroma and hematoma whereas major complications, such as pulmonary embolism, are less frequent. This study aimed to describe our technical procedure for abdominoplasty in patients with massive weight loss after bariatric surgery. Methods: In total, 196 patients were included. All patients who underwent abdominoplasty classic (group A) and abdominoplasty with the preservation and lift of Scarpa fascia (group B) and with umbilical transposition between May 2018 and May 2021 were included. Patients with concomitant correction of ventral hernia were excluded. Demographic and operative data were analyzed according to comorbidities and postoperative complications. Results: There were 160 (81.6%) women. The mean age was 43.6 years; the mean weight was 86.7 kg; and the mean BMI was 28.6 kg/m2. Five patients (2.5%) presented postoperative seroma. Four patients (2%) presented partial dehiscence/skin necrosis one of them requiring a revision. Finally, 26 patients presented a postoperative complication, with an overall incidence of 12.6%. The average postoperative hospital stay was 3.6. The rates of seroma were significantly higher in men, patients with a BMI > 30 kg/m2, and aged >50 years. Conclusion: Preserving Scarpa Fascia during surgical post-bariatric patient procedures reduces the seroma formation and the scar complication and reduces the tension of the inguinal-pubic region with correction of our deformation after weight loss. Improves reducing the drain and reducing seroma incidence suction and hospital stay.

Three-Dimensional Analysis of Upper and Lower Arches Using Digital Technology: Measurement of the Index of Bolton and Correspondence between Arch Shapesand Orthodontic Arches.

INTRODUCTION: Thanks to the great development of digital technology, viaCAD (computer-aided design) and CAM (computer-aided manufacturing) systems, digital models canbe used as an aid for orthodontic planning decision-making processes as there are numerous studies in the literature that support the validity ofthe digital model measurements of anterior teeth and the total coefficient of Bolton analysis. The aim of the present study isto compare the average length value of the current upper and lower arches with that of a hypothetical nickel-titanium wire and to confirm the reliability and accuracy of digitally taken measurements of the anterior and total Bolton coefficients.In this retrospective study, dental casts of 138 Caucasian adolescent patients were scanned with an extraoral scanner, and Ortho3Shape software was adopted for the following dental cast measurements: actual and ideal lengths of the lower arches and anterior and total Bolton coefficients.In the present study, we found that the mean value of the anterior coefficients of the Bolton index was compatible with those of previous studies, confirming the reliability of digital measurements.Therefore, digital CAD/CAM models may be a viable alternative to plaster models, as they can facilitate model preservation and recovery. For future studies, it would be better to use intraoral scanners (IOSs) to ensure greater accuracy, since they only require one step and allow obtaining better results for the patients.

Effects of mechanical forces on the formation of cutaneous wounds during skin expansion and emerging therapies for wound healing and scar prevention.

OBJECTIVES: To update a possible role of cosmeceutical topic treatment to obtain a better scar. METHODS: This is a preliminary supportive study. A total of 14 patients who went to the General Hospital of Mexico City, Mexico, between May and December 2020, for breast reconstruction were included in the current study. The biopsies were carried out to the scar area of the previous I° and II° surgery. The patients were thus divided into 2 groups: those who used Cicolea cream® as a treatment supplement and those who used only petrolatum. RESULTS: Collagen fibers arranged in a regular pattern in the group treated with Cicolea compared to dispersed collagen fibers in the group treated with pure petrolatum. Furthermore, the patients who presented hypertrophic or keloid scars secondary to mastectomy, developed after insertion of breast expanders an organized scarring process, with improvement of scar if treated with Cicolea. CONCLUSION: Based on our observations, it is possible to propose that the action of the polyphenols present in the different components of Cicolea® cream leads to a better evolution of the wound healing compared to the action of petrolatum composition.

Efficacy of 5% Aminolaevulinic Acid and Red Light on Enterococcus faecalis in Infected Root Canals.

BACKGROUND: In this ex vivo study, the aim was to evaluate the effects of ALAD and red light on Enterococcus faecalis in infected root canals using a special intracanal fiber. METHODS: A total of 70 extracted, single-rooted teeth were used. The teeth were decoronated at the length of the roots to approximately 15 mm and then instrumented. The apical foramen was sealed by composite resin, and the root canals were infected with a pure culture of E. faecalis ATCC 29212 for eight days at 37 °C. Following the contamination period, the roots were divided into seven groups, including the positive and negative control groups, and treated as follows: ALAD 45 min; red light activation 7 min; ALAD 45 min and red-light activation 7 min; sodium hypochlorite 2.5% 15 min; sodium hypochlorite 1% 15 min. The samples were taken by three sterile paper points, transferred to tubes containing 1 mL of PBS, and immediately processed for the number of colony-forming units and the cell viability by using live/dead. RESULTS: The best treatment is obtained with 2.5% NaOCl. Except for ALAD + red light vs. 1% NaOCl, a statistically significant difference is recorded for all treatments. The combination of 2.5% NaOCl and ALAD + 7 min irradiation produces an evident killing effect on the E. faecalis cells. On the other hand, 1% NaOCl is ineffective for the viability action, with 25% of dead cells stained in red. CONCLUSIONS: This ex vivo study shows that ALAD gel with light irradiation is an efficacious protocol that exerts a potent antibacterial activity against E. faecalis in infected root canals.