Changes in left ventricular repolarization after short-term testosterone replacement therapy in hypogonadal males.

BACKGROUND AND AIM: Evidences suggest that androgen deficiency is associated with sudden cardiac death (SCD). Our purpose was to analyse some electrocardiographic (ECG) markers of repolarization phase in hypogonadal patients either at baseline or after testosterone replacement therapy (TRT). PATIENTS AND METHODS: Baseline and after 6 months of testosterone replacement therapy, 14 hypogonadal patients and 10 age-matched controls underwent a short-term ECG recordings at rest and immediately after a maximal exercise test. The following ECG parameters have been collected: QTe (the interval between the q wave the end of T wave), QTp (the interval between the q wave and the peak of T wave), and Te (the interval between the peak and the end of T wave). RESULTS: At baseline, in the hypogonadal patients, corrected QTe and QTp values were longer at rest than in the controls at rest (p < 0.05), whereas, during the recovery phase, only the QTp remained significantly longer (p < 0.05). After TRT, hypogonadal patients showed an improvement only in Te (p < 0.05). Conversely, any difference between hypogonadal patients and control subjects was found with respect to the markers of temporal dispersion of repolarization phases, except for a worse QTp → Te coherence (p = 0.001) obtained during the recovery phase. CONCLUSIONS: In conclusion, at rest, hypogonadal patients suffer from a stable increase in the myocardial repolarization phase without an increase in its temporal dispersion and, hence, the SCD risk seems to be low.

Dental trauma in Italian children and adolescents with special health care needs. A cross-sectional retrospective study.

AIM: Dental trauma is a frequent finding in people with special health care needs. The aim of this study was to determine the prevalence of dental trauma in a sample of Italian children and adolescents with special health care needs. MATERIALS AND METHODS: 556 medical and dental records of children and adolescents visited from January 2010 to March 2015 were examined. Information about medical diagnosis, gender, site and type of dental trauma (DT) were collected. According to age and reflecting the dentition stage, the sample was divided into 3 groups: subjects aged 0-5 years (group A, primary dentition), 6-11 years (group B, mixed dentition), 12-18 years (group C, permanent dentition). RESULTS: 113 individuals experienced a DT (prevalence 20.3%), with no difference in relation to gender. Individuals with cerebral palsy and autism showed the highest frequency of DT: 39.6% and 30.4%, respectively. The highest frequency of DT occurred both in group A (21.8%) and B (21.5%), which differed significantly from group C (9%). Avulsion was the most frequent type of DT in the primary dentition (24%) and enamel-dentin fracture without pulp exposure in the permanent dentition (60%). Upper central incisors were the most affected teeth. CONCLUSION: The prevalence of DT in a sample of Italian children and adolescents with special health care needs is high, especially in young individuals with cerebral palsy and autism. Preventive strategies for those patients should be developed in order to reduce the risk of DT.

Thermal optical non-linearity of nematic mesophase enhanced by gold nanoparticles--an experimental and numerical investigation.

In this work the mechanisms leading to the enhancement of optical nonlinearity of nematic liquid crystalline material through localized heating by doping the liquid crystals (LCs) with gold nanoparticles (GNPs) are investigated. We present some experimental and theoretical results on the effect of voltage and nanoparticle concentration on the nonlinear response of GNP-LC suspensions. The optical nonlinearity of these systems is characterized by diffraction measurements and the second order nonlinear refractive index, n2, is used to compare systems with different configurations and operating conditions. A theoretical model based on heat diffusion that takes into account the intensity and finite size of the incident beam, the nanoparticle concentration dependent absorbance of GNP doped LC systems and the presence of bounding substrates is developed and validated. We use the model to discuss the possibilities of further enhancing the optical nonlinearity.

Effects of rapid maxillary expansion and mandibular advancement on upper airways in Marfan's syndrome children: a home sleep study and cephalometric evaluation.

PURPOSE: Evaluation of the effects of rapid maxillary expansion and mandibular advancement using Propulsor Universal Light appliance on the upper airways in Marfan's syndrome children through home sleep studies, Epworth Sleepiness Scale questionnaire, and cephalometric analysis of the upper airways on lateral radiographs. METHODS: The study sample consisted of 30 children with Marfan's syndrome, and the control group consisted of 30 untreated and matched children. For Marfan subjects, data were taken at different time points compared to treatment: at T0 (before treatment), T1 (after rapid maxillary expansion), and T2 (after mandibular advancement). For control subjects, data were taken at similar intervals, at three follow-up visits: at T0 (as a starting screening tool), T1 (after approximately 2 years), and T2 (in proximity of the peak skeletal growth). RESULTS: Apnea-hypopnea and oxygen desaturations were significantly higher in the study group at T0 and T1 compared with control children. At T2, the values were not significant (p value 0.442 for both apnea-hypopnea index (AHI) and oxygen desaturation index (ODI)). Horizontal airway dimensions were significantly reduced, and vertical airway values were significantly increased in Marfan's syndrome at T0 and T1 but not at T2 (p values at T2: 0.071 for Phw1-Psp, 0.106 for Phw1-Psp', 0.101 for Phw2-Tb, 0.559 for UAL in male and 0.560 for UAL in female). CONCLUSIONS: Early rapid maxillary expansion and mandibular advancement using Propulsor Universal Light appliance significantly improved airway patency of Marfan's syndrome children and are strongly encouraged as a routine treatment for both correction of class II malocclusions and prevention of obstructive sleep apnea.

Voltage transfer function as an optical method to characterize electrical properties of liquid crystal devices.

The voltage transfer function is a rapid and visually effective method to determine the electrical response of liquid crystal (LC) systems using optical measurements. This method relies on crosspolarized intensity measurements as a function of the frequency and amplitude of the voltage applied to the device. Coupled with a mathematical model of the device it can be used to determine the device time constants and electrical properties. We validate the method using photorefractive LC cells and determine the main time constants and the voltage dropped across the layers using a simple nonlinear filter model.

Correlation between oral health in disabled children and depressive symptoms in their mothers.

AIM: The aim of this study was to evaluate the presence and degree of depressive symptoms in mothers of disabled children and to assess the correlation between maternal major depression risk and son/daughter oral health. MATERIALS AND METHODS: A prospective study was conducted in 51 disabled children and their 51 mothers. In children dmft/DMFT values, food and/or sugar- sweetened consumption levels and daily tooth brushing frequency were evaluated. Depressive maternal symptoms were measured by EDPS questionnaire: the questionnaire scores were converted into positive predictive values (PPV) that represented the risk of falling into major depression. A regression analysis was performed on the variables (statical significance was set at p value ≤ 0.05). RESULTS: Children (8.68 ± 3.98 years old) average dmft/DMFT was 2.7. Fifty three percent of the mothers (38.37 ± 6.04 years) were at risk for depression (PPV > 60%), while depressive symptoms were already present in 25% of the subjects (PPV=100%). DISCUSSION AND CONCLUSION: Mothers of disabled children are more likely to fall into major depression compared to mothers of healthy children. For each mother-child couple the correlation between different variables was evaluated: there was a statistically significant correlation between children's dmft/DMFT values and mothers' depression risk. The risk of maternal depression was statistically correlated to prevalence of caries and sugar consumption in children.

Oral health and dental late adverse effects in children in remission from malignant disease. A pilot case-control study in Italian children.

AIM: To investigate with a reliable method the oral features in Italian patients in remission from cancer, highlighting the relationship with age at cancer therapy and to compare the data with healthy controls. MATERIALS AND METHODS: Twenty five childhood cancer survivors treated under the age of 10 years with chemotherapy w/wo Haemopoietic Stem Cell Transplantation and/or head-neck Radiotherapy, in remission from cancer for at least 3 years, were examined for dental caries and enamel defects. To assess dental age and dental abnormalities a panoramic radiograph was taken. Patients were grouped according to age at cancer therapy (<3 years: subgroup Y; 3.1-5 years: subgroup M; >5 years: subgroup O). A control group of 26 healthy children was included. RESULTS: There was not a statistically significant difference in caries prevalence between the two groups. A statistically significant difference between the two groups was found for enamel defects, dental abnormalities and dental age. The chi-squared test revealed a relationship between age at therapy and specific dental abnormalities. CONCLUSION: This study shows that cancer therapy may increase the risk of development of enamel defects and dental abnormalities, especially in children treated under the age of 3 years.

Homogenization modelling of antibiotic diffusion and adsorption in viral liquid crystals.

Systems of rod-shaped viruses have long been important to the science of living liquid crystals, as their monodispersity and uniform charge make them convenient model systems. Recently, it was shown that, upon the addition of polymers, suspensions of rod-shaped viruses form liquid crystals that are linked with increased tolerance of bacteria against antibiotics. We use homogenization to obtain effective equations describing antibiotic diffusion through these liquid crystals. The analytical results of homogenization are compared with numerical results from an exact microscopic model, showing good agreement and thus allowing us to identify the key parameters behind the process. Our modelling shows that the adsorption plays a key role in increasing antibiotic diffusion time and therefore the presence of nematic rod-shaped viruses may increase antibiotic tolerance through physical mechanisms alone. These results demonstrate the applicability of homogenization as an analytical tool to systems of liquid crystalline viruses, with relatively straightforward extension to more complex problems such as liquid crystalline biofilms, other biological liquid crystals and biological systems with different types of local structural order.

Giant right atrial thrombus in hepatocellular carcinoma: real-time characterization by cardiac magnetic resonance and real time three-dimensional echocardiography.

Hepatocellular carcinoma (HCC) with extension to the right atrium is an uncommon form of cardiac involvement. We report a case of a 67-year-old man admitted to our Department for the incidental findings of a mass in the right atrium. Physical examination revealed leg edema, distention of external jugular vein and ascites. The anamnestic collection revealed HCC occurred on post-alcoholic liver cirrhosis 3 years earlier. Transthoracic echocardiography revealed a dilated RA containing a mass, with superficial apposition of a thrombotic material. Bi-dimensional echocardiography is the most commonly used noninvasive tool for evaluating intracardiac masses. Although MRI is considered the gold standard, real-time three-dimensional echocardiography has the capability to obtain the entire volume reconstruction of an intracardiac mass, even with an irregular shape. Moreover, it permits an hemodynamic evaluation of the potential obstructive effects visualized from different angles and planes.

A decrease in sex ratio at birth nine months after the earthquake in L'Aquila.

INTRODUCTION: Multiple factors influence the secondary sex ratio (SSR) including stress, which appears to affect mainly the males born. OBJECTIVE: We evaluate the effects of the earthquake in L'Aquila on the SSR. MATERIALS AND METHODS: The SSR for the first six months of 2010 was compared to that of the same period of 2008. The chi-square test and Fisher's test were used for the statistical analysis. RESULTS: Nine months after the earthquake, an important reduction in the SSR was recorded: January 2010 versus January 2008 =0.62 versus 0.96. An overall fall in the SSR was also recorded when the first 3 months of 2010 were compared to the first three months of 2008: 0,82 versus 1,11. When the first three months of 2010 were compared with the second three months of 2010, a statistically significant increase of the sex ratio at birth was noted (0,82 versus 1,27).

Eruption delay in a 47 XXY male: a case report.

BACKGROUND: The 47,XXY syndrome, or Klinefelter syndrome, though it is a rare occurrence, it is the most common sex choromosome disorder affecting male subjects. This syndrome is underdiagnosed and seldomly before puberty. In this case, diagnosis was made before birth, through chorion villus sampling. CASE REPORT: A 16 month-old Italian male with 47 XXY syndrome showed the absence of primary teeth, with a delay of about 8-10 months, whereas during the first 15 months of life the auxological development has been normal both in weight and height (about 50th percentile). We assumed that this delay may be linked with Klinefelter syndrome, as sexual chromosomes play an important role in the dental development.

Development and validation of a taste sensitivity test in a group of healthy children.

AIM: This was to validate a taste test on healthy school children. A cross-sectional study was designed to perform a standardised clinical evaluation of the gustatory sensitivity. MATERIALS AND METHODS: Forty (18 males and 22 females) children were selected. Inclusion criteria were age between 5 and 12 years, absence of systemic disease and no antibiotic treatment in the last six months. The taste assessment tests were performed following a standardised protocol, repeated at two different intervals: a) tested at time 0; b) tested after 20-30 days. Tests were performed using a pipette with the sample solution: sucrose, sodium chloride, citric acid and quinine hydrochloride at different concentrations. The examiner reported in a grid the flavour perceived by the subject. A placebo (tap water) was administered in between the flavours RESULTS: The majority of the subjects detected the bitter taste at the lowest concentration (mean=1.83). The sour taste was detected with the second concentration (mean=2.56). The sweet solution was detected with the most diluted concentration (mean=1.56). The salty taste has a threshold of 2 (mean=2.04), which means that the majority of subjects detected the salty solution with the second concentration. Regarding the perceived intensity, it increases with the increasing concentrations and it reaches maximum values that are inversely proportional to the threshold, corresponding to the second concentration. Moreover, no statistically significant gender differences were detected regarding the threshold values or the perceived intensity. CONCLUSION: The proposed test allows for a controlled, reliable and standardised evaluation of the gustatory modality.

Oral health status of Italian children with Autism Spectrum Disorder.

AIM: Autism Spectrum Disorder (ASD) is characterised by communication deficits and repetitive unusual behaviours. The behaviour guidance of these children represents a challenge for the dental team. The aim of the study was to evaluate the oral health status in a group of Italian children with ASD. MATERIALS AND METHODS: Study Design: Sixty-four Italian children with ASD and 64 controls were included. Data were collected by means of questionnaires and clinical examinations. RESULTS: Dental trauma (p=0.007), bruxism (p=0.001) and biting objects habit (p=0.021) were more frequent in the study group; fluoride exposure was lower (p=0.001) (chi-square test). The mean plaque index was 1.48 ±0.75 in the study group and 0.81±0.56 in the control group (p=0.001; Mann-Whitney U test); the mean dmft/DMFT was 3.00 ±1.2 and 2.3 ±1.8 in the study group and 1.8 ±1.1 and 1.0 ±1.1 in the control group (p<0.001; Mann-Whitney U test). Anterior open bite was more frequent in the study group (p=0.013; Chi-square test). No significant differences were found for enamel defects, molar relationship, posterior crossbite and deep bite. Significantly more children with ASD showed a negative behaviour (80% vs 35%: p =0.001; Chi-square test). CONCLUSION Children with ASD have a poorer oral health status than healthy children. The early establishment of a home dental hygiene should be encouraged.

Subgingival periodontal pathogens in Down syndrome children without periodontal breakdown. A case-control study on deciduous teeth.

AIM: Down syndrome is the most common form of aneuploidia compatible with a long survival. The affected subjects are more susceptible to severe early-onset periodontal disease and show a lower risk to develop dental caries than the non-affected population. This study investigated the prevalence of periodontal pathogens in the subgingival plaque of deciduous teeth in children with Down syndrome without signs of periodontal breakdown. METHODS: Thirty children suffering from Down syndrome and 46 matched healthy subjects were studied. A total of 228 subgingival plaque samples from deciduous teeth were separately collected and evaluated by polymerase chain reaction assays. CONCLUSION: In absence of periodontal impairment, Down syndrome children display a clear presence of periodontal pathogens already in the deciduous dentition. The hypothesis of an intrinsic predisposing condition is here supported.

Craniofacial changes and treatment of the stomatognathic system in subjects with Cleidocranial dysplasia.

AIM: Cleidocranial dysplasia (CCD) is a rare disorder that is inherited as an autosomal genetic trait. It is characterised by defective ossification, delayed bone and tooth development, stomatognathic and craniofacial abnormalities and it is caused by mutations in the RUNX2 gene that is responsible for osteoblast differentiation. CCD is a dental disease that needs complex rehabilitation and the assistance of several specialists. In most cases, this disease precipitates towards the end of childhood with the progressive morbidity of the deciduous dentition, thus leading to edentulism at a young age and giving patients an older appearance. Several therapeutic approaches have been proposed within literature. The aim of this paper is to revise the literature on the proposed therapeutic approaches for the functional and aesthetical rehabilitation of the typical defects caused by CCD in the cephalic region, and to identify the most effective therapy currently available. CONCLUSIONS: The most effective therapeutic approach for the early treatment of the orthodontic and orthopaedic diseases in CCD patients would start with an orthopaedic treatment of the upper jaw followed by orthodontic and surgical treatments. When growth is completed a reintervention for maxillofacial surgery and the orthodontic treatment may be required. Finally, if some teeth are missing. function and aesthetics can be achieved replacing them with prosthesis.

Aicardi syndrome: a case report.

BACKGROUND: Aicardi Syndrome is an X-linked autosomal recessive neurodegenerative encephalopathy. The diagnostic triad is composed by infantile spasms, agenesis of corpus callosum and chorioretinal lacunae. Additional common findings are: microencephaly, spasticity and severe mental delay. It affects only females because of early embryonic lethality in males. A significant number of females with Aicardi syndrome are of normal birth and develop normally until three months of age when infantile seizures begin. Psychomotor retardation is usually severe, neuromotor retardation is commonly present with lack of motor and language skills. Literature reports only few information about the dentofacial features of the syndrome. CASE REPORT: We present the case of a patient, by describing the dental and facial characteristics with focus on dental prevention in order to avoid dental pain and the risks connected to general anaesthesia, and ultimately for improving the quality of life.

Cleidocranial dysplasia: etiology and stomatognathic and craniofacial abnormalities.

Cleidocranial dysplasia (CCD) is a rare disorder which is inherited as an autosomal genetic trait. It is characterized by defective ossification, delayed bone and tooth development, stomatognathic and craniofacial abnormalities, and it is caused by mutations in the RUNX2 gene that is responsible for osteoblast differentiation. The purpose of this review is to collect and analyze data in the literature on orofacial typical manifestations of the syndrome and to present knowledge of the eziopatogenics mechanisms of the CCD. Clinical, genetic, aetiopathogenetic studies on this syndrome were compliled through a systematic approach using Medline. This review reports the cranio-facial features and dental characteristics of the CCD on the basis of all data in the literature. This review pays particular attention on the eziopatogenics mechanisms of CCD and summarises the results of the most recent studies. Access to detailed review of the etiopathogenic mechanisms of CCD is a fundamental support for clinicians as it can allow to make an informed assessment regarding the most effective choice of therapy. The review shows how an interdisciplinary approach is necessary for an appropriate treatment since CCD patients suffer from a skeletal third class, transverse deficiency of the maxilla, supernumerary permanent teeth and deficient eruption of impacted permanent teeth.

Oral and craniofacial findings in a patient with methylmalonic aciduria and homocystinuria: review and a case report.

Combined methylmalonic aciduria and homocystinuria (MMA-HC) is a rare metabolic disease characterized by an inborn defect in B12 vitamin metabolism. This case report concerns an 11-year-old patient with MMA-HC, which developed during the neonatal period. The patient shows some of the facial features that were already reported in the literature (high forehead, large floppy, low-set ears, flat philtrum and hypotonia of perioral and masticatory muscles) but no dolichocephalic skull nor long face. The patient also shows signs that had not been previously described: epicanthal folds, broad nasal bridge, long and flat philtrum, amimic expression and, particularly, a postural alteration (the head is rotated and bent towards the left shoulder, which is lower than the right one). Such alteration can be attributed to visual impairment and is responsible for breaking muscular and skeletal balance in the frontal plane, thus causing the horizontal planes of both maxillary bones to converge towards the right--as highlighted by the cephalometric analysis of the Teleradio-graph of the skull in Posteroanterior projection according to Ricketts. As for the patient's teeth, eruption times are normal, but there are anomalies of shape (chisel-like central incisors). As far as dental caries is concerned, the patient's DMFT is 4 (D=4, M=0, F=0). This clinical case highlights the need for dental prevention programs suggested by the pediatrician once the pathology is diagnosed.

Self-induced soft-tissue injuries following dental anesthesia in children with and without intellectual disability. A prospective study.

PURPOSE: Self-induced soft-tissue injuries (SSI) are reported as local anesthesia complications, particularly in children. The purpose of the study was to evaluate the frequency of SSI following dental anesthesia in children with and without intellectual disability. METHODS: 241 children receiving dental treatments with local anesthesia were divided into 2 groups: A, children without intellectual disability (159 individuals, 299 injections); B, children with intellectual disability (82 individuals, 165 injections). Each group was divided into subgroups according to age, injection technique and dental treatment. Two days after the dental procedure, a phone survey was conducted to determine the presence of SSI. RESULTS: The frequency of SSI in group B was 19%, with no differences in relation to gender and age. In group A the frequency of SSI was significantly lower (9%; p = 0.002; Chi-square test); the children in the ≤ 6 years-old subgroup experienced a higher frequency of SSI (p = 0.002). The lower arch was at major risk of SSI in both groups (p = 0.002). According to a multilevel approach group (p = 0.001) and injection technique (p = 0.0001) significantly influenced SSI; no influence of dental treatment is evidenced. CONCLUSIONS: SSI are common complications of local anesthesia in young children and individuals with intellectual disability.

Trabectedin for the therapy of ovarian cancer.

Trabectedin is a marine-derivate antitumor drug with a relevant cytotoxic activity and good safety profile. It has been investigated for the treatment of solid diseases, including ovarian cancer (OC), breast cancer, and soft-tissue sarcoma. In 2009, results from the pivotal trial OVA-301 led the European Medicines Agency (EMA) to the approval of trabectedin in combination with PEGylated liposomal doxorubicin for the treatment of platinum-sensitive recurrent OC; further studies revealed an additional benefit also in the subgroup of patients with partially platinum-sensitive disease and in those with a BRCA-mutated status. Additionally, trabectedin demonstrated to prolong the time interval to the subsequent chemotherapy line. Recently, the improved understanding of the antitumor action exerted by trabectedin paved the way to new investigational trials exploring its combination with targeted therapies.