Paediatric Orthodontics Part 3: Masticatory function during development.

The importance of masticatory function during development, the aim of early therapies. Hypoplasia of the upper maxilla is a widespread condition which orthodontists often need to face during early treatment. Mechanical maxillary expansion (both rapid and slow) produce undiagnosed effects on the palatal suture and unwanted side- effects on the periodontium and alveolar process, as well as anchorage-teeth displacement, root resorption, bone fenestration. It is clear that early therapies need a non-mechanical and non-traumatic approach in the respect of the physiology and biology of one of the most important systems for the future health of the developing patient.

Successful pregnancy after uterine artery embolization for uterine arterovenous malformation: a rare case report.

OBJECTIVE: This paper reports on a rare case of pregnancy after uterine artery embolization (UAE) for uterine arteriovenous malformation (AVM). Debate exists about persistence of fertility in women after UAE. Adverse effects of this technique can modify both uterine echostructure, inducing necrosis and infarction, endometrial atrophy and uterine artery rupture, and ovarian reserve, causing persistent amenorrhea. Ovarian reserve appears to be affected by UAE in pre-menopausal women. However, younger ovaries (according to biological ovarian age) exhibit a greater capacity for recovery after ovarian damage. Therefore, larger studies are needed for more conclusive results. CASE REPORT: A 28-year-old woman was admitted to our department due to life-threatening uterine bleeding, resulting in tachycardia, pallor, and sweating. The patient came with a history of two spontaneous miscarriages. After sonography and computed tomography, AVMs were identified at uterine fundus and anterior wall. CONCLUSION: The pathogenesis of infertility after UAE is not yet known. The peculiarity of this case was that, only few months later, the patient became pregnant and gave birth to a live fetus at 37 weeks with cesarean delivery.

The influence of ovulation induction and assisted conception on maternal and perinatal outcomes of twin pregnancies.

OBJECTIVE: To compare obstetrical and neonatal outcomes of twin pregnancies conceived via assisted reproductive technology (ART) with those of naturally conceived ones and to investigate the influence of the ART procedure type on these parameters. PATIENTS AND METHODS: This observational study included 450 ART and 647 spontaneous twin pregnancies delivered over 15 years at a single university-based hospital of Rome, Italy. Logistic and linear regression models adjusted for confounding factors were used to evaluate the effect of ART and the type of assisted conception (IVF/ICSI, ovulation induction ± intrauterine insemination, egg/embryo donation) on maternal and perinatal outcomes. RESULTS: The mean gestational age was significantly lower in pregnancies conceived via ART. The occurrence rates of gestational diabetes, antenatal admission, prophylactic administration of corticosteroid, very preterm delivery and neonatal intensive care unit admission were higher in the ART group. Twin pregnancies achieved via egg/embryo donation had a lower risk of maternal thrombocytopenia and cervical incompetence and were at greater risk of receiving corticosteroid prophylaxis and patent ductus arteriosus than pregnancies obtained by IVF/ICSI. Conception by ovulation induction was associated with reduced risk of hyperemesis gravidarum and longer neonatal hospitalization compared to pregnancies obtained by IVF/ICSI. CONCLUSIONS: Assisted conception was associated with adverse obstetrical outcomes and lower gestational age, but after adjustment for gestational age neonatal immediate outcomes were similar to those observed in the spontaneous group. There were no many important differences in the outcomes of twin pregnancies obtained by a different type of conception.

Ovarian transposition in young women and fertility sparing.

OBJECTIVE: Ovarian transposition is a highly effective surgical procedure used to preserve ovarian function in premenopausal patients with cancers requiring postoperative or primary pelvic radiotherapy. Pelvic irradiation determines severe damage of ovarian DNA and iatrogenic ovarian failure with premature menopause, necessity of long-term hormone replacement therapy and infertility. MATERIALS AND METHODS: We conducted an extensive research of the literature in Medline between January 2000 and April 2015 using the key-words "ovarian transposition radiotherapy", "radiotherapy gonadal function", radiotherapy fertility sparing". The population included young women with normal ovarian function affected by cancers that required pelvic radiotherapy. We have examined 32 articles reporting on 1189 women undergoing ovarian transposition. Median age was 32.5 years, follow up was median 48 months. The procedure has been performed in patients less than 40 years of age. Surgery has been achieved by laparotomy or laparoscoy. We have analyzed effects of radiotherapy on ovarian function. RESULTS: The proportion of women treated by ovarian transposition preserved ovarian function was 70%. About 86% of patients did not develop ovarian cysts and in 98-99% of cases did not occur any metastatic disease. CONCLUSIONS: Ovarian transposition is associated with significant preservation of ovarian function and a low frequency of complications as cysts and metastasis. In 31% of cases the procedure can fail. Further studies are needed to evaluate the efficacy of ovarian transposition and the follow up. Ovarian transposition should be discussed at the time of cancer diagnosis in every premenopausal woman requiring pelvic radiotherapy.

Evaluation of perchlorate tolerant photo-cured calcium selective electrodes for use in flow injection potentiometry.

A photo-cured membrane selective to calcium, based on the calcium bis [4-(1',1',3',3'-tetramethylbutyl)phenyl]phosphate ionophore and incorporating the lipophilic additive, potassium tetraki(4-chlorophenyl)borate, that can tolerate up to 200 nM perchlorate ionic background in the flow injection potentiometry mode has been previously reported (T. Dimitrakopoulos, J.R. Farrell and P.J. Ives, Electroanalysis, 8 (1996) 391). Improvements in the electrode slope and sensitivity of the previously described photo-cured calcium membrane-based electrode were achieved when anhydrous calcium chloride salt was dissolved into the pre-cured membrane composition and then photo-cured. Similar to the previously reported photo-cured calcium ion-selective electrode (ISE), the improved photo-cured calcium ISE can measure calcium in a high perchlorate background in the flow injection potentiometric mode.

Field-portable flow-injection analysers for monitoring of air and water pollution.

There has been a rapid growth in the development of field-portable analytical instrumentation capable of in-situ and real-time feedback of data from remote sites. Advances have been made in applications for many technologies aided by developments in electronics, computing and telecommunications systems. This report presents a brief review of these developments and particularly of portable flow-injection systems applied in both the liquid and gas phase modes of operation with potentiometric sensors and gas sensors of the tin-oxide semiconductor types.

[Hormone replacement therapy (HRT). The effects at 12 months on the risk factors for menopausal osteoporosis]. / Terapia ormonale sostitutiva (HRT). Effetti a dodici mesi sugli indici di rischio per l'osteoporosi menopausale.

Cessation of ovarian activity is accompanied by a more or less marked and more or less accelerated reduction in bone mass; the degree and speed of the process--which occurs in all women--depends on individual (genetic factors influencing peak bone mass, duration of child-bearing period), iatrogenic (treatment with corticosteroids or thyroid hormones) or accidental factors (post-traumatic immobilization). Whatever the factor that triggers off the process, the end result is the destruction of bone tissue. This process may be documented by hematochemical (Nordin's test) and instrumental parameters (MOC and similar techniques). Oestroprogestin (and to a lesser extent calcitonin) hormone replacement therapy has been demonstrated to be highly efficacious in countering this involutive process. The authors report data obtained following the evaluation of 35 women in menopause undergoing. Nordin's test and measurement of the plasma level of estradiol using RIA, before and after twelve months after the start of osteoprotective treatment. Of the 35 patients 9 received only progestin, 22 an oestroprogestin combination (of these 18 patients received estrogen transdermally and 4 orally), and 4 calcitonin administered parenterally. A statistically significant positive correlation with Nordin's test was only found in the group receiving oestrogen therapy. In conclusion, it may be affirmed that in the absence of contraindications oestrogens represent the elective form of treatment for menopausal osteoporosis. Acceptable results have been reported in the literature also using calcitonin, but this treatment could not be evaluated in this study owing to the reduced number of the sample treated.

[The effects of hormone replacement therapy (HRT) on lipid metabolism in the menopause]. / Effetti della terapia ormonale sostitutiva (HRT) sul metabolismo lipidico in menopausa.

INTRODUCTION AND AIMS: During menopause the number of cardiovascular attacks increases parallel to the elimination of estradiol production. The administration of the latter reverses this tendency owing to a compound mechanism (improved HDL) cholesterol/total cholesterol ratio, diminished vasal resistance). MATERIALS AND METHODS: The authors present a study performed in 34 patients in menopause receiving oestroprogestinic replacement therapy using an oral or transdermal route. Metabolic status (serum concentrations of total cholesterol (TC) and HDL cholesterol (C.HDL) was evaluated in all patients before treatment and after 12 months. RESULTS: A statistically significant positive correlation (p < 0.0001) was found between the use of oestrogen and serum levels of HDL. This correlation appeared to be more evident in patients using transdermal treatment compared to the oral form. CONCLUSIONS: The authors conclude that in the absence of contraindications, hormone replacement therapy in menopause exercises a beneficial effect on the lipid status, contributing to diminishing the risk of cardiovascular attacks. The possibility of an increased incidence of breast cancer is now being evaluated, whereas effective protection of the endometrium against the risk of hyperplasia and cancer was shown using the doses of progestin used in this study, which coincide with those currently prescribed in the literature.

Oral bacterial therapy reduces the duration of symptoms and of viral excretion in children with mild diarrhea.

BACKGROUND: Oral administration of live Lactobacillus casei strain GG is associated with the reduction of duration of diarrhea in children admitted to the hospital because of diarrhea. The purposes of this work were to investigate the clinical efficacy of oral administration of Lactobacillus in children with mild diarrhea who were observed as outpatients, and to see whether Lactobacillus GG can reduce the duration of rotavirus excretion. METHODS: Duration of diarrhea was recorded in 100 children seen by family pediatricians and randomly assigned to receive oral rehydration or oral rehydration followed by the administration of lyophilized Lactobacillus casei, strain GG. Rotavirus was looked for in the stools of all children and in those in whom results were positive, stools were examined again 6 days after the onset of diarrhea. RESULTS: In 61 children results were positive for rotavirus and in 39 results were negative. Duration of diarrhea was reduced from 6 to 3 days in children receiving Lactobacillus GG, with a similar pattern in rotavirus-positive and -negative children. Six days after the onset of diarrhea, stools in only 4 out of 31 children that received Lactobacillus GG were positive for rotavirus compared with positive findings in 25 out of 30 control subjects. CONCLUSIONS: Oral administration of Lactobacillus GG is effective in rotavirus-positive and rotavirus-negative ambulatory children with diarrhea. Furthermore, it reduces the duration of rotavirus excretion.

Acute inflammatory demyelinating polyradiculoneuropathy associated with perforin-deficient familial haemophagocytic lymphohistiocytosis.

UNLABELLED: This study reports the first paediatric case of acute inflammatory demyelinating polyradiculoneuropathy (AIDP) associated with a fatal haemophagocytic lymphohistiocytosis (HLH). The patient developed progressive weakness of the lower limbs in the context of a picture of infectious mononucleosis and Epstein-Barr virus (EBV) infection. After an apparent improvement, a fulminant hepatic failure and pancytopenia ensued, leading to death. Molecular genetic studies documented a compound heterozygosity for two mutations in the perforin (PRF1) gene as the background defect for a familial haemophagocytic lymphohistiocytosis (FHL). CONCLUSION: In this patient EBV infection triggered both AIDP and FHL. The latter condition was due to PRF1 deficiency. Two novel mutations in the PRF1 gene were concomitantly present in the patient. The first caused an amino acid change, while the second introduced a stop codon in the sequence which resulted in a truncated protein.