Successful rechallenge with azacytidine and venetoclax after sustained treatment-free remission in a relapsed acute myeloid leukemia patient: a case report.

Combined therapy with venetoclax and hypomethylating agents has significantly improved the outcome of unfit patients ineligible for intensive chemotherapy. A recently published exploratory analysis of the VIALE-A trial reported that up to 51% of patients achieving remission survived more than 2 years. These data along with those from reallife settings, lead to questioning how long it is appropriate to continue treatment in long-term survivors. Accordingly, recent retrospective studies suggested the feasibility of suspending therapy in selected patients while maintaining prolonged responses. Also, these studies showed that retreatment may induce a second remission in almost a third of patients. We report the case of a patient who received salvage therapy with venetoclax and azacytidine, that was discontinued few cycles after blasts clearance because of severe hematological toxicity. Despite suspension, he maintained a sustained response lasting almost one year and was successfully retreated with the same combination when a second relapse occurred.

Histomorphometric evaluation of bovine bone and equine bone matrix in maxillary sinus floor augmentation: a systematic review.

The aim of this study was to evaluate the efficiency of bovine and equine bone substitute materials used in sinus augmentation techniques. The research protocol was carried out using the PubMed database, including articles from October 2019 until February 2020 and those in English only. The search on PubMed (MED-LINE) was carried out with the following keywords: sinus augmentation OR sinus lift AND bovine bone graft OR equine bone matrix. The articles identified included randomised clinical trials, cross-sectional studies and case series. Outcomes were the percentage of newly formed bone, remaining graft particles and soft tissue in a follow-up at least of 5 months. The use of bovine bone graft (ABB) as a graft material in maxillary sinus elevation was evaluated in 9 studies. According to the quality assessment, 4 of the 9 studies were analysed and an arithmetic mean was performed showing the following results: newly formed bone (NFB 22.74%), residual grafts (RG 29.36%) and soft tissue percentage (SF 48.51%). The use of equine bone matrix (EBM) was assessed in four different studies including an RCT, a cross-sectional study and two case series; a mean percentage calculated by the extracted data of the four studies was estimated with newly formed bone (NFB 44.51%), residual grafts (RG 17.24%) and soft tissue percentage (SF 36.62%). EBM appears to be as effective as ABB for the maxillary sinus floor augmentation procedure.

The dentist's role in diagnosis and treatment of obstructive sleep apnea syndrome: a literature review.

The purpose of this work was to present a review of the literature concerning obstructive sleep apnea syndrome, and the role of the dentist in this pathology, both to identify elements useful for a good diagnosis and to apply the available therapeutic strategies. In literature there is no unanimous opinion on the treatment of OSAS. The multidisciplinary approach is necessary, creating teams made up of dentists, otolaryngologists and medical experts in sleep disorders, in order to develop a cooperation-based treatment plan for the disease. In this review, the importance of early diagnosis, orthodontic therapy in order to restore normal function is underlined, since OSAS is linked to a high risk of hypertension, cardiovascular diseases, daytime sleepiness, domestic and work accidents, with consequent deterioration of the quality of life.

Silica dioxide colloidal solutions is efficient in the treatment of chronic periodontitis: a case control study.

The objective of this study was to compare the efficacy of supportive periodontal therapy (i.e. scaling and rooth planning, SRP) alone versus a chemical device silica dioxide (SiO2) colloidal solutions (SDCS) used in association with SRP in the treatment of chronic periodontitis in adult patients. A total of 20 patients with a diagnosis of chronic periodontitis (40 localized chronic periodontitis sites) in the age group of 35 to 55 were selected. None of these patients have previously received any surgical or non-surgical periodontal therapy and demonstrated radiographic evidence of moderate bone loss. Two non-adjacent sites in separate quadrants were selected in each patient to monitorize treatment efficacy (split mouth design). Clinical pocket depth (PD) and microbial analysis (MA) were analyzed at baseline and 15th day. SPSS program and paired simple statistic T-test were used to detect significant differences. Total bacteria loading, Tannerella Forsitia and Treponema Denticola loading were statistically reduced when SiO2 is locally delivered. SDCS gel is an adjuvant therapy which should be added to SRP in the management of moderate to severe chronic periodontitis.

Bruma MAD: a new way of treating OSAS patients.

The aim of this study was to introduce a new adjustable device in the treatment of obstructive sleep apnea syndrome (OSAS). The new appliance has a different way to regulate and move the mandible through the presence of two occlusal lifts, that can leave an open posterior space, and the complex system formed by the peduncle and the steel plate that can easily move forward the mandible. This system guarantees a posterior space for the tongue but mostly for the passage of air. The principal aim of Bruma MAD is to contrast the pharyngeal collapsing and to prevent hypopnea or apnea. Further clinical studies are needed to confirm and to evaluate the predictability of this new device.

Fit evaluation of cad/cam fabricated all-ceramic restorations based on direct and indirect digitalization in vivo: a systematic review.

The aim of this study was to compare the fit of all-ceramic restorations on natural teeth fabricated through a direct digital workflow or an indirect digital workflow. An electronic search of publications was established from three electronic databases: Cochrane, PubMed and Web of Science. The search strategy used a combination of controlled vocabulary and free-text words. The detailed search design and strategies, including keywords, are presented below. The authors used two filters to follow data for the research: papers written in English and published in the last 5 years. The search resulted in 3042 titles. Following the first stage of screening, after the records identification through database manual searching, 3047 potentially relevant studies were identified. After the second stage screening, 38 full text publications were obtained and analyzed and 17 were excluded. Afterwards, 22 articles resulted eligible after full text reading and a cross search of the articles references was accomplished and 5 articles were consequently added. At last, 6 articles were included in the quantitative analysis. This study was designed to compare the fit of restorations obtained by means of a direct or indirect digital workflow. The values reported on the maximum acceptable gap in scientific literature range from 50 to 200 µm, so there does not seem to be an objective limit based on scientific evidence. According to the most accepted marginal discrepancy in the literature, most of the values of the studies examined are in the 200 µm acceptability range. Within the limitations of this systematic review, computer-aided design and computer-aided manufacturing (CAD/CAM) fabricated restorations obtained by means of an intraoral scanner (IOS) showed better marginal and internal fit than restorations obtained through conventional impression and subsequent laboratory scanning. According to the results of this systematic review, the direct digital workflow resulted as a valid alternative to the indirect digital workflow to produce CAD/CAM all-ceramic restorations.

Chlorhexidine gel used as antiseptic in periodontal pockets.

The aim of this study was to evaluate the adjunctive benefit offers by the administration of a chlorhexidine based local drug deliver (Chlo-SITE) into periodontal socket after a full mouth disinfection session. The study design was a randomized, crossover, clinical trial conducted on 60 non-smokers subjects with chronic periodontitis. Each volunteer was subjected to a one-stage full mouth disinfection session and, immediately after that, test product (Chlo-SITE) was inserted in 1 pocket in 2 quadrant. The 1° and 4° quadrant were used for the study with the application of antiseptic (Test); the 2° and 3° as a control. Periodontal probe (PD), bleeding on probing (BOP) and plaque index (PI) was collected at baseline (T0), after 7 days (T1), after 4 weeks (T2). The results of this study suggest that the application of xanthan-based chlorhexidine gel (Xan-CHX) offers a great benefit in improving of the indices in chronic periodontitis.

Periodontal disease in subjects suffering from coronary heart disease.

The aim of present study is to evaluate the greater risk of periodontal disease in subjects affected by cardiovascular disease. The statistical study includes 200 patients equally divided into a test and a control group. The test group is made up of hospitalized patients from the cardiology division of the S. Salvatore hospital of L'Aquila and the second made up of subjects that frequented a dental clinic. All patients were subject to anamnesis and clinical evaluation for periodontal disease. The index used for this clinical examination were CPTIN index (Community Periodontal Index for Treatment Needs), pocket depth index (PPD), probing bleeding index (PBI), and plaque index (Silness, Loe). All data were collected and a comparative analysis was done of the results obtained from the two groups. Analysing the data concerning the average of lost and present teeth in the oral cavity and the damage of periodontal attachment we notice that cardiopathic subjects had a loss of periodontal attachment 2 times greater than in the control group and major condition of edentulism. A frequency test called the "chi-square test" showed that cardiopathic patients had a greater frequency of periodontal disease. The development of periodontal disease in subject suffering from coronary heart disease is faster and more aggressive than in healthy subjects. Therefore, the prevention of periodontal disease is simple and effective way to reduce the risk of cardiovascular disease.

Analyze my face.

Plastic surgery is gaining more and more popularity, while stigma and popular myths about it are gradually decreasing. Analyze My Face conjunctly deals with the two main problems of facial plastic surgery: the excessive rate of dissatisfaction, which results in high revision requests and negative psychological side-effects and the “diagnosis by procedure” approach, which leads to erroneous measurements. This new and innovative method of Digital Facial Analysis is a direct non-expensive online service that provides professional and documented in-depth consultation to patients before they decide to undergo any type of facial intervention. The paper thoroughly explains the scientific method with which professionals provide customers with a facial assessment based on specific parameters which will be discussed (height, width, proportions, direction of facial growth, the way they assess each facial area in detail (eyes, mouth, cartilage), and the motivations for which they suggest to correct eventual defects through precise measurements, indicators and suggested interventions. Long-term evaluation of stability of surgical results and patient satisfaction achieved with digital facial analysis has not yet been established and needs further research. However, it is important to underline that the AMF approach tends to consider exclusively possible and feasible procedures that do not compromise functionality and that do not put patients in danger of serious damage. Problems or deformities that cannot be treated are always indicated. AMF aims to maximize professionality by giving practitioners an additional tool to aid their work, give unbiased opinions and look at the overall picture. It also aims to help patients by soothing their way into the complicated world of aesthetic surgery.

Bruxism in children: Use of the Functional Plane of Monaco (FPM).

BACKGROUND: Bruxism is a condition that results from hyperactivity in the central nervous system, and factors such as stress or other anxious conditions increase the frequency of episodes. When bruxism occurs at a young age, tooth wear can occur. The extent of wear can lead to the need for restorative dentistry and prosthetic treatments to restore the morphological and functional integrity of the teeth, with high costs associated with such treatments. CASE REPORT: A healthy 15-year-old boy presented to the orthodontist observation. His incisal ridges appeared thin, without mamelons, and with increased translucency. For treatment, the authors used only the Functional Plane of Monaco (FPM), a device which he had to wear 16 hours during the day. CONCLUSION: The orthodontist successfully treated an orthopaedic/orthodontic case with the FPM device.

Efficacy of two mouthwashes on 3-day supragingival plaque regrowth: a randomized crossover clinical trial.

BACKGROUND: The aim of this study was to evaluate the antiplaque effects of an alcohol-free essential oil (alcohol-free EO) mouthwash and an amine fluoride/stannous fluoride with zinc lactate (SnFl-Zn) mouthwash compared to a positive control of chlorhexidine (CHX) mouthwash, using an in vivo plaque regrowth model of 3 days. MATERIALS AND METHODS: The study was designed as a double-masked, randomized, crossover clinical trial, involving 20 volunteers to compare two different mouthwashes, using a 3-day plaque accumulation model. After receiving thorough professional prophylaxis at baseline, over the next 3 days, each volunteer refrained from all oral hygiene measures and performed two daily rinses with 20 ml of the test mouthwashes. A 0.20% CHX rinse served as a positive control. At the end of each experimental period, plaque was assessed, and the panellists completed a questionnaire. Each subject underwent a 14-day washout period, and then, there was another allocation. RESULTS: The SnFl-Zn mouthwash has shown a better inhibitory activity on plaque regrowth compared to the alcohol-free EO mouthwash in the whole mouth (plaque index = 1.93 against 2.45, respectively), but there was less of an effect compared to the CHX group, with an overall plaque index of 1.41. The differences of 0.52 between alcohol-free EO and SnFl-Zn and between SnFl-Zn and CHX and of 0.96 between alcohol-free EO and CHX were all statistically significant (P < 0.001). CONCLUSION: The alcohol-free EO mouthwash seemed to have less of an inhibiting effect on plaque regrowth than the amine fluoride/SnFl-Zn mouthwash and the CHX control.

Driving, dementia and Australian physicians: primum non nocere?

Older Australians are increasingly reliant on automobiles as their sole form of transport. As our population is ageing and the prevalence of dementia is increasing, it is anticipated that the number of drivers with dementia will rise over time. Much of the literature relating to driving and dementia focuses on safety rather than mobility. The objective of this paper is to highlight several topical ethical issues that pertain to Australian drivers with dementia. It is recommended that future research, policy and practice should centre on the crucial mobility and transport needs of our senior citizens.

Association between obesity and periodontal disease in children.

AIM: The objective of this study was to analyse the relationship between obesity and periodontal disease in children. The null hypothesis is that obese and normal weight children show no different degree of periodontal status. MATERIALS AND METHODS: The sample for this case control study consisted of 20 males and 24 females with a mean age of 9.43±2.05 years old and mean body mass index standard deviation score (BMI-SDS) of 2.16±0.37 in the test group, and 33 males and 26 females with a mean age of 9.67±1.46 years old and BMI-SDS of 0.22±1.79 in the control group. The periodontal status was assessed using plaque accumulation, bleeding on probing (BOP) index, probing depth (PD) and clinical attachment level (CAL). RESULTS: The test group showed higher plaque deposits and BOP and the difference between the two groups was statistically significant (p< 0.05). No significant difference between the two groups was found regarding the loss of clinical attachment, though it was worse in obese children. Categorical variables described as frequency and percentage were compared using the Fisher's exact test or test chi square. Continuous variables were analysed using the Mann-Whitney test. CONCLUSION: The study showed an association between obesity and periodontal risk indicators in children that in the long term may lead to oral conditions. The oral health of overweight/obese subjects should be more carefully supervised and checked in order to prevent oral alterations.

[Development of a method for the assessment of melamine in urines by GC-MS/MS. An attempt to define a reference value]. / Messa a punto di un metodo di valutazione della melamina su urine in GC-MSMS. Un tentativo di definizione di un valore di riferimento.

Melamine is used in the synthesis of resins used for the manufacture of laminates, plastics and coatings, including materials in contact with food such as crockery. A method for the assessment of melamine by GC-MSMS in urine samples was developed and tested in 100 non-occupationally exposed subjects: 63 females (14-66) and 37 males (15-65). The LOD and LOQ were 4 microg/l and 13.4 microg/l respectively. Results showed traces of melamine in the urines of 21% of subjects monitored (10-29.7 microg/l). Presence of melamine and time since last meal at sampling were inversely related (p = 0.021). In addition a significant correlation (p = 0.00) between the presence of the substance in urines and the use of melamine dishes was shown.

Using dense seismo-acoustic network to provide timely warning of the 2019 paroxysmal Stromboli eruptions.

Stromboli Volcano is well known for its persistent explosive activity. On July 3rd and August 28th 2019, two paroxysmal explosions occurred, generating an eruptive column that quickly rose up to 5 km above sea level. Both events were detected by advanced local monitoring networks operated by Istituto Nazionale di Geofisica e Vulcanologia (INGV) and Laboratorio di Geofisica Sperimentale of the University of Firenze (LGS-UNIFI). Signals were also recorded by the Italian national seismic network at a range of hundreds of kilometres and by infrasonic arrays up to distances of 3700 km. Using state-of-the-art propagation modeling, we identify the various seismic and infrasound phases that are used for precise timing of the eruptions. We highlight the advantage of dense regional seismo-acoustic networks to enhance volcanic signal detection in poorly monitored regions, to provide timely warning of eruptions and reliable source amplitude estimate to Volcanic Ash Advisory Centres (VAAC).

Ground deformation reveals the scale-invariant conduit dynamics driving explosive basaltic eruptions.

The mild activity of basaltic volcanoes is punctuated by violent explosive eruptions that occur without obvious precursors. Modelling the source processes of these sudden blasts is challenging. Here, we use two decades of ground deformation (tilt) records from Stromboli volcano to shed light, with unprecedented detail, on the short-term (minute-scale) conduit processes that drive such violent volcanic eruptions. We find that explosive eruptions, with source parameters spanning seven orders of magnitude, all share a common pre-blast ground inflation trend. We explain this exponential inflation using a model in which pressure build-up is caused by the rapid expansion of volatile-rich magma rising from depth into a shallow (<400 m) resident magma conduit. We show that the duration and amplitude of this inflation trend scales with the eruption magnitude, indicating that the explosive dynamics obey the same (scale-invariant) conduit process. This scale-invariance of pre-explosion ground deformation may usher in a new era of short-term eruption forecasting.

Adaptive-optics corrections available for the whole sky

Adaptive-optics systems can in principle allow a telescope to achieve performance at its theoretical maximum (limited only by diffraction), by correcting in real time for the distortion of starlight by atmospheric turbulence. For such a system installed on an 8-m-class telescope, the spatial resolution and sensitivity could be up to 100 times better than conventional imaging. Adaptive-optics corrections have hitherto been achieved only for regions of the sky within a few arcseconds of a bright reference source. But it has been proposed theoretically that by using multiple guide stars, the tomography of atmospheric turbulence could be probed and used to extend adaptive-optics corrections to the whole sky. Here we report the experimental verification of such tomographic corrections, using three off-axis reference stars approximately 15 arcsec from the central star. We used the observations of the off-axis stars to calculate the deformations of the wavefront of the central star, and then compare them with the real measured values. This tomographic approach is found to reduce variations in the wavefront by approximately 92%. Our result demonstrates that a serious barrier to achieving diffraction-limited seeing over the whole sky has been removed.

Concerning the localization of steroids in centrioles and basal bodies by immunofluorescence.

Specific steroid antibodies, by the immunofluorescence technique, regularly reveal fluorescent centrioles and cilia-bearing basal bodies in target and nontarget cells. Although the precise identity of the immunoreactive steroid substance has not yet been established, it seems noteworthy that exogenous steroids can be vitally concentrated by centrioles, perhaps by exchange with steroids already present at this level. This unexpected localization suggests that steroids may affect cell growth and differentiation in some way different from the two-step receptor mechanism.