Platelet rich plasma grafting technique combined with trans-sinusal post-extractive implants placement in the posterior maxilla: a technical report and brief literature review.

The atrophic posterior ridges are usually characterized by poor bone quality and quantity: this situation requires the use of bone regenerative techniques. Other alternative surgical approaches are investigated. Nowadays the use of trans-sinus implants offers some advantages due to its feasibility. Today, bone grafting may be practical, but depends on many factors, such as the type of bone graft used (autogenous, alloplastic, or xenograft), host response, age of the patient, various complications associated with grafting procedures, infection, and, most importantly, the time spent while the grafted material matures and is taken up by the bone. So, this case report describes the feasibility of an alternative surgical technique associated to PRP (Platelet Rich Plasma).

New trends in adjunctive treatment and diagnosis in medication-related osteonecrosis of the jaw: A 10-year review.

Medication-related osteonecrosis of the jaw (MRONJ) is a major disease under study for over the last twenty years. Different classifications have been proposed and many therapies for the different stages have been applied. The evolution of treatments lead to an increasingly conservative approach. Numerous adjuvant treatments have been proposed in the last decade. All these complementary treatments have been proposed mainly to resolve or reduce the painful stress, predominantly caused by bacterial infection, simplifying the wound healing process and improving patients' compliance. Nowadays "secondary" treatments, such as autologous platelet concentrates (APCs, more specifically PRP, PRGF or PRF), hyperbaric oxygen (HBO), Auto/tetracycline fluorescence-guided bone surgery (AF-GBS/TF-GBS), medical drugs like teriparatide or the combination between pentoxifylline and tocopherol, fluorodeoxyglucose positron emission tomography (FDG-PET), laser and/or low-laser therapy and ozone therapy are more or less well documented and known considering their clinical effectiveness. The aim of the present review is the evaluation of the quantity and quality of scientific studies concerning this specific topic.

Laser lingual frenectomy: basal eutonia achievement by natural homeostatis.

The aim of present study is a macro evaluation of adjustment to allow homeostasis before and after frenectomy. Macro analysis was done on 7 pediatric patients tested firstly simple surface elettromyography (EMG) to evaluate masticatory muscles, secondly the Romberg's test to assess the posture and thirdly cephalometric analysis according to Giannì and Rocabado to assess orthodontic variations. The frenectomy was performed with diode laser (wavelength 890 nm). Pre-frenectomy EMG outcomes indicate a clear masticatory muscular imbalance with a different electrical activity compared to physiological standard values and functional basal balance. Results after frenectomy EMG show a normalization of basal values with an improvement of mandibular posture. Depending on cephalometric analysis, outcomes reveal a tendency to normalize the cervical lordosis, previously altered. Ultimately, pre-frenectomy Romberg's test shows initial instability in the static posture, which decreases after frenectomy. In conclusion, the short lingual fraenum not only has static correlations with the oral cavity but also dynamic connections with the cervical posture and muscular basal organization. So, homeostasis includes macro alterations involving muscular tone and bone position. Frenectomy could favor the restoration of the basal eutonia achieved by a natural homeostasis.

Zygomatic implants supported rehabilitations in atrophic maxilla: sinus complications, radiological, periodontal and prosthodontic evaluations: a one year follow up retrospective longitudinal study.

The rehabilitation of maxillary bone atrophy represents one of the main challenges of modern oral implantology. The use of zygomatic implants in the prosthetic rehabilitation of the patient affected by severe maxillary bone atrophy is another therapeutic alternative, not exempt from complications. The present study included 19 patients with edentulous maxillae who were treated between 2013 to 2015 with at least two zygomatic implants at the Department of Maxillofacial Surgery, Verona, Italy. The purpose of this retrospective longitudinal study was to evaluate sinus complications and radiological, periodontal and prosthetic evaluations of zygomatic implants technique in severe atrophic. Implant-prosthetic rehabilitation of the upper jaw edentulous severely atrophic using zygomatic implants represents one safe and repeatable technique. In terms of implant survival from our study showed an implant CRS (common reporting standard) of 98.5% and a prosthetic CRS 100% with a mean follow-up period of 19.2 months (range). Both recorded data are superimposed on major reported studies in literature.

Clinical performance of leukocyte differential on the new Roche Cobas Vega haematological analyzer.

The Roche Cobas Vega is a five-part differential haematological analyzer evolving from the former Cobas Helios, Argos and Micros. As the leukocyte differential of Cobas Vega displays several interesting features, we analyzed its clinical performance and compared it either to three other commercial haematological analyzers (Technicon-Bayer H*2, Coulter STKS and Abbott CD-3500) or to the manual reference method, as described in the National Committee for Clinical Laboratory Standards (NCCLS) H20-A protocol. Within- and between-batch coefficients of variations (CVs) of the white blood cell differential were satisfactory and close, or even better than the ones reported for the other instruments: 0.81% (neutrophils), 1.87% (lymphocytes), 6.76% (monocytes), 7.73% (eosinophils) and 22.55% (basophils). The identification of abnormalities in the white blood cell differential was obtained either on the basis of the instrument-specific ranges or on the generation of one or more flags by comparison with results of the manual reference method. The Vega demonstrated remarkable performance in terms of specificity (90.0%), sensitivity (91.6%) and both positive (97.7%) and negative (69.1%) predictive values; likewise, the global efficiency was the best (90.3%) among the analyzers we evaluated. The flags generated in the presence of morphological abnormalities of the samples displayed excellent sensitivity (from 88.9% to 100%), specificity (from 93.5% to 98.3%) and satisfactory positive (from 51.1% to 66.7%) and negative (from 98.3% to 100%) predictive values. We conclude that the analytical performance of the new Cobas Vega haematological analyzer can significantly improve the identification of various haematological abnormalities as an important contribution to the accuracy is provided by the new staining for granulocytes.

Lipoprotein(a) concentrations are increased in patients with myocardial infarction and angiographically normal coronary arteries.

It is generally accepted that Lp(a) is an independent risk factor of cardiovascular diseases. Since the apolipoprotein component of Lp(a) shows some homologies to plasminogen, it is, however, unclear as to whether the pathological effect is due to the role played by the lipoprotein in lipid metabolism or in the fibrinolytic system. We compared two groups of patients with myocardial infarction, with and without angiographically documented coronary artery disease. In the latter group, imbalances in the clotting system are very likely, while members of the former group may also display disturbances of lipid metabolism. The results show that the two groups display differences in lipid metabolism, whereas they have similar patterns of thrombogenicity indices and Lp(a) values. This study seems to support the hypothesis that Lp(a) does play a role in the fibrinolytic system, since even those myocardial infarctions without obstructive coronary artery disease have a high frequency of Lp(a) concentrations above 300 mg/l, i.e. similar to the situation found in the myocardial infarctions with angiographically documented coronary artery disease. Whether the high Lp(a) concentrations in the two groups are related to an impaired fibrinolysis will be the subject of further investigation.

Advantages of a new anticoagulant in routine hematology on the Coulter Counter S-Plus STKR analyzer.

The authors report the advantages of a new anticoagulant-antiaggregant mixture that avoids the deleterious effects of ethylenediaminotetraacetic acid (EDTA) on mean platelet volume and also prevents EDTA-induced platelet clumping. It is suitable for routine cell counting and sizing with the Coulter Counter S-Plus STKR. The values of the common hematologic parameters agree well with those from EDTA-treated samples and are stable for at least eight hours after sampling.

EDTA-induced platelet aggregation can be avoided by a new anticoagulant also suitable for automated complete blood count.

In vitro EDTA-induced platelet aggregation is a fairly rare event but can have serious clinical consequences producing pseudothrombocytopenia and pseudoleukocytosis. Sixteen specimens with previously recognized EDTA-induced platelet aggregation were collected in a new anticoagulant-antiaggregant mixture containing trisodium citrate 17 mmol/l, pyridoxal 5'-phosphate 11.3 mmol/l and Tris 24.76 mmol/l (CPT mixture) and analyzed at various times after venepuncture with four hematological instruments: Coulter Counter S-Plus STKR, Technicon H6000, Technicon H1 and Ortho ELT-8. In CPT-anticoagulated specimens the signals and instrumental flags of platelet clumping were absent, and the platelet number correlated very well with a microscopic count from a finger stick drawn into Unopette. The complete blood count was very similar in "normal" hematological specimens either collected in K3. EDTA or in CPT, although Technicon H1 and Ortho3 ELT-8 required a suitable calibration for MCV and hematocrit in the latter mixture. Mean platelet volume was stable for up to 24 h only in CPT-collected specimens, if it was measured on a Coulter Counter S-Plus STKR. In routine hematological practice CPT can be an alternative anticoagulant to K3. EDTA, most suitable for automated complete blood count and useful in avoiding EDTA-induced platelet clumping.

Unpredictable effects of K3 EDTA on mean platelet volume.

The changes of mean platelet volumes (MPVs) begin immediately upon exposure of the blood to K3EDTA, and differences from sample to sample are unpredictable, predominantly in the first two hours from the venipuncture. MPVs variations can range from -25 to 23.1% in respect to MPVs in untreated whole blood immediately processed. These results were obtained by a new electrooptical device (Technicon H X 1) that provides complete blood cell counting and sizing. If whole blood is collected and diluted with a reagent used by the instrument to sphere and fix red blood cells and platelets, MPVs values do not change significantly within 180 minutes from venipuncture. This approach allows one to study the true values of MPVs on Technicon H X 1.

[Griffith test in the evaluation of psychomotor development in the 1st year of life. A longitudinal study]. / Il test di Griffith per la valutazione dello sviluppo psicomotorio nel primo anno di vita. Studio longitudinal.

Griffith psychometric test has been experimented on a group of 20 healthy newborn infants, monitored during their 1st year of life with quarterly check-ups. It was clear that the development general rates were constantly higher than the original values reported by the English author. In particular, in 12 months old infants, the rates appeared significantly higher than the rates observed on the same Italian specimen in past periods. A transverse and longitudinal study of the psychomotor development of subjects included in the specimen has given the opportunity to verify some of his features. The development outlines, traced by employing the average rates relevant to the 5 different aspects monitored (motor, personal-social, language, eye-hand co-ordination, practical reasoning), appeared to be well-balanced, that is without dissynchronisms between the different scales. The only exception being the scale of the social behaviour, were the average rates appear to be sensibly higher at every age. Individual development outlines, on the contrary, appeared to be disjointed in all aspects (except for 4 cases). In the longitudinal analysis then, some noteworthy oscillations in both general and partial rates, were observed among the controls carried out in subsequent periods in all the subjects.

[Howie's antithrombin activity and thrombin inhibitors in the nephrotic syndrome]. / Attività antitrombinica secondo Howie ed inibitori della trombina nella sindrome nefrosica.

A prospective study was carried out on a group of 28 patients affected by nephrotic syndrome in order to compare the antithrombin activity, measured by the technique of Howie, the antithrombin III, measured with chromogenic substrate and by radial immunodiffusion, the alpha 2-macroglobulin and the alpha 1-antitrypsin. An increased level of alpha 2-macroglobulin and of the antithrombin activity, measured by the technique of Howie and a reduction of the level of antithrombin III and of alpha 1-antitrypsin was observed. It is suggested that the increased antithrombin activity is related to the increase of alpha 1-antitrypsin was observed. It is suggested that the increased antithrombin activity is related to the increase of alpha 2-macroglobulin concentration in spite of the simultaneous decrease of antithrombin III.

[Intracranial hemorrhages in the full-term newborn infant. Psychomotor development and neurologic sequelae]. / Emorragie intracraniche del neonato a termine. Sviluppo psicomotorio e sequele neurologiche.

Recently increased utilization of high definition T. C. scan and U. S. has led, in recent years, to diagnose and to localize the intracranial haemorrhage of the term newborns. It has been possible to study the outlook of this disease. The neuro-psychological development of the children, affected by intracranial haemorrhage at the birth, is more impaired when the haemorrhage is intraparenchimal: intracerebellar or intracerebral. Our cases show that a haemorrhage causes only discord on the neuro-psycholological development. When, on the other hand, haemorrhage is associated with anoxicbrain damage, especially bilateral, take place major sequelae.