Automatic ultrasound technique to measure angle of progression during labor.

OBJECTIVE: To evaluate the accuracy and reliability of an automatic ultrasound technique for assessment of the angle of progression (AoP) during labor. METHODS: Thirty-nine pregnant women in the second stage of labor, with fetus in cephalic presentation, underwent conventional labor management with additional translabial sonographic examination. AoP was measured in a total of 95 acquisition sessions, both automatically by an innovative algorithm and manually by an experienced sonographer, who was blinded to the algorithm outcome. The results obtained from the manual measurement were used as the reference against which the performance of the algorithm was assessed. In order to overcome the common difficulties encountered when visualizing by sonography the pubic symphysis, the AoP was measured by considering as the symphysis landmark its centroid rather than its distal point, thereby assuring high measurement reliability and reproducibility, while maintaining objectivity and accuracy in the evaluation of progression of labor. RESULTS: There was a strong and statistically significant correlation between AoP values measured by the algorithm and the reference values (r = 0.99, P < 0.001). The high accuracy provided by the automatic method was also highlighted by the corresponding high values of the coefficient of determination (r2 = 0.98) and the low residual errors (root mean square error = 2°27' (2.1%)). The global agreement between the two methods, assessed through Bland-Altman analysis, resulted in a negligible mean difference of 1°1' (limits of agreement, 4°29'). CONCLUSIONS: The proposed automatic algorithm is a reliable technique for measurement of the AoP. Its (relative) operator-independence has the potential to reduce human errors and speed up ultrasound acquisition time, which should facilitate management of women during labor. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Survey on patients' attitude towards the nutritional counselling in the dental setting.

AIM: A healthy diet could help to prevent both oral and systemic diseases, with dentists and nutritionists supplementing their skills. The dental setting, where patients periodically refer to seeking oral health care, represents a powerful opportunity for nutritional counselling. To the best of our knowledge, no study is available on patients' attitudes towards dietary counselling in the dental setting. This cross-sectional study investigates patients' attitude towards receiving nutritional support within the dental setting and it elucidates whether a transdisciplinary approach would be well accepted. MATERIALS AND METHODS: A questionnaire was administered to patients attending three different clinics: a private clinic, a hospital dental clinic of the national healthcare system and the private dental practice within the same hospital. RESULTS: Three hundred thirteen questionnaires were collected. Most dental patients acknowledged receiving nutritional advice from both dentists and nutritionists. The nutritionist within the dental setting was positively perceived, providing useful advice to prevent oral and systemic diseases and also drawing up a diet with periodic follow-ups. DISCUSSION AND CONCLUSION: These findings support the positive attitude of patients towards receiving nutritional counselling within the dental setting. The dental clinics can be pivotal in oral and systemic disease screening and prevention and a multidisciplinary approach is highly encouraged.

Genetics/epigenetics of oral premalignancy: current status and future research.

Squamous cell carcinoma (SCC) of the oral and oropharyngeal region is the sixth most common malignancy in the world today. Despite numerous advances in treatment, long-term survival from this disease remains poor. Early detection can decrease both morbidity and mortality associated with this neoplasm. However, screening for potentially malignant disease is typically confounded by difficulty in discriminating between reactive/inflammatory lesions vs those lesions that are premalignant in nature. Furthermore, the histologic diagnosis of dysplasia can be subjective and is thus prone to a considerable range of interpretation. Similarly, no definitive, validated criteria exist for predicting which dysplastic lesions are most likely to progress to cancer over time. Given this state of science, the presence of dysplasia can only be used to indicate that an oral lesion may have an increased risk of malignant transformation. Molecular biomarkers capable of identifying the subset of lesions likely to progress to cancer are required to eliminate this clinical diagnostic dilemma. The purpose of this review is to assess the current state of knowledge regarding genetic/epigenetic alterations observed in oral mucosal premalignancy. In addition, recommendations for future research studies directed at defining the predictive capacity of specific biomarkers in this modeling are presented.

Detection of survivin mRNA in healthy oral mucosa, oral leucoplakia and oral cancer.

BACKGROUND: Survivin is involved in modulation of cell death and cell division processes. Survivin expression in normal adult tissues has not been fully understood, although it is markedly lower than in cancer, where it is over-expressed. OBJECTIVE: To investigate survivin expression in normal, potentially malignant and cancerous oral mucosa. METHODS: We measured survivin mRNA levels by real-time RT-PCR in specimens of oral mucosa (15 from normal mucosa, 17 from potentially malignant lesions, 17 from neoplasms). Scores were compared using Kruskal-Wallis test and post hoc according to Conover. Chi-squared test was used for dichotomous data. RESULTS: The median relative levels of survivin mRNA resulted six for normal mucosa, eight for potentially malignant lesions, 13 for cancers: differences among these three groups were statistically significant, as between cancer and potentially malignant lesions. Expression in normal mucosa and potentially lesions group showed no significant difference. Low, but not marginal expression of survivin in normal mucosa is a new finding, and it could be explained with the higher sensibility of our methods. CONCLUSIONS: Survivin expression in oral potentially malignant lesions might indicate a progressive deregulation of expression paralleling oncogenesis, particularly during the first stages of process, suggesting a putative predictive role for survivin.

Electrochemical surface modification of titanium for implant abutments can affect oral bacteria contamination.

PURPOSE: This research concerns the characterization of an electrochemical surface treatment applied to titanium, focused especially on the treatment of the transmucosal area of dental implants and abutments. The treatment is applied to improve soft tissue adhesion, to control and limit bacteria adhesion and proliferation, and to improve the aesthetic performance through a proper colorization of the metal surface. METHODS: The electrochemical treatment considered, obtained on titanium by Anodic Spark Deposition technique (ASD), was performed in a calcium phosphate enriched solution. The bacteria behaviour was assessed by in vitro and in vivo tests. RESULTS: The investigated ASD treatment showed some antibacterial effect. No negative cytocompatibility effects were found on MG63 - human osteosarcoma cell lines and L929 - murine fibroblasts. CONCLUSIONS: The ASD modified treatment was found capable of modifying the titanium oxide layer providing a prevalent anatase crystalline structure and a microporous morphology, which can play an important role in the tissue integration process. The treatment was found capable of enriching the surface with calcium, providing improved biocompatibility and a light gray colorization. This last point is important for the aesthetic improvement of dental implant systems in the transgingival area.

Combination therapy with subcutaneous interleukin-2 and interferon-alpha in advanced renal cancer patients with poor prognostic factors.

Sixteen patients with metastatic renal cell carcinoma were treated with a combination of low-dose subcutaneous interleukin-2 (IL-2) and recombinant interferon (IFN)-alpha. One treatment course included 6 weeks of treatment followed by a 2-week rest. Patients received therapy as outpatients. All patients were assessable for toxicity and response assessment. Nine patients experienced severe toxicities resulting in dosage modification. The major treatment-limiting side effects were gastrointestinal, cutaneous, fever and flu-like symptoms. One patient (6%) had partial remission and six patients (37.5%) had disease stabilization. Overall median survival was 8 months. In our study IL-2 and IFN-alpha showed a low activity and a quite high toxicity. It seems that the prognostic factors per se rather than treatment options might impact the treatment results in advanced renal cancer patients.

[Spontaneous cholecysto-cutaneous fistula. Observation of a case and review of the literature]. / La fistola colecisto-cutanea spontanea. Osservazione di un caso e revisione della letteratura.

A case of spontaneous gallbladder-cutaneous fistula is reported with emphasis on the rarity of this lesion after the introduction of cholecystectomy.

[Computerized dynamic endothermography of the gastrointestinal mucosa as an indirect index of the state of vascularization of the abdominal organs. A preliminary note]. / L'endotermografia dinamica computerizzata della mucosa gastrointestinale quale indice indiretto dello stato di vascolarizzazione degli organi addominali. Nota preliminare.

Computerized Dynamic Endothermy (CDE) has been applied to the evaluation of the gastroenteric microcirculation. This new method enables mucosal temperature changes to be detected in a dynamic and functional way. With preventive induction of a temperature change (cold stimulus), the instrument measures the time required for the establishment of previous mucosal temperature. Computerized data are displayed in the form of a time/temperature curve. Results obtained on rabbits showed, during ischaemic conditions, a greater reduction of gastric layer temperature during cold stimulus than in basal conditions, followed by a slower return to basal temperature during the recovery time.

[A new type of small calibre carbon fiber arterial prosthesis]. / Sur un nouveau type de prosthèse artérielle de petit calibre en fibres de carbone.

A new type of vascular prosthesis, made of pyrolytic carbon fibres, was tested on growing pigs. Fourteen grafts (4 x 33 mm) were implanted on the infrarenal aorta and removed 15 s, 60 m and 7, 15, 30, 60 and 120 days after surgery. Specimens were examined by light and scanning electron microscopy. As controls ten pigs underwent excision and re-implantation of a 30 mm segment of infrarenal aorta. Autografts were removed 7 to 120 days after surgery. All but one carbon grafts, as well as all autografts were patent at the time of removal. Basic characteristics of carbon grafts, as shown by the present study, may be summarized as follows: 1) thromboresistance of the inner surface, at the time of implantation, 2) development of a thin neo-intima, 3) rapid and complete endothelialization of the flow surface, 4) good viability of the inner layers and 5) solid anchorage to peri-graft tissues.

Experimental determination of the operative parameters for a double antibody solid phase radioimmunoassay of luteinizing and follicle-stimulating hormones in serum.

The experimental parameters of a Double Antibody Solid Phase (DASP) radioimmunoassay (RIA) for the determination of serum luteinizing (LH) and follicle-stimulating (FSH) hormones, are described. The lowest detection limits can be fixed at about 20 pg LH and about 10 pg FSH. Evidence of parrallelism among the dose-response curves and the dilution curves of different sera is provided for FSH-RIA and for about 92% of the tested sera for LH-RIA. The antisera dilution curves are reported (final titres: (/160 - 10(3) for anti-LH and 1/40 - 10(3) for anti-FSH). The traditional cross-reaction study in buffer indicates that 5.38 and 46.8) muU TSH/ml mimic 1 ng LH/ml and 1 ng FSH/ml respectively. The regression-line equations of antigen recovery (f = found, e = expected) are: lH f = 0.94 LH e + 0.91 and FSH f = 1.05 FSH e + 0.17; the same equations when TSH is added become: LH f = 1.30 LH e + 1.46 and FSH f = 1.40 FSH e -- 0.37. It is concluded that LH-RIA is interfered by TSH over 8-10 muM TSH/ml and in function of TSH concentration; FSH-RIA is not interfered by TSH up to 4-5 ng FSH/ml; for higher FSH levels, TSH interferes according to a linear law (angular coefficient 1.40) and not in function of its concentration. LH and FSH levels throughout normal menstrual cycle in follicular phase, centre peak and luteal phase are: 3.14 +/- 1.16, 16.71 +/- 12.99, 2.31 +/- 1.04 ng LH/ml (mean +/- 2SD) and 3.57 +/- 0.95, 5.72 +/- 2.90, 2.57 +/- 0.80 ng FSH/ml (mean +/- 2SD) respectively. Finally, the within-assay coefficient of variation is 7.65% for LH-RIA and 3.16% for FSH-RIA.

Surface immunofluorescence assay for diagnosis of Lyme disease.

A surface immunofluorescence assay (SIFA) was analyzed and compared with a conventional indirect immunofluorescence assay (IFA) and whole-cell enzyme-linked immunosorbent assay (ELISA) for detecting immunoglobulin G (IgG) antibodies to Borrelia burgdorferi in sera from patients with Lyme disease. Fifty-five patients with syphilis and 33 patients with rheumatoid arthritis were used as disease controls. The sensitivity of the SIFA was low during the acute phase of Lyme disease (sera from seven of nine patients presenting with erythema chronicum migrans were negative during the first 2 months of illness); later, seroconversion was observed in all patients at various times during convalescence. Sera from five patients with complicated Lyme disease were strongly positive. SIFA was found to be highly specific, since sera from all patients with secondary or latent syphilis and patients with rheumatoid arthritis did not react in the test. Strong cross-reactivity occurred when these sera were tested in conventional IFA and ELISA; sera from 38 (69%) patients with syphilis were positive by IFA and sera from 51 (93%) patients were positive by ELISA, whereas 7 (21%) and 12 (36%) of the serum samples from patients with rheumatoid arthritis were positive by IFA and ELISA, respectively. Immunoblot analysis of SIFA-positive sera showed that the 31- and 34-kDa outer surface proteins (proteins A and B, respectively) of B. burgdorferi were the major reactive antigens involved in the test. The results support a role for SIFA in the investigation of complicated Lyme disease as well as in the differentiation of Lyme disease from other diseases associated with B. burgdorferi cross-reactive antibodies.

Tatamento endourologico da estenose ureterointestinal / Endourologic treatment of ureterointestinal

Dez pacientes com estenose ureteroiintestinal foram tratados por tecnica endourologica endoscopoco compreendeu dilataçao endoscopica com balao (5 casos), incisao com faca fria (2 casos) e dilataçao precedida por incisao com eletrodo (2 casos). Os autores discutem a indicaçao, evoluçao e as tecnicas endoscopicas para tratamento da afecçao.