A multicenter observational study on Medication-Related Osteonecrosis of the Jaw (MRONJ) in advanced cancer and myeloma patients of a cancer network in North-Western Italy.

BACKGROUND: Incidence of Medication-Related Osteonecrosis of the Jaw (MRONJ) related to cancer and myeloma treatments is undetermined, with scarce data varying from 2 to 7.8/million/year in limited investigated populations. A 9-years [2009-2018] regional-wide survey was conducted, deploying the North-Western Italy Cancer Network ("Rete Oncologica Piemonte e Valle d'Aosta"), to assess number and main characteristics of MRONJ cases among myeloma/cancer patients, within a population of 4.5 million inhabitants. MATERIAL AND METHODS: MRONJ cases were collected retrospectively from January 2009 to June 2015; from July 2015 to December 2018, data were collected prospectively. Number of new MRONJ cases per year, underlying disorder, drug(s) administered, treatment duration, site and onset timing of MRONJ were detailed. RESULTS: 459 MRONJ cases were identified. Primary diseases were breast cancer (46%), prostate cancer (21%), myeloma (19%), and other types of carcinoma (14%). Patients received antiresorptive treatment either alone (399; 88.47%) or in combination with biological agents (52; 11.53%); 8 patients (1.7%) received only antiangiogenic drugs. Zoledronic acid [388] and denosumab [59] were the most frequently administered drugs. Mandible was involved in 296 (64,5%) cases. Number of new MRONJ cases was stable from 2009 to 2015, with a mean of 51.3 cases per year (raw incidence: 11.6/million/year), declining in the 2016-2018 years to 33.3 cases per year (raw incidence: 7.5/million/year). CONCLUSIONS: With such discrepancy of cases overtime being partially explicable, number of new MRONJ cases per year are consistent with those observed in a previous study [2003-2008] in the same region, being instead higher than those reported in other populations.

Pulsatile electrical impedance response from cerebrally dead adult patients is not a reliable tool for detecting cerebral perfusion changes.

The original objective of this work was to verify the possibility of using electrical pulsatile cerebral impedance measurements as a diagnostic aid for assessing the brain-death condition in adults; a subordinate target was to validate a simple method for detecting perfusional changes in the brain. To this end, impedance signals were recorded, for a comparative study, from both live subjects and brain-dead patients, using a simple four-electrode arrangement. Rather unexpectedly, pulsatile transcephalic impedance waveforms exhibiting a temporal dependance similar to those of live subjects were detected in artificially ventilated, cerebrally dead, adult subjects; distributions of the time delays between impedance peaks and ECG peaks were also recorded for the two groups (dead and live subjects). These data provided no evidence, at the 1% significance level, against the hypothesis that the two sample groups are drawn from identical populations. The detection of impedance variations from brain-dead patients can be explained by the residual persistence of blood flow through the scalp, by mechanical variations synchronous with the heart beat and by the presence of the oscillating flow and the systolic spikes that precede the final blood flow arrest. The fact that impedance variations can be traced back to a multiplicity of causes, unrelated to the normal unidirectional flow, renders the transcephalic impedance method inappropriate for detecting cerebral perfusion changes in adults. This conclusion is also strengthened by some theoretical results recently derived from a multilayer model of the head.

Real-time spectral analysis of HRV signals: an interactive and user-friendly PC system.

We present a real-time system, built around a PC and a low-cost data acquisition board, for the spectral analysis of the heart rate variability signal. The Windows-like operating environment on which it is based makes the computer program very user-friendly even for non-specialized personnel. The Power Spectral Density is computed through the use of a hybrid method, in which a classical FFT analysis follows an autoregressive finite-extension of data; the stationarity of the sequence is continuously checked. The use of this algorithm gives a high degree of robustness of the spectral estimation. Moreover, always in real time, the FFT of every data block is computed and displayed in order to corroborate the results as well as to allow the user to interactively choose a proper AR model order.

Cerebral blood-flow monitor for use in neonatal intensive care units.

The implementation of a real-time multichannel system for monitoring cerebral blood-flow is described. The instrument relies on a completely modular architecture and is based on the principle of measuring the electrical impedance between a number of periodically sensed electrode pairs positioned around the subject's head. The whole setup is controlled by a host computer that performs several functions, such as real-time acquisition, analysis, display and data logging. Two operating options can be chosen by the user: a normal mode that allows continuous monitoring and a triggered mode in which the measurement cycle is automatically started by the occurrence of a preset condition in some other circulatory signal, e.g. the permanently available ECG signal. The design is considerably user-friendly and embodies a number of special safety precautions to take account of the peculiar condition of patients, usually newborn infants hospitalized in intensive care units.

An instrument for real-time spectral estimation of heart rate variability signals.

A Digital Signal Processor (DSP)-based instrument is proposed for estimating and displaying the Heart Rate Variability (HRV) spectrum in real-time. It consists of an intelligent module which is properly interfaced to an IBM PC and whose operations are independent from the computer's other tasks. In this way, the simultaneous recording of the ECG sequence, needed for the more complete off-line analysis, can be performed by the same host. The employed hybrid spectral estimator (in which a classical FFT analysis follows the autoregressive extrapolation of data) appears to be the most apt for the present fixed point arithmetics implementation. The reliability of the instrument and its accuracy are checked both with suitable test signals and by comparison with the results obtained through off-line analysis of the same ECG tracks. The instrument is presently used for cardiovascular investigations, in particular for quickly picking patients with cardiac autonomic neuropathy (CAN) out of a population of diabetic subjects.

[The clinical evaluation of acetoxyethylcefuroxime in dentistry]. / Valutazione clinica dell'acetossietilcefuroxima in campo odontoiatrico.

The study examines the use of an oral antibiotic with a wide spectrum of action tested in dentistry belonging to the cephalosporin class: acetoxyethylcefuroxime. The pharmaceutical industry has succeeded in synthesising a prodrug of parenteral cephalosporin "Metoxyrinic cefuroxime sodium", thus resolving the problems presented by earlier molecules such as: scarce bioavailability, poor palatability and collateral effects at a gastroenteric level. This is a 2nd generation cephalosporin whose mechanism of action consists in the capacity to selectively block the synthesis of the peptidoglycan, a fundamental component of the cell wall of both Gram+ and Gram- bacteria. The study, which was performed in the Division of Odontostomatology of the Mauriziano Hospital in Turin, examined 59 patients suffering from some of the most commonplace dental pathologies such as: apical periodontitis-alveolitis-odontogenic abscesses-eighth teeth in dysodontiasis-maxillary cysts. The following clinical parameters were evaluated in both outpatients and those undergoing surgery: swelling, pain, lymphoadenopathy at the start of treatment, and at days 3 and 5 of treatment. A 250 mg tablet was administered every 12 hours for 5 days. Owing to the rapid resolution of symptoms and the limited collateral effects observed, the authors conclude that the drug may be regarded as the elective form of treatment.

[Paget's disease with an exclusively maxillary location. A case report]. / Malattia di Paget ad esclusiva localizzazione mascellare. Descrizione di un caso.

The authors illustrate a case report of Paget's disease in an exclusively cranio-facial localisation. Paget's disease is a dystrophy of an osteo-condensing type. Excess bone remodelling activity, due primarily to hyperclastic hyperactivity, leads to accelerated resorption and excess tissue formation. This marked alteration of the metabolism causes the hypertrophy of the bones involved, with zones of greater density and increased vascularisation. Its clinical manifestations include morphological deformations and painful symptoms in the areas affected. Complications may include pathological fractures, medullary or radicular compression, heart failure (rare), sarcomatous transformation (approximately 1% of cases). The case reported here describes a 70-year-old who was admitted to the out-patient clinic of the Odontostomatological Division of the Ospedale Mauriziano in Turin for a dental check up. The patient had had 6 teeth removed during the past 2 weeks in a private clinic. At the time of the control a mucous crater was present, also involving the underlying bone, at the level of the extracted 2.6 tooth. The patient had kept the teeth which had been removed some of which showed that the roots were surrounded by alveolar bone. A dental panoramic x-ray and cranial x-ray were performed using 3 projections and showed the remodelling of the cranial theca and upper jaw. The suspicion of Paget's disease was confirmed by hematochemical tests, bone scintigraphy with calcium phosphate and by the histologic examination of the alveolar bone fragments adhering to the root surface of the extracted teeth.(ABSTRACT TRUNCATED AT 250 WORDS)

[The dental patient and diabetes mellitus. The practical indications to be followed in the case of minor oral surgery and extractive surgery]. / Paziente odontoiatrico e diabete mellito. Indicazioni pratiche da seguire in caso di interventi di piccola chirurgia orale e di chirurgia estrattiva.

Certain general aspects of diabetes mellitus (DM) and the diagnostic procedures for assessing metabolic compensation are reviewed. A series of indications to be followed in dental treatment in the DM patient is then reviewed in order to avoid complications.

Measurement of zero-count probability in photoelectron statistics.

The probability of zero-count P(0)(T) (as a function of the counting interval T) is one of the most interesting functions characterizing a light field. Experimentally, P(0)(T) is usually obtained by measuring successively the zero-count probability for a set of different intervals. This procedure exposes the measurement of P(0)(T) to errors imputable to drift. We present a simple zero-counter which is essentially free from drift effects and displays P(0)(T) directly on the CRT of an oscilloscope for sixteen values of T. Another advantage of the instrument is a conspicuous reduction of the overall measuring time.

Triggering techniques in triggered photon-counting.

In the measurement of triggered photon-counting distributions (TPCDs) the triggering pulse which starts a collecting interval may be picked up according to different random procedures. We investigate, both theoretically and experimentally, the extent to which TPCDs are affected by the choice of the triggering pulses. It turns out that in ordinary conditions the measured distribution may be significantly influenced by the triggering procedure. This result is another manifestation of the bunching effect and indicates that a great deal of attention should be exercised in performing and interpreting triggered photon-counting.

Multipurpose analyzers for photoelectron statistics: implementation and use.

The statistical properties of variously scattered laser light can be derived from photocount data through the estimate of different functions. Even if the second-order correlation usually plays the main role, other function (e.g., triggered and nontriggered distributions, moments of various order, and higher-order correlations) may give more appropriate results in many experimental conditions. We present a multifunction analyzer whose working principle is based on the acquisition of a long sequence of interpulse intervals (through a circuitally simple personal-computer front-end interface), which is followed by the off-line calculation of one or more of the functions for which an algorithm is available. Up to 5 × 10(5) photopulse intervals can be recorded at a maximum rate of approximately 2 × 10(5) data points/s. A short description of the algorithms used to calculate the different functions is given together with some useful hints and a table of typical processing times.

[Presence and type of fillings found in a group of 531 school aged children]. / Presenza e tipo di otturazioni riscontrate in una popolazione di 531 bambini in età scolare.

An epidemiological investigation carried out in a population of children aged between six and twelve is reported. The relationship between caries and type of filling encountered was analysed.

[Evaluation of the plaque-periodontal disease relation in a homogeneous group of 531 school aged children]. / Valutazione del rapporto placca-malattia parodontale su un campione omogeneo di 531 bambini di età scolare.

The data collected in a sample of 531 pupils of the primary schools of Val Pellice aged between 7 and 10 have been examined. These data suggest with sufficient reliability that periodontal disease is a threat even in this age segment.

[Computerization of an epidemiological record model. The computer in the epidemiology of dental disease]. / Computerizzazione di un modello di scheda epidemiologica. L'informatica nell'epidemiologia delle malattie dentarie.

A new method for computerized epidemiological data is proposed. Personal experience in a study of 531 children of school age from the Val Pellice is reported.

[Study of oral hygiene in a group of 531 children using OHI-S]. / Studio dell'igiene dentale in una popolazione di 531 bambini secondo l'OHI-S.

An analysis of the results of an epidemiological study on 531 children aged between 7 and 10 and resident in the mountain district of Val Pellice is presented. Special reference is made to the bacterial plaque and tartar.

[DMFT. Relations between different epidemiological studies]. / DMFT. Rapporti fra diversi studi epidemiologici.

An epidemiological study was carried out on a sample of 531 children aged between 7 and 10 in Val Pellice (TO). Analysis of their DMFT showed-data that were no different to those reported in similar studies carried out in Northern Italy.

Edge-detection schemes highly suitable for hardware implementation.

Two schemes for edge detection of real images based on gradient maxima are presented. Images are filtered with narrow filters to increase localization. Experimental results and theoretical considerations suggest that the exact shape of the filter is not critical for good performance of the algorithm. Therefore a filter can be chosen to allow for a highly efficient hardware implementation, for example, a binary filter or a 4-bit finite-impulse-response filter. Because the digitized values of a binary filter are powers of 2, the hardware implementation does not require time-consuming computations, such as multiplication and time shift, but just appropriate addressings. The performance of this scheme, or a similar scheme using 4-bit filters, is as satisfactory as that of more sophisticated schemes. Therefore these low-cost schemes are likely to be more suitable for hardware implementation.

Measurements of surface roughness: use of a CCD camera to correlate doubly scattered speckle patterns.

We describe an instrument, built around a commercial CCD camera and some fast image-processing boards, that evaluates roughness height by measuring the average size of doubly scattered speckle patterns. The device is a variant of a recent proposal that was based on the use of a spatial modulator to perform the Fourier transform of a speckle image. In the present setup, the Fourier transform is replaced by the direct evaluation of a second-order correlation function. Strictly speaking, the device proposed in this paper is not a real-time device but its response time (approximately 10 s) is sufficiently short to be of practical value for many applications. Updated CCD cameras that will significantly improve the performance of our prototype are already on the market.