Physical and chemical mechanisms involved in adhesion of orthodontic bonding composites: in vitro evaluations.

BACKGROUND: Bond strength of orthodontic composite is strongly influenced by molecular and structural mechanisms. Aim of this in vitro study was to compare bond strength of light-cure orthodontic composites by measuring debonding forces and evaluating locations of bond failure. Investigations on chemical compositions clarified adhesive behaviors and abilities, exploring effects of ageing processes in this junction materials. METHODS: Twelve enamel discs, from human premolars, were randomly coupled to one orthodontic adhesive system (Transbond XT™ 3 M UNITEK, USA, Light-Cure Orthodontic Paste, LEONE, Italy and Bisco Ortho Bracket Paste LC, BISCO, Illinois) and underwent to Shear Bond Strength test. Metallic brackets were bonded to twenty-seven human premolar, with one of the adhesive systems, to quantify, at FE-SEM magnifications, after debonding, the residual material on enamel and bracket base surfaces. Raman Spectroscopy analysis was performed on eight discs of each composites to investigate on chemical compositions, before and after accelerated aging procedures in human saliva and sugary drink. RESULTS: Orthodontic adhesive systems showed similar strength of adhesion to enamel. The breakage of adhesive-adherent bond occurs in TXT at enamel-adhesive interface while in Bisco and Leone at adhesive-bracket interface. Accelerated in vitro aging demonstrated good physical-chemical stability for all composites, Bisco only, was weakly contaminated with respect to the other materials. CONCLUSION: A similar, clinically adequate and acceptable bond strength to enamel for debonding maneuvers was recorded in all orthodontic adhesive systems under examination. No significant chemical alterations are recorded, even in highly critical situations, not altering the initial mechanical properties of materials.

[Telemedicine: a Proxemics tool of Primary Care?] / La telemedicina: uno strumento di prossemica dell'assistenza territoriale?

The impact of demographic and sociopolitical phenomena such as population aging, economic and social changes derivinf from globalization and the pervasiveness of information technologies, require innovative and efficient responses to new health needs, characterized by the increase o in the numer of healthcare procedures and its complexity. The COVID 19 has had a negative impact on the that context. This paper demonstrates that the telemdicine enables to optimize resources, as well as to ensure the distancing and delivery times of services. The telemedicine in the time of COVID is the new proxemics tool of Primary care.

A single-nucleotide polymorphism in the canine cytochrome b5 reductase (CYB5R3) gene is associated with sulfonamide hypersensitivity and is overrepresented in Doberman Pinschers.

Canine sulfonamide hypersensitivity (HS) has been associated with a variant in the cytochrome b5 reductase gene (CYB5R3 729A>G), which encodes a drug-detoxifying enzyme. Study objectives were to determine variant allele frequency in Doberman Pinschers (DOBE), a breed which may be predisposed to sulfonamide HS, and to characterize the effects of CYB5R3 729G on gene expression and function. CYB5R3 729A>G allele frequencies were compared between DOBE (n = 24) vs. non-Doberman (non-DOBE; n = 60) dogs. CYB5R3mRNA expression, protein expression, and reduction of sulfamethoxazole hydroxylamine were compared between banked canine liver samples of 729AA vs. GG genotype. The 729G allele was overrepresented in DOBE (1.00) vs. non-DOBE dogs (0.567, p < .0001). mRNA and protein expressions as well as cyt b5 reductase activity were similar between livers of AA and GG genotype. All Doberman Pinschers in this study were homozygous for CYB5R3 729G, which could contribute to this breed's apparent predisposition to sulfonamide HS. However, CYB5R3 729G does not alter sulfamethoxazole detoxification capacity, so a direct role could not be demonstrated. It is possible that this marker is linked to another contributing variant.

Advanced chondrosarcomas: role of chemotherapy and survival.

BACKGROUND: There are limited data about the role of chemotherapy in patients with advanced chondrosarcomas. METHODS: The medical charts of 180 patients with advanced chondrosarcomas having received chemotherapy in 15 participating institutions between 1988 and 2011 were reviewed. RESULTS: Median age was 52 years. Sixty-three percent of patients had conventional chondrosarcoma and 88% had metastatic disease. Combination chemotherapy was delivered in 98 cases (54.5%). One hundred and thirty-one patients (73%) received an anthracycline-containing regimen. Using RECIST, the objective response rate was significantly different according to histological subtype, being 31% for mesenchymal chondrosarcoma, 20.5% for dedifferentiated chondrosarcoma, 11.5% for conventional chondrosarcoma and 0% for clear-cell chondrosarcoma (P = 0.04). Median progression-free survival (PFS) was 4.7 months [95% confidence interval (CI) 3-6.5]. Performance status (PS) ≥2, number of metastatic sites ≥1 and single-agent regimen were independently associated with poor PFS. Median overall survival (OS) was 18 months (95% CI 14.5-21.6). PS, number of metastatic sites and palliative surgery were independently associated with OS. CONCLUSIONS: Conventional chemotherapy have very limited efficacy in patients with advanced chondrosarcoma, the highest benefit being observed in mesenchymal and dedifferentiated chondrosarcoma. These data should be used as a reference for response and outcome in the assessment of investigational drugs in advanced chondrosarcoma.

Attitudes of Italian Infertile Women Toward Ethical and Regulatory Limits of Medically Assisted Procreation (MAP).

Objective: Outline the views of Italian women, with fertility problems, on Medically Assisted Procreation. Methods: We have collected the opinions of 448 infertile women. The items used in the questionnaire were created with a qualitative method based on the Medically Assisted Procreation's most important bioethics issues and on the basis of the limits imposed by Law. The questions of the first part of the questionnaire were open; in the second part was closed ("Yes/No"); for each method they were asked whether they would introduce a legal limit to prohibit it. The tests have been standardized with test-retest method. Results: We found that much of the disputes that have, over time, been made to Law 40 of 2004 by Italian Courts, are shared by patients with infertility problems. Italian women do not share the legal limit for Medically Assisted Procreation in over 43 women, heterologous in-semination with seed donation and egg donation. Moreover, our sample show that Italian women do not share legal limit to pre-implantation genetic diagnosis and cryopreservation of embryos. Moreover, it emerges that many Italian infertile patients disagree with the Medically Assisted Procreation for homosexual couples. Conclusion: It will be important, in the event of a legislative reform in Italy on the Medically Assisted Procreation, also consider the point of view of women with infertility problems.

Advanced well-differentiated/dedifferentiated liposarcomas: role of chemotherapy and survival.

BACKGROUND: Data regarding the role of systemic therapy in patients with advanced well-differentiated/dedifferentiated liposarcomas (WDLPS/DDLPS) are limited. METHODS: From 2000 to 2010, 208 patients with advanced WDLPS/DDLPS received chemotherapy in 11 participating institutions. Clinical and pathological data were collected by reviewing medical records. RESULTS: Median age was 63 years (range 32-84). Combination chemotherapy was delivered in 85 cases (41%) and single agent in 123 cases (59%), respectively. One hundred and seventy-one patients (82%) received an anthracycline-containing regimen. Using RECIST, objective response was observed in 21 patients (12%), all treated with anthracyclines. Median progression-free survival (PFS) was 4.6 months [95% confidence interval (CI) 3.3-5.9]. On multivariate analysis, age and performance status (PS) were the sole factors significantly associated with poor PFS. Median overall survival (OS) was 15.2 months (95% CI 11.8 -18.7). On multivariate analysis, grade and PS were the sole factors significantly associated with OS. CONCLUSIONS: Chemotherapy was associated with clinical benefit in 46% of patients with advanced WDLPS/DDLPS. OS remains poor, even though visceral metastatic disease is less frequent than in other sarcomas.

Use of piezosurgery device in management of oral surgery complications: clincal case and clinical experience report.

The root displacement into the maxillary sinus could be a complication of oral surgery in the upper jaw. In these cases, the root removal is needed in order to avoid the occurrence of sinus pathologies. Piezosurgery techniques could assure a safer management of such complications, because of the clear surgical visibility and the selective ability of cut. The aim of this article is to present a case of oral surgery complication (root displacement in the right maxillary sinus), in which piezosurgery technique helped for a correct and safe clinical management, allowing to reduce the soft tissue damage.

Sars-CoV-2 Infection After Lung Transplantation: Is There Professional Liability?

Abstract: For the first time in the literature, a case of Sars-Cov-2 infection after lung Transplantation has been described. This case, particularly rare, brought attention on the in-depth screening for Sars-CoV-2 on lung donor. In addition to infectious problems, it is important to focus attention on medico-legal issues related to this case. In fact, from the point of view of professional responsibility, in theory, there could be criteria for identifying professional responsibility. The author analyzes the possible presence of medical liability in this specific case.

COVID-19 Pandemic and Balance of Constitutional Rights.

ABSTRACT: In 2020 the World Health Organization declared the Covid-19 to be a pandemic. Governments around the world are facing a tough challenge that could jeopardise the national healthcare systems. Safeguarding the rights of Covid patients and all citizens - especially those who are now even more vulnerable than they were before - is part of this challenge. This work aims to examine the issues arising from the current emergency in terms of how individuals' constitutional rights have been balanced and how much people at the highest risk amid this pandemic - the homeless, the inmates in prison, geriatric and psychiatric patients, and doctors on the Covid frontline - have been protected. This analysis focuses mostly on one of the worst-hit countries by the SARS-CoV-2: Italy.

Evaluating urinary continence and preoperative predictors of urinary continence after robot assisted laparoscopic radical prostatectomy.

PURPOSE: We evaluated urinary continence using a validated questionnaire in a series of consecutive patients who underwent robot assisted laparoscopic radical prostatectomy, and identified the preoperative predictors of the return to urinary continence. MATERIALS AND METHODS: The clinical records of 308 consecutive patients who underwent robot assisted laparoscopic radical prostatectomy for clinically localized prostate cancer at a tertiary academic center were prospectively collected. All patients were continent before surgery. Urinary continence was evaluated using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form instrument. All of the patients reporting no leak in response to the question, "How often do you leak urine?" were defined as continent. RESULTS: A total of 273 patients (90%) were continent 12 months after robot assisted laparoscopic radical prostatectomy. Continent patients were significantly younger (61.4 +/- 6.4 vs 64.1 +/- 6.1 years, p = 0.02) than those who were incontinent. On univariable regression analysis patient age at surgery (OR 1.075, p = 0.024) and Charlson comorbidity index (OR 1.671, p = 0.007) were significantly associated with 12-month continence status. On multivariable analysis age (OR 1.076, p = 0.027) and Charlson comorbidity index (OR 1.635, p = 0.009) were independent predictors of continence rates. CONCLUSIONS: Using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form 90% of patients undergoing robot assisted laparoscopic radical prostatectomy reported no urine leak 12 months after surgery. Patient age at surgery and Charlson comorbidity index were independent predictors of the return to urinary continence, whereas notably no variable related to prostate cancer was significantly correlated with urinary continence.

The decline of COVID-19-related deaths and the risk of underestimating the pandemic.

COVID-19 pandemic has put a strain on the stability of National Health Systems and society itself. The decline in COVID-19-related mortality is positive. However, we do not know the reason for this decline associated with a rise in infection in many countries of the world. For these reasons, this is not the time to lower our guard and excessively reduce preventive strategies against COVID-19.

La pandémie de COVID-19 a mis à rude épreuve la stabilité des systèmes de santé nationaux et de la société elle-même. La baisse de la mortalité liée aux COVID-19 est positive. Cependant, nous ne connaissons pas la raison de cette diminution associée à une contagion dans de nombreux pays du monde. Pour ces raisons, le moment n'est pas venu de baisser la garde et de diminuer excessivement les stratégies préventives contre le COVID-19.

Apps for COVID-19 contact-tracing: Too many questions and few answers.

Recently, for the second phase of prevention of the COVID-19 Pandemic, it is being assumed the use of an app for the prevention of infections COVID-19. The utility of these apps is not yet proven and the apps for COVID-19 contact-tracing probably cannot be used as a preventive tool until the bioethics and legal issues related to their use are resolved.

Récemment, pour la deuxième phase de la prévention de la pandémie de COVID-19, on suppose l'utilisation d'une application pour la prévention des infections COVID-19. L'utilité de ces applications n'est pas encore prouvée et les applications pour le suivi des contacts COVID-19 ne peuvent probablement pas être utilisées comme un outil préventif tant que les problèmes de bioéthique et juridiques liés à leur utilisation ne sont pas résolus.

Letter to the editor in response to "Is it time for international guidelines on physical restraint in psychiatric patients?"

The Mastrogiovanni case was a revolutionary case in the field of Italian forensic psychiatry. A recent judgment of the Court of Cassation has defined what the legal limits of mechanical restraint should be. On the other hand, even today, there is a gap in the scientific community about the presence of guidelines governing mechanical restraint. It is probably time to create specific guidelines to protect the psychiatric patient and the mental health worker.

Use of starter cultures of dairy origin in the production of Salame nostrano, an Italian dry-cured sausage.

The aim of this study was the evaluation of the use of selected lactic acid bacteria (LAB) starter culture of dairy origin in the production of low-acid fermented sausages (Salame nostrano) produced in a small-scale plant in Umbria (Italy), and their effect on microbiological, physico-chemical and sensorial properties of the products. Salame nostrano was obtained with two different technological processes: with and without the addition of selected LAB starter cultures. Microbial counts of safety indicators were lower in salami made with the addition of starter cultures. Pathogens after the first week of ripening were only detected from salami made without the addition of starter cultures. Control salami were rated as paler and harder, whereas those made with the addition of starter cultures as slightly saltier, juicier and in general more acceptable. Selected dairy-origin starter (SDS) cultures did prevent the growth of safety indicators, greatly reduced the rate of isolation of pathogens and increased the acceptability of full-ripened salami.

An in vitro system for the comparison of excision and wet-dry swabbing for microbiological sampling of beef carcasses.

An in vitro system for the comparison of wet-dry swabbing and surface tissue excision was developed to ascertain whether the commonly accepted statement of the advantage (in terms of bacterial recovery) of the tissue excision method is also legitimate when different kinds of bacteria are used. A total of 1,770 sections (2.5 by 10 cm) of bovine skin were individually inoculated on the subcutaneous fat side by spreading various suspensions of marker organisms (nalidixic acid-resistant Escherichia coli, vancomycin-resistant Enterococcus faecalis, and methicillin-resistant Staphylococcus aureus) at different concentrations and sampled by two standard methods: cotton wet-dry swabbing and excision. Most counts from cuts sampled by excision were significantly (P < 0.05) higher than the wet-dry swabs; however, no differences were observed between the control and the sampling method when sections were inoculated with bacterial solutions at a concentration of 10(3) CFU/ml and sampled by excision. For sections inoculated with bacterial solutions at a concentration of 10(3) CFU/ml, counts given as log CFU/25 cm2 ranged from 1.97 (S. aureus sampled by wet-dry swab) to 3.06 (S. aureus sampled by excision). For sections inoculated at a concentration of 10(4), counts given as log CFU/25 cm(2) ranged from 2.15 (E. faecalis sampled by wet-dry swab) to 3.19 (S. aureus sampled by excision). For sections inoculated at 10(5), counts given as log CFU/25 cm(2) ranged from 2.94 (E. faecalis, wet-dry swab) to 3.98 (S. aureus, excision), and for sections inoculated at 106, counts given as log CFU/25 cm(2) ranged from 3.53 (E. coli, wet-dry swab) to 4.69 (S. aureus, excision). The proposed system, which enabled a considerable amount of samples to be analyzed under controlled experimental conditions and a large number of data to be generated in a short time, demonstrated among the tested microorganisms that whereas the excision method recovered the highest number of bacteria, control means were always (with the exception of an inoculum of 10(3)/ml) significantly higher than means from either of the sampling methods. Our results indicate that particular attention should be paid to the diverse microflora that can contaminate carcasses in a given slaughterhouse and that it is not appropriate to generalize by saying that the destructive method is the reference technique for the bacteriological sampling of carcasses in slaughterhouses, especially when the contamination is higher than 10(3) CFU/25 cm(2).

[Sacrococcygeal chordoma: clinico-radiologic and histologic characteristics]. / Cordoma sacrococcigeo: aspetti clinico-radiologici e istologici.

Chordoma is a rare, slow-growing, malignant tumor which usually localizes in the sacrococcygeal area. The authors report the case of a 36-year-old woman treated by sacral resection by a posterior approach. At admission, the patient reported a 5-month history of sacral pain. Digital rectal examination revealed a presacral mass. CT and above all MR revealed the presence and the precise extent of the mass which involved the last sacral vertebra and the coccyx. Diagnosis was confirmed histologically. Bilateral S-3 nerve roots were preserved. No radiotherapy was given. After 4 years the patients is free of disease.

[Alcohol-related liver diseases in the aged]. / Patologia epatica alcool-correlata nell'anziano.

In these last years the authors have devoted themselves to chronic alcoholism rehabilitation. They have studied 99 over 65 years old subjects. In these subjects gastrointestinal pathology alcohol correlated incidence has been studied. An abdominal echography and an esophagogastroduodenoscopy have been performed in all these subjects. In some subjects, on the guide line of these tests, the authors have put through more tests: hepatosplenic scintigraphy, hepatic biopsy, laparoscopy, colonoscopy. Statistic elaboration was performed by chi-square test. The conclusions of this study are: 1) the diagnostic importance of association between echography and scintigraphy; 2) the low prevalence of severe hepatic alcohol related lesions in the elderly; 3) the importance of alcohol in hepatocarcinoma etiopathogenesis; 4) the incidence and the importance of phlogistic and ulcerous gastroduodenal lesions in elderly alcoholics.

Sealants in dentistry: a systematic review of the literature.

UNLABELLED: The occlusal surface is the most affected area by dental caries and the sealing of the pits and of the fissures has been found, in time, the preventive method most effective trying to counteract the onset. Currently, the WHO considers it as a primary preventive measure, in other words one of the most effective and least invasive available to ensure the complete protection and the total preservation of the occlusal carious by the phenomenon. PURPOSE: THE AIM OF THIS WORK HAS BEEN TO PERFORM A SYSTEMATIC REVIEW OF THE LITERATURE ON CLINICAL TRIALS OF DIFFERENT SEALING MATERIALS, IN ORDER TO: compare their individual characteristics, highlight the reliability and the long-term efficacy and identify the most significant variables, both technological and clinics, in order to declare whether or not the success of this method prior. MATERIALS AND METHODS: The research has been carried out in the MEDLINE database by choosing keywords as "sealants" and "follow up". Only studies published in the last thirteen years have been considered and have been evaluated only types of scientific articles that fall within the definition of Anglo-Saxon "Clinical Trial" and "Controlled Clinical Trial", excluding all experimental works in vitro, case-reports, meta-analyzes and literature reviews. Have been also considered only scientific papers on patients between the ages of 0 and 18 years. RESULTS: Out of 29 studies, evaluating a total of 2900 individuals (aged between 2.5 and 17 years), 7411 seals made by using resin-based sealants (RB Sealants), modified glass ionomer sealants (RMGI) and compomer sealants have been analyzed. The best retention capacity of the material in time has been obtained from the use of RB Sealants compared to RMGI, demonstrating retention values much lower with partial loss of material at a distance of one year from the clinic. The compomers demonstrate retention values intermediates. The incidence of caries in a year is negligible for all sealants application. CONCLUSIONS: In terms of retention, resin-based sealants (RB Sealants) are the materials that give more guarantees of success at 12 months, while in the same period there haven't been significant differences in caries prevention of disease among the various classes sealing materials analyzed.