Implant-prosthetic rehabilitation of the atrophic posterior mandible with additively manufactured custom-made subperiosteal implants: a cohort study.

The aim of this study was to retrospectively analyse a series of patients with posterior mandibular atrophy rehabilitated with custom-made subperiosteal implants. The study included patients with severe posterior mandibular atrophy who had undergone rehabilitation with subperiosteal implants between September 2018 and August 2022 in the Maxillofacial Surgery Operative Unit of the University Hospital of Sassari. Complications and the success rate were reviewed. Data from 30 implants placed in 17 patients were included and analysed. There were no major complications during the surgeries. The main postoperative sequela was oedema, which was reported as moderate by most patients and had completely regressed within 10 days of surgery. No partial or complete exposures, infections, or loss of the implants were detected during follow-up (average follow-up 22.5 months). Control computed tomography scans, performed at 6 months and then annually in all cases, did not show significant bone loss below the abutments, displacement of the implants, or loss or loosening of the osteosynthesis screws. Subperiosteal implants may represent a safe and reliable technique for the rehabilitation of severe atrophy of the posterior mandible. Prospective studies with a long follow-up will be needed to establish the long-term results of this type of implant-prosthetic rehabilitation.

Effect of iron chelation on anti-pseudomonal activity of doxycycline.

BACKGROUND: Increasing resistance of microorganisms to antimicrobial agents is a growing concern and there is a lack of novel agents. This has stimulated the exploration of novel strategies for treatment of infection. OBJECTIVE: To investigate synergistic interactions between five tetracyclines and tobramycin with an iron chelator (CP762) against two reference strains and nine clinical isolates of Pseudomonas aeruginosa from cystic fibrosis patients. METHOD: Microdilution assays for minimal inhibitory concentration determination and checkerboard assays were used to assess synergy between antibiotics and CP762. Given the iron-binding capacity of tetracyclines, the binding of iron with doxycycline was investigated using Job's plot methodology. Synergy between the iron-bound form of doxycycline and CP762 was compared with that of unbound doxycycline and CP762. Enhancement of doxycycline anti-biofilm activity was also assessed. RESULTS: There was synergy between CP762 and all tetracyclines, except minocycline, against the reference strains but that against clinical isolates was variable. Synergy was not demonstrated for tobramycin against any of the strains tested. This led to the hypothesis that iron chelation preserves the binding of tetracyclines to the bacterial ribosome. Susceptibility to iron-bound doxycycline was decreased by two- to four-fold and synergistic interactions with the iron chelator were consistently more intense with iron-bound doxycycline than with doxycycline alone. The doxycycline-iron chelator combination also significantly reduced cell viability in established biofilms. CONCLUSION: The data in this study provide evidence that iron chelation enhances the anti-pseudomonal activity of tetracyclines, specifically doxycycline.

Malignant tumours of the parotid gland: management of the neck (including the clinically negative neck) and a literature review.

Major salivary gland malignancies are rare, constituting 1%-3% of head-neck tumours. The surgical management of the clinically negative neck (cN0) does not have a univocal consensus yet. We have carried out a retrospective study on 119 cases of malignant parotid tumours that were surgically treated between January 1999 and January 2014. Our aim was to analyse preoperative findings (cytotype, cTNM) and to correlate these with postoperative results (grading, histotype, occult neck metastasis) in patients with parotid tumours to obtain an appropriate indication for neck management. In cN0 patients with a T1, T2 low-grade cancer a wait-and-see approach is preferred. Instead, in cNO patients with high-grade or low-grade T3, T4 tumours an elective neck dissection (END) is always planned. Levels II, III and IV, at least, must be dissected. The decision to dissect level V or I depends on the location of the primary tumour. In the cN0 group 19 of 58 (32.7%) patients who underwent an END had occult metastases. In clinically positive neck (cN+) patients a Modified Radical Neck Dissection (MRND), at least, must be performed. The criteria to add adjuvant radiotherapy (PORT) include deep lobe parotid tumours, advanced lesions (T3-T4), microscopic (R2) or macroscopic (R1) residual disease after surgery, high grade tumours, perineural diffusion, lymph node metastasis, capsular rupture, and local recurrence after previous surgery. Kaplan-Meier analyses have shown a reduction in the overall survival (OS) from 100% to 91% and in disease-free survival (DFS) from 100% to 95.5% for the NO-PORT and PORT group, respectively. In our study, the cN0 pN+ patients had a higher degree of DFS compared to the cN+.

Effectiveness of endoscopic septoplasty in different types of nasal septal deformities: our experience with NOSE evaluation.

Septal deviations are the most frequent cause of nasal obstruction, and represent a common complaint in rhinologic practice. Since the first description of Lanza et al. in 1991, the use of the endoscope for the correction of septal deformities is increasingly more frequent. The purpose of this study is to evaluate the effectivenes of the endoscopic septoplasty for the correction of each of the 7 types of septal deformities according to the Mladina's classification. A retrospective chart review was performed in 59 consecutive patients presenting to our Department for Endoscopic Septoplasty from February 2012 to August 2014. For each deviation, descriptive statistics (mean and standard deviation, significant increase/decrease) was used to asses the corrective capacity and time-dependent effects at follow-up. This study shows that the corrective power of endoscopic septoplasty is different according to the type of deviation. To our knowledge this is the first study that evaluates the corrective capacity of this technique for each deviation by analysing pre- and postoperative objective outcomes as well as subjective outcomes gathered from the validated NOSE questionnaire. Even if endoscopic septoplasty may now be considered a reliable alternative to the classic technique, it is essential to identify the right deformity preoperatively in order to provide the correct therapeutic choice.

Solid-phase synthesis of Rhodamine-110 fluorogenic substrates and their application in forensic analysis.

A novel synthetic route for the rapid and efficient preparation of fluorogenic substrates utilizing Rhodamine-110 or similar fluorophores is reported. Applicability of the synthesized peptide substrate within a forensic casework context is also presented.

Transorbital transnasal endoscopic combined approach to the anterior and middle skull base: a laboratory investigation.

Orbital approaches provide significant trajectory to the skull base and are used with differently designed pathways. The aim of this study is to investigate the feasibility of a combined transorbital and transnasal approach to the anterior and middle cranial fossa. Cadaveric dissection of five silicon-injected heads was used. A total of 10 bilateral transorbital approaches and 5 extended endonasal approaches were performed. Identification of surgical landmarks, main anatomical structures, feasibility of a combined approach and reconstruction of the superior orbital defect were examined. Rod lens endoscope (with 0° and 45° lenses) and endoscopic instruments were used to complete the dissection. The transorbital approach showed good versatility and provides the surgeon with a direct route to the anterior and middle cranial fossa. The transorbital avascular plane showed no conflict with major nerves or vessels. Large exposure area from crista galli to the third ventricle was demonstrated with significant control of different neurovascular structures. A combined transorbital transnasal approach provides considerable value in terms of extent of exposure and free hand movement of the two surgeons, and allows better visualisation and control of the ventral skull base, thus overcoming the current surgical limits of a single approach. Combination of these two minimally invasive approaches should reduce overall morbidity. Clinical trials are needed to evaluate the virtual applications of this approach.

Anabolic steroids detected in bodybuilding dietary supplements - a significant risk to public health.

Twenty-four products suspected of containing anabolic steroids and sold in fitness equipment shops in the United Kingdom (UK) were analyzed for their qualitative and semi-quantitative content using full scan gas chromatography-mass spectrometry (GC-MS), accurate mass liquid chromatography-mass spectrometry (LC-MS), high pressure liquid chromatography with diode array detection (HPLC-DAD), UV-Vis, and nuclear magnetic resonance (NMR) spectroscopy. In addition, X-ray crystallography enabled the identification of one of the compounds, where reference standard was not available. Of the 24 products tested, 23 contained steroids including known anabolic agents; 16 of these contained steroids that were different to those indicated on the packaging and one product contained no steroid at all. Overall, 13 different steroids were identified; 12 of these are controlled in the UK under the Misuse of Drugs Act 1971. Several of the products contained steroids that may be considered to have considerable pharmacological activity, based on their chemical structures and the amounts present. This could unwittingly expose users to a significant risk to their health, which is of particular concern for naïve users.

Iron-sensitive fluorescent probes: monitoring intracellular iron pools.

Several iron-sensitive fluorophores have been investigated in a range of cell types in order to quantify iron(II) levels in the cytosol and the cytoplasm. Both iron(II) and iron(III) cause fluorescence quenching of these probes and changes in cytosolic iron levels can be monitored in a reproducible manner. However the precise quantification of iron(II) in the cytosol is complicated by the uncertainty of the structure of many of the quenched species that exist under in vivo conditions. Precise knowledge of these structures is essential for quantitative purposes. The lysosomal and mitochondrial iron pools have only been the subject of relatively few studies at the time of writing. Calcein-AM has been widely adopted for the monitoring of changes in iron levels in a range different cell types.

Use of the SMAS flap for reconstruction of the parotid lodge.

The purpose of our study was to evaluate the benefits of the SMAS flap in patients with benign tumours of the parotid gland treated by superficial parotidectomy. We carried out a retrospective chart review on 123 patients suffering from benign tumours of the parotid gland admitted to our Institution between March 1997 and March 2010. A superficial parotidectomy was performed in all the cases reported. Our sample was divided in two groups basing SMAS flap reconstruction done (Group 2) or not (Group 1) after superficial parotidectomy. Reconstruction using SMAS flap was accomplished in 64 patients. Chi-square test was used to assess statistical difference between the two groups. The level of statistical significance was P < 0.05. No significant differences concerning hematoma, wound infection and facial paralysis were observed between the first and second group (3.38 vs 1.56% [P > 0.05], 8.47% vs 4.68% [P > 0.05], 5.08% vs 0.00% [P > 0.05]). Transient facial nerve weakness, fistula, dip skin and Frey's syndrome were significantly more frequent without SMAS flap reconstruction (10.16% vs 3.125% [P < 0.05], 13.55% vs 3.125% [P < 0.05], 13.55% vs 3.125% [P < 0.05], 20.33% vs 0% [P < 0.05] respectively). The use of the SMAS flap is able to reduce the cosmetic and functional complications that occur after the removal of a benign tumour of the parotid through the superficial parotidectomy technique, above all, it reduces the occurrence of Frey's syndrome.

Castleman's disease mimicking a parotid gland tumor: report of a case and review of the literature.

Castleman's disease (giant lymph node hyperplasia, angiofollicular hyperplasia, lymphoid hamartoma, benign giant lymphoma), is a quite rare and complex disease of lymphoid tissue that causes progressive lymph node enlargement, typically presenting as a solitary mediastinal mass. It was first described by Castleman et al in 1956. The head and neck regions are the second, less common site for this lesion. The preoperative diagnosis is very often extremely difficult and the routine investigations are often inconclusive. A multicentric extension of this disease shows poorer prognosis compared to the unifocal Histologically, three types do exist: the hyaline-vascular type, the plasma cell type and the mixed type. The etiology and pathogenesis is still unclear. In the literature, to our knowledge, only 112 cases have been reported involving head and neck, and only 22, including our own, interesting the parotid gland. In this report we describe a rare singular of Castleman's disease presenting as a tumor of the inferior pole of the parotid gland extending in the submandibular region, in a 35-year-old woman. The patient undergone a surgical treatment and, therefore, the mass was successfully totally removed.

Circumscribed myositis ossificans of the masseter muscle: report of a case.

Myositis Ossificans (MO) is an unusual pathological entity still largely unknown, characterized by dystrophic calcification leading to heterotopic ossification of intramuscular connective tissue. The masticatory muscles are exceptionally involved. Four distinct types of myositis ossificans have been described: MO Progressiva, which is a genetic disorder involving several muscular groups; MO Circumscripta, limited to a single muscle and generally due to calcification of an intramuscular haematoma following severe trauma and progressive ossification; MO Pseudo-malignant limited to soft tissue and not associated to any trauma; MO associated to paraplegia. A case of circumscribed myositis ossificans of the masseter muscle in a 62 years-old woman is reported.

Intra-articular loose osteochondroma of the temporomandibular joint.

Osteochondroma or osteocartilaginous exostosis is one of the most common benign bone tumours. It usually develops in the metaphyses of long flat bones, but rarely occurs in the oral and maxillofacial area, where it is generally associated with the coronoid process or the condyle. Loose osteochondromas inside the joint are generally a rare pathology usually described in large joints. The authors present a case of an intra-articular loose osteochondroma of the temporomandibular joint (TMJ), which represents the first case of such a pathological entity in the literature. The authors suggest that it should be considered in any differential diagnosis of loose bodies described in the TMJ.

[Effect of atropine on hypophyseal gonadotropins in the basal condition and under GnRH stimulation]. / Azione dell'atropina sulle gonadotropine ipofisarie in condizioni basali e dopo stimolo con GnRH.

The Authors have tested serum levels of LH and FSH in 10 healthy males after stimulation test with GnRH preceded by administration i.m. of 1 mg. of atropine 10' and 1 hour before the test, to examine some interferences of the drug on ipophisary gonadotropins. Atropine has no effect on LH and FSH release because there are no differences between mean values of the hormones during the test with and without atropine, at any time it is administered. All the data obtained have been controlled with Student's "t" test.

[Effects of pentobarbital on serum PRL and TSH in the basal condition and under TRH stimulation in man: preliminary note]. / Effetti del pentobarbital sui livelli sierici di PRL e TSH in condizioni basali e dopo stimolo con TRH nell'uomo: nota preliminare.

The Authors have tested serum levels of PRL and TSH in six healthy males, anaesthesized with 20 mg./Kg. body weight of pentobarbital with and without stimultion with TRH. PB has no effect on serum levels of TSH but there is an inhibition of PRL release 180', 240' and 360' after the administration of the drug. The AA. have found no effects of PB on the stimulation test with TRH. All the data obtained have been examined with Student's "T" test.

[Effects of pentobarbital on serum levels of LH and FSH, in normal conditions and after GnRH stimulation: preliminary report]. / Effetti del pentobarbital sui livelli sierici di LH ed FSH, nell'uomo, in condizioni basali e dopo stimolo con GnRH: nota preliminare.

The authors have tested serum levels of LH and FSH in healthy males anaesthetized with 20 mg/Kg body weight of pentobarbital, and stimulation test with GnRH. LH has reached levels higher than the stimulation test has been practised in the anaesthetized volunteers than in subjects awakes. The AA. have also showed that there is no effect on psychic stress and of atropine, used as preanaesthetic drug, on serum levels of the pituitary hormones. At the end, PB has no effect on serum levels of FSH.

[Inhibitory effects of atropine on serum prolactin levels after TRH stimulation]. / Effetto inibente dell'atropina sui livelli sierici di prolattina dopo stimolo con TRH.

The authors have tested serum levels of PRL after administration of atropine 10' and 60' before stimulation test with TRH, in 12 male and 12 female. The administration of the drug 10' before TRH has inhibited the PRL release, in all the groups. No effect presented atropine if administered 60' before TRH test.

[Effect of surgical stress on TSH and on the extra-thyroid metabolism of T4 (preliminary experiment)]. / Effetto dello stress chirurgico sul TSH e sul metabolismo extratiroideo della T4 (esperienza preliminare).

The effect of the surgery on the TSH and on the extra thyroid T4 metabolism was studied in thirty euthyroid patients. The TSH showed a light increase thirty minutes after the skin cut. There were no remarkable changes of T4 serum levels, while the serum triiodothyronine concentration fell during and after the operation, with a concomitant rise in reverse triiodothyronine.