Prevalence of molar incisor hypomineralization among school children in Rome, Italy.

Molar incisor hypomineralization (MIH) is a highly prevalent condition associated with increased caries experience, dental pain and treatment need. Aim of this study was to determine the prevalence and severity of MIH in a group of 7-8 years old primary school children living in Rome, Italy; and to assess the association with caries experience and possible perinatal risk factors. A survey has been conducted in the city of Rome, between April 2019 and March 2020 with a total of 49 primary schools and 176 2nd grade primary school classes and a total of 3611 children being involved. Of these, a subset of 346 children of 21 primary schools was selected for the epidemiological investigation. The prevalence of MIH was of 18.2%, with girls showing twice the probability of being subject to a mild-severe condition. Molar location was present in 71.4%, while location on both molar plus incisor was present in 28.6% of cases. The mean DMFT was 0.44 ± 0.78, "D" was 0.17 ± 0.58; the mean dmft was 1.7 ± 2.56, "d" was 1.32 ± 2.21. Female gender, caries experience, insufficient oral hygiene were risk factors. The incidence of MIH is increasing in the pediatric population. Knowledge about diagnosis and treatment options should be disseminated among dental professionals.

Anatomical variations of the superficial ulnar artery: case series observed on historical specimens prepared by Ludwik Karol Teichmann.

BACKGROUND: This report presents a series of cases representing variant origin and course of the ulnar artery, namely the superficial ulnar artery (SUA), observed during the review of collection of historical specimens prepared in the 19th century by the prominent Polish anatomist Ludwik Karol Teichmann and his collaborators, exhibited in the Anatomy Museum of Jagiellonian University Medical College. RESULTS: Three distinct variants of the SUA were found on anatomical specimens of the upper limb with arteries injected by using Teichmann's method. In case no. 1, the SUA originated from the brachial artery slightly above the interepicondylar line of the humerus. This aberrant vessel gave off the common interosseous artery in the upper half of the cubital fossa and then ran superficially to the bicipital aponeurosis and over the muscles arising from the medial epicondyle of the humerus. The cases no. 2 and 3 involved two similar variants of the superficial artery in which the common interosseous artery arose from the radial artery. In the unique case no. 4, the SUA arose from the radial artery. CONCLUSIONS: The SUA shows diverse anatomy regarding its topography and blood supply territory. Orthopaedic, hand, and plastic surgeons should be aware of anatomic variations of the SUA both in planning and in conducting surgeries of the upper limb.

A computed tomography comprehensive evaluation of the ostium of the sphenoid sinus and its clinical significance.

BACKGROUND: The purpose of this research was to evaluate the size of the sphenoid sinuses' ostia, the distance between them and the distance between the medial margin of the ostia and the median line in the Polish adult population. MATERIALS AND METHODS: The analysis was undertaken as a retrospective study of 296 computed tomography (CT) scans of patients (147 females, 149 males) with no comorbidities in their sphenoid sinuses. The paranasal sinuses were investigated by using Spiral CT Scanner (Siemens Somatom Sensation 16), in the option Siemens CARE Dose 4D, without administering any contrast medium. Having obtained transverse planes, multiplans reconstruction tool was used in order to glean sagittal and frontal planes. RESULTS: The average size of both sphenoid sinus ostia was 0.31 cm for both genders (for females ranging from 0.1 to 0.5 cm and from 0.1 to 0.6 cm for males). The mean distance between both sphenoid sinus ostia was 0.6 cm for both genders (the range for females was 0.1-1.4 cm, whereas 0.1-1.8 cm for males). The average distance between the medial margin of the ostium and the median line was 0.32 cm for both genders (0.31 cm for females in the range of 0-0.9 cm and 0.32 cm for males in the range of 0-1 cm). CONCLUSIONS: Intraoperative identification of the sphenoid sinus ostia might prove difficult and their inadequate excision could lead to potential iatrogenic complications, hence detailed anatomical descriptions are still warranted in specific populations in order to perform safe and effective procedures.

Risk Management for a Legally Valid Informed Consent.

ABSTRACT: Gelli-Bianco law (Law no. 24/2017) intervenes both in order to divide healthcare liability between the healthcare professional and the facility in which he/she exercises and to incentivize the latter to adopt an organizational model suitable for managing the risk associated with the provision of any healthcare service, including the information for consent. In fact, the healthcare facility must guarantee clear, complete and adequate information on the specific case, which, therefore, cannot consist of standard forms to be signed by the patient, under penalty of a flawed consent to treatment and consequent healthcare liability in the event of an adverse event. The regulation mandates that safety must be guaranteed through proper prevention tools and health care risk management, in con-junction with the most effective use of structural, technological and organizational resources available. It further spells out the obligation of health care professionals to contribute to risk prevention while administering health care procedures. For this reason, the consent information constitutes a source of risk for the responsibility of the healthcare provider and the Facility and it must necessarily be managed. Risk Management is the management tool that can allow the healthcare facility to improve the quality and safety of the services provided, optimizing the risk of adverse events through proper moni-toring of the same. This paper will be published, following a special agreement, on the two journals "Igiene e Sanità Pubblica" and "La Clinica Tera-peutica", in Italian and in English, in order to increase the diffusion to a wider audience.

Knowledge of Emergency Management of Avulsed Teeth among Italian Dentists-Questionnaire Study and Next Future Perspectives.

(1) Background: In Italy, about one fourth of all schoolchildren experience a trauma to the permanent dentition. Management of avulsion trauma is challenging and requires adherence to clinical protocols. The aim of this study was to investigate the management knowledge of avulsed teeth among Italian dentists and to promote the guidelines' dissemination through the use of new social media. (2) Methods: The survey was carried out during the COVID-19 lockdown in Italy (March-May 2020). The questionnaire was sent anonymously to a total of 600 dentists. The questionnaire consisted of two parts. Part A-demographic and professional data and Part B-management of traumatic avulsion. (3) Results: The response rate was 50.6% and the mean fraction of correct responses was 0.524. Issues related to the therapeutic management of avulsed teeth were shown to be not well understood by the respondents. Professionals with qualifications in dentistry and those who declared to know the guidelines responded better, while other demographic and professional factors were insignificant. (4) Conclusions: Italian dentists' knowledge of the management of avulsion trauma should be improved. Educational programs and campaigns must be undertaken to improve their awareness and adherence to the Italian and international guidelines.

Risk management and Healthcare responsibility. How to guarantee legal protection in Medicine.

Having regard to the increasing attention to the issue of safety and health of patients and workers by low, the hypothesis that this topic will be the growing trend in the next years does not seem to be manifestly unfounded. For this reason, it is wise for healthcare professionals to already be aware that any violation of the interests underlying the legislation in question entails a ruling on civil and/or criminal liability. It is therefore necessary to identify the most suitable means to prevent undue harm occurring, partly to exempt healthcare professionals and hospitals from compensation costs, thereby providing them with recourse to insurance coverage. Healthcare facility organisations must adopt Risk Management techniques as a tool to simultaneously guarantee the effectiveness of health services (in this case), the efficiency of the management economy, and finally compliance with all legally required precautions. This will relegate the occurrence of an adverse event to remote and unpredictable hypotheses, thus guaranteeing useful recourse to insurance coverage to compensate any harm that does occur.

Challenges in diagnosing and managing non-cavitated occlusal caries lesions. A Literature overview and a report of a case.

AIM: Aim of this literature overview was to analyze the diagnostic procedures of hidden caries lesions and to present a restorative protocol. METHODS: A literature overview was performed in order to evaluate hidden caries etiological hypothesis and the reported prevalence. The diagnostic procedure is performed with the aid of an intra-oral fluorescence based camera and the restorative procedure is completed with the use of a novel bisphenol-A free composite. RESULTS: Non cavitated occlusal caries lesions prevalence is high in young adults population. Diagnosis of hidden caries requires both high sensitivity and specificity. CONCLUSIONS: The novel diagnostic and restorative protocol showed to be highly effective in hidden caries assessment and restoration.

The dimensions of the sphenoid sinuses: evaluation before the functional endoscopic sinus surgery.

BACKGROUND: The following study aimed to evaluate the dimensions (anteroposterior, transverse and vertical) of the sphenoid sinuses in the adult population. MATERIALS AND METHODS: The study was conducted as a retrospective analysis of the computed tomography (CT) scans of the paranasal sinuses of 296 patients (147 females and 149 males), who did not present any pathology in the sphenoid sinuses. The CT scans of the paranasal sinuses were done with the spiral CT scanner, without using any contrast medium. After obtaining transverse planes, frontal and sagittal planes were created using secondary reconstruction tool. RESULTS: The anteroposterior dimension was found to be 2.65 cm on average, in the range of 0.5-4.3 cm. The transverse dimension was on average 1.98 cm, ranging from 0.5 cm to 4.9 cm. The average vertical dimension was found to be 2.1 cm, in the range of 0.7-3.7 cm. CONCLUSIONS: Due to the high incidence of the anatomical variants of the paranasal sinuses, a CT scan is recommended in all patients before a planned surgery in order to avoid the potential iatrogenic complications. Dimensions of the sphenoid sinuses might point towards more at risk variants, but there is still a substantial amount of research that needs to be done in that aspect.

A hexavalent Coxsackievirus B vaccine is highly immunogenic and has a strong protective capacity in mice and nonhuman primates.

Coxsackievirus B (CVB) enteroviruses are common human pathogens known to cause severe diseases including myocarditis, chronic dilated cardiomyopathy, and aseptic meningitis. CVBs are also hypothesized to be a causal factor in type 1 diabetes. Vaccines against CVBs are not currently available, and here we describe the generation and preclinical testing of a novel hexavalent vaccine targeting the six known CVB serotypes. We show that the vaccine has an excellent safety profile in murine models and nonhuman primates and that it induces strong neutralizing antibody responses to the six serotypes in both species without an adjuvant. We also demonstrate that the vaccine provides immunity against acute CVB infections in mice, including CVB infections known to cause virus-induced myocarditis. In addition, it blocks CVB-induced diabetes in a genetically permissive mouse model. Our preclinical proof-of-concept studies demonstrate the successful generation of a promising hexavalent CVB vaccine with high immunogenicity capable of preventing CVB-induced diseases.

Oral health in a cohort of individuals on a plant-based diet: a pilot study.

INTRODUCTION: Plant-based diets are associated with a lower: (i) body mass index, (ii) rates of death from ischemic heart disease, (iii) serum cholesterol, (iv) incidence of high blood pressure, (v) type II diabetes mellitus and cancer, with an overall longer life expectancy. However, little data concerning the oral health in individuals on a plant-based diet are available. AIM: The aim of the present study was to investigate the general and clinical oral health status in a cohort of adults who had been following a plant-based diet for a minimum of 24 months. MATERIAL AND METHODS: For this purpose, individuals were administered two questionnaires (a.Questionnaire investigating risk areas for oral diseases; b. Italian version of the Oral Health Impact Profile -14 (IOHIP-14)) by a dental hygienist and clinical examination of the oral cavity was carried out. RESULTS: Seventy-seven adult individuals were enrolled. On average, they followed a plant-based diet for the last four years, had four meals a day and brushed their teeth twice a day. Fruit was the most frequently consumed food at breakfast by 48 of the participants. Thirty-four responders did not drink beer or wine, 65 did not drink spirits, 57 avoided carbonated beverages and 62 (80.5%) did not consume any highly-sugared beverages. Different dental therapies in the previous three years were reported in 36 of the responders. Overall, answers "never and almost never" to the IOHIP-14 questionnaire were observed in 87% to 100% of the individuals. Multiple logistic regression analysis revealed that fresh fruit consumption at lunch had a protective effect against caries (p<0.05). CONCLUSIONS: In conclusion, this study showed that individuals on a plant-based diet have good overall oral health conditions. These features are in agreement with the behavior of these subjects towards an overall healthy life style.

New theory of acoustic signal detection in the inner ear - An explanation of bifilar structure of the cochlea.

In this work a new theory of acoustic signal detection in the inner ear and an experimental explanation of the causes of bifilar cochlear structure was presented. Our innovative approach describes sound detection in a completely different way from the one currently adopted. It requires analyzing the inner ear system in the form of a bent spiral and assuming that perilymph in such a small system behaves like a non-Newtonian fluid. The necessity of analyzing the system in the form of a bifilar spiral results from the need to compensate the head movements, so far omitted in the analysis. We suggest that the construction and the role of the oval window and the stapes are different than just a simple piston that converts mechanical signals to hydrokinetic ones. Stapes provides uniform distribution of the hydrokinetic signal in the spiral cochlear system, and the conversion of momentum to angular momentum creates a force perpendicular to the vestibular membrane, which causes the effect of its deflection, what has not yet been explained.

Powerful 3-µm lasers acousto-optically Q-switched with KYW and KGW crystals.

We report, to the best of our knowledge, the first use of KY(WO4)2 and KG(WO4) acousto-optical Q-switches in 3-µm powerful lasers. Q-switches of two different designs (normal incidence with antireflection coatings, and Brewster-angle cut crystals) operate in lasers based on Er:YAG, Cr:Yb:Ho:YSGG, and Cr:Er:YSGG laser crystals. Gain and lifetime of laser crystals significantly influence the regime of Q-switched generation. Er:YAG and Cr:Yb:Ho:YSGG lasers deliver pulses with 10.8 mJ and 17.5 mJ energy, respectively. Pulses with energy of 29.6 mJ and duration of 75 ns in the TEM00 mode are obtained in a Cr:Er:YSGG laser. The energy is scaled up to 85.7 mJ in the two-stage master oscillator power amplifier system. Powerful laser systems of this kind are in the region of interest for pumping other mid-IR laser media (e.g., Fe:ZnSe and Fe:CdSe), OPOs, CO2 lasers, and amplifiers. Preliminary experiments on microstructuring of transparent materials by the laser-induced backside wet etching method demonstrate the potential of such lasers to build the foundation for dye-free tissue and cell engineering concepts.

Association between P-selectin levels and left atrial blood stasis in patients with nonvalvular atrial fibrillation.

BACKGROUND: P-selectin - a biomarker of platelet and endothelial cell activation is elevated in patients with non-valvular atrial fibrillation (NVAF). However, the association between sP-selectin level and thromboembolic complications in NVAF patients remains controversial. We tested the hypothesis that plasma soluble P-selectin (sPSL) level correlates with the measures of left atrial blood stasis in NVAF. METHODS: Plasma sPSL concentration was measured using solid-phase ELISA in 103 NVAF patients (age 63 ±â€¯14 years; 26% women) and 48 normal sinus rhythm controls (NSR; age 64 ±â€¯14 years; 41% women) who were not on aspirin. Within the group of NVAF cases, 27 had no spontaneous echocardiographic contrast (SEC) detected by transesophageal echocardiography, 31had mild SEC, 15 moderate, 20 severe, and 10 patients had left atrial appendage thrombus (LAAT). RESULTS: The median soluble sPSL level was higher in NVAF cases compared to NSR controls [(interquartile range) 26 (20-32) ng/mL vs 22 (15-29) ng/mL, p = 0.0045]. Only NVAF patients with CHA2DS2-VASc score ≥ 1 had higher sPSL level compared to NSR controls. Patients with severe SEC had significantly higher sPSL levels [32 (24-38) ng/mL] compared to all other NVAF patients (p = 0.0042) and to NSR controls (p < 0.0001). Also NVAF patients with LAAT had higher sPSL level compared to NSR controls. CONCLUSIONS: There is a direct correlation between p-selectin level and severe blood stasis in the left atrium. Only NVAF patients with CHA2DS2-VASc score ≥ 1 or with LAAT had higher sPSL level compared to NSR controls.

Influence of Cryopreservation on Structural, Chemical, and Immunoenzymatic Properties of Aortic Valve Allografts.

OBJECTIVES: The problems in preparing (including cryopreservation) and implanting aortic valve allografts (AVAs) is widely elaborated, but some issues need explanation. MATERIAL AND METHODS: Twenty AVAs cryopreserved in dimethylsulphoxide/RPMI solution under -160°C for 1-15 years and 3 controls stored at +4°C up to 2 weeks, from 19 male and 4 female donors, aged 20-51, ±30.8 years, were examined using light (LM), digital (DM), and scanning electron microscopy (SEM), energy dispersion X-ray spectroscopy (EDS), and enzyme-linked immunosorbent assay immunoenzymatic tests (PECAM1, CD34). RESULTS: All AVAs were macroscopically correct. LM revealed normal structure of leaflets but massive endothelial decellularization (±59 cells remained on the surface of 5 mm scraps). DM and SEM demonstrated generally normal collagen structures, but local alterations, probably influenced by freezing-thawing (gaps, separated plates) or being initial phase of native degeneration (grains). EDS detected a little elevated calcium amount in 1 specimen only. The mean PECAM1 and CD34 concentrations were at similar low level in all probes. CONCLUSIONS: Fresh and cryopreservation technologies did not significantly influence the basic properties of AVA leaflets; however, massive endothelial decellularization was present in both groups. Therefore, no endocardial cell activity nor signs of inflammation were observed. These results were independent of donors' age and sex, processing technology, and time of storage of cryopreserved AVAs.

Majocchi's granuloma (granuloma trichophyticum) in a guinea pig owner: A case report and literature review.

Majocchi's granuloma is a folliculitis caused by dermatophytes, which is most commonly located on the skin of the lower limbs in women. A favorable factor for the infection is an injury caused by epilation, which, together with an existing fungal infection, can lead to the spread of folliculitis to other parts of the body. The disease is extremely rare (Burgdorf et al., 2010). The aim of this article is to describe the case of a patient who developed severe edematous lesions of the lower extremities from a mycosis infection with Trichophyton mentagrophytes varietas granulosum, the carrier of which was a domestic guinea pig.

Clinical comparison between an opaque and a clear pit and fissures sealants: a 12-month split-mouth, randomized controlled study.

TRIAL DESIGN: We design a clinical splith-mouth, randomized controlled study, in which the retention of an opaque and clear pit and fissures sealants were evaluated and their effectiveness compared at 6 and 12 months of follow up. A secondary aim was to evaluate the possibility of using a fluorescence based intra-oral camera through the clear sealant to monitor enamel demineralization. METHODS: Consecutive young adolescents with at least two molars with code 0, 1, 2 caries evidenced following the International Caries Detection and Assessment System (ICDAS II) were enrolled. A split-mouth randomized allocation was carried out. One skilled operator applied the sealant under 3.5 X magnification. A second operator evaluated clinical retention and performed the intra-oral camera assessments at 6 and 12 months follow up. RESULTS: A total of 42 patients, (20 males and 22 females, mean age 14.25) with 176 dental lesions were enrolled. Nine patients dropped out accounting for 26 teeth lost during follow up. Overall, a total of 150 sealed teeth were evaluated in the study. In 77 cases the clear sealant was used, while in 73 the opaque sealant was utilized. The opaque sealant rated 100% complete retention at 6 months, and 97.3% at 12 months, while the clear selant 91.8% and 85.9% respectively. Demineralization under clear selant was registered when sealant partial detachment occurred. CONCLUSIONS: The overall retention rate of an opaque sealant was higher than that of a clear sealant after 12 months of follow-up. This difference may partly be due to difficulty in clinical detection of clear sealants during follow-up. Fluorescence based intra-oral camera seems useful to monitor enamel demineralization in clear sealant.

Four years of African swine fever in Poland. New insights into epidemiology and prognosis of future disease spread.

Four and a half years of African Swine Fever (ASF) in population of free-ranging wild boars and domestic pigs revealed a number of novel insights into the disease epidemiology. Until No- vember 20th, 2018, in total 3048 cases in wild boars and 213 outbreaks in domestic pigs have been confirmed. In spite of low contagiosity as well as low rate of ASF spread in wild boars the disease has an enormous socio-economical impact on the production of pigs in Poland. One of the most important aspects which directly influences the dynamics of ASF spread is the unpredictable hu- man activity. Another important factor responsible for continuous ASF spread is fast recovery of wild boar population in spite of efforts taken by hunters. Assuming our scientific opinion ASF seems to be present in wildlife for the incoming few or several years. Therefore, extraordinary measures should be prepared and undertaken to limit the risk of the occurrence of future out- breaks in domestic pigs. One of the most crucial issues is implementation of strict biosecurity measures in all domestic pigs holdings.

Effects of controlled physical activity on immune cell phenotype in peripheral blood in prehypertension - studies in preclinical model and randomised crossover study.

Hypertension (HT) is a global public health issue. There are many behavioural risk factors including unhealthy diet, tobacco use and alcohol consumption as well physical inactivity that contribute to the development of high blood pressure (BP) and its complications. Favourable effect of regular physical activity on treatment or prevention of hypertension by improvement of endothelial function is widely accepted however little is known about its relationship with immune system. Thus, the aim of this study was to assess the role of moderate regular physical activity on immune cell phenotype. T cell and monocyte subsets were characterised in 31 subjects with prehypertension (130 - 139 mmHg systolic and 85 - 89 mmHg diastolic blood pressure) who participated in moderate training (3 times/week) on cyclometers for 3 months in crossover study design. Complementary study was performed in murine model of Ang II-induced hypertension and ten-week-old animals were trained on a treadmill (5 times/week, 1 hour) for 2 weeks before and 1.5 weeks after minipumps implantation. In the context of elevated blood pressure regular physical activity had modest influence on immune cell phenotype. Both in human study and murine model we did not observe effects of applied exercise that can explain the mechanism of BP reduction after short-term regular training. Twelve-weeks regular training did not affect the activation status of T lymphocytes measured as expression of CD69, CD25 and CCR5 in human study. Physical activity resulted in higher expression of adhesion molecule CD11c on CD16+ monocytes (especially CD14 high) without any changes in leukocytes subpopulation counts. Similar results were observed in murine model of hypertension after the training. However the training caused significant decrease of CCR5 and CD25 expressions (measured as a mean fluorescence intensity) on CD8+ T cells infiltrating perivascular adipose tissue. Our studies show modest regulatory influence of moderate training on inflammatory markers in prehypertensive subjects and murine model of Ang II induced hypertension.

Controlled aerobic training improves endothelial function and modifies vascular remodeling in healthy adults with high normal blood pressure.

The aim of the study was to assess endothelial function in adults with high normal blood pressure (HNBP) undergoing controlled aerobic training. The study was conducted among 31 volunteers with HNBP. Subjects underwent supervised cycle ergometer training for 12 weeks. Exercise intensity was assessed by monitoring the pulse with intention to keep the heart rate increase within the range of 40% to 65% of the heart rate reserve. The control group consisted of 14 healthy adults, not subjected to any intervention. The control group was examined twice at 12-week intervals (non-exercising time control). Vascular endothelial function was determined by flow-mediated dilation (FMD) and by measuring total nitric oxide products (NOx). The measurement of carotid intima-media complex thickness (IMT) was an indirect method of assessing vascular remodeling. Blood pressure (ABPM method), anthropological parameters and lipid profile were also assessed. There was a significant change in FMD after 3-month training in the study group: the average FMD training was 5.21 ± 2.17%, while after the program FMD increased to 9.46 ± 3.69% (P < 0.001). After training, the NOx also increased from 1.01 ± 0.38 µmol/L to 1.27 ± 0.48 µmol/L (P < 0.001). Effects were observed irrespective of participants' sex. Interestingly, a modest but significant reduction of IMT was also observed, from 0.5 ± 0.06 mm to 0.46 ± 0.10 mm (P = 0.04). There was also a reduction in the percentage of body fat content from 25.01 ± 8.77% to 22.31 ± 8.79% (P < 0.001). No statistically significant changes were noted after 12 weeks of training in the blood pressure and lipid profile. In the control group no statistically significant changes of any parameter were observed. Regular aerobic exercise improves nitric oxide-dependent endothelial function of the vessels and can initiate regression of atherosclerosis in people with HNBP.

[Knowledge, attitude and behavior towards oral health: gender differences between parents].

OBJECTIVES: The aim of this study is to compare the results of a survey carried out on a sample of mothers and fathers about the knowledge and personal attitudes towards their own oral health and in terms of attention to that of their children. Mutual analogy and cognitive and behavioral differences between parents have been evaluated; in particular as the early assumption of a healthy lifestyle can influence the proper development of their children. MATERIALS AND METHODS: This survey was conducted using a paper questionnaire distributed to a population of parents, men and women, in several private dental practices in Rome. The study lasted about three months. RESULTS: The results obtained from this study show that values obtained by mothers and fathers are essentially equivalent, there are no statistically significant differences (p> 0.05). CONCLUSIONS: This study has shown that there are no significant thinking and behavioral differences between parents regarding their oral hygiene and that of their children. Both parents have been shown to recognize the importance of continuous monitoring and to be aware of techniques and oral hygiene aids suitable for adults and children, although this knowledge is not always applied in daily lifestyles and oral hygiene.