Impact of the COVID-19 pandemic on HPV vaccination coverage in the general population and in PLWHs.

OBJECTIVE: On March 11, 2020, the World Health Organization (WHO) has declared the novel coronavirus (COVID-19) outbreak as a global pandemic. COVID-19 pandemic has impacted health services, including immunization programs, with a consequent reduction in vaccination coverage in those categories for which the prevention of vaccine-preventable diseases is strongly recommended. SUBJECTS AND METHODS: We conducted a retrospective cross-sectional study on the general population and on PLWHs, comparing anti-human papillomavirus (HPV) vaccination coverage data in 2019, before COVID-19 pandemic, and the 2020 data, after the announcement of the pandemic state and the lockdown and the implementation of restrictive measures to contain the contagion. RESULTS: Compared to 2019, 2020 data show a 42% reduction in HPV vaccine coverage in the general population and 36% in PLWHs. The greatest reduction in anti-HPV vaccination coverage occurred during periods of greatest restriction and mainly concerned the general population. CONCLUSIONS: The prevention of vaccine-preventable diseases remains essential. Above all, it is essential to increase and recover the anti-HPV vaccine coverage, in consideration of the data that show its preventive oncological efficacy.

Adherence to the three Italian screening in a sample of women (and men) in the Southern Italy.

INTRODUCTION: Although scientific evidence shows the numerous benefits of screening programs, in Italy. There is a great disparity between the regional coverage of the North and South despite the screening programs have been activated for several years in all regions even with territorial differences. OBJECTIVE: The aim of our study was to evaluate the knowledge and adherence to different screenings in the population, the influence exercised by the local health authority the role of the general practitioner in advising and referring patients to screening tests and the main causes of refuse. MATERIAL AND METHODS: The study was carried out, from December 2019 to May 2020, through the administration of anonymous self-filled "ad hoc" questionnaires to women and men over 26 years old. RESULTS: in our sample 36% have never performed a breast check and 39% of the interviewees never had a mammogram; for cervical cancer 25% did not ever perform screening and 65% did not have an indication by GP. The worst result was found for colorectal cancer (only 27% of the sample performed the screening). The role of GP was fundamental for and similar to other studies, was fundamental in fact,similar to other studies the most frequent reported reasons for the non-execution of screening were the lack of physicians' advice, follwed by lack of time, the most frequent reported reasons for the non-execution of screening were the lack of physicians' advice, a lack of time, fear of cancer and embarrassment at visiting a gynaecologist. DISCUSSION AND CONCLUSIONS: the study carried out found that despite the knowledge of the oncological disease and the possibilities of prevention is fairly rooted in the population, adherence to the screening is quite inadequate, especially as regards colorectal cancer.

Orofacial pain evaluation in children.

AIM: Pain evaluation in children and its diagnosis are problems not always easy to solve. Children, because of their immaturity, are not always able to well communicate or to describe the clear characteristics of the disease by which they are affected. Moreover, they are often unable to report the real intensity of the pain they experience. These problems are related to their immature, not fully evolved psyche. Such problems can create difficulties to the physician who is called to examine and evaluate the origin of orofacial pain, as well as hesitation regarding when it could be necessary to start a drug therapy. Aim of this work is to propose the basic tools for the evaluation and measurement of pain that are better suitable for children, as these instruments can be used together with an accurate anamnesis and a meticulous examination, in order to formulate a precise differential diagnosis among the pathologies that affect the head and neck. A list of the most common painful diseases affecting this area is also presented. METHODS: A systematic literature review about the methods for evaluation and measurement of pain in children was conducted. The commonly used scales of measurement were examined: VAS, VSN, CAS, FPS and the Oucher SCALE. The different pathologies of head and neck and their characteristics are described and the possible causes of orofacial pain have been divided into extracranial and intracranial, in order to easily direct diagnosis. RESULTS: Orofacial pain in children is an issue of great interest in consideration of its high frequency in paediatric dentistry. Its measurement and evaluation is possible despite the small compliance of paediatric patients. Thanks to the modern technique and knowledge this evaluation can be realistic and reproducible. CONCLUSION: Evaluation scales of pain are suitable at any age and skill of the child and, together with a careful anamnesis and a proper clinical examination, allow the clinician to conduct a precise differential diagnosis of the pain so as to set the ideal therapy for the little patient.

Calibre Persistent Labial Artery: Clinical Features and Immunohistochemistry Diagnosis.

Calibre persistent labial artery (CPLA) usually presents as an asymptomatic papule on the lower lip and can be easily misdiagnosed as a mucocele, haemangioma, venous lake, varix or fibroma. When it is ulcerated, squamous cell carcinoma is the most usual differential diagnosis. Here, we report a case of a 25-year-old woman with no previous relevant medical history who presented with a complaint of an asymptomatic, non-ulcerated, progressively growing nodule (over the last 5 months) on the upper lip. In this case, the diagnosis was made clinically and confirmed by immunohistochemical analysis. We conclude that clinicians should be aware of CPLA and it should be included in the differential diagnosis of labial mucosal papules. Sometimes, the immunohistochemical analysis is necessary to make a correct diagnosis.

The piezoelectric osteotomy technique compared to the one with rotary instruments in the surgery of included third molars. A clinical study.

AIM: The purpose of this study is to compare surgical times, the saving of bonytissues, the postoperative course of the extraction of included third molars in patients treated with piezoelectric surgery compared to those treated with conventional rotary instruments. METHODS: The study included 140 patients with upper and lower third molars included. 70 of them were treated with osteotomy using conventional rotary instruments (Group 1) and 70 more with osteotomy through piezosurgery Mectron® (GROUP 2). The treatment protocol was the same for both groups. The time of surgery and the saving of bonytissues in the intra-operative have been estimated; moreover, 24-48-72 hours and 7 days after the surgery, two other parameters have been estimated: facial swelling and trismus. The swelling, trismus and the saving of bony tissues were assessed by a surgery gauge. RESULTS: The average surgical time was 15 minutes in Group 1 and 20 minutes in Group 2. The savings of bonytissues was greater in Group 2 than in group 1 by 2.7 mm. The average facial swelling was 6.23 mm for group 1 and 2.86 mm for group 2 24 hours after the surgery, of 5.22 mm for group 1 and 1.76 mm for group 2 48 hours after the intervention, of 3.75 mm for Group 1 and 0.85 for group 2 72 hours after the surgery, of 0.86 mm for group 1 and 0.12 for group 2. The average trismus was of 14.76 mm in Group 1 and 11.15 mm in Group 2. Statistical analysis showed a significant reduction of swelling, trismus and a bigger saving of bony tissues in Group 2 and a reduction in surgical time in Group 1. CONCLUSION: The osteotomy technique with a piezoelectric instrument has produced a significant reduction in facial swelling, trismus and a bigger saving of bony tissues than with conventional rotary instruments. A slight lengthening in terms of surgical time has been recorded, compared to the use of conventional rotary instruments.

Expression of sexual hormones receptors in oral squamous cell carcinoma.

Sexual hormones play an important role in expression of genes involved in a wide variety of biological and neoplastic processes. The information on Estrogen Receptors (ER) expression in non-target tissues is very few and, in particular, the studies in head and neck tumors are still controversial. Recent studies analyzed the role of Tamoxifen (TAM) on Oral Squamous Cell Carcinoma (OSCC) lines in relation to the presence/absence of ER. The purpose of the present study was to evaluate the expression of sexual hormones receptors mRNAs, in particular Estrogen Receptor alpha (ERα) and Androgen Receptor (AR) mRNA in OSCC tissues. The study group comprised 20 samples of OSCC, harvested from 20 otherwise healthy subjects (14 males and 6 females, mean age 58.2y, range 38-74). The control group was formed by 20 samples of normal mucosa harvested around the margins of the specimens (at least 1 cm from the lesion margins). Estrogens Receptor alpha (Era) and Androgen Receptor (AR) mRNA expressions were analyzed by RT-PCR carried out on total RNAs extracted from both cancerous and healthy tissues. Obtained data were evaluated by Shapiro-Walk normality test and compared by Student's t test. Results with p<0.05 were considered statistically significant. AR transcripts were less expressed in OSCC specimens than in healthy tissues, while levels of ERα transcripts significantly increased in tumor samples. These preliminary data show different expression patterns of AR and ERα mRNAs in malignant tissues of oral mucosa and could suggest an involvement of these sexual hormones in oral cancer.

Ex vivo expansion of bone marrow stromal cells by platelet-rich plasma: a promising strategy in maxillo-facial surgery.

The aim of our study is to evaluate in vitro the response of bone marrow stromal cells (BMSCs) to platelet-rich plasma (PRP), in order to clarify the potential role of their combined use in a preclinical phase preceding BMSCs transplantation for bone repair and regeneration procedures. The incubation of BMSCs with PRP promoted a remarkable, dose- and time- dependent, growth stimulation, that was paralleled to a strong increase in the quantity of type I collagen and to a significant decrease in the activity of the early osteoblastic differentiation marker, alkaline phosphatase (AP). Once PRP was removed and osteogenic inducers were added, AP returned to levels comparable to the control, while the late phenotypic markers, osteocalcin and matrix calcification, were enhanced to higher levels than in controls. Our data demonstrate that PRP induces a remarkable ex vivo enrichment of BMSCs maintaining their differentiative potential. Thus PRP represents a valid preclinical tool for obtaining an effective, rapid and safe ex vivo expansion of BMSCs prior to their clinical utilization in bone engineering.

Reducing medication errors.

This article describes initiatives one institution developed to improve systems for detecting and preventing adverse medication events. Our discussion focuses on issues regarding the frequency and incidence of medication errors, the trials of traditional versus anonymous incident reporting, and the efforts to improve systems rather than placing blame and punishment on individuals. Initiatives such as improved documentation of pediatric patient weights and hepatic and renal function, increase of direct physician order entry into our Medical Information System (MIS), elimination of nonemergent verbal orders, and new and improved MIS ordering matrices (incorporating medical protocols and pathways) have led to more rational and efficient practices. Improved error prevention and critical incident review have identified on-going opportunities for improvement. Although the direct impact on patient outcomes is not yet measurable, numerous positive results have allowed for improved clinical decision making, streamlining of processes, increased regulatory compliance, and a positive culture change.

New abutment for a screw-retained, implant-supported crown.

The 1-piece, implant-supported abutment and crown, colloquially described as the UCLA abutment, commonly is used to fabricate single, screw-retained crowns. This abutment was designed to allow attachment of the crown directly to the implant and requires a waxing and casting procedure by a laboratory technician. A new prefabricated abutment has been developed that uses a similar approach but does not require the waxing and casting process. The PDQ abutment is made from a metal-ceramic alloy that is custom contoured by grinding to support a porcelain veneer. Porcelain then is fired to the contoured abutment to develop the 1-piece artificial crown. This article describes the use of the PDQ abutment.

[Maxillary sinus surgical lift. Summers' technique versus lateral surgical approach]. / Sollevamento chirurgico del seno mascellare. Tecnica di Summers vs approccio chirurgico laterale.

BACKGROUND: After an extensive review of the literature regarding maxillary sinus lift procedures, the authors report the results of a retrospective study carried out by the Institute of Oral and Maxillofacial Surgery at the Second University of Naples. METHODS: A group of 9 patients aged between 18 and 50 years old, including two females, were enrolled in this study. At the preliminary evaluation, the sites to be analysed showed a bone height between the residual crest and the sinusal membrane not exceeding 8 mm. All patients responded positively to specific preimplantation requisites. Commercially pure titanium fixtures were used as well as demineralised freeze-dried bovine bone and autologous bone graft from the retromolar region. RESULTS: All patients were followed for at least 15 months and no clinical check-ups were missed during that time. No implant was lost and no cases of spire exposure were reported. Postoperative vertical bone resorption was within normal values. CONCLUSIONS: Summers technique and its variations with bone grafts of various kinds represents a valid aid for edentulous maxillary rehabilitation with scarce osseous resources in the postero-superior sectors. It offers a number of advantages compared to the traditional technique using an invasive lateral approach and is more acceptable to patients. However, in spite of this positive experience, the follow-up in the literature still appears to be too short. The authors, are therefore cautious in expressing their absolute preference for Summers technique and stress the need to wait for further long-term results.

[Tuberculosis in Italy: available data and open questions]. / Tubercolosi in Italia: dati disponibili e questioni aperte.

OBJECTIVES: To describe the epidemiological trend of tuberculosis (TB) in Italy. DESIGN: Descriptive study on the basis of routine information sources: TB deaths (1955-1993) and TB notifications (1955-1995). To identify persons with AIDS (PWAs) among notified TB cases, a record linkage with the National AIDS Registry was performed. RESULTS: From 1955 to 1993, the TB mortality constantly decreased by a mean of 7.6% per year. From 1955 to 1995, the crude annual total incidence of TB decreased from 25.26 to 9.12 per 100,000. The trend of decrease of pulmonary TB ceased in 1980, whereas the incidence of extrapulmonary TB began to markedly increase in 1980. Between 1992 and 1995, the average annual meningitis notification rate in children < five years was 0.045 per 100,000. In 1995, the curve of incidence rates by age shows two peaks (> 75 years and 25-34 years). Persons with AIDS and foreigner-born persons represented in total 11.3% of TB cases (1992-1995); in the age class 25-34 years, this proportion was 32.5% (34.1% in 1995). A considerable undernotification of TB among PWAS was detected. CONCLUSION: The TB incidence is no longer decreasing due to the changes of TB case definition in 1987 and the.

Biocompatibility studies on glass ionomer cements by primary cultures of human osteoblasts.

Glass ionomer cements (GICs) are materials largely employed in the dental field that have been considered recently as cements in orthopaedic surgery for their proven osteogenic features. The aim of this study was to compare the response of cultured human osteoblastic cells to a number of commercial glass ionomer cements in order to provide indications useful for the further development of formulations that have potential for use as cements or implants in repair and replacement of bone tissue. The GICs tested were: Ketac-Fil Aplicap, lonocem lonocap 1,0, GC Fuji II, GC Fuji II LC and Vitremer 3M. Several features such as plating efficiency, adhesion and morphology of the cells were studied, as well as the only specific biochemical parameter of osteoblastic phenotype, namely osteocalcin production. In addition, the colonisation of materials by osteoblastic cells was verified by means of scanning electron microscopy. Altogether, the results obtained indicate that four of the five glass ionomer cements tested are biocompatible, showing vital cells adhering to the materials, proliferating and expressing the biochemical markers of osteoblastic phenotype, whereas Vitremer 3M, although currently employed in the dental field, exhibits a great cytotoxicity toward the cells. The adverse reaction of this GIC can be attributed to the leaching of at least two components of the polyacidic phase evidenced by protonic magnetic resonance analysis (PMR), namely 2-hydroxyethylmethacrylate (HEMA), and an unidentified acidic species. The addition of pure HEMA at the same concentrations found by means of PMR to cultures of osteoblastic cells resulted in a complete cell death. Our results also show that in vitro methods employing primary cultures of human cells specific to the implant sites of prostheses are appropriate and suitable tools for evaluating biocompatibility of materials. Furthermore, this kind of approach can provide indications useful in the design of novel materials as well as in improving the characteristics of the formulations already available.

[Hepatitis C in Italy in 1992: analysis of individual reports]. / Epatite C in Italia nel 1992: analisi delle schede individuali.

The Authors examined the individual reporting forms of Hepatitis C infections received by the Communicable Diseases Reporting Centre of the Ministry of Health during the year 1992. Thanks to the adoption of a point estimator, 1448 cases of viral hepatitis C have been sorted out. The incidence rate of Hepatitis C has been, on the whole, 2.8 per 100,000, 3.9 for males and 1.9 for females. The highest incidence by age was observed at 20-29 y, and also among women aged 60-69 y. Moreover, the incidence was higher in the low socio-economic classes. Analyzing the data by geographical area, the highest incidence (11.8 per 100,000) was observed in the Basilicata Region, and the County of Potenza, in that Region, reached up 16.7 per 100,000.

[The characteristics and properties of calcium phosphates in biomaterial formulations used in dentistry. 1]. / Caratteristiche e proprietà di alcuni fosfati di calcio presenti nella formulazione di biomateriali impiegati in odontostomatologia. Nota 1.

In this work we present the features and the properties of natural and synthetic apatites, which we use in an experimental study of various commercial products composed by calcium phosphate. After having considered the general concepts of biomaterials and biocompatibility, we describe non biological tests used for the characterization of these products. Biomaterials used in this study are: reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac Blu, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2 Osprogel, Bio-oss, Biostite, Osprovit, Merck Hydroxiapatite. Tests used are: X-ray fluorescence (XRF), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), thermogravimetric and thermodifferential analysis (TG, DTG, DTA), scanner-ing electron microscopy (SEM) morphological analysis. Last but not least, we underline the particular features of these tests whose interpretation allows a more precise definition of the bioactivity of a biocompatible material.

[The thermal analysis of mineral-based biomaterials used in dentistry. 5]. / Analisi termiche di biomateriali a base minerale utilizzati in odontostomatologia. Nota 5.

In this study the following commercial products were thermo-analysed (TG, DTG, DTA): reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac Blu, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-Oss, Biostite, Osprovit, Merck Hydroxiapatite. The apparatus utilized was a Setaram TAG 24, in a symmetrical set up, which gave the TG, DTG and DTA analysis simultaneously. The analysis of all the materials were performed in correct operative conditions. The thermo analyses gave useful information about the thermal stability of the samples. The TG analysis gave the data relative to the percentage of weight loss due to the volatile substances in the samples (H2Oass C, OH-, CO2). The DTG graph made it possible to establish the presence of carbonate apatite and/or hydroxyapatite or the absence of both the substances. Finally, DTA and DTG analyses allowed show the presence of various organic substances. These data were very useful to characterize the examined materials and confirmed the extreme importance and sensibility of this method.

[Infectious endocarditis in dentistry practice: recent controversies and modes of the use of antibiotic prophylaxis]. / L'endocardite infettiva nella pratica odontostomatologica: recenti controversie e modalità di applicazione dell profilassi antibiotica.

A survey by questionnaire to assess the daily practice of the antibiotic prophylaxis of infective endocarditis by physicians attending post-graduate schools of the Institutes of Oral Surgery and Stomatology (Group A n = 83) and Cardiology (Group B n = 46) of the Second University of Naples has been conducted. They were asked about dental procedure and cardiopathies that require prophylaxis for infective endocarditis, the relationship between infective endocarditis and rheumatic disease and the provision of antibiotic. Extraction of tooth and dental and oral surgery have been reported as the most risky procedures. Moreover provision of antibiotic prophylaxis was suggested to patients not at risk (pacemaker or coronary artery bypass), and was not suggested in high risk conditions (mitral valve prolapse with regurgitation and hypertrophic cardiomyopathy). Most of the 50-60% practitioners usually start the prophylaxis 24-48 hours before the procedure and prolong it for 48-72 hours. These results underline the need for improvement of the knowledge for the antibiotic prophylaxis of infective endocarditis.

Dimethyl sulfoxide therapy in the treatment of vesicant extravasation: two case presentations.

The prevention and treatment of vesicant extravasation presents unique nursing challenges. In two case studies, the authors describe the clinical response of patients to dimethyl sulfoxide after multivesicant extravasation. The patients studied did not experience deep tissue necrosis or resultant morbidity related to extravasation. Dimethyl sulfoxide has practical applications in the management of vesicant extravasation. However, further research is needed to fully define its role.