Isolation of NDM-1-producing Pseudomonas aeruginosa sequence type ST235 from a stem cell transplant patient in Italy, May 2013.

We describe the first isolation of an NDM-1-producing Pseudomonas aeruginosa in Italy. In May 2013, a patient with acute lymphoblastic leukaemia and history of prior hospitalisation in Belgrad, Serbia, underwent stem cell transplantation at a tertiary care hospital in Rome, Italy. After transplantion, sepsis by NDM-1-producing P. aeruginosa occurred, leading to septic shock and fatal outcome.

[Pre- and post-operative information for the laryngectomized patient: verification of the validity of a brochure]. / L'informazione pre e post-operatoria del laringectomizzato: verifica della validità di un opuscolo.

For those patients who are candidates for total laryngectomy, therapy is not terminated upon surgery and subsequent speech therapy. Treatment must, instead, take into consideration numerous, important psychological problems which arise upon learning the diagnosis and the need for radical surgery. Therefore, all those who come into contact with the patient during the different phases of disease (i.e. the surgeon, ward nurses, speech therapists) must all be made sensitive to such problems. At times the participation of a psychologist is required. Detailed information on both the temporary and permanent modifications due to surgery and on the possibility of obviating the changed physical status are essential to this "global" therapeutic strategy. The authors have, therefore, prepared an explanatory handbook which briefly analyzes the different problems linked to the total laryngectomy in clear, understandable language. Furthermore, they supply information regarding the new behaviour required after surgery. In order to check how valid this type of instrument is as a graphic support to the irreplaceable information given by the health care workers, a questionnaire was sent to 123 members of the Modena Section of the Laryngectomee Association. This questionnaire dealt with the handbook, the information and advice they gained from it both before and after surgery. Questions also involved what sort of speech therapy they had undergone, whether they had an electronic larynx and, if so, was it used. The judgement given on the brochure by most of those interviewed and on the timeliness of its uses from the preoperative stages on was favorable. This favorable judgment stems from the often insufficient information and psychological support provided patients who have undergone, or who will undergo, a total laryngectomy. Such conclusion is clearly drawn from the responses given to the questionnaire. Moreover, the statements given by some of the laryngectomees (even some who had undergone surgery quite some time ago) indicate that they did not know some of the information and practical advice given. Another fact that emerged from the responses is that the esophageal voice is the means of communication of choice and that the electronic larynx was only used in cases where speech therapy had failed.

[Considerations concerning respiratory physiopathology in a case of total arhinia]. / Considerazioni di fisiopatologia respiratoria a proposito di un caso di arina.

The Authors describe their personal experience in a rare case of total arhinia in a young boy, now seven years old, whose psycho-physical development is normal and who is healthy except for recurrent conjunctivitis due to the absence of nasolacrimal ducts. The Authors consider the possibility that in the case of total absence of the nasal function, as in total arhinia, the oropharyngeal and laryngotracheobronchial mucosa may acquire those functional and defensive properties typically belonging to nasal mucosa. In the subject in question, in fact, functional respiratory and immunosecretory parameters are normal. On the other hand, being well known how problematic acquired severely compromised nasal functions are one would think that only in the case of congenital absence of the nose can the lower aerodigestive structures compensate successfully. In the Authors' opinion this clinic observation contradicts the widely held belief that nasal respiration is absolutely necessary from the moment of birth on.

[The therapy of cervical adenopathies in tumors of the lip and oropharynx]. / Terapia delle adenopatie cervicali nei tumori del labbro e dell'orofaringe.

The authors, after some notes of topographic anatomy about the lymph nodes of the cervical area, examine the different therapeutic managements of lymph node metastasis of lip and oropharynx carcinoma. From these data, the authors put in evidence that almost all the surgeons and the radiotherapists do agree about the inclusion of radiotherapy, polychemotherapy and, more often, surgery in the treatment of cervical lymph node metastasis. The authors experience suggests no treatment of the cervical region in case of N0 lower lip cancer, especially if the neck is thin, and easy to examine, but it is necessary a careful follow-up in order to discover as soon as possible a clinic metastasis. They do not exclude that this behaviour could be suggested also in other neoplastic disorders, but the decision should be based on the histologic kind and grading, on the extension and on the possibility to exclude any cervical involvement. Beside this, the authors come to the conclusion that, in case of N1, N2, N3, the treatment of the cervical regions can not be avoided. The surgical treatment is the neck dissection, functional or radical, alone or together with radiotherapy and polychemotherapy. They finally report that the postoperative radiotherapy for cervical metastasis must be properly used when the capsular rupture is histologically proved.

[In vitro study of periodontal ligament cells]. / Studio in vitro delle cellule del legamento periodontale.

BACKGROUND: The aim of this research is to outline a procedure able to promote specific cellular differentiation and proliferation with consequent periodontal regeneration. To achieve this goal, use was made of various compounds supposed to have the capacity of aiding periodontal regeneration. METHODS: The cells utilised for this study were obtained from explants of human periodontal ligaments. Their proliferation and differentiation capacity was examined in the presence of: coral granules (350, 500 mu), collagene type 1, growth factors (Platelet derived growth factor, PDGF and Transforming growth factor beta 1, TGF beta 1), both on their own and in different combination with one another. The differentiation activity was evaluated by ultrastructural morphological method (Transmission electron microscope-TEM) and by spectrophotometric investigation of the alkaline phosphatasis (ALP). RESULTS: The data show that the coral granules and among the growth factors used only TGF beta 1 stimulate the differentiation activity of the periodontal ligament cells valued on the basis of their capacity of producing ALP. These data are supported by the observation with TEM. CONCLUSIONS: From these results it is suggested that there may be therapeutic efficiency in the periodontal field of substances promoting cellular proliferation and differentiation.

Turbinoplasty: personal technique and long-term results.

An original conservative technique for surgical reduction of the inferior turbinates, called turbinoplasty, is described. We analyzed, in 308 cases, the functional objective and subjective outcome of turbinoplasty itself and in comparison with more destructive procedures called turbinotomies. The results show that both procedures (in skilled hands!) are good. Turbinoplasty is in any case a quick, safe, efficacious operation, well-accepted by the patient, and should therefore be considered one of the first choices.

Salivary gland tumors: revision of 391 cases according to the new WHO classification.

We reviewed 391 cases of salivary gland tumors collected in a 13 year period at the Institute of Pathological Anatomy of the University of Modena, according to the new WHO classification (1991). A diagnosis of pleomorphic adenoma was changed in adenoid cystic carcinoma. Within malignant tumors, 16 cases were reclassified, and new entities, such as polymorphous low-grade adenocarcinoma, papillary cystoadenocarcinoma and salivary duct carcinoma were introduced. Mucoepidermoid carcinomas were subdivised in low-grade and high-grade tumors, but at the follow-up histological grade did not correlate with clinical behaviour of the lesions.

A comparative study of a surgical method and scaling and root planing using the Odontoson.

This investigation compared a traditional periodontal surgical method with a non-surgical treatment of scaling and root planing by an ultrasonic device (Odontoson M) using irrigation with an iodised solution. 8 adult patients with periodontal disease were each treated at 2 randomly chosen quadrants by a Widman flap type surgical technique, and the remaining non-surgically. The patients then attended bi-monthly oral hygiene sessions over a period of 1 year. At that stage, clinical evaluation revealed that the Odontoson M plus an ionized irrigant solution achieved a statistically comparable outcome to that of surgical treatment, even in the pockets initially up to 7 mm in depth.

The evaluation of the interface between bone and a bioceramic dental implant.

Methods for evaluating the interface between bone and an experimental dental implant have been analyzed. The material studied was a titanium implant coated with a mixture of alumina and titanium dioxide by means of a plasma-jet system with the dog as the animal model. The evaluations were made on two levels: (1) in vivo, by analyzing radiographs of the peri-implant zone with a video display computer (2) in vitro, after explantation, by analyzing vertical and horizontal sections of the sample with an optical and a scanning electron microscope, and by a video display computer analysis of the microradiographs of these sections.

Prognostic significance of nucleolar organizer regions in recurrent pleomorphic adenomas of salivary glands.

Pleomorphic adenoma (PA) is the commonest tumor of salivary glands. It is considered a benign tumor which may recur and rarely metastatize. There are no reliable histological criteria for predicting recurrences of PA. In this paper, Ag-NOR expression, evaluated by means a computer assisted image analysis system, has been tested on 11 cases of PA, their recurrences, 10 non recurrent PA and 5 cases of carcinoma ex PA. Mean AgNOR count, mean AgNOR area and mean AgNOR area/particle were determined in each group. AgNOR count and area did not show any significant differences between recurrent and non recurrent PA. On the contrary, AgNOR area/particle seems to be a useful tool in predicting the clinical behaviour of this lesion.