Minimally invasive approach to eliminate pyogenic granuloma using Er, Cr: YSGG laser

Backgroung. PG or granuloma pyogenicum is a common tumor like growth of the oral cavity that is considered to be of non-neoplastic nature, arising commonly as a result of constant low grade trauma and poor oral hygiene and in few instances because of hormonal disturbances. Since it is a benign lesion, choice of treatment is surgical excision with removal of underlying cause if any. A newer treatment modality using laser has been reported. Case report. A 16-year-old male patient reported to our sector of oral medicine with the chief complaint of intra-oral painless growth since four months. Past history and medical history did not reveal any relevant information. He was taking no medication and had no history of known drug allergy. On intra-oral examination smooth surfaced and lobulated growth of approximately 1.5 × 1 × 0.5 cm in size was present in the palate. The lesion was pedunculated and was freely movable over peduncle. The surface of the lesion showed non-omogenous red color whereas in certain area was covered by yellowish plaque like material. On palpation, growth was non-tender, nonfluctuant, hard and fibrous in consistency. Treatment plan comprising of excisional biopsy of the lesion using an Er, Cr: YSGG laser. An elliptical incision was made around the peduncle, the lesion was lifted along with the underlying periosteum from the bone surface and removed. Hemostasis was achieved with the same laser and healing was obtained for second intention. Excised specimen was preserved and sent for histopathological examination. At 7 days recall, the gingival tissues were healthy with successful healing. Conclusion. Excisional surgery is the treatment of choice for PG. The use of laser may be a valid approach for the excision of this lesion, as it is minimally invasive and offers many clinical advantages (minimal intra-operative bleeding,hemostasis, reduced times of healing)

Diode laser treatment of a large oral hemangioma

Background. Several options can be taken into account to treat hemangiomas; the most considered is the surgical excision, although total removal is not always possible, especially for large lesions, since vital structures can be involved. Another treatment includes the diode laser therapy. Objectives. The aim of this study was to report a clinical case of micro-invasive treatment of a large oral hemangioma in the buccal mucosa using a 900 nm diode laser. Case report. A 49-year-old female patient was referred to our sector of oral medicine reporting difficult chewing, swelling, and occasionally bleeding, from a congenital neoformation. Clinical examination revealed a dark blue and multiglobular (size 5x3 cm) lesion of the right buccal mucosa. After diascopy, loss of normal coloration in the place of the lesion was observed. After the eco-doppler evaluation, a diagnosis of congenital haemangioma was formulated, and the patient was treated by photocoagulation by diode laser at 900 nm wavelenght, and 2.5 W of power, in continuous wave mode for 90 s. Irradiation was delivered by means of a flexible quartz fiber that was kept 2-3 mm away from the lesion. Treatment was performed without topical, local, or general anesthesia, in six-monthly-sessions. All stages of treatment and healing were photographically documented. After the treatment, the lesion was blanched and visibile shrinkaged. No adverse effects (atrophy, scars, hyper- or hypopigmentation) were observed after the treatment. No intra and postoperative pain was reported by the patients. On 3-months follow-up, no recurrence was observed. Conclusions. Likewise reported by other studies, diode laser photocoagulation treatment proved to be an useful method for the treatment of oral hemangiomas. For the safety of use and the absence of intra and postoperative discomfort for patients, it would be considered a valuable tool in the treatment of large hemangiomas

System architecture and deployment scenarios for SESAME: small cEllS coordinAtion for Multi-tenancy and Edge services

The surge of the Internet traffic with exabytes of data flowing over operators’ mobile networks has created the need to rethink the paradigms behind the design of the mobile network architecture. The inadequacy of the 4G UMTS Long term Evolution (LTE) and even of its advanced version LTE-A is evident, considering that the traffic will be extremely heterogeneous in the near future and ranging from 4K resolution TV to machine-type communications. To keep up with these changes, academia, industries and EU institutions have now engaged in the quest for new 5G technology. In this paper we present the innovative system design, concepts and visions developed by the 5G PPP H2020 project SESAME (Small cEllS coordinAtion for Multi-tenancy and Edge services). The innovation of SESAME is manifold: i) combine the key 5G small cells with cloud technology, ii) promote and develop the concept of Small Cells-as-a-Service (SCaaS), iii) bring computing and storage power at the mobile network edge through the development of non-x86 ARM technology enabled micro-servers, and iv) address a large number of scenarios and use cases applying mobile edge computing

The combination of laser-assisted surgery with PRP for the treatment of BRONJ in cancer patient. A pilot study

Aim. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a well-known potential complication of bisphosphonates (BPs) therapy and its treatment could reckon on different approaches. Recently, encouraging results for BRONJ were showed from some clinical studies using Er, Cr: YSGG laser-assisted surgery. Platelet-Rich Plasma (PRP), a new approach to promote tissue regeneration and healing, may be a promising complementary therapy. The aim of this pilot study is to study the effectiveness, in terms of clinical healing, of a combined treatment (laserassisted surgery and topical PRP) for BRONJ in a group of cancer patients. Methods. Ten oncological patients (3 males, 7 females; aged 69-89 years, mean age 76.2±5.8) with BRONJ were consecutively recruited. BRONJ was classified (T0) according to. All patients underwent pre- and peri-operatory antibiotic prophylaxis, and preparation of autologous PRP; the following combined surgical protocol was applied: i) exposure of the surgical area, through the creation of surgical edges; ii) courettage of the necrotic bone and, if present, sequestrectomy, by using a Er, Cr: YSGG laser; iii) application of autologous PRP over the entire bone cavity; iiii) suture of surgical flaps. All patients performed a CT after 3 months from surgery (T1) in order to re-stage of the disease. Successful treatments were considered the complete healing and the radiological improvement (transition from a higher stage to a lower one). Results. At T0 6/10 patients were stage IB, 2/10 were stage IIA and 2/10 were stage IIB. At T1, 3/10 (30%) cases (2 cases IB and 1 case IIB) showed no clinical and radiological signs of BRONJ relapse; 5/10 (50%) cases (4 cases IB and 1 case IIB) showed clinical improvement, whereas 2/10 (20%) (both IIA) showed no-improvement. Conclusion. The association of laser-assisted surgery and topical PRP, firstly investigated in this study, seems useful in BRONJ healing among cancer patients. Further investigation is necessary in order to validate these preliminary result

Conservative Surgical Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw with Er,Cr:YSGG Laser and Platelet-Rich Plasma: A Longitudinal Study

Abstract Introduction: The management of bisphosphonate-related osteonecrosis of the jaw (BRONJ), with no evidence-based guidelines, remains controversial. We aimed to evaluate the efficiency of a conservative surgical treatment combining Er,Cr:YSGG laser and platelet-rich plasma (PRP) for the treatment of BRONJ in cancer patients.Methods:We performed a longitudinal cohort study. Inclusion criteria were (1) age 65 18 years; (2) cancer diagnosis; (3) treatment with NBP because of the underlying cancer. Results:We consecutively recruited ten patients diagnosed with BRONJ in stage I or II. These patients underwent a surgical laser-assisted therapy together with autologous PRP. At the latest follow-up at 12 months, clinical improvement was observed in eight patients. Registration Number is IRCT20180329039159N1. Conclusion:We could successfully manage the BRONJ utilizing this combined protocol to heal the 30% of surgically treated sites and to improve the 50% of patients' lesions clinically. Our findings suggest that a surgical approach combined with Er,Cr:YSGG laser and PRP benefit cancer patients with general health issues

Superior Antibacterial Activity of Integral Lemon Pectin Extracted via Hydrodynamic Cavitation

Pectin extracted via hydrodynamic cavitation in water only from waste lemon peel and further isolated via freeze drying displays significant antibacterial activity against Staphylococcus aureus, a Gram positive pathogen which easily contaminates food. The antibacterial effect of the new IntegroPectin is largely superior to that of commercial citrus pectin, opening the way to advanced applications of a new bioproduct now obtainable in large amounts and at low cost from citrus juice industry's waste

Autonomous and Human-Driven Vehicles Interacting in a Roundabout: A Quantitative and Qualitative Evaluation

Optimizing traffic dynamics in an evolving transportation landscape is crucial, particularly in scenarios where autonomous vehicles (AVs) with varying levels of autonomy coexist with human-driven cars. While optimizing Reinforcement Learning (RL) policies for such scenarios is becoming more and more common, little has been said about realistic evaluations of such trained policies. This paper presents an evaluation of the effects of AVs penetration among human drivers in a roundabout scenario, considering both quantitative and qualitative aspects. In particular, we learn a policy to minimize traffic jams (i.e., minimize the time to cross the scenario) and to minimize pollution in a roundabout in Milan, Italy. Through empirical analysis, we demonstrate that the presence of AVs} can reduce time and pollution levels. Furthermore, we qualitatively evaluate the learned policy using a cutting-edge cockpit to assess its performance in near-real-world conditions. To gauge the practicality and acceptability of the policy, we conduct evaluations with human participants using the simulator, focusing on a range of metrics like traffic smoothness and safety perception. In general, our findings show that human-driven vehicles benefit from optimizing AVs dynamics. Also, participants in the study highlight that the scenario with 80% AVs is perceived as safer than the scenario with 20%. The same result is obtained for traffic smoothness perception

Micronized cellulose from citrus processing waste using water and electricity only

Along with a water-soluble fraction rich in pectin, the hydrodynamic cavitation of citrus processing waste carried out in water demonstrated directly on semi-industrial scale affords an insoluble fraction consisting of micronized cellulose of low crystallinity ("CytroCell"). Lemon and grapefruit CytroCell respectively consist of 100-500 nm wide cellulose nanorods, and of 500-1000 nm wide ramified microfibrils extending for several ?m. These findings establish a technically viable route to low crystallinity micronized cellulose laying in between nano- and microcellulose, using water and electricity only