Dental Ritual Mutilations and Forensic Odontologist Practice: a Review of the Literature

Uvod: Etnička sakaćenja imaju antropološko značenje, kako u suvremenom tako i u nekadašnjem ljudskom ponašanju, ovisno o geografskim, religioznim i kulturnim čimbenicima koji znatno mogu pomoći forenzičnom stomatologu u postupku izrade dentalnog profila. Sakaćenje zuba i ukrasi na njima bili su, i još uvijek jesu, uobičajeni među mnogim etničkim skupinama i kulturama. Kroz povijest ljudskoga roda zdravlje zuba bilo je simbol mladosti, ljepote i snage, ali može imati i druga značenja. Sakaćenje zuba obilježje je mnogih nestalih kultura i prakticiralo se uglavnom tijekom religijskih rituala, u estetske svrhe i kao simbol pripadnosti određenoj socijalnoj skupini. No slični običaji i danas su uobičajeni u nekim područjima diljem svijeta. Materijali i metode: Članak je zapravo sustavni pregled literature o ritualnom sakaćenju zuba iz ranih 1960-ih, a uključeni su i podatci s PubMeda, Scopusa i Google Scolara. Istaraživanje je namjerno ograničeno na ritualno sakaćenje koje se može definirati kao bilo koje nepovratno narušavanje integriteta ljudskoga organizma učinjeno u ritualne svrhe i bez namjere liječenja. Zato su isključeni svi slučajevi pojedinačnih ili višestrukih samovađenja zuba učinjenih iz psihotičnih razloga te oralno sakaćenje djece jer se takva praksa u nekim etničkim skupinama smatra terapijskom. Zaključak: Spoznaje o promjenama na zubima nakon oralnoga sakaćenja važne su pri identifikaciji živih ili umrlih osoba, ili čak ljudskih ostataka jer odaju odgovarajuće informacije o etničkom i kulturološkom podrijetlu subjekta. U ovom članku navedena su i neka medicinskopravna stajališta o sakaćenju zuba, a namijenjena su doktorima dentalne medicine.Background: Ethnic mutilations have a social and anthropological significance both in contemporary and past human behavior, influenced by geographic, religious and cultural factors which can greatly help forensic odontologist’s practice in dental profiling process. ental ritual mutilations and dental decorations were - and still are - practiced among many ethnic groups and cultures. Throughout the history of humanity, having healthy teeth has a symbolic meaning of youth, beauty and strength, but it can also have other meanings. Dental ritual mutilations were documented in many cultures in the past and were practiced mainly for religious rituals purposes, for esthetic reasons and because they represented a symbol of status or of belonging to a particular social group. Similar rituals are still performed. Material and Method: The present paper is a systematic review of the literature reporting on dental ritual mutilations from the early 1960s and is included in Pubmed, Scopus and Googlescholar. The research was deliberately limited only to the ritual mutilations, which can be defined as “any irreversible impairment of the integrity of the human organism, made with a ritual purpose and without any curative aim”. Therefore all the articles dealing with single or multiple dental self extractions of psychotic origins were excluded, as well as the infant oral mutilations, since the practice is deemed to have therapeutical effects among ethnic groups dedited to this practice. Conclusions: The knowledge of dental alteration due to oral mutilations can be a powerful tool for the identification procedures of living or dead persons or even in human remains especially providing relevant information about the ethnic origins and the cultural background of a subject. Some medical legal issues for the odontologist about dental mutilation are also addressed in the paper

Transient global amnesia: Isolated event or healthy predictor? Clinical experience of an Italian Emergency Department

Transient global amnesia (TGA) is a clinical syndrome characterized by reversible anterograde amnesia, in which the patient is alert, self-awareness appears intact and other neurological symptoms are absent. The diagnosis is based on the following criteria: i) witnessed event; ii) acute onset of anterograde amnesia; iii) no accompanying neurological symptoms; iv) no alteration of consciousness; v) no epileptic features; vi) resolution within 24 hours; vii) exclusion of other causes. We conducted a cohort study at the Department of Emergency Medicine on 119 patients with TGA diagnosis from 2010 to 2014, with follow-up evaluation by telephone interview. The objectives of our study were to evaluate the frequency of subsequent episodes, to identify predisposing factors, and to investigate whether TGA is a possible predictor of neurological disease. The frequency of comorbidity in our population was in line with literature. We observed a recurrence rate of 9.5%, with a prevalence for the male gender, while no other factor correlates with TGA recurrence. TGA was not a predictor of further neurological diseases. In conclusion, TGA is a benign pathology with a low probability of relapse. Accordingly, management in Emergency Department should be based on a correct initial clinical classification for rapid discharge

Comment on 'Cancer genetic counselling' by P. Mandich et al.

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Characterization of the dispirotripiperazine derivative PDSTP as antibiotic adjuvant and antivirulence compound against Pseudomonas aeruginosa

Pseudomonas aeruginosa is a major human pathogen, able to establish difficult-to-treat infections in immunocompromised and people with cystic fibrosis (CF). The high rate of antibiotic treatment failure is due to its notorious drug resistance, often mediated by the formation of persistent biofilms. Alternative strategies, capable of overcoming P. aeruginosa resistance, include antivirulence compounds which impair bacterial pathogenesis without exerting a strong selective pressure, and the use of antimicrobial adjuvants that can resensitize drug-resistant bacteria to specific antibiotics. In this work, the dispirotripiperazine derivative PDSTP, already studied as antiviral, was characterized for its activity against P. aeruginosa adhesion to epithelial cells, its antibiotic adjuvant ability and its biofilm inhibitory potential. PDSTP was effective in impairing the adhesion of P. aeruginosa to various immortalized cell lines. Moreover, the combination of clinically relevant antibiotics with the compound led to a remarkable enhancement of the antibiotic efficacy towards multidrug-resistant CF clinical strains. PDSTP-ceftazidime combination maintained its efficacy in vivo in a Galleria mellonella infection model. Finally, the compound showed a promising biofilm inhibitory activity at low concentrations when tested both in vitro and using an ex vivo pig lung model. Altogether, these results validate PDSTP as a promising compound, combining the ability to decrease P. aeruginosa virulence by impairing its adhesion and biofilm formation, with the capability to increase antibiotic efficacy against antibiotic resistant strains

Linear Optics Simulation of Non-Markovian Quantum Dynamics

The simulation of quantum processes is a key goal for the grand programme aiming at grounding quantum technologies as the way to explore complex phenomena that are inaccessible through standard, classical calculators. Some interesting steps have been performed in this direction and this scenario has recently been extended to open quantum evolutions, marking the possibility to investigate important features of the way a quantum system interacts with its environment. Here we demonstrate experimentally the (non-)Markovianity of a process where system and environment are coupled through a simulated transverse Ising model. By engineering the evolution in a fully controlled photonic quantum simulator, we assess and demonstrate the role that system-environment correlations have in the emergence of memory effects.Comment: 4+2 pages, 4 figures, RevTeX

Contemporary snapshot of tumor regression grade (TRG) distribution in locally advanced rectal cancer: a cross sectional multicentric experience.

Pre-operative chemoradiotherapy (CRT) followed by surgical resection is still the standard treatment for locally advanced low rectal cancer. Nowadays new strategies are emerging to treat patients with a complete response to pre-operative treatment, rendering the optimal management still controversial and under debate. The primary aim of this study was to obtain a snapshot of tumor regression grade (TRG) distribution after standard CRT. Second, we aimed to identify a correlation between clinical tumor stage (cT) and TRG, and to define the accuracy of magnetic resonance imaging (MRI) in the restaging setting. Between January 2017 and June 2019, a cross sectional multicentric study was performed in 22 referral centers of colon-rectal surgery including all patients with cT3-4Nx/cTxN1-2 rectal cancer who underwent pre-operative CRT. Shapiro-Wilk test was used for continuous data. Categorical variables were compared with Chi-squared test or Fisher's exact test, where appropriate. Accuracy of restaging MRI in the identification of pathologic complete response (pCR) was determined evaluating the correspondence with the histopathological examination of surgical specimens.In the present study, 689 patients were enrolled. Complete tumor regression rate was 16.9%. The "watch and wait" strategy was applied in 4.3% of TRG4 patients. A clinical correlation between more advanced tumors and moderate to absent tumor regression was found (p = 0.03). Post-neoadjuvant MRI had low sensibility (55%) and high specificity (83%) with accuracy of 82.8% in identifying TRG4 and pCR.Our data provided a contemporary description of the effects of pre-operative CRT on a large pool of locally advanced low rectal cancer patients treated in different colon-rectal surgical centers

Carriers of ADAMTS13 Rare Variants Are at High Risk of Life-Threatening COVID-19

Thrombosis of small and large vessels is reported as a key player in COVID-19 severity. However, host genetic determinants of this susceptibility are still unclear. Congenital Thrombotic Thrombocytopenic Purpura is a severe autosomal recessive disorder characterized by uncleaved ultra-large vWF and thrombotic microangiopathy, frequently triggered by infections. Carriers are reported to be asymptomatic. Exome analysis of about 3000 SARS-CoV-2 infected subjects of different severities, belonging to the GEN-COVID cohort, revealed the specific role of vWF cleaving enzyme ADAMTS13 (A disintegrin-like and metalloprotease with thrombospondin type 1 motif, 13). We report here that ultra-rare variants in a heterozygous state lead to a rare form of COVID-19 characterized by hyper-inflammation signs, which segregates in families as an autosomal dominant disorder conditioned by SARS-CoV-2 infection, sex, and age. This has clinical relevance due to the availability of drugs such as Caplacizumab, which inhibits vWF-platelet interaction, and Crizanlizumab, which, by inhibiting P-selectin binding to its ligands, prevents leukocyte recruitment and platelet aggregation at the site of vascular damage

Pathogen-sugar interactions revealed by universal saturation transfer analysis

Many pathogens exploit host cell-surface glycans. However, precise analyses of glycan ligands binding with heavily modified pathogen proteins can be confounded by overlapping sugar signals and/or compounded with known experimental constraints. Universal saturation transfer analysis (uSTA) builds on existing nuclear magnetic resonance spectroscopy to provide an automated workflow for quantitating protein-ligand interactions. uSTA reveals that early-pandemic, B-origin-lineage severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike trimer binds sialoside sugars in an “end-on” manner. uSTA-guided modeling and a high-resolution cryo–electron microscopy structure implicate the spike N-terminal domain (NTD) and confirm end-on binding. This finding rationalizes the effect of NTD mutations that abolish sugar binding in SARS-CoV-2 variants of concern. Together with genetic variance analyses in early pandemic patient cohorts, this binding implicates a sialylated polylactosamine motif found on tetraantennary N-linked glycoproteins deep in the human lung as potentially relevant to virulence and/or zoonosis

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys