LA RIABILITAZIONE IMPLANTOPROTESICA DEI PAZIENTI SOTTOPOSTI A RESEZIONE ONCOLOGICA DEI MASCELLARI: NOSTRO PROTOCOLLO DI TRATTAMENTO.

I pazienti sottoposti a resezione oncologica per patologia neoplastica del cavo orale, subiscono interventi chirurgici molto spesso mutilanti che, nonostante la ricostruzione del difetto osseo e dei tessuti molli, determinano una alterazione della normale anatomia della cavitá orale, una alterazione dei normali movimenti della lingua e della mandibola, un deficit della sensibilitá propriocettiva della mucosa orale. Tutte queste variabili determinano una impossibilitá da parte del paziente di poter tollerare una protesi convenzionale mucosupportata. Fattore secondario, ma non meno importante, che puó rendere ancora meno tollerata questo tipo di protesi é sicuramente la radioterapia in quanto questo tipo di trattamento sia inteso come terapia adiuvante sia come inteso come terapia neoadiuvante, determina iposcialia associata a vari gradi di mucosite orale. Alla luce di quanto fin qui esposto, due significative innovazioni chirurgiche e tecnologiche hanno rivoluzionato la ricostruzione funzionale dei pazienti sottoposti a resezione oncologica dei mascellari: i lembi liberi rivascolarizzati e gli impianti osteointegrati. I lembi liberi rivascolarizzati consentono un´affidabile riparazione di complessi ed estesi difetti dei tessuti post-resezione oncologica; gli impianti osteointegrati forniscono un efficace ed affidabile mezzo di ritenzione, stabilizzazione e supporto dell`apparato masticatorio ricostruito. L´utilizzo di impianti osteointegrati in pazienti con difetti maxillo-mandibilari é un tipo di trattamento ormai comune ed affidabile e che ha trovato consenso negli ultimi 15 anni. Da allora, le esperienze in merito si sono succedute numerose e l’inserimento di impianti endossei costituisce ormai il naturale completamento della ricostruzione funzionale maxillo-mandibolare. La standardizzazione di tale protocollo é giustificato dall’alta percentuale di successo di questa metodica e dalla sua riproducibilitá. Nondimeno, l’accurata programmazione del trattamento riabilitativo rimane uno dei cardini della riuscita, soprattutto a lungo termine. Lo scopo di questa tesi é presentare una ampia casistica di pazienti oncologici (111) sottoposti a riabilitazione protesica implantosupportata e valutare, attraverso uno studio retrospettivo, il comportamento degli impianti (706) in relazione ad una serie di variabili

Prevention of Mandibular Third Molar Extractionâ Associated Periodontal Defects: A Comparative Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141207/1/jper0389.pd

Prevention of Mandibular Third Molar Extractionâ Associated Periodontal Defects: A Comparative Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141207/1/jper0389.pd

Neke činjenice i izazovi u problemu sinteze antenskih nizova

Many efforts have been done in recent years to solve array synthesis problems in a way as effective as possible. Stochastic optimization schemes have been widely applied to this end, notwithstanding their performance rapidly lowers as the size of the problem increases. This trend has led to neglect mathematical properties of the problem, as convexity or partial convexity, which may be very useful to devise really effective synthesis procedures. In this paper we show that in a number of array synthesis problems of significant practical interest global optimisation is not required at all, or can be limited to a subset of the unknowns. This is by no means an academic point, as we show that a proper exploitation of the convexity allows to achieve, in a much shorter time, design solutions significantly better than those obtained by using general purpose global optimization techniques.Zadnjih godina učinjeni su mnogi napori kako bi se riješio problem sinteze antenskih nizova na najefikasniji mogući način. Često su primjenjivane stohastičke optimizacijske sheme premda performance metode drastično opadaju kako raste veličina problema. Ovaj trend je doveo do potpunog negiranja matematičkih svojstava romatranog problema, jer je negirano svojstvo konveksnosti odnosno djelomične konveksnosti koje se može iskoristiti za razvoj izrazito efikasne metode sinteze. U radu ćemo pokazati da mnogi problemi sinteze antenskih nizova od značajnog praktičnog interesa uopće ne zahtijevaju globalnu optimizacijsku metodu, ili se globalna optimizacijska metoda može primijeniti na podskup varijabli-nepoznanica. Ta činjenica je mnogo šira od akademske diskusije jer ispravno korištenje svojstva konveksnosti omogućuje dizajn antenskog niza, postignut u puno kraće vrijeme, sa značajno boljim svojstvima u odnosu na dizajn postignut globalnom optimizacijskom metodom

A systematic review and meta-analysis

The relationship between antiphospholipid antibodies (aPL) and autoimmune haemolytic anaemia (AIHA) has never been systematically addressed. The aim of this study is to assess the link between aPL and AIHA in adult systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). This study performed an EMBASE/PubMed search from inception to June 2019 and meta-analysis using Peto’s odds ratios. The pooled prevalence (PP) of IgG/IgM anticardiolipin (aCL) and lupus anticoagulant (LA) was greater in AIHA +ve than AIHA –ve patients (34.7% vs. 27.6%, p = 0.03; 33.3% vs. 21.8%, p < 0.0001; 20.9% vs. 8.3%, p = 0.01). The PP of AIHA was greater in: (1) IgG and IgM aCL +ve than-ve patients (21.8% vs. 11.1%, p = 0.001 and 18.7% vs. 6.3%, p < 0.0001), (2) in SLE related APS than in primary APS patients (22.8% vs. 3.9% p < 0.0001), (3) in APS +ve than APS-ve SLE patients (23.2% vs. 8.4%, p = 0.01), and (4) in thrombotic APS than non-thrombotic APS/SLE patients (26.8% vs. 10%, p = 0.03). The PP of IgG/IgM aCL and LA was greater in DAT +ve than DAT-ve patients (42.4% vs. 12.8%, p < 0.0001; 26.2% vs. 12.8%, p = 0.03 and 29.2% vs. 15.7%, p = 0.004 respectively). It was found that AIHA prevalence is maximal in SLE with aPL/APS, low-moderate in SLE without aPL and minimal in PAPS. Moreover, AIHA is rightly included among the classification criteria for SLE but not for APS/aPL. The significance of an isolated DAT positivity remains unclear in this setting.publishersversionpublishe

Similar reduction of cholesterol-adjusted Vitamin E serum levels in simple steatosis and non-alcoholic steatohepatitis

OBJECTIVES: Reduced vitamin E levels have been reported in patients with non-alcoholic steatohepatitis (NASH), but no conclusive data on patients with simple steatosis (SS) are available. Aim of this study was to investigate the association betweenserum vitamin E levels and SS. METHODS: A cohort of 312 patients with cardio-metabolic risk factors was screened for liver steatosis by ultrasonography (US). We reasonably classified as SS patients with US-fatty liver, normal liver function tests (LFTs) and with Cytokeratin 18 o246 mIU/ml. Liver biopsy was performed in 41 patients with US-fatty liver and persistent elevation of LFTs (46 months). Serum cholesterol-adjusted vitamin E (Vit E/chol) levels were measured. RESULTS: Mean age was 53.9±12.5 years and 38.4% were women. Non-alcoholic fatty liver disease (NAFLD) was detected at US in 244 patients; of those 39 had biopsy-proven NASH and 2 borderline NASH. Vit E/chol was reduced in both SS (3.4±2.0, Po0.001), and NASH (3.5±2.1, P=0.006) compared with non-NAFLD patients (4.8±2.0 μmol/mmol chol). No difference was found between SS and NASH (P=0.785). After excluding patients with NASH, a multivariable logistic regression analysis found that Vit E/chol (odds ratio (OR): 0.716, 95% confidence interval (CI) 0.602–0.851, Po0.001), alanine aminotransferase (ALT, OR: 1.093, 95% CI 1.029–1.161, P=0.004), body mass index (OR: 1.162, 95% CI 1.055–1.279, P=0.002) and metabolic syndrome (OR: 5.725, 95% CI 2.247–14.591, Po0.001) were factors independently associated with the presence of SS. CONCLUSIONS: Reduced vitamin E serum levels are associated with SS, with a similar reduction between patients with SS and NASH, compared with non-NAFLD patients. Our findings suggest that the potential benefit of vitamin E supplementation should be investigated also in patients with SS

Reparative giant cell granuloma in a pediatric patient

Reparative giant cell granulomas are benign, infrequent tumors, of non-odontogenic origin, that develop at central or peripheral level. Peripherally located lesions are frequently denominated ?giant cell epulis?, and never correspond to true neoplasia, but rather to inflammatory reactions secondary to another lesion (hemorrhage, etc.). It should be taken into account, that in general, head and neck tumors of infancy usually demonstrate an atypical biological behaviour. Furthermore, the anatomicopathologic diagnosis is often compromised in this type of lesion. We present the case of a 6-year-old boy, who, three weeks after suffering a slight facial trauma, developed a painless, exophytic swelling of approximately 4 cm, with bleeding on palpation, in the ipsilateral hemimaxilla. The lesion demonstrated rapid, progressive and continuous growth. The facial CT and incisional biopsy confirmed the suspected diagnosis of reparative giant cell granuloma. The patient was surgically treated, carrying out a left marginal maxillectomy associated with the extirpation of the soft-tissue lesion. The resultant defect was reconstructed with a Bichat fat-pad providing the patient with optimal esthetic and functional results. The definitive anatomicopathologic report of the surgical piece is compatible with reparative giant cell granuloma

Relevance of vein wall thickness in Behcet's disease: A systematic review and meta-analysis.

ObjectivesTo perform a meta-analysis on articles evaluating the common femoral vein wall thickness (VWT) in Behcet's disease and its possible clinical, laboratory and treatment correlates (BD).MethodsSystematic search of EMBASE and PubMed databases from inception to October 2023; we employed random effect meta-analyses for continuous outcomes.ResultsThe meta-analysis included 9 case-control and 1 cohort study: the VWT was greater in BD (n = 650) than in controls (n = 396) (p 2 = 94.4%); a sensitivity analysis that included mean age of BD participants, gender, disease duration and activity, C-reactive protein, smoking status, immune-suppressive and anti-inflammatory medication, revealed that the heterogeneity variance was partly explained by age (p ConclusionVWT is greater in BD than controls: age, male gender, disease duration and smoking relate to VWT that was greater in BD patients with a history of thrombotic/vascular disease. Prospective studies are required to assess whether VWT may be considered a vascular marker of disease activity

Subclinical atherosclerosis in Behcet's disease and its inverse relation to azathioprine use: an updated meta-analysis

To evaluate the intima media thickness of carotid arteries (IMT) and its clinical, laboratory and treatment correlates in Behcet's disease (BD). Systematic search of EMBASE and PubMed databases from January 2016 to October 2022; we employed random effect meta-analyses for continuous outcomes and Peto's odds ratio for rare events. The meta-analysis included 36 case control studies: the IMT was greater in BD (n = 1103) than in controls (n = 832) (p 2 = 86.9%); a sensitivity analysis that included mean age of BD participants, gender, disease duration and activity, atherogenic index of plasma, blood pressure, C-reactive protein, ethnicity, smoking status, anti-inflammatory and immune suppressive agents, revealed that male gender, mean age of participants and azathioprine use (the latter two in inverse fashion) partly explained the heterogeneity variance (p = 0.02, p = 0.005, and p = 0.01). The IMT was greater in vascular (n = 114) than in non-vascular BD (n = 214) (p = 0.006). BD patients (n = 782) had a greater pooled prevalence of carotid plaques than controls (n = 537) (13.1% vs. 2.97%, p < 0.0001). Subclinical carotid artery atherosclerosis represents a vascular feature of BD, independently of the traditional cardiovascular risk factors. The inverse correlations between IMT, age and azathioprine use suggest that thicker carotid arteries at disease onset eventually regress with immune suppressive treatment: this assumption needs verification on adequately designed clinical trials