The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres

Purpose: In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a national multicenter study to analyze the impact of PMRT on breast reconstruction. Methods: We conducted a retrospective case-control multicenter study on women undergoing breast reconstruction. Data were collected from 18 Italian Breast Centres and stored in a cumulative database which included the following: autologous reconstruction, direct-to-implant (DTI), and tissue expander/immediate (TE/I). For all patients, we described complications and surgical endpoints to complications such as reconstruction failure, explant, change in type of reconstruction, and reintervention. Results: From 2001 to April 2020, 3116 patients were evaluated. The risk for any complication was significantly increased in patients receiving PMRT (aOR, 1.73; 95% CI, 1.33-2.24; p < 0.001). PMRT was associated with a significant increase in the risk of capsular contracture in the DTI and TE/I groups (aOR, 2.24; 95% CI, 1.57-3.20; p < 0.001). Comparing type of procedures, the risk of failure (aOR, 1.82; 95% CI, 1.06-3.12, p=0.030), explant (aOR, 3.34; 95% CI, 3.85-7.83, p < 0.001), and severe complications (aOR, 2.54; 95% CI, 1.88-3.43, p < 0.001) were significantly higher in the group undergoing DTI reconstruction as compared to TE/I reconstruction. Conclusion: Our study confirms that autologous reconstruction is the procedure least impacted by PMRT, while DTI appears to be the most impacted by PMRT, when compared with TE/I which shows a lower rate of explant and reconstruction failure. The trial is registered with NCT04783818, and the date of registration is 1 March, 2021, retrospectively registered

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p &lt; 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p &lt; 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p &lt; 0.0001) or urgent (20.4% vs. 38.5%; p &lt; 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p &lt; 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Notas sobre a Carta de Veneza

This paper presents a critical reading of the Venice Charter, an Icomos key document, fruit of a conference held in 1964. The Charter is often quoted in Brazil but is not always properly understood. The conservation and restoration charters - especially those produced by international institutions - are documents that have an indicatory or, at the most, prescriptive character. They constitute the deontological foundation of many professionals involved in preservation, but they are not recipes for immediate use. In order to elaborate a well-founded reading of the document, its ideas must be understood in connection to the theoretical postulates of the time they were engendered and to the developments of the field. Thus this paper will examine these subjects, commenting and enlightening the Charter's articles and pointing out the origins of specific ideas. It also discusses how the Charter relates to previous documents and their theoretical foundations. This approach, based in a critical analysis, is necessary in order to reach a fuller interpretation of the Charter's indications so that they can be used in the present

In Vitro Shear Bond Strength of Orthodontic Brackets after Enamel Conditioning with Acid Etching and Hydroabrasion

The purpose of this study was to evaluate the shear bond strength and adhesive remnant index ARI) of orthodontic brackets following enamel conditioning with acid etching, hydroabrasion, and with both procedures. Thirty extracted human premolars were divided into three groups and received either acid etching, hydroabrasion or both procedures. Orthodontic brackets were bonded with composite resin. Shear bond strength was tested with a tensile machine, then the teeth were observed under a stereomicroscope to evaluate ARI scores. The enamel morphology after each conditioning method was evaluated with scanning electron microscope imaging. A one-way ANOVA and a Kruskal&minus;Wallis H test were used to compare the bond strength and the ARI scores among the three groups. Hydroabrasion alone produced shear bond strength values below clinical acceptability, while the combination of acid etching and hydroabrasion produced the highest values. The ARI scores in the hydroabrasion group were significantly different from the other groups. Hydroabrasion followed by acid etching was effective in increasing the shear bond strength of orthodontic brackets. Further in vivo studies are needed to confirm the cost and benefits of this technique

Soft-tissue changes after Class II malocclusion treatment using the Sander bite-jumping appliance: a retrospective study

The soft tissue profile outcome after functional treatment of Class II malocclusion is important for a patient's aesthetic and psychosocial results. The soft tissue effects of the Sander bite-jumping appliance (BJA), which is the device that produces the greatest mandibular advancement according to a systematic review, have never been investigated. The aim of the present study was to assess the soft tissue effects of the BJA in comparison to matched untreated controls

Anti-inflammatory and antioxidant effects of flavonoid-rich fraction of bergamot juice (BJe) in a mouse model of intestinal ischemia/reperfusion injury

The flavonoid-rich fraction of bergamot juice (BJe) has demonstrated anti-inflammatory and antioxidant activities. The aim of work was to test the beneficial effects of BJe on the modulation of the ileum inflammation caused by intestinal ischemia/reperfusion (I/R) injury in mice. To understand the cellular mechanisms by which BJe may decrease the development of intestinal I/R injury, we have evaluated the activation of signaling transduction pathways that can be induced by reactive oxygen species (ROS) production. Superior mesenteric artery and celiac trunk were occluded for 30 min and reperfused for 1 h. The animals were sacrificed after 1 h of reperfusion, for both histological and molecular examinations of the ileum tissue. The experimental results demonstrated that BJe was able to reduce histological damage, cytokines production, adhesion molecules expression, neutrophil infiltration and oxidative stress by a mechanism involved both NF-κB and MAP kinases pathways. This study indicates that BJe could represent a new treatment against inflammatory events of intestinal I/R injury

Liver X receptors activation, through TO901317 binding, reduces neuroinflammation in Parkinson’s disease

<div><p>Parkinson's disease (PD) is a neurodegenerative disease in which degeneration of nigrostriatal neurons and inflammation are key players. The aim of our study was to analyze the function of LXRs in neurodegenerative diseases as PD using <i>in vivo</i>, <i>ex vivo</i> and <i>in vitro</i> models of PD; for this purpose, we observed the effects of the LXR agonist, TO901317, in neuroinflammatory pathway related to PD. We performed an <i>in vivo</i> model of PD using the neurotoxin 1-methyl-4-phenyl-1, 2,3,6-tetrahydropyridine (MPTP) and our results clearly showed that TO901317 administration reduces all of the inflammatory markers involved in PD such as iNOS and COX2, IκB-α and NF-κB. Moreover, to confirm the neuroprotective properties of TO901317, that we obtained with the in vivo model, we performed also an <i>ex vivo</i> and <i>in vitro</i> models of PD. All the results taken, confirmed that TO901317 is able to modulate the neuroinflammatory pathway involved in PD increasing the locomotors function. Therefore, TO901317, LXR synthetic agonist, could be studied as a new target in a neurodegenerative disorder like PD.</p></div