Gender assessment through three-dimensional analysis of maxillary sinuses by means of Cone Beam Computed Tomography

OBJECTIVE: The availability of a low dose radiation technology such as Cone Beam Computed Tomography (CBCT) in dental practice has increased the number of scans available for forensic purposes. Moreover, specific software allows for three-dimensional (3D) characterization of the maxillary sinuses. This study was performed to determine whether sinus maxillary volumes can be useful to identify gender after validating the use of the Dolphin software as a tool for volumetric estimation of maxillary sinus volumes. PATIENTS AND METHODS: The validation was performed by four different operators measuring the volume of six phantoms, where the real volume was already known. The maxillary sinus volumes of 52 patients (26 males and 26 females) mean age 24.3 were calculated and compared between genders and sagittal skeletal class subdivision. The measurements for patients and phantoms were based on CBCT scans (ILUMA™) processed by Dolphin 3D software. RESULTS: No statistical difference was observed between the real volume and the volume measurements performed by the operators. No statistical difference was found in patient's maxillary sinus volumes between gender. CONCLUSIONS: Based on our results, it is not possible to support the use of maxillary sinuses to discern sexual difference in corpse identification

Three-dimensional Computed Tomography for cephalometric studies of patients with dentomaxillofacial dysgnathia [La Tomografia Computerizzata 3D nella diagnosi cefalometrica delle disgnazie dento-maxillo-facciali]

Objectives: The aim of this work was to compare traditional radiographic cephalometry with that based on three-dimensional computed tomography (3D CT) and to evaluate the pros and cons of two different 3D CT methods. Materials and methods: Two adult patients were examined with traditional radiographic methods and with two different tomographic techniques: fan beam CT and cone beam CT. The cephalograms obtained with these methods were analyzed with a traditional digital cephalometric approach and with 3D cephalometric software. Results and Conclusions: Computed Tomography provides more accurate information than traditional radiography since it eliminates the problems of deformation, magnifi cation, superimposition, and artifacts. It is especially useful in the presence of oral-maxillofacial dysgnathia since it allows study of the skull in each of the three dimensions. Cone beam technology uses a low dose of radiation and is less costly for patients and medical structures. With 3D cephalometric software, one can fully exploit the 3D data obtained with CT. It is especially valuable in the study of patients with maxillofacial asymmetry since the two sides of the face can be examined separately and then compared. © 2011 Elsevier Srl. All rights reserved

Type I autoimmune hepatitis:clinical course and outcome in an Italian multicentre study

BACKGROUND: Many reports of autoimmune hepatitis (AIH) were written in the 'pre-Hepatitis C era' and data on the natural history are still incomplete. AIM: To evaluate the clinical presentation and the natural history of type I AIH. METHODS: Seventy-three consecutive patients with a regular follow-up of at least 2 years were prospectively included in the study. The mean follow-up was 91 +/- 61 months. RESULTS: Patients with 'acute' onset at presentation were significantly older than patients with 'chronic' onset (P < 0.05) and had significantly higher serum levels of transaminase, gamma-glutamyltransferase and bilirubin; Prothrombin time was significantly lower in the said group compared with AIH patients with 'chronic' onset. In 4 of 63 (6.3%) female patients, AIH had the onset during pregnancy; in all of them the outcome of pregnancy was favourable. The major events during the follow-up included oesophageal varices (n = 9) and ascites (n = 4), and 60 patients remained in remission while receiving immunosuppression. None of the patients died during the follow-up, but seven patients were transplanted. The cumulative transplant-free probability of survival was 73.5% at 280 months. CONCLUSIONS: Elderly patients have more frequently an acute onset at presentation. Survival in AIH is apparently good; with early diagnosis, and improved medical therapy, liver transplantation for AIH will become a rare event in future

Maximal amenable subalgebras of von Neumann algebras associated with hyperbolic groups

We prove that for any infinite, maximal amenable subgroup H in a hyperbolic group G, the von Neumann subalgebra LH is maximal amenable inside LG. It provides many new, explicit examples of maximal amenable subalgebras in II 1 factors. We also prove similar maximal amenability results for direct products of relatively hyperbolic groups and orbit equivalence relations arising from measure-preserving actions of such groups

Maximal amenable subalgebras arising from maximal amenable subgroups

We provide a general criterion to deduce maximal amenability of von Neumann subalgebras LΛ ⊂ LΓ arising from amenable subgroups Λ of discrete countable groups Γ. The criterion is expressed in terms of Λ-invariant measures on some compact Γ-space. The strategy of proof is different from S. Popa's approach to maximal amenability via central sequences [Po83], and relies on elementary computations in a crossed-product C *-algebra

Comparison of three therapeutic regimens for genotype-3 hepatitis C virus infection in a large real-life multicentre cohort

Background &amp; Aims: In the direct-acting antiviral era, treatment of genotype-3 HCV (HCV-GT3) is still challenging. Real-life comparisons between recommended regimens, sofosbuvir (SOF)+daclatasvir (DAC), SOF/velpatasvir (VEL), glecaprevir/pibrentasvir (GLE/PIB), are scarce. We aimed at filling this data gap. Methods: Sustained virological response 12&nbsp;weeks after treatment completion (SVR12) was assessed for all HCV-GT3 patients consecutively treated within the Lombardia web-based Navigatore HCV-Network; differences in SVR12 across regimens were evaluated by logistic regression. Results: Of the 2082 subjects with HCV-GT3, 1544 were evaluable for comparisons between regimens: SOF&nbsp;+&nbsp;DAC (1023, 66.2%), SOF/VEL (369, 23.9%), GLE/PIB (152, 9.8%). Patients treated with former regimens were more frequently male, cirrhotic, HIV-positive, pretreated, used ribavirin in their regimen, and had lower baseline HCV-RNA. SVR12 was similar across groups: 94.8% in SOF&nbsp;+&nbsp;DAC, 97.6% in SOF/VEL, 96.7% in GLE/PIB (P&nbsp;=.065). At univariate analysis, SVR12 was associated with female gender (97.9% vs 94.8%, P&nbsp;=.007) and lower median pretreatment Log10HCV-RNA (5.87 vs 6.20, P&nbsp;=.001). At multivariate logistic regression analysis, treatment with SOF/VEL was associated with a higher likelihood of SVR12 than SOF&nbsp;+&nbsp;DAC, but only in the absence of ribavirin (98% vs 90.3%). Female gender and lower pretreatment HCV-RNA were independently associated with SVR12. Conclusions: In a large real-life setting of HCV-GT3-infected patients with a high proportion of cirrhosis, the success rate was remarkable. The slight advantage of SOF/VEL on SOF&nbsp;+&nbsp;DAC was significant only without ribavirin. The current prescription shift towards novel regimens (ie SOF/VEL and GLE/PIB) in easier-to-treat patients allows ribavirin-free and shorter schedules without mining SVR12 in this &lt;&gt; genotype

Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry

Portal vein thrombosis may occur in cirrhosis; nevertheless, its prevalence, and predictors are still elusive. To investigate this issue, the Italian Society of Internal Medicine undertook the “Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry” (PRO-LIVER). This prospective multicenter study includes consecutive cirrhotic patients undergoing Doppler ultrasound examination of the portal area to evaluate the prevalence and incidence of portal vein thrombosis over a 2-year scheduled follow-up. Seven hundred and fifty-three (68&nbsp;% men; 64&nbsp;±&nbsp;12&nbsp;years) patients were included in the present analysis. Fifty percent of the cases were cirrhotic outpatients. Viral (44&nbsp;%) etiology was predominant. Around half of the patients had a mild-severity disease according to the Child–Pugh score; hepatocellular carcinoma was present in 20&nbsp;%. The prevalence of ultrasound-detected portal vein thrombosis was 17&nbsp;% (n&nbsp;=&nbsp;126); it was asymptomatic in 43&nbsp;% of the cases. Notably, more than half of the portal vein thrombosis patients (n&nbsp;=&nbsp;81) were not treated with anticoagulant therapy. Logistic step-forward multivariate analysis demonstrated that previous portal vein thrombosis (p&nbsp;&lt;&nbsp;0.001), Child–Pugh Class B&nbsp;+&nbsp;C (p&nbsp;&lt;&nbsp;0.001), hepatocellular carcinoma (p&nbsp;=&nbsp;0.01), previous upper gastrointestinal bleeding (p&nbsp;=&nbsp;0.030) and older age (p&nbsp;=&nbsp;0.012) were independently associated with portal vein thrombosis. Portal vein thrombosis is a frequent complication of cirrhosis, particularly in patients with moderate–severe liver failure. The apparent undertreatment of patients with portal vein thrombosis is a matter of concern and debate, which should be addressed by planning interventional trials especially with newer oral anticoagulants. Clinicaltrials.gov identifier NCT01470547