Periapical healing after simplified endodontic treatments: A digital subtraction radiography study

Abstract Aim To evaluate the 6-month outcome of endodontic treatment of periapical lesions with integrated systems by clinical examination and digital subtraction radiography (DSR). Methodology Eighty-four patients with chronic periapical pathosis were randomly allocated to two groups and received endodontic treatment with Revo-S/One Step Obturator (G1, n = 41) or GTX/GTX Obturator (G2, n = 43). Six months later, clinical examination and DSR analysis were performed. Non-parametric statistical methods were used (p Results Total healing, partial healing and failure occurred in 48.4%, 48.4% and 3.2% of cases in G1, in 50.0%, 43.8% and 6.2% of cases in G2, respectively. No significant difference was detected. Conclusions The integrated endodontic techniques allowed for a high 6-month success rate in both groups in accordance with literature data

Quality of canal obturation assessed by micro-computed tomography: Influence of filling technique and post placement in canals shaped with Reciproc

Abstract Aim To assess by micro-computed tomography (μCT) the quality of fillings in canals shaped with Reciproc considering the effects of filling technique and post insertion. Methodology The canals of 60 single-rooted teeth were instrumented with Reciproc R40 and randomly assigned to four groups (n = 15): G1, single point; G2, as G1 + DT Light Post; G3, continuous wave of condensation; G4, as G3 + DT Light Post. The filling voids were quantified by μCT. Data were statistically analysed by non-parametric test (p Results Filling greater than 96% of the entire canal volume was observed in all groups. The volume of internal voids was greater in G3 than in G4 (p Conclusions Our findings support the use of simplified techniques of canal shaping, filling with matching taper points and post cementation

A two-year report of a comparative randomized controlled trial on the treatment of upper central incisors with periapical lesions

Aim To evaluate the two-year success rate of primary root canal treatment performed with two integrated shaping and filling systems on upper central incisors with chronic periapical pathosis. Methodology The trial enrolled 60 patients with an untreated maxillary central incisor presenting a chronic periapical lesion smaller than 5 mm in diameter, who were randomly assigned to two treatment groups: G1 (n = 30), Revo-S/One Step Obturator; G2 (n = 30) GTX/GTX Obturator. The patients underwent single-session root canal treatments by an experienced endodontist and were followed up for two years. The clinical evaluation entailed percussion and palpation tests. Two independent examiners rated the radiographic healing on the basis of a previously described scale. Comparability between groups in terms of baseline clinical parameters was tested with a Mann-Whitney test (age, apical gauging) and \u3c72 test (tenderness to percussion and palpation). The comparison of clinical data and radiographic healing scores between the groups and among time points was carried out with non-parametric statistical methods (p < 0.05). Results The two groups were comparable in terms of baseline clinical parameters. All patients were available for the re-evaluation after two years. Only one patient per group was positive to the clinical tests at the final recall. An improvement of radiographic healing scores along the follow-up period was observed. After two years, the lesions were scored as totally healed, partially healed and not healed in 93.3%, 3.3% and 3.3% of cases in G1 and in 93.3%, 0% and 6.7% of cases in G2, without pointing out statistically significant differences between groups. Conclusions Both the two tested integrated shaping and filling systems proved to be effective for the treatment of upper central incisors with periapical pathosis. When monitoring the healing of periapical lesions, follow-up times longer than one year may be required to observe complete healing

Physical activity regulates tnfα and il-6 expression to counteract inflammation in cystic fibrosis patients

Background: Cystic fibrosis (CF) is one of the most common inherited diseases. It is characterised by a severe decline in pulmonary function associated with metabolic perturbations and an increased production of inflammatory cytokines. The key role of physical activity (PA) in improving the health status of CF patients and reducing lung function decline has recently been demonstrated. This study evaluated interleukin-6 (IL-6) and tumour necrosis factor α (TNFα) expression in two subgroups of CF patients classified based on PA. Methods: We selected 85 CF patients; half of them regularly undertook supervised PA in the three years leading up to the study and half of them were not physically active. Patients were analysed for serum IL-6 and TNFα levels using enzyme-linked immunosorbent assays. Results: We found that the expression levels of IL-6 and TNFα differed in terms of their regulation by PA. In particular, TNFα levels negatively correlated with FEV1% decrease/year and FEV1% decrease (p = 0.023 and p = 0.02, respectively), and positively correlated with serum fasting glucose (p = 0.019) in PA CF patients. In contrast, in the NPA subgroup, TNFα levels were positively correlated with IL-6 (p = 0.001) and negatively correlated with adiponectin (p = 0.000). In addition, multiple logistic regression analysis confirmed that PA is an independent modulator of the inflammatory state. Conclusions: PA modulates inflammatory processes in CF patients by regulating the secretion of pro-inflammatory cytokines and thus ameliorating lung function. Our data show that PA is a useful complementary strategy in the management of CF and that TNFα may be a marker of these effects of PA

Trattamenti endodontici semplificati di lesioni periapicali: valutazione del risultato clinico con Digital Subtraction Radiography

RiassuntoObiettiviValutare la guarigione di lesioni periapicali dopo sei mesi dal trattamento con sistemi integrati di strumentazione e otturazione canalare.Materiali e metodiSessanta pazienti con lesione periapicale sono stati assegnati a gruppi di trattamento (n=30) con sistema RevoS+One Step Obturator (G1) o con GTX+GTX Obturator (G2). La guarigione è stata valutata a sei mesi clinicamente e con Digital Subtraction Radiography (test non parametrici, p0,05).ConclusioniIl successo a sei mesi è alto e in linea coi dati della letteratura. Le tecniche semplificate considerate sono efficaci nel trattamento di lesioni periapicali.SummaryAimTo assess the healing of periapical lesions six months after the treatment with integrated systems for root canal shaping and filling.MethodologySixty patients with periapical lesion were randomly assigned to two treatment groups (n=30) with RevoS+One Step Obturator (G1) or GTX+GTX Obturator (G2). Healing was assessed by clinical examination and Digital Subtraction Radiography after six months (non-parametric tests, p0.05).ConclusionsThe six-month success was high and consistent with previously reported findings. The considered simplified techniques are effective for the treatment of periapical lesions

Mannose-binding lectin genetic analysis: possible protective role of the HYPA haplotype in the development of recurrent urinary tract infections in men

SummaryFactors related to bacterial virulence and/or to the host have been implicated in the pathogenesis of recurrent urinary tract infections (rUTI), but in most cases the cause is unknown. Mannose binding lectin (MBL) is an acute phase glycoprotein that exerts immunological functions by binding to the surface of a variety of pathogens. Some human gene variants reduce MBL activity thereby predisposing the host to bacterial and viral infections. The aim of this study was to investigate MBL2 gene variants in relation to rUTI risk. Six MBL gene variants and seven haplotypes were analyzed by PCR and direct sequencing in rUTI patients (n = 83) and in healthy subjects from southern Italy (n = 642). The frequencies of the L allele (−550) and the HYPA haplotype were higher in controls than in patients stratified according to sex (p < 0.05). Our data indicate that the HYPA haplotype in the MBL2 gene could be associated with a minor risk of developing rUTI in males

Physical activity and sport performance: adiponectin in relation to different physio-pathological status

Adiponectin (Acrp30), and in particular its High Molecular Weight (HMW) oligomers, contributes to enhance insulin sensitivity and to reduce inflammation levels. Physical exercise improves body’s biochemical balance and metabolism resulting effective in the prevention and therapy of metabolic diseases. Whether improvement of metabolic features mediated by physical exercise is associated with changes in Acrp30 serum composition is not yet clarified. In the present study, we investigated total Acrp30 expression and its oligomeric status in two different metabolic status: professional Water Polo (WP) Players and adult patients affected by Cystic Fibrosis (CF) that performed regular physical exercise. CF is an inherited metabolic disease characterized by alterations in lipid and glucidic metabolism. Our results demonstrated significant elevated BMI, AST and LDH levels and, conversely, significantly lower concentrations of total cholesterol and VLD were present in WP players. No significant difference was found in total Acrp30 and/or HMW oligomers. Interestingly, in WP players, a direct relationship between total Acrp30 and monocytes as well as an inverse relationship between total Acrp30 and AST levels were found. ACDC molecular screening revealed previously described SNPs. In CF patients, physical exercise has significant effects on lipid and glycemic metabolism. Indeed, patients that performed exercise are characterized by significant decrease of either VLDL, cholesterol and triglycerides, border-line significant decrease of either total cholesterol/HDL and non-HDL cholesterol/HDL ratio and by trend decrease of total, LDL and non-HDL cholesterol, although not significant. It’s to highlight that physical exercise significantly reduces glycemia and HOMA-IR and increases serum albumin. However, physical exercise does not modify Acrp30 concentrations that, on the other hand, result significantly higher in all CF patients compared to controls. In conclusion, even if peripheral muscle abnormalities and respiratory factors limit exercise in patients with CF, our study indicated that physical activity has beneficial effects on lipid and glycemic metabolism in these patients not associated with Acrp30

Biliverdin Protects against Liver Ischemia Reperfusion Injury in Swine

Ischemia reperfusion injury (IRI) in organ transplantation remains a serious and unsolved problem. Organs that undergo significant damage during IRI, function less well immediately after reperfusion and tend to have more problems at later times when rejection can occur. Biliverdin has emerged as an agent that potently suppress IRI in rodent models. Since the use of biliverdin is being developed as a potential therapeutic modality for humans, we tested the efficacy for its effects on IRI of the liver in swine, an accepted and relevant pre-clinical animal model. Administration of biliverdin resulted in rapid appearance of bilirubin in the serum and significantly suppressed IRI-induced liver dysfunction as measured by multiple parameters including urea and ammonia clearance, neutrophil infiltration and tissue histopathology including hepatocyte cell death. Taken together, our findings, in a large animal model, provide strong support for the continued evaluation of biliverdin as a potential therapeutic in the clinical setting of transplantation of the liver and perhaps other organs

COVID-19 and atrial fibrillation: Intercepting lines

Almost 20% of COVID-19 patients have a history of atrial fibrillation (AF), but also a new-onset AF represents a frequent complication in COVID-19. Clinical evidence demonstrates that COVID-19, by promoting the evolution of a prothrombotic state, increases the susceptibility to arrhythmic events during the infective stages and presumably during post-recovery. AF itself is the most frequent form of arrhythmia and is associated with substantial morbidity and mortality. One of the molecular factors involved in COVID-19-related AF episodes is the angiotensin-converting enzyme (ACE) 2 availability. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses ACE2 to enter and infect multiple cells. Atrial ACE2 internalization after binding to SARS-CoV-2 results in a raise of angiotensin (Ang) II, and in a suppression of cardioprotective Ang(1–7) formation, and thereby promoting cardiac hypertrophy, fibrosis and oxidative stress. Furthermore, several pharmacological agents used in COVID-19 patients may have a higher risk of inducing electrophysiological changes and cardiac dysfunction. Azithromycin, lopinavir/ritonavir, ibrutinib, and remdesivir, used in the treatment of COVID-19, may predispose to an increased risk of cardiac arrhythmia. In this review, putative mechanisms involved in COVID-19-related AF episodes and the cardiovascular safety profile of drugs used for the treatment of COVID-19 are summarized

Management of Metastatic Endometrial Cancer: Physicians' Choices Beyond the First Line. A MITO Survey

BACKGROUND: Endometrial cancer (EC) therapeutic and diagnostic approaches have been changed by the development of a new prognostic molecular classification, the introduction of dostarlimab in microsatellite instability (MSI) high pre-treated advanced EC patients with further expected innovation deriving from lenvatinib plus pembrolizumab regardless MSI status. How this is and will be translated and embedded in the clinical setting in Italy is not known; this is why we developed Multicentre Italian Trials in Ovarian cancer and gynaecologic malignancies (MITO) survey on the current practice and expected future changes in EC. METHODS: We designed a self-administered, multiple-choice online questionnaire available only for MITO members for one month, starting in April 2021. RESULTS: 75.6% of the respondents were oncologists with a specific focus on gynaecologic malignancies and 73.3% of the respondents declared the availability of clinical trials in second line treatment for advanced EC. The therapeutic algorithm in second line was heterogeneous, being the most frequent choice administering anthracyclines followed by endocrine therapy or enrolling in clinical trials. While more than half of the clinicians declared that they performed the molecular classification, only six/45 respondents (13.3%) ran all the tests needed for it. On the other hand, 80% of them declared regular assessment of MSI status with IHC as recommended. The therapeutic approach in MSI high advanced EC patients has changed since dostarlimab approval. Indeed the most frequent choice in second line has been chemotherapy (53.3%) before its availability, while dostarlimab has been preferred in more than three-fourths of the cases (75.6%) after its approval. As for MSS patients, 77.8% of clinicians would choose lenvatinib plus pembrolizumab for them in second line once approved. CONCLUSIONS: Despite the selected sample of respondents from Italian MITO centres showing good knowledge of diagnostic and therapeutic innovations in EC, these are not fully implemented in everyday clinics, except for MSI status assessment