Occlusal Load Considerations in Implant-Supported Fixed Restorations

The advent of new technologies in the field of medicine and dentistry is creating improvements that lead clinicians to have materials and procedures able to improve patients' quality of life. The aim of this article is to evaluate occlusion load and its consequences on fixed implant-supported prosthesis. New materials have granted clinicians the possibility achieve great aesthetic results in dental prosthesis, and new procedures allow them to standardize and give precise and repeatable results, especially for the functional and long-term stability aspects of products. Some principles should be carefully evaluated and applied to every dental prosthesis; the evaluation of the forces and fitting of meso-structures to dental implants, an aspect that is often not well considered by clinicians, is the main focus of this article

Deep Spitzer 24 μm COSMOS Imaging. I. The Evolution of Luminous Dusty Galaxies—Confronting the Models

We present the first results obtained from the identification of ~30,000 sources in the Spitzer/24 μm observations of the COSMOS field at S_(24 μm) ≳ 80 μJy. Using accurate photometric redshifts (σ_ z ~ 0.12 at z ~ 2 for 24 μm sources with i ^+ ≳ 25 mag AB) and simple extrapolations of the number counts at faint fluxes, we resolve with unprecedented detail the buildup of the mid-infrared background across cosmic ages. We find that ~50% and ~80% of the 24 μm background intensity originate from galaxies at z ≳ 1 and z ≳ 2, respectively, supporting the scenario where highly obscured sources at very high redshifts (z ≳ 2) contribute only marginally to the cosmic infrared background. Assuming flux-limited selections at optical wavelengths, we also find that the fraction of i ^+-band sources with 24 μm detection strongly increases up to z ~ 2 as a consequence of the rapid evolution that star-forming galaxies have undergone with look-back time. Nonetheless, this rising trend shows a clear break at z ~ 1.3, probably due to k-correction effects implied by the complexity of spectral energy distributions in the mid-infrared. Finally, we compare our results with the predictions from different models of galaxy formation. We note that semianalytical formalisms currently fail to reproduce the redshift distributions observed at 24 μm. Furthermore, the simulated galaxies at S _(24 μm) > 80 μJy exhibit R–K colors much bluer than observed and the predicted K-band fluxes are systematically underestimated at z ≳ 0.5. Unless these discrepancies mainly result from an incorrect treatment of extinction in the models they may reflect an underestimate of the predicted density of high-redshift massive sources with strong ongoing star formation, which would point to more fundamental processes and/or parameters (e.g., initial mass function, critical density to form stars, feedback,...) that are still not fully controlled in the simulations. The most recent backward evolution scenarios reproduce reasonably well the flux/redshift distribution of 24 μm sources up to z ~ 3, although none of them is able to exactly match our results at all redshifts

Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia

The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ (n = 601), the agreement between patients and their informants on CAI ratings, to explore patients' insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet's agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients' and informants' ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Economic consequences of investing in anti-HCV antiviral treatment from the Italian NHS perspective : a real-world-based analysis of PITER data

OBJECTIVE: We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy. METHODS: A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered. RESULTS: The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively. CONCLUSIONS: This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV

Paediatric Nonfunctioning Adrenocortical Carcinoma with Extension up to Right-Side Heart: Cardiac Surgery Approach

Adrenocortical carcinoma is a rare malignancy. Due to late diagnosis and no adequate effective adjuvant treatment, prognosis remains poor. Only approximately 30% of these malignancies are confined to the adrenal gland when they are diagnosed, as these tumors tend to be found years after their genesis. Cardiac involvement of adrenal carcinoma is very rare. We report a rare case of a 7-year-old female with right adrenal cortical carcinoma, involving the right-side heart

Surgical Treatment of Idiopathic Enlargement of the Right Atrium

Idiopathic enlargement of the right atrium (IERA) is a very rare abnormality. Approximately one-half (48%) of the patients with a congenital enlargement of the right atrium have no symptoms. When they occur, symptoms include shortness of breath (28% of cases), palpitations (17%), arrhythmias (12%), and in rare cases, right heart failure and extreme tiredness. We report one such case of a young man with a disproportionally enlarged right atrium. The basal transthoracic echocardiogram demonstrated a huge right atrium with a thick smoke pattern and mild tricuspid regurgitation in the absence of congenital heart disease. Magnetic resonance imaging confirmed the right atriomegaly, with initial compression of the right ventricle, and excluded congenital heart defects or absence of pericardium. The patient underwent surgical resection of the right atrial wall and the atriotomy was closed, leaving an atrial chamber of normal consistency and size. The resected atrium had normal and homogeneous wall thickness without significant fibrosis which confirmed the diagnosis of an idiopathic enlargement of the right atrium

Occlusal Load Considerations in Implant-Supported Fixed Restorations

The advent of new technologies in the field of medicine and dentistry is creating improvements that lead clinicians to have materials and procedures able to improve patients’ quality of life. The aim of this article is to evaluate occlusion load and its consequences on fixed implant-supported prosthesis. New materials have granted clinicians the possibility achieve great aesthetic results in dental prosthesis, and new procedures allow them to standardize and give precise and repeatable results, especially for the functional and long-term stability aspects of products. Some principles should be carefully evaluated and applied to every dental prosthesis; the evaluation of the forces and fitting of meso-structures to dental implants, an aspect that is often not well considered by clinicians, is the main focus of this article

Bicuspid Aortic Valve in Children and Adolescents: A Comprehensive Review

Bicuspid aortic valve (BAV) is the most common congenital heart defect. Prevalence of isolated BAV in the general pediatric population is about 0.8%, but it has been reported to be as high as 85% in patients with aortic coarctation. A genetic basis has been recognized, with great heterogeneity. Standard BAV terminology, recently proposed on the basis of morpho-functional assessment by transthoracic echocardiography, may be applied also to the pediatric population. Apart from neonatal stenotic BAV, progression of valve dysfunction and/or of the associated aortic dilation seems to be slow during pediatric age and complications are reported to be much rarer in comparison with adults. When required, because of severe BAV dysfunction, surgery is most often the therapeutic choice; however, the ideal initial approach to treat severe aortic stenosis in children or adolescents is not completely defined yet, and a percutaneous approach may be considered in selected cases as a palliative option in order to postpone surgery. A comprehensive and tailored evaluation is needed to define the right intervals for cardiologic evaluation, indications for sport activity and the right timing for intervention