Evaluation of vision in gnathological and orthodontic patients with temporomandibular disorders: a prospective experimental observational cohort study

Objectives: Temporomandibular disorders (TMDs), orthodontic diseases, and vision dysfunctions seem to be strictly related. The purpose of this study was to prove the relationship, to evaluate the prevalence and the distribution of vision defects in dysfunctional and orthodontic patients, and to establish the type of the relationship. Materials and Methods: A total of 100 patients with TMDs were selected and studied through epidemiological analyses of the following factors: gnathological parameters (temporomandibular joint pathologies according to Diagnostic Criteria for Temporomandibular Disorders); occlusal and skeletal parameters (overjet, overbite, dental class, transversal discrepancies, and mandibular asymmetry); and orthoptic parameters (refractive defects and oculomotor diseases). A prospective experimental observational cohort study was conducted. A comparison with the average frequency of vision defects of the Italian population was performed. The prevalence of vision defects was evaluated. All gnathological and orthodontic parameters were associated with the orthoptic ones. A descriptive and statistical analysis of the data was carried out with the Statistical Package for the Social Sciences software; z test (P 0.05), frequency analysis (frequency 50%), chi-square test, and Student's t test (P 0.05) were performed. The scientific consistency was evaluated by using the scientific criteria of Bradford Hill. Results: The comparison with the Italian population showed a higher frequency of refractive defects in the study sample (P 0.001). The most frequent vision defects were phorias (92%) and tropia (3%). The increased frequency of ocular convergence reduction in the presence of disc displacement with reduction was significant (n = 28; 60%; P 0.05). In the presence of asymmetry, low frequencies of astigmatism (n = 18; 30%) were observed compared to its absence (n = 22; 54%) (P 0.05) and high frequencies of motor ocular deviations (n = 59; 100%) were observed compared to its absence (n = 36; 88%) (P 0.05). In the presence of headache, low frequencies of emmetropia (n = 13; 22%) and higher frequencies of hyperopia (n = 18; 30%) were observed (P 0.05). Two of five scientific criteria of Bradford Hill were met. Conclusion: It seems to emerge a possible positive relationship between TMD and vision defects. In particular, the most interesting associations were found between functional or skeletal orthognathic alterations and oculomotor dysfunctions. However, it was not possible to establish the type of relationship

Bactericide effect of powerful Ultrasonic Bone Surgery device (piezo-surgery) : Oral surgey application in BRONJ treatment: (Biphosphonate Related osteonecrosis of the jaws)

I farmaci Bifosfonati sono composti chimici analoghi del pirofosfato e sono in grado di determinare un rallentamento del riassorbimento osseo agendo sul metabolismo degli osteoclasti. L’Osteonecrosi dei mascellari(8-9-10) è stata classificata come una potenziale reazione avversa legata all’uso di farmaci Amino-Bifosfonati ed è da lungo tempo considerata una condizione di difficile risoluzione a causa del rallentato turn-over del metabolismo osseo. L’obiettivo di questo lavoro è stato quello di identificare eventuali presidi chirurgici in grado di risolvere il problema dell’osteonecrosi(11) ed eventualmente impedirne la recidiva, riportata in letteratura come una evenienza frequente. Nel presente studio sono stati trattati 16 pazienti (11 donne e 5 maschi) di età compresa tra 59 e 82 anni,(69aa media). Di questi: 10 pazienti erano stati sottoposti a terapia con bifosfonati a causa di neoplasie metastatizzate, di cui 9 con Acido Zoledronico e 1 con Acido Pamidronico; invece, 6 pz. erano stati trattati per osteoporosi con Acido Alendronico. Undici pazienti riportavano lesioni osteonecrotiche a carico dell’osso mandibolare (10 nella regione anteriore e 1 in quella posteriore); quattro pazienti avevano lesioni a carico del mascellare superiore; un paziente ha avuto una osteonecrosi a carico della mandibola prima ed a distanza di 4 mesi a carico del mascellare superiore; due sul mascellare anteriore, ed altri due sul mascellare posteriore. Per il trattamento chirurgico delle lesioni necrotiche sono state utilizzate attrezzature per la chirurgia ossea ad ultrasuoni ad alta potenza ( 90 Watt) e bassa frequenza (24-32kz) (Ultrasonic-Bone Surgery -U.B.S.). I risultati ottenuti hanno dimostrato che tutti i pazienti trattati avevano avuto una remissione dei sintomi ed una chiusura completa per prima o per seconda intenzione delle ferite entro le prime due settimane dall’intervento. Durante il follow-up (che va da un minimo di 6 mesi fino a 12 mesi) cui sono stati sottoposti tutti i pazienti, non si è manifestata ad oggi alcuna recidiva. Dovrebbero essere presi in considerazione altri pazienti ma gli attuali risultati incoraggiano ulteriori esperimenti in vivo/in vitro in merito all’uso della chirurgia ad ultrasuoni nel trattamento delle osteonecrosi

Serum levels of tumour associated glycoprotein (TAG 72) in patients with gynaecological malignancies.

Serum levels of TAG 72 were measured in 726 serum samples from patients with benign and malignant gynaecological conditions in order to evaluate the clinical usefulness of TAG 72 alone or in combination with other tumour markers. Sixty-six per cent of patients with ovarian cancer showed abnormal concentrations of TAG 72 antigen. A good correlation was also found between serial TAG 72 values and the clinical course of disease during chemotherapy and follow-up. In cervical and endometrial cancer abnormal TAG 72 values occurred in 23% and 14% of cases, while none of the patients with breast cancer had abnormal TAG 72 levels. Among patients with benign disease only one out of 12 patients (8%) with benign ovarian tumours and one of 15 patients with uterine fibromyomatosis (7%) showed high TAG 72 serum levels. However, the determination of TAG 72 did not increase the sensitivity of CA 125 and squamous cell carcinoma antigen (SCC), in ovarian and cervical cancer, respectively. The systemic administration of recombinant interferon alpha-2b to 15 patients with ovarian cancer and different basal levels of TAG 72 did not increase serum levels of the antigen

A possible role of fzd10 delivering exosomes derived from colon cancers cell lines in inducing activation of epithelial–mesenchymal transition in normal colon epithelial cell line

Exosomes belong to the family of extracellular vesicles released by every type of cell both in normal and pathological conditions. Growing interest in studies indicates that extracellular vesicles, in particular, the fraction named exosomes containing lipids, proteins and nucleic acid, represent an efficient way to transfer functional cargoes between cells, thus combining all the other cell–cell interaction mechanisms known so far. Only a few decades ago, the involvement of exosomes in the carcinogenesis in different tissues was discovered, and very recently it was also observed how they carry and modulate the presence of Wnt pathway proteins, involved in the carcinogenesis of gastrointestinal tissues, such as Frizzled 10 protein (FZD10), a membrane receptor for Wnt. Here, we report the in vitro study on the capability of tumor-derived exosomes to induce neoplastic features in normal cells. Exosomes derived from two different colon cancer cell lines, namely the non-metastatic CaCo-2 and the metastatic SW620, were found to deliver, in both cases, FZD10, thus demonstrating the ability to reprogram normal colonic epithelial cell line (HCEC-1CT). Indeed, the acquisition of specific mesenchymal characteristics, such as migration capability and expression of FZD10 and markers of mesenchymal cells, was observed. The exosomes derived from the metastatic cell line, characterized by a level of FZD10 higher than the exosomes extracted from the non-metastatic cells, were also more efficient in stimulating EMT activation. The overall results suggest that FZD10, delivered by circulating tumor-derived exosomes, can play a relevant role in promoting the CRC carcinogenesis and propagation

Super selective arterial embolization to treat radiation-induced hemorrhagic gastritis: a case report and review of the literature

Radiation-induced hemorrhagic gastritis (RIHG) is a rare but potentially fatal event following radiotherapy for locally advanced gastric cancer; the treatment of this condition is not standardized. Only few cases of RIHG have been reported, treated with different therapeutic approaches. Here we report the case of a 79-year-old patient who underwent subtotal gastrectomy for gastric cancer, followed by adjuvant chemo-radiotherapy. Approximately 3 months after the end of the treatment, she developed recurrent diffuse bleeding originating from the entire mucosa of the gastric pouch and from a marginal ulcer. As the bleeding was refractory to several endoscopic treatments and surgery was not indicated, the patient underwent two sessions of transcatheter selective arterial embolization, with resolution of bleeding. Arterial embolization has already been reported for the treatment of hemorrhagic cystitis, developing after irradiation of the pelvis for prostate, bladder, rectum, and cervix cancer. However, to our knowledge, it has never been reported as a treatment for hemorrhagic gastritis. Based on this case, we suggest arterial embolization as an option in the management of RIHG, when standard endoscopic treatment fails

Cross-sectional relationship among different anthropometric parameters and cardiometabolic risk factors in a cohort of patients with overweight or obesity

Background Body fat distribution influences the risk of cardio-metabolic disease in people with overweight. This study was aimed at identifying the anthropometric parameters more strongly associated with the majority of cardio-metabolic risk factors. Methods This study included 1214 subjects (840 women), with a body-mass-index (BMI) = 25 Kg/ m2, aged 39.2 ± 13 years. Fasting blood glucose (FBG), triglycerides (TG), total, HDL- and LDL-cholesterol, uric acid, vitamin D, high-sensitive C-reactive protein (hs-CRP), white blood cells (WBC), platelets, insulin and insulin resistance (HOMA-IR), systolic (SBP) and diastolic blood pressure (DBP), smoking habit and snoring were evaluated as cardio-metabolic risk factors.We also included the Systematic COronary Risk Evaluation (SCORE) to estimate cardiovascular risk in our study population. BMI, waist circumference (WC), waistto- height-ratio (WHtR) and neck circumference (NC) were evaluated as anthropometric parameters. Results All four anthropometric parameters were positively associated to SBP, DBP, TG, FBG, insulin, HOMA-IR, WBC, and snoring (p<0.001), and negatively associated with HDL-cholesterol (p<0.001). NC showed a positive association with LDL-cholesterol (ß = 0.76; p = 0.01; 95% C.I. 0.19 to 1.32), while vitamin D was negatively associated to WC (ß = -0.16; p<0.001; 95% C.I. -0.24 to -0.09), BMI (ß = 0.42); p<0.001; 95% C.I. -0.56 to -0.28) and WHtR (ß = -24.46; p<0.001; 95% C.I. -37 to -11.9). Hs-CRP was positively correlated with WC (ß = 0.003; p = 0.003; 95% C.I. 0.001 to 0.006), BMI (ß = 0.01; p = 0.02; 95% C.I. 0.001 to 0.012) and WHtR (ß = 0.55; p = 0.01; 95% C.I. 0.14 to 0.96). SCORE was associated to NC (ß = 0.15; 95% CI 0.12 to 0.18; p<0.001), BMI (ß = -0.18; 95% CI -0.22 to 0.14; p<0.001) and WHtR (ß = 7.56; 95% CI 5.30 to 9.82; p<0.001). Conclusions NC, combined with BMI and WC or WHtR could represent an essential tool for use in clinical practice to define the cardio-metabolic risk in individuals with excess body weight

Adherence to a mediterranean diet and thyroid function in obesity: A cross-sectional Apulian survey

BackgroundMuch research suggests that Mediterranean eating habits and lifestyle contribute to counteract the risk of chronic diseases while promoting longevity, but little information is available on the effects of the Mediterranean diet (Med-Diet) on thyroid function, particularly among overweight/obese subjects. Nevertheless, consistent data reported a slight increase in serum levels of the thyroid-stimulating hormone (TSH) and a higher rate of conversion of thyroxine (T4) to triiodothyronine (T3) in obesity. This cross-sectional study was aimed at investigating the relationship between adherence to the Med-Diet and circulating thyroid hormones in a cohort of overweight/obese subjects from Apulia (Southern Italy). Methods: We studied 324 consecutive outpatient subjects (228 women and 96 men, age range 14–72 years) taking no drug therapy and showing normal levels of thyroid hormones, but complicated by overweight and obesity (body mass index (BMI) ≥ 25 Kg/m2). The PREDIMED (PREvención con DIeta MEDiterránea) questionnaire was cross-sectionally administered to assess the adherence to the Med-Diet, and hormonal, metabolic, and routine laboratory parameters were collected. Results: Higher adherence to Med-Diet was found to be inversely related to free T3 (p < 0.01) and T4 (p < 0.01) serum levels. Considering each item in the PREDIMED questionnaire, people consuming at least four spoonfuls of extra-virgin olive oil (EVOO) per day, as well as those consuming at least two servings of vegetables per day, had lower free T3 levels (p 0.033 and p 0.021, respectively). Furthermore, consuming at least four spoonfuls of EVOO per day was found to be associated to lower free T4 serum concentrations (p 0.011). Multinomial logistic regression models, performed on tertiles of thyroid hormones to further investigate the relationship with Med-Diet, corroborated the significance only for free T4. Conclusion: Increased adherence to the Med-Diet was independently associated to a slightly reduced thyroid function, but still within the reference range for free T3 and T4 serum levels. This first finding in this field opens up a research line on any underlying biological interplay

Efficacy of hemostatic powders as monotherapy or rescue therapy in gastrointestinal bleeding related to neoplastic or non-neoplastic lesions

Background Hemostatic powder (HP) in gastrointestinal bleeding (GIB) is mainly used as rescue therapy after failure of conventional hemostatic procedures (CHP). Aim To define the best field of application and the efficacy of HP as first choice monotherapy or rescue therapy. Methods We compared the efficacy of HP monotherapy, HP rescue therapy, and CHP in the management of active GIB due to neoplastic and non-neoplastic lesions. Results A total of 108 patients, 43 treated with HP as either first choice or rescue therapy and 65 with CHP, were included in the study. The most frequent sources of bleeding were peptic ulcer and malignancy. Immediate hemostasis rates were: HP monotherapy = 100% in peptic ulcer and 100% in malignancy; HP rescue therapy = 93.2% in peptic ulcer and 85.7% in malignancy; CHP = 77.9% in peptic ulcer and 41.7 in malignancy. Definitive hemostasis rates were: HP monotherapy = 50% in peptic ulcer and 45.5% in malignancy; HP rescue therapy = 73.3% in peptic ulcer and 85.7% in malignancy; CHP = 69.1% in peptic ulcer and 33.3% in malignancy. No difference was found in terms of additional intervention between the three groups. Conclusions HP is highly effective as monotherapy and rescue therapy in GIB. GIB related to malignancy may be the best field of application of HP, but confirmatory studies are necessary