Orthodontic treatment need and prevalence of malocclusions in the Orthodontic Unit of "Sapienza - University of Rome" : a six - year clinical experience

AIM The objective of this epidemiological survey was to investigate the dental-skeletal features of subjects attending the Public Dental Service in U.O.C. (Orthodontic Department of “La Sapienza University of Rome) and compare them with the existing body of evidence coming from other surveys. Accordingly, the Index of Orthodontic Treatment Need (I.O.T.N.) was employed, in order to achieve a common framework to allow the shaping of public health prevention practices. MATERIALS & METHODS A sample of 3491 subjects in the Orthodontic Department of “La Sapienza- University of Rome” (UOC) was evaluated with the adoption of I.O.T.N. to define malocclusion severity. RESULTS In the result analysis, it was observed that class II malocclusion was more frequent in the sample (40%), and a large part of the examined population also presented mandibular dental crowding (43%), increased overjet (41%), increased overbite (38%). Only 26,44% (20,17% IOTN 4; 6,27% IOTN 5) had strong need for orthodontic treatment. CONCLUSION The realization of epidemiologic investigations to establish priority for treatment need is therefore particularly useful, not only to estimate the prevalence of some clinical conditions in the observed population, but also to plan targeted interventions, such as interceptive and corrective therapies in growing children. CLINICAL SIGNIFICANCE These interventions could solve specific clinical situations and/or prevent their escalation. Only in this way it’s possible to avoid fragmenting the limited resources available, using them for patients with an objective need

Cognitive-Behavioral and Pharmacological Treatments for Insomnia: A Combined Approach

Insomnia is the most prevalent sleep disorder (10-40%). It is defined as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep and that results in some form of daytime impairment. Among the typical symptoms, there are fatigue, decreased mood or irritability, general malaise, and cognitive impairment. According to the International Classification of Sleep Disorders 3rd edition, ICSD-3, it has been defined as chronic (lasting more than three months) or short-term insomnia (less than three months).In clinical practice, the usual therapeutic approach is pharmacological (benzodiazepines, z drugs, slow wave sleep enhancers), even if the American Academy of Sleep Medicine (AASM), the American College of Physicians (ACP), and the European Sleep Research Society (ESRS) guidelines suggest that the first clinical choice should be non-pharmacological (cognitive behavioral therapy). A combined (non-pharmacological and pharmacological)approach could be considered in poor responders to manage drug dependence and to increase compliance to treatment and patients' quality of life

Mirror imaging of impacted and supernumerary teeth in dizygotic twins: a case report

Background: Mesiodens is the most common type of supernumerary tooth found in the premaxilla. It might be discovered during the clinical examination as a casual finding on a radiograph or as the cause of an unerupted maxillary central incisor. The genetic transmission of supernumerary and impacted teeth is poorly understood. Mirror imaging in twins has been reported frequently in relation to several unilateral dental anomalies including mesiodens. This phenomenon is the appearance of an asymmetrical feature or anomaly occurring on the right side of one twin but on the left side of the other twin. The event of mesiodens mirror imaging in monozygotic twins has been described in literature. Results: This is the first reported case of mesiodens mirror imaging in dizygotic twins. The described mesiodens caused the eruption failure of maxillary permanent incisors. The supernumerary teeth were removed to facilitate the spontaneous eruption of the impacted permanent maxillary incisors. Clinical Implications: Studies related to supernumerary teeth can be useful to clinicians in the early diagnosis of this anomaly. Clinical and radiographic examinations provide a correct therapeutic approach

Initial Trajectory Assessment of the RAMSES Mission to (99942) Apophis

(99942) Apophis is a potentially hazardous asteroid that will closely approach the Earth on April 13, 2029. Although the likelihood of an impact has been ruled out, this close encounter represents a unique opportunity for planetary science and defense. By investigating the physical and dynamical changes induced by this interaction, valuable insights into asteroid cohesion, strength, and internal structure can be obtained. In light of these circumstances, a fast mission to Apophis holds great scientific importance and potential for understanding potentially hazardous asteroids. To this aim, ESA proposed the mission RAMSES (Rapid Apophis Mission for SEcurity and Safety) to reach Apophis before its close encounter. In this context, the paper focuses on the reachability analysis of (99942) Apophis, examining thousands of trajectories departing from Earth and reaching the asteroid before the fly-by, using a low-thrust spacecraft. A two-layer approach combining direct sequential convex programming and an indirect method is employed for fast and reliable trajectory optimization. The results reveal multiple feasible launch windows and provide essential information for mission planning and system design

Autism Spectrum Disorders: Is Mesenchymal Stem Cell Personalized Therapy the Future?

Autism and autism spectrum disorders (ASDs) are heterogeneous neurodevelopmental disorders. They are enigmatic conditions that have their origins in the interaction of genes and environmental factors. ASDs are characterized by dysfunctions in social interaction and communication skills, in addition to repetitive and stereotypic verbal and nonverbal behaviours. Immune dysfunction has been confirmed with autistic children. There are no defined mechanisms of pathogenesis or curative therapy presently available. Indeed, ASDs are still untreatable. Available treatments for autism can be divided into behavioural, nutritional, and medical approaches, although no defined standard approach exists. Nowadays, stem cell therapy represents the great promise for the future of molecular medicine. Among the stem cell population, mesenchymal stem cells (MSCs) show probably best potential good results in medical research. Due to the particular immune and neural dysregulation observed in ASDs, mesenchymal stem cell transplantation could offer a unique tool to provide better resolution for this disease

Estimating and correcting interference fringes in infrared spectra in infrared hyperspectral imaging

Short-term acclimation response of individual cells of Thalassiosira weissflogii was monitored by Synchrotron FTIR imaging over the span of 75 minutes. The cells, collected from batch cultures, were maintained in a constant flow of medium, at an irradiance of 120 μmol m−2 s−1 and at 20 °C. Multiple internal reflections due to the micro fluidic channel were modeled, and showed that fringes are additive sinusoids to the pure absorption of the other components of the system. Preprocessing of the hyperspectral cube (x, y, Abs(λ)) included removing spectral fringe using an EMSC approach. Principal component analysis of the time series of hyperspectral cubes showed macromolecular pool variations (carbohydrates, lipids and DNA/RNA) of less than 2% after fringe correction

Obstructive sleep apnea syndrome and cognitive impairment: effects of CPAP

Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder characterised by repetitive episodes of upper airway obstruction (apnea) or reduced airflow (hypopnoea) despite persistent respiratory effort. Apnea is defined as the cessation of breathing for at least 10 seconds during sleep, while hypopnoea is defined as at least 30% reduction in airflow for 10 seconds associated with oxygen desaturation and sleep fragmentation. The presence in the general population is about 4%. The principal symptoms are: excessive daytime sleepiness (EDS), snoring, dry throat, morning headache, night sweats, gastro-esophageal reflux, and increased blood pressure.Long term complications can be: increased cardio-cerebrovascular risk and cognitive impairment such as deficiency in attention, vigilance, visual abilities, thought, speech, perception and short term memory.Continuous Positive Airway Pressure (CPAP) is currently the best non-invasive therapy for OSAS.CPAP guarantees the opening of upper airways using pulmonary reflexive mechanisms increasing lung volume during exhalation and resistance reduction, decreasing electromyografical muscular activity around airways.The causes of cognitive impairments and their possible reversibility after CPAP treatment have been analysed in numerous studies. The findings, albeit controversial, show that memory, attention and executive functions are the most compromised cognitive functions.The necessity of increasing the patient compliance with ventilotherapy is evident, in order to prevent cognitive deterioration and, when possible, rehabilitate the compromised functions, a difficult task for executive functions

Patient expression of emotions and neurologist responses in first multiple sclerosis consultations

Background: Anxiety and depression are common in people with multiple sclerosis (MS), but data on emotional communication during MS consultations are lacking. We assessed patient expressions of emotion and neurologist responses during first-ever MS consultations using the Verona Coding Definitions of Emotional Sequences (VR-CoDES). Methods: We applied VR-CoDES to recordings/transcripts of 88 outpatient consultations (10 neurologists, four MS Italian centers). Before consultation, patients completed the Hospital Anxiety and Depression Scale (HADS). Multilevel sequential analysis was performed on the number of cues/concerns expressed by patients, and the proportion of reduce space responses by neurologists. Results: Patients expressed 492 cues and 45 concerns (median 4 cues and 1 concern per consultation). The commonest cues were verbal hints of hidden worries (cue type b, 41%) and references to stressful life events (type d, 26%). Variables independently associated with number of cues/concerns were: anxiety (HADS-Anxiety score >8) (incidence risk ratio, IRR 1.08, 95% CI 1.06-1.09; p <0.001); patient age (IRR 0.98, 95% CI 0.98-0.99; p <0.001); neurologist age (IRR 0.94, 95% CI 0.92-0.96; p=0.03); and second opinion consultation (IRR 0.72, 95% CI 0.60-0.86; p=0.007). Neurologists reacted to patient emotions by reducing space (changing subject, taking no notice, giving medical advice) for 58% of cues and 76% of concerns. Anxiety was the only variable significantly associated with ‘reduce space’ responses (odds ratio 2.17, 95% CI 1.32-3.57; p=0.003). Conclusions: Patient emotional expressions varied widely, but VR-CoDES cues b and d were expressed most often. Patient anxiety was directly associated with emotional expressions; older age of patients and neurologists, and second opinion consultations were inversely associated with patient emotional expression. In over 50% of instances, neurologists responded to these expressions by reducing space, more so in anxious patients. These findings suggest that neurologists need to improve their skills in dealing with patient emotions