Epidemiology, prevention and control of oral diseases in pediatric subjects

Caries and periodontal diseases are a neglected epidemic by millions of Italians who suffer unnecessarily from them. Both diseases are preventable and the combination of high prevalence, high morbidity and relative inattention from the National Health Service (NHS), makes caries and periodontal disease a significant public health problem. In this perspective, the World Health Organization and the University of Milan have promoted a national epidemiological study aimed at a sample of 4, 6 and 12-years-old students from schools in the North, Central and South of Italy. The study provides for the administration of a questionnaire to parents and a dental examination carried out at school by dentists trained by the WHO. In our town the epidemiological study planning and the survey were carried out by professors of the School of Specialization in "Pediatric Dentistry" (Prof. G. Giuliana and Prof. G. Pizzo) supported by specialist dentists from the same School, calibrated according to the WHO methodology. The survey was carried out between 2017 and 2019 involving 2701 children attending schools in the 8 districts of the town. The parents were sent a letter which explained the nature of the survey and contained a pre-printed form for the issue of informed consent to participate in the survey with a questionnaire regarding the family nuclear, the oral hygiene and eating habits of the minor and the child's previous dental experiences. The ICDAS (International Caries Detection and Assessment System) was used to detect the prevalence of carious lesions. The dentist used for each child visited a dental mirror and the CPI (Community Periodontal Index) index for periodontal assessment. Preliminary results showed that 25.3% of 12-years-old students had gingival bleeding and 41.1% had tartar. The caries index (ICDAS) shows us that as early as 4 years, 20% of children have initial carious lesions, 37% have dentine caries and that 34.38% have highly destructive caries. At 12 years, 34.95% had initial carious lesions, 46% had cavities that already affected dentin and that 42.44% had highly destructive cavities. The exigence to implement a program of prevention / early treatment of caries/gingivitis in pediatric subjects living in Palermo, since the first months of child's life, was born from the data analysis. The project "Un sorriso per 54 tutti i bambini", carried out at the U.O. of "Pediatric Dentistry" of Policlinico Paolo Giaccone in Palermo, was therefore finalised in order to 1) improve efficiency and effectiveness in the promotion of the oral health of minors, through the creation of a preventive / assistance route of significant social health impact; 2) assess the effectiveness of the preventive methodologies adopte

Laterolateral teleradiography of the skull as a screening method for OSA/OSAS, in patients in orthodontic treatment

Aim: Obstructive sleep apnea syndrome (OSAS) is the most common type of sleep apnea and it is caused by complete or partial obstruction of the upper airway. Adenotonsillar hypertrophy, obesity, cranio-facial anomalies and neuromuscular diseases are the main risk factors for the development of OSAS in the pediatric age. Specially several studies identify the relationship between respiratory disorders in sleep and obesity, and, in particular, between OSAS and obesity, designing a prevalence of OSAS among obese subjects between 14 and 78%. The diagnosis of OSAS in the child is of great importance as it can lead to neurocognitive and behavioral complications, growth retardation, systemic arterial hypertension, pulmonary hypertension, cardiovascular disease and metabolism. The WHO (World Health Organization) has established the new criteria for the classification of Obesity on the basis of BMI and the risk of comorbidities, identifying a moderate risk for underweight subjects, a very low risk for normal weights and an increased risk from severe to severe for overweight and obese individuals respectively. According to that the aim of this study is to evaluate the correlation between obstructive sleep apnea syndrome and cephalometric variables in children considering age and BMI. Materials and methods: Children aged 7–10 years and 11-14 years with no genetic syndrome, previous otorhinolaryngologic or orthodontic therapy treatments are being selected from our Departments of Paediatric Dentistry, University of Palermo, and from the Department of Orthodontics, University of Messina (Italy). All patients so far recruited and visited for orthodontic problems were in mixed or early permanent dentition phase, with the first upper molars fully erupted and presented to the history of several symptoms of Osas, such as recurring episodes of shallow or paused breathing during sleep, waking up frequently to urinate, morning headaches, memory or learning problems and not be able to concentrate or feeling irritable. Dental records and lateral cephalometric radiographs were obtained for all of the patients and than they have been subjected to paediatric, otolaryngology and polysomnography visits. Subject with a positive diagnosis of Osas were studied and they were divided in group based on their BMI. In all groups the inter-molar distance in dental records was measured, and the cephalometric traces have been calculated. As reported by the study by Galeotti et al. the cephalometric measurements analysed are S-PNS, ad1-PNS, and ad2-PNS for the nasopharynx; p-pp and pa for oropharynx; H-H’ for the Hyoid bone; SNA for the maxilla; SNB;ANB and Go-Me for the mandible; S-Go, N-Me and P-A for facial Height; SN for cranial base; SN-MP and PP-MP for the typology, and angle ArGoMe for Growth prevision. At the time that children are still in the way of recruitment the results may not yet be defined; however it is necessary to emphasize the importance of the study, because in the child respiratory disturbances in the sleep, and in particular the OSAS, are often underestimated, despite representing the third place between the threats of health after the smoke and the excess of weight

Sirtuins 1–7 expression in human adipose-derived stem cells from subcutaneous and visceral fat depots: influence of obesity and hypoxia

The sirtuin family comprises seven NAD+-dependent deacetylases which control the overall health of organisms through the regulation of pleiotropic metabolic pathways. Sirtuins are important modulators of adipose tissue metabolism and their expression is higher in lean than obese subjects. At present, the role of sirtuins in adipose-derived stem cells has not been investigated yet. Therefore, in this study, we evaluated the expression of the complete panel of sirtuins in adipose-derived stem cells isolated from both subcutaneous and visceral fat of non-obese and obese subjects. We aimed at investigating the influence of obesity on sirtuins' levels, their role in obesity-associated inflammation, and the relationship with the peroxisome proliferator-activated receptor delta, which also plays functions in adipose tissue metabolism. The mRNA levels in the four types of adipose-derived stem cells were evaluated by quantitative polymerase chain reaction, in untreated cells and also after 8 h of hypoxia exposure. Correlations among sirtuins' expression and clinical and molecular parameters were also analyzed. We found that sirtuin1-6 exhibited significant higher mRNA expression in visceral adipose-derived stem cells compared to subcutaneous adipose-derived stem cells of non-obese subjects. Sirtuin1-6 levels were markedly reduced in visceral adipose-derived stem cells of obese patients. Sirtuins' expression in visceral adipose-derived stem cells correlated negatively with body mass index and C-reactive protein and positively with peroxisome proliferator-activated receptor delta. Finally, only in the visceral adipose-derived stem cells of obese patients hypoxia-induced mRNA expression of all of the sirtuins. Our results highlight that sirtuins' levels in adipose-derived stem cells are consistent with protective effects against visceral obesity and inflammation, and suggest a transcriptional mechanism through which acute hypoxia up-regulates sirtuins in the visceral adipose-derived stem cells of obese patients

Lagrangian pathways of upwelling in the Southern Ocean

The spatial and temporal variability of upwelling into the mixed layer in the Southern Ocean is studied using a 1/10° ocean general circulation model. Virtual drifters are released in a regularly-spaced pattern across the Southern Ocean at depths of 250, 500, and 1000 m during both summer and winter months. The drifters are advected along isopycnals for a period of four years, unless they outcrop into the mixed layer, where lateral advection and a parameterization of vertical mixing is applied. The focus of this study is on the discrete exchange between the model mixed layer and the interior. Localization of interior-mixed layer exchange occurs downstream of major topographic features across the Indian and Pacific basins, creating “hotspots” of outcropping. Minimal outcropping occurs in the Atlantic basin, while 59% of drifters outcrop in the Pacific sector and in Drake Passage (the region from 140° W to 40° W), a disproportionately large amount even when considering the relative basin sizes. Due to spatial and temporal variations in mixed layer depth, the Lagrangian trajectories provide a statistical measure of mixed layer residence times. For each exchange into the mixed layer, the residence time has a Rayleigh distribution with a mean of 30 days; the cumulative residence time of the drifters is 261 ± 194 days, over a period of four years. These results suggest that certain oceanic gas concentrations, such as CO_2 and ^(14)C, will likely not reach equilibrium with the atmosphere before being re-subducted

Unsolved Problems about Supernovae

A number of unsolved problems and open questions about the nature and the properties of supernovae are identified and briefly discussed. Some suggestions and directions toward possible solutions are also considered.Comment: 7 pages, Proceedings of 'Probing Stellar Populations out to the Distant Universe', Cefalu, Italy, Sep 7-19, 2008, AIP Conf. Proc. Serie

Advances on GRB as cosmological tools

Several interesting correlations among Gamma Ray Bursts (GRB) prompt and afterglow properties have been found in the recent years. Some of these correlations have been proposed also to standardize GRB energetics to use them as standard candles in constraining the expansion history of the universe up to z>6. However, given the still unexplained nature of most of these correlations, only the less scattered correlations can be used for constraining the cosmological parameters. The updated E_peak-E_gamma correlation is presented. Caveats of alternative methods of standardizing GRB energetics are discussed.Comment: 8 parges, AIP conf. proc. "Probing stellar populations out to the distant universe, Cefalu' 2008" Vol. 1111, pp. 579-58

The formation and evolution of early-type galaxies : solid results and open questions

The most recent results and some of the open key questions on the evolution of early-type galaxies are reviewed in the general cosmological context of massive galaxy formation.Comment: 8 pages, invited review at the workshop "Probing Stellar Populations out to the Distant Universe", Cefalu` (Italy), September 7 - 19, 200

Spectral libraries and their uncertainties

Libraries of stellar spectra are fundamental tools in the study of stellar populations and in automatic determination of atmospheric parameters for large samples of observed stars. In the context of the present volume, here I give an overview of the current status of stellar spectral libraries from the perspective of stellar population modeling: what we have currently available, how good they are, and where we need further improvement

Early metal enrichment in high-redshift quasars

Quasars are powerful systems whose spectrum is rich of metal features that allow us to investigate the chemical evolution of galaxies at very high redshift, even close to the reionization epoch. I review the main observational constraints on the metallicity of quasars host galaxies at high redshift and discuss the implications and issues for models of galaxy evolution in the early universe.Comment: 8 pages, invited review at the workshop "Probing Stellar Populations out to the Distant Universe

Estimation of the variance in any point of an electron-density map for any space group

In a recent paper [Giacovazzo & Mazzone (2011). Acta Cryst. A67, 210-218] a mathematical expression of the variance at any point of the unit cell has been described. The formulas were derived in P1 for any type of Fourier synthesis (observed, difference and hybrid) under the following hypothesis: the current phases are distributed on the trigonometric circle about the correct values according to von Mises distributions. This general hypothesis allows the variance expressions to be valid at any stage of the phasing process. In this paper the method has been extended to any space group, no matter whether centric or acentric. The properties of the variance generated by space-group symmetry are described; in particular it is shown that the variance is strictly connected with the implication transformations, which are basic for Patterson deconvolution. General formulas simultaneously taking into account phase uncertainty and measurement errors have been obtained, valid no matter what the quality of the model