Low-Level Light Therapy in Orthodontic Treatment: A Systematic Review

This current review aims to provide an overview of the most recent research from the last 10 years on the potential of low-level light therapy (LLLT) in the orthodontic field, particularly focusing on studies about tooth movement, root resorption, pain perception during treatment, and the stability of orthodontic miniscrews. “Low-level laser,” “orthodontic,” and “LLLT” were the search terms utilized on the databases Scopus, Web of Science, and PubMed, and the Boolean operator “AND” was utilized. Of the 974 studies found, 41 publications related to our topic were included in this review. Many authors agree that LLLT could trigger an enhanced biological reaction next to the tooth in the periodontium, promoting osteoblast proliferation and differentiation, while it could also have a positive impact on bone regeneration and on increasing the rate of tooth movement, enhancing the stability of miniscrews and minimizing the occurrence of root resorption. Regarding pain management during treatment studies, the results have been controversial. Conclusions: even though further studies are still needed, the use of LLLT can improve both clinical results and patient comfort during treatment by reducing treatment duration, improving clinical aspects, such as miniscrew stability, and minimizing root resorption. Further investigations are needed to assess whether LLLT offers any real benefits regarding pain relief

LUCAS Versus Manual Chest Compression During Ambulance Transport : A Hemodynamic Study in a Porcine Model of Cardiac Arrest

Background-Mechanical chest compression (CC) is currently suggested to deliver sustained high-quality CC in a moving ambulance. This study compared the hemodynamic support provided by a mechanical piston device or manual CC during ambulance transport in a porcine model of cardiopulmonary resuscitation. Methods and Results-In a simulated urban ambulance transport, 16 pigs in cardiac arrest were randomized to 18 minutes of mechanical CC with the LUCAS (n=8) or manual CC (n=8). ECG, arterial and right atrial pressure, together with end-tidal CO2 and transthoracic impedance curve were continuously recorded. Arterial lactate was assessed during cardiopulmonary resuscitation and after resuscitation. During the initial 3 minutes of cardiopulmonary resuscitation, the ambulance was stationary, while then proceeded along a predefined itinerary. When the ambulance was stationary, CC-generated hemodynamics were equivalent in the 2 groups. However, during ambulance transport, arterial and coronary perfusion pressure, and end-tidal CO(2 )were significantly higher with mechanical CC compared with manual CC (coronary perfusion pressure: 43 +/- 4 versus 18 +/- 4 mmHg; end-tidal CO2: 31 +/- 2 versus 19 +/- 2 mmHg, P Conclusions-This model adds evidence in favor of the use of mechanical devices to provide ongoing high-quality CC and tissue perfusion during ambulance transport.Peer reviewe

COVID-19 in the tonsillectomised population

Objective: Interactions between SARS-CoV-2 and pharyngeal associated lymphoid tissue are thought to influence the manifestations of COVID-19. We aimed to determine whether a previous history of tonsillectomy, as a surrogate indicator of a dysfunctional pharyngeal associated lymphoid tissue, could predict the presentation and course of COVID-19. Methods: Multicentric cross-sectional observational study involving seven hospitals in Northern and Central Italy. Data on the clinical course and signs and symptoms of the infection were collected from 779 adults who tested positive for SARS-CoV-2, and analysed in relation to previous tonsillectomy, together with demographic and anamnestic data. Results: Patients with previous tonsillectomy showed a greater risk of fever, temperature higher than 39°C, chills and malaise. No significant differences in hospital admissions were found. Conclusions: A previous history of tonsillectomy, as a surrogate indicator of immunological dysfunction of the pharyngeal associated lymphoid tissue, could predict a more intense systemic manifestation of COVID-19. These results could provide a simple clinical marker to discriminate suspected carriers and to delineate more precise prognostic models

Reduction of Neuropathic and Inflammatory Pain through Inhibition of the Tetrahydrobiopterin Pathway

Human genetic studies have revealed an association between GTP cyclohydrolase 1 polymorphisms, which decrease tetrahydrobiopterin (BH4) levels, and reduced pain in patients. We now show that excessive BH4 is produced in mice by both axotom- ized sensory neurons and macrophages infiltrating damaged nerves and inflamed tissue. Constitutive BH4 overproduction in sensory neurons increases pain sensitivity, whereas blocking BH4 production only in these cells reduces nerve injury-induced hy- persensitivity without affecting nociceptive pain. To minimize risk of side effects, we targeted sepiapterin reductase (SPR), whose blockade allows minimal BH4 production through the BH4 salvage pathways. Using a structure-based design, we developed a potent SPR inhibitor and show that it reduces pain hypersensitivity effectively with a concomitant decrease in BH4 levels in target tissues, acting both on sensory neurons and macrophages, with no development of tolerance or adverse effects. Finally, we demonstrate that sepiapterin accumulation is a sensitive biomarker for SPR inhibition in vivo

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Pattern of care and effectiveness of treatment for glioblastoma patients in the real world: Results from a prospective population-based registry. Could survival differ in a high-volume center?

BACKGROUND: As yet, no population-based prospective studies have been conducted to investigate the incidence and clinical outcome of glioblastoma (GBM) or the diffusion and impact of the current standard therapeutic approach in newly diagnosed patients younger than aged 70 years. METHODS: Data on all new cases of primary brain tumors observed from January 1, 2009, to December 31, 2010, in adults residing within the Emilia-Romagna region were recorded in a prospective registry in the Project of Emilia Romagna on Neuro-Oncology (PERNO). Based on the data from this registry, a prospective evaluation was made of the treatment efficacy and outcome in GBM patients. RESULTS: Two hundred sixty-seven GBM patients (median age, 64 y; range, 29-84 y) were enrolled. The median overall survival (OS) was 10.7 months (95% CI, 9.2-12.4). The 139 patients 64aged 70 years who were given standard temozolomide treatment concomitant with and adjuvant to radiotherapy had a median OS of 16.4 months (95% CI, 14.0-18.5). With multivariate analysis, OS correlated significantly with KPS (HR = 0.458; 95% CI, 0.248-0.847; P = .0127), MGMT methylation status (HR = 0.612; 95% CI, 0.388-0.966; P = .0350), and treatment received in a high versus low-volume center (HR = 0.56; 95% CI, 0.328-0.986; P = .0446). CONCLUSIONS: The median OS following standard temozolomide treatment concurrent with and adjuvant to radiotherapy given to (72.8% of) patients aged 6470 years is consistent with findings reported from randomized phase III trials. The volume and expertise of the treatment center should be further investigated as a prognostic factor

Influence of stress on wild Marsican brown bear chemical immobilization.

Capture of wild bears with leg holding snares causes fear, anxiety, excitement, muscular activity and resistance to holding which in turn elicit in an acute stress response: neuro-hormonal responses are then activated, but these may interfere with anaesthetics efficacy and safety. Hormonal and physiological parameters have been used to evaluate stress level in bears after chemical immobilization; to our knowledge however, behavioral indicators prior to drug injection have never been used to evaluate it. The aim of this study was to evaluate if stress induced using Aldrich snare\u2019s restraint influenced anesthetics requirements for chemical immobilization and physiological parameters. Data sheets collected during 43 adult Marsican brown bear (Ursus arctos marsicanus) captures (27 males and 16 females) in the Abruzzo, Lazio and Molise National Park (Italy) were reviewed. Before chemical immobilization, a stress score (0 - 4) was assigned to each bear by an experienced veterinarian (LG) based on the behavioral reactions to leg-holding snare entrapment. A medetomidine-ketamine combination was administered intramuscularly by remote injection: supplemental doses were injected until a safe approach to the animal was possible. Dose used, induction time (time from injection to recumbency), approach time (time from injection to safe handling) and physiological parameters collected within 15 \ub1 5 minutes of chemical immobilization were analyzed by Spearmann correlation test. Stress score showed a positive correlation with the total dose of medetomidine (r=0.0030) and ketamine used (r=0.0008): more stressed bears required greater dosages then less stressed animals. Stress score positively correlated with rectal temperature (r=0.015) and heart rate (r=0.044). Time to approach was correlated to stress only in female, not in male bears. Other slight differences were observed between male and female bears. This is the first study evaluating the level of stress induced by physical restraint in Marsican brown bears and it showed that stress influenced not only physiological parameters but also anaesthetics needs, thus the anaesthetic protocol should be tailored to the bear\u2019s stress state

Management of chemical immobilization of brown bear (Ursus arctos) in the Abruzzo, Lazio and Molise National Park on 235 cases from 1990 to 2013.

235 chemical immobilizations, 44 on captive and wild brown bears (Ursus arctos, n=5) and 171 on Marsican brown bears (Ursus arctos marsicanus, n=44) were recorded. Age and body weight (mean \ub1 standard deviation) of captured animals was 9.81\ub16.28 years and 149.25\ub162.29 kg and 9.68\ub16.15 years and 147.54\ub160.71 kg in brown bear and Marsican brown bears respectively. The following anesthetic combinations were injected intramuscular by a remote equipment: medetomidine 0.05-0.09 mg/kg and ketamine 3-7 mg/kg (group MK: n=209); xylazine 7-13 mg/kg and ketamine 3-8 mg/kg (group XK: n=17); tiletamine-zolazepam 4-8 mg/kg (group TZ: n=9). In MK and XK groups, atipamezol was administered at the end of the procedure. Bears were darted after physical restraint (Aldrich snares or tube trap) or in free ranging situations. Complete anesthetic record, including heart rate (HR), respiratory rate (RR), rectal body temperature (T) and saturimetry (SpO2), and biometric data form were filled in. The first physiologic parameters were recorded within 20 minutes from darting, as soon as adequate depth of anesthesia allowed safe handling of the animal, and were compared between groups with ANOVA test. Statistical significance was set at P<0.05. Anaesthesia induction time was similar between groups and ranged from 7 to 11minutes. HR was similar in groups MK and XK but higher in TZ group; HR was higher in wild than captive bears. RR was similar between groups. Recovery time was shorter in MK and XK than TZ group. Peri-operative complications were reported in 16/235 immobilizations and included vomiting and respiratory complications: 7,1%, 5% and 0% of complications were reported in group MK, XK and TZ respectively. All recoveries were uneventful. Knowledge of the target species biology, trained personnel, deep knowledge of advantages and disadvantages anesthetic drugs is mandatory during wildlife chemical immobilization