The association between Ponticulus Posticus and Dental Agenesis: a retrospective study

OBJECTIVE: Neural tube defects may increase the risk of an abnormal development of skull, vertebral column and teeth formation, including dental agenesis in non syndromic patients. The association between the presence of a congenital Dental Agenesis (DA) and the Atlantooccipital Ligament (AOL) calcification, known as "Ponticulus Posticus" (PP), as possible links can be investigated. DESIGN: After a systematic review of the scientific literature on this topic, two independent examiners assessed the AOL calcification in lateral cephalograms of 350 non syndromic patients(7-21 years old). The results were compared with a control group (non syndromic patients, without congenital missing teeth). RESULTS: The 16.3% of the population studied by cephalometric analysis revealed a prevalence rate of PP (both complete and partial) with a slight male predominance is seen, not statistically significant (χ square test = 0.09; p= 0.76). In both sexes complete PP is more observed. In the patients affected by DA the frequency of PP is the 66.6% (both complete than partial). The χ square test with Yates correction showed a significative difference(χ= 66.20; p value= 0.00) between PP in patients with DA compared to not affected by DA. CONCLUSIONS: PP is not an uncommon anomaly. Since orofacial pain like migraine and other symptoms are often associated to PP, during routine radiographic examination, if detected, it should be documented in patients' health record and with symptoms, further investigation should be sought for. These findings encourage to think there's an association between DA in non syndromic patients and neuro-crestal cells defects

Estudo de aumento de casos de óbitos embrionários e fetais diagnosticados por ultrassonografia durante o surto de Zika vírus

The aim of the research was to describe the main causes of fetal death to improve the quality of care for pregnant women. The Zika virus is a virus of the Flavoviridae family, the Dengue and Chikungunya viruses also belong to this family and are transmitted by the Aedes mosquito. There is a concern of the World Health Organization and the Ministry of Health with the increase in cases of Zika virus in pregnant women, since infection with this virus can lead to the presence of neurological changes, such as microcephaly and fetal loss diagnosed by pelvic or transvaginal obstetric ultrasound. . During the period of outbreak of Zika virus infection, there was an increase in cases of deaths diagnosed by ultrasound examination, in the period from 2005 to 2020. Conclusion: The survey identified the socioeconomic level, the obstetric background, the lack of adequate medical monitoring during prenatal care and difficulty in reporting, which are factors that are directly involved with the difficulty of investigating the causes of fetal/embryonic deaths.O objetivo da pesquisa foi descrever as principais causas de óbito fetal para melhorar a qualidade de atendimento as gestantes. O Zika vírus é um vírus da família Flavoviridae, também pertencem a essa família os vírus da Dengue e Chikungunya, e são transmitidos pelo mosquito Aedes. Há uma preocupação da Organização Mundial de Saúde e do Ministério da Saúde com o aumento de casos de Zika vírus em gestantes, pois a infecção por esse vírus pode levar à presença de alterações neurológicas, como microcefalia e perda fetal diagnosticada pela ultrassonografia obstétrica pélvica ou transvaginal. Durante o período de surto da infecção por Zika vírus, houve um aumento dos casos de óbitos diagnosticados pelo exame de ultrassom, no período de 2005 a 2020. Conclusão: A pesquisa identificou o nível socioeconômico, os antecedentes obstétricos, a falta de acompanhamento médico adequado durante o pré-natal e dificuldade de notificação, os quais são fatores que estão envolvidos diretamente com a dificuldade de investigação das causas dos óbitos fetais/embrionários

Partial breast irradiation: Targeting volume or breast molecular subtypes?

The eligibility criteria for partial breast irradiation (APBI) are mainly based on histopathological factors, which not always explain the clinical behaviour of breast cancers. International guidelines represent useful platform to collect data for continued refinement of patient selection, but the clinical applicability to APBI series showed some limitations, particularly among the intermediate and high-risk groups. The heterogeneity of APBI techniques, along with the heterogeneity of breast cancer, generates clinical results, where the predictive value of the histopathological factors can assume different weight. There is a need of further refinement and implementation of risk factors. Currently, the impact of breast cancer subtype on local control is matter of investigation, and treatment decision about radiotherapy is generally made without regard to the breast cancer subtype. However, receptor status information is easily available and some histopathological factors have not a definite role, there is no uniform interpretation. As molecular classification becomes more feasible in the clinical practice, it will provide added value to conventional clinical tumour characteristics in predicting local recurrence in breast cancer and may play an important role as predictor of eventual patient outcomes

Italian collective bargaining at a turning point. WP CSDLE “Massimo D’Antona”.INT – 139/2017

In the past eight years the Italian system of industrial relations has been undergoing a prolonged transitional phase (Carrieri and Treu 2013; Barbera and Perulli 2014; Leonardi and Sanna 2015; Guarriello 2014; Gottardi 2016). The numerous events that have occurred have changed some of its traits within a relatively short period. The various causes are both exogenous and endogenous, economic as well as institutional. The main exogenous factors are globalisation, the financial crisis and the economic downturn, as well as interventions by international institutions in national policy-making. This scenario is to some extent shared with other countries and is currently exerting pressure on different models of industrial relations (Katz and Darbishire 2000) towards neoliberal convergence (Streeck 2009; Baccaro and Howell 2011). Under growing pressure from so-called ‘New European Economic Governance’ (NEEG), many national lawmakers – and especially in the Southern European countries (Rocha 2014; J. Cruces et al. 2015; Leonardi 2016) – have stepped up deep labour law reforms, with the purpose of reducing the traditional prioritisation of multi-employer bargaining and the favourability principle, allowing company-level agreements to derogate in pejus from higher bargaining levels or even labour legislation (Marginson 2014; Van Gyes and Schulten 2015; Bordogna and Pedersini 2015; Cella 2016)

New technologies to improve root canal disinfection

Effective irrigant delivery and agitation are prerequisites to promote root canal disinfection and debris removal and improve successful endodontic treatment. This paper presents an overview of the currently available technologies to improve the cleaning of the endodontic space and their debridement efficacy. A PubMed electronic search was conducted with appropriate key words to identify the relevant literature on this topic. After retrieving the full-text articles, all the articles were reviewed and the most appropriate were included in this review. Several different systems of mechanical activation of irrigants to improve endodontic disinfection were analysed: manual agitation with gutta-percha cones, endodontic instruments or special brushes, vibrating systems activated by low-speed hand-pieces or by sonic or subsonic energy, use of ultrasonic or laser energy to mechanically activate the irrigants and apical negative pressure irrigation systems. Furthermore, this review aims to describe systems designed to improve the intracanal bacterial decontamination by a specific chemical action, such as ozone, direct laser action or light-activated disinfection. The ultrasonic activation of root canal irrigants and of sodium hypochlorite in particular still remains the gold standard to which all other systems of mechanical agitation analyzed in this article were compared. From this overview, it is evident that the use of different irrigation systems can provide several advantages in the clinical endodontic outcome and that integration of new technologies, coupled with enhanced techniques and materials, may help everyday clinical practice

Anticoagulation in cirrhosis: a new paradigm?

The liver plays a crucial role in coagulation cascade. Global hemostatic process is profoundly influenced by the presence of liver disease and its complications. Patients with cirrhosis have impaired synthesis of most of the factors involved in coagulation and fibrinolysis process due to a reduced liver function and altered platelet count secondary to portal hypertension. Altered routine tests and thrombocytopenia were considered in the past as associated with increased risk of bleeding. These concepts explain both the routine use of plasma and/or platelets transfusion in patients with liver cirrhosis, especially before invasive procedures, and why these patients were considered "auto-anticoagulated". New recent evidences show that patients with liver cirrhosis have a more complex hemostatic alteration. Despite the presence of altered levels of factors involved in primary hemostasis, coagulation and fibrinolysis, patients with stable cirrhosis have a rebalanced hemostatic, which however can easily be altered by decompensation or infection, both in hemorrhagic or thrombotic direction. Patients with cirrhosis have an increased risk of venous thrombotic events (namely portal vein thrombosis) while bleeding seems to be related to the grade of portal hypertension rather than to a hemostatic imbalance. The use of anticoagulants both as treatment or prophylaxis is safe, reduces the rate of portal vein thrombosis and decompensation, and improves survival. Standard laboratory coagulation tests are unable to predict bleeding and are inadequate for the assessment of hemostatic status in these patients, hence more comprehensive tests are required to guide the management of thrombotic and bleeding complications

Turismo digitale in Toscana. Sviluppo di un piano di Destination Marketing per la via Francigena.

Con questo progetto è stato elaborato un piano di Destination Marketing, basandosi su tecniche di analisi e strategie comunemente note nell'ambito del marketing classico e territoriale: analisi del contesto territoriale, analisi dell'offerta turistica, analisi della domanda turistica, analisi della concorrenza, per poi continuare con un'analisi SWOT, segmentazione, targeting e posizionamento della destinazione, anche in riferimento ai competitors individuati. Per applicare la strategia elaborata, si è fatto riferimento ad una destinazione, la via Francigena, che, negli ultimi anni, ha subito numerosi interventi e piani d'azione

Expression and Localization of aquaporin‐1 in Temporomandibular Joint Disc with Internal Derangement

Background: Internal derangement is the most frequent arthropathy affecting the temporomandibular joint, where its commonest form is anterior disc displacement with or without reduction. Despite the frequency of the disorder, the biochemical features of displaced discs are still unclear. Methods: We investigated the expression pattern and localization of aquaporin‐1, an important channel protein involved in plasma membrane water permeability, in patients with anterior disc displacement (both with and without reduction), with a view to assessing the characteristics of local tissue responses to the microenvironmental changes induced by abnormal mechanical loading of the displaced disc. Protein expression was studied by immunohistochemistry in different areas of discs from 18 patients with anterior disc displacement with or without reduction and in four normal controls. Results: A greater proportion of cells immunopositive for aquaporin‐1 were detected in diseased than in normal discs. Whereas protein expression was substantially similar in the different areas of normal discs, a significantly larger number of immunopositive cells were detected in the posterior band of displaced discs without reduction and in the anterior and intermediate bands of those with reduction. Conclusions: These findings suggest that aquaporin‐1 is expressed and upregulated in temporomandibular joint with anterior disc displacement (both with and without reduction)

Network Awareness of P2P Live Streaming Applications

Early P2P-TV systems have already attracted millions of users, and many new commercial solutions are entering this market. Little information is however available about how these systems work. In this paper we present large scale sets of experiments to compare three of the most successful P2P-TV systems, namely PPLive, SopCast and TVAnts. Our goal is to assess what level of "network awareness" has been embedded in the applications, i.e., what parameters mainly drive the peer selection and data exchange. By using a general framework that can be extended to other systems and metrics, we show that all applications largely base their choices on the peer bandwidth, i.e., they prefer high-bandwidth users, which is rather intuitive. Moreover, TVAnts and PPLive exhibits also a preference to exchange data among peers in the same autonomous system the peer belongs to. However, no evidence about preference versus peers in the same subnet or that are closer to the considered peer emerges. We believe that next-generation P2P live streaming applications definitively need to improve the level of network-awareness, so to better localize the traffic in the network and thus increase their network-friendliness as wel