La Sindrome delle apnee ostruttive del sonno. Studio osservazionale multicentrico in un campione affetto da comorbilità, valutazione delle correlazioni tra parametri occlusali, antropometrici e otorinolaringoiatrici con la gravità dell'OSAS

La sindrome delle apnee ostruttive del sonno (Obstructive Sleep Apnea Syndrome o OSAS) è un grave problema di salute che impatta notevolmente sulla qualità di vita di chi ne soffre e la cui importanza sta emergendo solo negli ultimi anni. Il piano d'Azione Globale dell’Organizzazione Mondiale della Sanità per la prevenzione e il controllo delle malattie non trasmissibili (2013-­‐2020) definisce tra i 9 obiettivi globali la riduzione relativa del 25% della mortalità precoce dovuta a malattie croniche entro il 2025. L’OSAS è una patologia cronica con importanti implicazioni economiche e sociali, ad elevata prevalenza, spesso sotto diagnosticata e sotto trattata. Il 12 Maggio 2016 è stato approvato in conferenza Stato Regioni il documento “La Sindrome delle Apnee ostruttive del sonno”, al fine di proporre, attraverso un approccio multidisciplinare, una strategia finalizzata alla prevenzione ottimale dell’OSAS e al controllo delle sue comorbilità, suggerendo la necessità di promuovere azioni preventive in grado di ridurre i rischi associati e di realizzare una diagnosi precoce per consentire un tempestivo intervento terapeutico. Questo elaborato di tesi ha avuto come obiettivo principale la ricerca della prevalenza dell’OSAS nella popolazione generale e nella popolazione lavorativa a rischio di incidentalità e di infortuni. Lo studio nasce nel 2018 dalla sinergia tra Sapienza Università di Roma e l’Istituto Nazionale per gli Infortuni e Assicurazioni sul Lavoro (INAIL) nell’ambito del progetto BRIC dal titolo: “SLeeP@SA: salute sul lavoro e prevenzione delle obstructive sleep apnea: un’epidemia silenziosa”. Nel primo capitolo sono descritte tutte le generalità riguardo la patologia OSAS quali l’epidemiologia, fisiopatologia, i fattori di rischio, diagnosi e trattamento. Nel secondo capitolo l’argomento trattato è la nascita e lo svolgimento del progetto articolato nelle sue diverse fasi ovvero gli obiettivi, la strutturazione dell’attività di ricerca di natura multicentrica, la formulazione del questionario, l’elaborazione del database atto alla raccolta dei dati, le metodologie della raccolta dei dati partendo dalla fase di pretest e la fase di raccolta vera e propria. Il terzo capitolo è dedicato ai fattori odontoiatrici con il ruolo dell’odontoiatra come sentinella epidemiologica. Nel quarto capitolo è descritta l’analisi dei dati basata sulla terza sezione del questionario relativa agli aspetti odontoiatrici, antropometrici e otorinolaringoiatrici correlati alla gravità dell’OSAS

Hepatic endotheliitis in Golden Syrian hamsters (Mesocricetus auratus) experimentally infected with SARS-CoV-2

Hepatic injuries in COVID-19 are not yet fully understood and indirect pathways (without viral replication in the liver) have been associated with the activation of vascular mechanisms of liver injury in humans infected with SARS-CoV-2. Golden Syrian hamsters are an effective model for experimental reproduction of moderate and self-limiting lung disease during SARS-CoV-2 infection. As observed in humans, this experimental model reproduces lesions of bronchointerstitial pneumonia and pulmonary vascular lesions, including endotheliitis (attachment of lymphoid cells to the luminal surface of endothelium). Extrapulmonary vascular lesions are well documented in COVID-19, but such extrapulmonary vascular lesions have not yet been described in the Golden Syrian hamster model of SARS-CoV-2 infection. The study aimed to evaluate microscopic liver lesions in Golden Syrian hamsters experimentally infected with SARS-CoV-2. In total, 38 conventional Golden Syrian hamsters, divided into infected group (n=24) and mock-infected group (n=14), were euthanized at 2-, 3-, 4-, 5-, 7-, 14-, and 15-days post infection with SARS-CoV-2. Liver fragments were evaluated by histopathology and immunohistochemical detection of SARS-CoV-2 Spike S2 antigens. The frequencies of portal vein endotheliitis, lobular activity, hepatocellular degeneration, and lobular vascular changes were higher among SARS-CoV-2-infected animals. Spike S2 antigen was not detected in liver. The main results indicate that SARS-CoV-2 infection exacerbated vascular and inflammatory lesions in the liver of hamsters with pre-existing hepatitis of unknown origin. A potential application of this animal model in studies of the pathogenesis and evolution of liver lesions associated with SARS-CoV-2 infection still needs further evaluation

OSAS: aspetti epidemiologici correlati ai fattori di rischio eziologici in età pediatrica

Obiettivo di questo lavoro è quello di dare una lettura ai dati di prevalenza dei Disturbi Respiratori del Sonno (DRS) e della Sindrome delle Apnee Ostruttive del Sonno (OSAS) presenti nella letteratura, correlandoli a quelli che sono i fattori eziologici che giocano un ruolo predisponente e determinante nella insorgenza dell’OSAS anche in età pediatrica. Questa lettura consente di evidenziare le caratteristiche principali che differenziano l’OSAS nell’adulto e nel bambino e di individuare il ruolo dei fattori eziologici determinanti che agiscono nelle varie fasce di età, andando ad osservare come essi pongano le basi di un processo evolutivo di questa sindrome dall’età pediatrica a quella adulta, aiutando in tal modo l’approccio preventivo e precoce alla patologia OSAS

New perspectives in graphene-based nanomaterials and surface disinfection

BACKGROUND: Chemical disinfection of surfaces and instruments for infection control in dental units is a relevant practice, especially at the time of antibiotic resistance microbes. Resistant bacteria are in fact, involved in the high incidence of healthcare-acquired infections, recognized as critical emergence in hospitals and clinics around the world. Infected patients disseminate and release many multidrug-resistant Gram-negative and Gram–positive species to other ones and to healthy people: such bacteria share the ability to survive on various hospital surfaces for long periods and for this reason they are difficult to eradicate by cleaning and chemical disinfection. In this regard, the use of nanomaterials as novel and non-traditional antibacterial agents offers new insight in the field of disinfection. Here we report the development of carbon based nanomaterials, such as graphene nanoplatelets (GNPs) decorated with Zinc oxide nanorods (ZNGs) to be used as disinfectant agents in dentistry units. METHODS: ZNGs were produced at Sapienza NanoLab by thermal expansion of graphite; ZNGs were obtained by subsequent hydrothermal growth of zinc oxide nanorods on GNPs (graphene nanoplatelets), used as seed layers. These nanomaterials were spray coated on different surfaces with different porosity and the antimicrobial properties were evaluated by the colony forming unit method (CFU), against Staphylococcus aureus and Pseudomonas aeruginosa as main representatives of Gram positive and Gram negative bacteria, respectively. RESULTS: Characterization of ZNGs sprayed on the different surfaces was performed by Field-Emission Scanning Electrone Microscope and XRD analysis. Microscope images showed the nanorods of ZNGs emerging out from the surfaces having average diameter of ~34 nm and length of 300–400 nm. The XRD pattern of ZNGs did not detect any diffraction peaks of impurity, suggesting that the synthesized nanomaterials were of high-purity. Treated surfaces with the above nanomaterial showed a strong antimicrobial power with respect to the untreated surfaces. Indeed, the survival of both types of bacteria was almost less than 10% after 30 minutes in the case of cells inoculated on treated surface. CONCLUSIONS: ZNGs can be exploited as promising antimicrobial agents to be used as disinfectants in dental units

Frenulectomy with diode laser technology in paediatric patients: quantitative and qualitative evaluations. Randomized double- blind clinical trial

Abstract: Background: Ankyloglossia is an anatomical alteration of the frenulum length, volume, compactness, and insertion. It can lead to alterations in the ability to swallow and chewing, and dysfunctional coordination amongst cranio-facial muscles; these alterations are often responsible for respiratory alterations, skeletal malocclusions and dyslalia or the delay of speech. The aim of this study is to estimate the efficacy of lingual frenulectomy with diode-laser technology through a qualitative and quantitative evaluation. Methods: One hundred and twenty-five pediatric patients were recruited: 100 with a lingual pathological frenulum were randomly divided into four operating groups; the other 25 with a borderline pathological frenulum were recruited as a control group. Each patient was included in a follow-up program (T0-T1-T2-T3-T4) for a quantitative and qualitative evaluation: the first through an accurate measurement of Kotlow’s free tongue measurement (≥16), Mouth Opening with Tongue Tip to incisive papilla (MOTTIP), Maximal Intercisal Mouth Opening (MIO) and Protrusion; and the second using the Assessment Tool for Lingual Frenulum Function (ATLFF), Bristol Tongue Assessment Tool (BTAT), and grade of tongue functionality. Results: The increase of the aforementioned quantitative parameters was circa 10 mm, and all patients reacquired full functionality of the tongue. Conclusions: Diode-laser technology is efficient and innovative in the treatment of pathological lingual frenulums

Early class III treatment using a hybrid rapid palatal expander and facemask in a patient with partially edentulous maxilla post MNTI removal: a case report

Abstract: This case report describes the orthodontic treatment of a 9-year-old girl who presented with multiple agenesis, maxillary contraction, and skeletal Class III malocclusion after the surgical removal of a melanocytic neuroectodermal tumour of infancy (MNTI) or the so-called melanocytic progonoma at 40 days of age. The lack of dental anchorage in the posterior segment of the second quadrant and the search for maximum control during suture expansion to reduce dental effects led to the use of a hybrid rapid palatal expander (RPE) with dental anchorage in the first quadrant and skeletal anchorage on the two miniscrews placed in the second quadrant, to allow a more even distribution of expansion forces. The expansion procedures performed with the hybrid anchorage device and extraoral traction demonstrate the possibility of solving the contraction in the posterior segments and anterior crossbite in a few months with maximum control of the applied forces, despite the objective difficulties related to the specificity of the case

Produção de espécies reativas de oxigênio e diminuição da atividade da catalase induzidas por citocinas inflamatórias em uma linhagem representativa de células estreladas hepáticas

44

Modulação da expressão de PPARs durante a conversão fenotípica de um modelo de células estreladas hepáticas

15

Modulação da expressão de PPARs durante a conversão fenotípica de um modelo de células estreladas hepáticas

15