Premature loss of primary molars in children: space recovery through molar distalisation. A literature review

Aim: The integrity of primary dentition is essential in the development of the jaws and permanent occlusion. The consequences of a premature loss of primary molars are: space loss, crowding, risk of impaction of the permanent teeth, ectopic eruption, anomalous inclination of the teeth adjacent to the loss molar, reduction of arch length. The mesial displacement of the posterior permanent teeth during eruption can cause a loss of space, which can be regained with orthodontic appliances. Therefore, a careful diagnosis is of great importance to be able to decide what appliance is indicated to recover from this situation. Molar distalisation consists in displacing permanent molars distally, allowing them to reach class I relationship and to recover the correct space for the second bicuspids when the second deciduous molar has been lost early. Methods: The aim of this study is to carry out a narrative literature review regarding the different appliances and their effectiveness in regaining space after premature loss of the upper primary molars. Conclusion: The paediatric dentist should be aware of the advantages and disadvantages related to each device and select the most appropriate distalisation appliance based on an individual plan of diagnosis and a careful treatment. The distalisation of the upper molar must be adequately stabilised and so it is important to consider also some retainers such as Nance's appliance, the Palatal Plate, the extraoral traction, the utility arch, or II Class elastic bands

From data to practice: brain meningioma treatment in elderly patients – a survey of the Italian Society of Neurosurgery (SINch®) and systematic review and meta-analysis

The management of meningioma in elderly patients (MEP) presents a complex and evolving challenge. Data available offer conflicting information on treatment options and complications. This survey aimed to examine the current approach to MEP, comparing the national profile to data in the current literature. A survey addressing the treatments options and management of meningioma in elderly was designed on behalf of SINch (R) (Societa Italiana di Neurochirurgia) and sent via email to all Chiefs of Neurosurgical Departments. The survey remained open for responses from May 5th, 2022, until November 21st, 2022. A search of the literature published between January 2000 and March 2023, in accordance to PRISMA guidelines, was included. A total of 51 Neurosurgical centers participated in the survey. The caseload profile of each center influences the choice of treatment selection (Stereotactic Radiosurgery versus open surgery) (p = 0.01) and the consolidated practice of discussing cases within a multidisciplinary group (p = 0.02). The pooled meta-analysis demonstrated a significant increased risk in the elderly group for permanent deficits (p < 0.00001), postoperative infections (p = 0.0004) and hemorrhage (p = 0.0001), perioperative mortality (p < 0.00001), and medical complications (p < 0.00001) as compared to the young population. This study presents the initial comprehensive analysis of the existing trends in the surgical management of MEP in Italy. The significant variation in practices primarily stems from the absence of standardized guidelines. While most centers have adopted an integrated approach, there is a need to promote a multidisciplinary care model. Prospective studies are needed to gather robust evidence in this clinical setting

Salivary proteomic profile of young healthy subjects

Background: The incidence of noncommunicable diseases (NCDs) has been rapidly ramped up worldwide. Hence, there is an urgent need to non-invasively detect NCDs possibly by exploiting saliva as a ‘liquid biopsy’ to identify biomarkers of the health status. Since, the absence of standardized procedures of collection/analysis and the lack of normal ranges makes the use of saliva still tricky, our purpose was to outline a salivary proteomic profile which features healthy individuals.Methods: We collected saliva samples from 19 young blood donors as reference population and the proteomic profile was investigated through mass-spectrometry.Results: We identified 1,004 proteins of whose 243 proteins were shared by all subjects. By applying a data clustering approach, we found a set of six most representative proteins across all subjects including Coronin-1A, F-actin-capping protein subunit alpha, Immunoglobulin J chain, Prosaposin, 78 kDa glucose-regulated protein and Heat shock 70 kDa protein 1A and 1B.Conclusion: All of these proteins are involved in immune system activation, cellular stress responses, proliferation, and invasion thus suggesting their use as biomarkers in patients with NCDs

Agenesia degli incisivi laterali superiori: approccio e trattamento [Approach and treatment of lateral incisor agenesis]

Le agenesie degli incisivi laterali della serie decidua o permanente rappresenta un problema di sempre maggiore riscontro nella pratica odontoiatrica. Le esigenze funzionali ed estetiche del paziente richiedono la conoscenza di approcci terapeutici diversi in funzione del quadro clinico. L\u2019approfondimento di questa tematica appare quindi di rilevante importanza nel nostro settore. Nonostante il dibattito sia ancora attuale ci proponiamo di fornire delle linee guida basate sull\u2019analisi della letteratura, che possano essere utili a classificare prima e risolvere poi questa situazione clinica.The treatment of dental agenesis of deciduous or permanent series is an increasing problem reflected in the dental practice. Patient\u2019s functional and aesthetic requirements requiring a knowledge of different therapeutic approaches in function of the clinical picture. The deepening of this issue is therefore of great importance in our area. Despite the debate still present we aim to provide guidelines based on a literature\u2019s review, that may be useful to classify first and then solve this clinical situation

Optimal Wheeler Language Recognition

A Wheeler automaton is a finite state automaton whose states admit a total Wheeler order, reflecting the co-lexicographic order of the strings labeling source-to-node paths). A Wheeler language is a regular language admitting an accepting Wheeler automaton. Wheeler languages admit efficient and elegant solutions to hard problems such as automata compression and regular expression matching, therefore deciding whether a regular language is Wheeler is relevant in applications requiring efficient solutions to those problems. In this paper, we show that it is possible to decide whether a DFA with n states and m transitions recognizes a Wheeler language in O(mn) time. This is a significant improvement over the running time $$O(n^{13} + m\log n)$$ of the previous polynomial-time algorithm (Alanko et al. Information and Computation 2021). A proof-of-concept implementation of this algorithm is available in a public repository. We complement this upper bound with a conditional matching lower bound stating that, unless the strong exponential time hypothesis (SETH) fails, the problem cannot be solved in strongly subquadratic time. The same problem is known to be PSPACE-complete when the input is an NFA (D’Agostino et al. Theoretical Computer Science 2023). Together with that result, our paper essentially closes the algorithmic problem of Wheeler language recognition

Are optimal cerebral perfusion pressure and cerebrovascular autoregulation related to long-term outcome in patients with aneurysmal subarachnoid hemorrhage?

Background and Objectives: Continuous assessment of the cerebrovascular autoregulation (CVA) through use of the pressure reactivity index (PRx), a moving linear correlation coefficient between mean arterial blood pressure and intracranial pressure, has been effective in optimizing cerebral perfusion pressure (CPPopt) in traumatic brain injured (TBI) patients. This study investigates the feasibility of measuring CPPopt in patients with aneurysmal subarachnoid hemorrhage (aSAH) by continuously assessing the CVA. Methods: Twenty-nine aSAH patients were enrolled, and data from CVA status, CPPopt, and periods when CPP was below, within, or above CPPopt were computed daily. Outcome was assessed at 6 months with the Glasgow Outcome Scale. Mann- Whitney U test was used to analyze differences in the duration of impaired CVA and duration of CPP below CPPopt in patients with good and poor outcomes. Multivariable logistic regression analysis was used to identify independent predictors of outcome. Results: CVA monitoring data were available for all 29 patients with a total monitoring time of 2757 h. The duration of impaired CVA was 36.5% (interquartile range: 24.6 to 49.8) of the total monitoring time in 15 patients with good outcome and 71.6% of the total monitoring time (51.2 to 80.0) in 14 patients with poor outcome (Mann-Whitney U test 3.295, P=0.0010). PRx-based CPPopt could be identified in 26 patients (89.6%) with a total monitoring time of 2691 h. The duration of CPP below the CPPopt range was 28.0% (interquartile range: 18.0 to 47.0) of the total monitoring time in patients with good outcome and 76.0% (48.5 to 82.5) in patients with poor outcome (Mann- Whitney U test 2.779, P=0.0054). Glasgow Coma Scale score and duration of impaired CVA were independently associated with 6-month outcome (Glasgow Coma Scale score odds ratio: 1.95, 95% confidence interval: 1.01-3.75; duration of impaired CVA odds ratio: 0.88, 95% confidence interval: 0.78-0.99). Conclusions: The assessment of CVA and CPPopt is feasible in aSAH patients and may provide important information regarding long-term outcome. A PRx above the 0.2 threshold and a CPP below the CPPopt range are associated with worse outcome