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

The fear of being laughed at among psychiatric patients

The fear of being laughed at brings to the fore the problematic side of an otherwise very positive aspect of human experience. In the streamline of investigations analyzing the presence and characteristics of gelotophobia, a study focusing on psychiatric patients was carried out. The diagnoses were established according to the criteria of the DSM IV TR (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM), APA, 2000). Based both on clinical and empirical observations, the main hypothesis advanced was that using the Geloph15 scale, Ss with a psychiatric diagnosis would have higher mean scores than Normal Controls. An additional hypothesis was that intragroup differences were also expected among the various diagnostic categories. The main hypothesis was amply supported, and explanatory suggestions of the finding were proposed. Intragroup differences proved also to be significant. Patients with personality disorders and patients with schizophrenic disorders scored higher than Normal Controls and the other diagnostic groups. And also the number of years spent in psychiatric care resulted significantly associated with higher gelotophobia mean scores. From the present study, a circular, interactive relationship was confirmed between laughter and mental health, which can alternatively be highly positive or deeply negativ

Massive pulmonary embolism as a rare complication of a stab in the inguinal region in a HIV-positive patient: a case report

Venous thromboembolism (VTE) is a severe preventable disease; HIV-infection represents a prothrombotic condition, because of specific factors due to the virus itself, the host response and the antiretroviral therapy. Our aim is to raise awareness of thromboembolic risk when dealing with HIV-positive patients presenting to the Emergency Department for treatment of injuries, even though small

Analysis of the sanitary survey 2015-2017 conducted in the Gulf of La Spezia (Italy): reclassification of the areas of production of live bivalve molluscs.

The sanitary survey is aimed at classify-ingNoand monitoring the production areas of live bivalve molluscs (LBM) and it is performed using standards that are provided by the Centre for Environment, Fisheries and Aquaculture Science’s Guide to Good Practice. In this study, data from the sanitary survey carried out by the Asl5 Spezzino on the production areas of the gulf of La Spezia during the period 2015-2017 were analysed. The number and type of the analysis performed both on the total sampling and on the individual target species, as well as the number and type of found non-com-pliance (assessed on both mandatory parameters and on parameters fixed by the local monitoring plan) were considered. Data were also compared with those from the sanitary survey 2012-2014. Appropriate statistic tests were used to evaluate data from E. coli and Norovirus monitoring. Overall, 4306 analysis were performed, especially on the species M. galloprovin-cialis (89%) and they were mostly focused on to the search of biological agents. 160 NC were detected. Most of the NC concerns the Norovirus’s positivity (93.75%) in M. galloprovincialis and C. gigas. A correlation between the levels of E. coli and rain-fall/seasonality (higher levels in the colder months) was proved, especially in the sampling points located in the inner part of the dam and in the Portovenere Bay. Class B was reconfirmed for M. galloprovincialis, the production areas of C. gigas were reclassified as A and those of V. verrucosa were definitively closed. The sanitary sur-vey was therefore confirmed as a useful tool for reclassification and for monitoring LBM production areas

Anisakis spp. larvae in different kinds of ready to eat products made of anchovies (Engraulis encrasicolus) sold in Italian supermarkets

In this study the occurrence of visible anisakid larvae in semi-preserved anchovy products sold on the Italian market was investigated. Totally, 107 ready to eat products (33 salted-ripened, 49 in oil and 25 marinated) were sampled. Each sample was digested, then the digested material was observed under natural and UV light. Parasites were counted, collected and microscopically identified to genus level. A representative subset was molecularly identified using the cox2 gene. At least one visible Anisakis sp. larva was found in 54.2% of the total 107 products analysed and totally 1283 dead larvae were collected. Anisakis sp. larvae were found in all the 33 salted products and 1139 (88.8%) larvae were collected, with a range of 1â105 parasites per product. Larval density per gram was 0.13. Anisakis sp. larvae were found in 49.0% of the products in oil and 143 (11.1%) larvae were isolated, with a range of 0â28 and a density of 0.03. Only 1 larva was found in the 25 marinated products (4.0%, density 0.00). A highly significant difference between all the product categories in respect of number of larvae per product, frequency of products contaminated by at least one larva and larval density per gram was found. Within the subset of larvae molecularly analysed (n = 122), 92 (75.4%) were identified as A. pegreffii and 30 (24.6%) as A. simplex. This study showed that semi-preserved anchovy products heavily contaminated with Anisakis spp. larvae reach the market. Beyond the negligible risk for anisakidosis, the presence of dead visible parasites may cause immediate rejection in consumers. In addition, the potential risk related to allergic reactions in sensitized individuals needs to be further assessed. In order to avoid commercialization of obviously contaminated products, fresh anchoviesâ batches intended for the production of such products should be accurately selected by the processing industry applying inspection methods

Role of the mucins in pathogenesis of COPD: implications for therapy.

Introduction: Evidence accumulated in the last decade has started to reveal the enormous complexity in the expression, interactions and functions of the large number of different mucins present in the different compartments of the human lower airways. This occurs both in normal subjects and in COPD patients in different clinical phases and stages of severity.Areas covered: We review the known physiological mechanisms that regulate mucin production in human lower airways of normal subjects, the changes in mucin synthesis/secretion in COPD patients and the clinical efficacy of drugs that modulate mucin synthesis/secretion.Expert opinion: It is evident that the old simplistic concept that mucus hypersecretion in COPD patients is associated with negative clinical outcomes is not valid and that the therapeutic potential of 'mucolytic drugs' is under-appreciated due to the complexity of the associated molecular network(s). Likewise, our current knowledge of the effects of the drugs already available on the market that target mucin synthesis/secretion/structure in the lower airways is extremely limited and often indirect and more well-controlled clinical trials are needed in this area

Inter-familial and intra-familial phenotypic variability in three Sicilian families with Anderson-Fabry disease.

Abstract BACKGROUND: Anderson-Fabry disease (AFD) is an inborn lysosomal enzymopathy resulting from the deficient or absent activity of the lysosomal exogalactohydrolase, α-galactosidase A. This deficiency, results in the altered metabolism of glycosphingolipids which leads to their accumulation in lysosomes, thus to cellular and vascular dysfunction. To date, numerous mutations (according to recent data more than 1000 mutations) have been reported in the GLA intronic and exonic mutations. Traditionally, clinical manifestations are more severe in affected hemizygous males than in females. Nevertheless, recent studies have described severe organ dysfunction in women. THE AIM OF THE STUDY: This study reports clinical, biochemical, and molecular findings of the members of three Sicilian families. The clinical history of these patients highlights a remarkable interfamilial and intrafamilial phenotypic variability which characterizes Fabry disease relative to target organs and severity of clinical manifestations. DISCUSSION: Our findings, in agreement with previous data, report a little genotype-phenotype correlation for the disease, suggesting that the wide phenotypic variability of Anderson-Fabry disease is not completely ascribable to different gene mutations but other factors and mechanisms seem to be involved in the pathogenesis and clinical expression of the disease. Moreover, this study emphasies the importance of pedigree analysis in the family of each proband for identifying other possibly affected relatives

Decreased humoral immune response in the bronchi of rapid decliners with chronic obstructive pulmonary disease

Background: Identification of COPD patients with a rapid decline in FEV1 is of particular interest for prognostic and therapeutic reasons. Objective: To determine the expression of markers of inflammation in COPD patients with rapid functional decline in comparison to slow or no decliners. Methods: In COPD patients monitored for at least 3 years (mean ± SD: 5.8 ± 3 years) for lung functional decline, the expression and localization of inflammatory markers was measured in bronchial biopsies of patients with no lung functional decline (FEV1% + 30 ± 43 ml/year, n = 21), slow (FEV1% ml/year, − 40 ± 19, n = 14) and rapid decline (FEV1% ml/year, − 112 ± 53, n = 15) using immunohistochemistry. ELISA test was used for polymeric immunoglobulin receptor (pIgR) quantitation “in vitro”. Results: The expression of secretory IgA was significantly reduced in bronchial epithelium (p = 0.011) and plasma cell numbers was significantly reduced in the bronchial lamina propria (p = 0.017) of rapid decliners compared to no decliners. Bronchial inflammatory cell infiltration, CD4, CD8, CD68, CD20, NK, neutrophils, eosinophils, mast cells, pIgR, was not changed in epithelium and lamina propria of rapid decliners compared to other groups. Plasma cells/mm2 correlated positively with scored total IgA in lamina propria of all patients. “In vitro” stimulation of 16HBE cells with LPS (10 μg/ml) and IL-8 (10 ng/ml) induced a significant increase while H2O2 (100 μM) significantly decreased pIgR epithelial expression. Conclusion: These data show an impaired humoral immune response in rapid decliners with COPD, marked by reduced epithelial secretory IgA and plasma cell numbers in the bronchial lamina propria. These findings may help in the prognostic stratification and treatment of COPD

Expression of targets of the RNA-binding protein AUF-1 in human airway epithelium indicates its role in cellular senescence and inflammation

INTRODUCTION: The RNA-binding protein AU-rich-element factor-1 (AUF-1) participates to posttranscriptional regulation of genes involved in inflammation and cellular senescence, two pathogenic mechanisms of chronic obstructive pulmonary disease (COPD). Decreased AUF-1 expression was described in bronchiolar epithelium of COPD patients versus controls and in vitro cytokine- and cigarette smoke-challenged human airway epithelial cells, prompting the identification of epithelial AUF-1-targeted transcripts and function, and investigation on the mechanism of its loss. RESULTS: RNA immunoprecipitation-sequencing (RIP-Seq) identified, in the human airway epithelial cell line BEAS-2B, 494 AUF-1-bound mRNAs enriched in their 3'-untranslated regions for a Guanine-Cytosine (GC)-rich binding motif. AUF-1 association with selected transcripts and with a synthetic GC-rich motif were validated by biotin pulldown. AUF-1-targets' steady-state levels were equally affected by partial or near-total AUF-1 loss induced by cytomix (TNFα/IL1β/IFNγ/10 nM each) and siRNA, respectively, with differential transcript decay rates. Cytomix-mediated decrease in AUF-1 levels in BEAS-2B and primary human small-airways epithelium (HSAEC) was replicated by treatment with the senescence- inducer compound etoposide and associated with readouts of cell-cycle arrest, increase in lysosomal damage and senescence-associated secretory phenotype (SASP) factors, and with AUF-1 transfer in extracellular vesicles, detected by transmission electron microscopy and immunoblotting. Extensive in-silico and genome ontology analysis found, consistent with AUF-1 functions, enriched RIP-Seq-derived AUF-1-targets in COPD-related pathways involved in inflammation, senescence, gene regulation and also in the public SASP proteome atlas; AUF-1 target signature was also significantly represented in multiple transcriptomic COPD databases generated from primary HSAEC, from lung tissue and from single-cell RNA-sequencing, displaying a predominant downregulation of expression. DISCUSSION: Loss of intracellular AUF-1 may alter posttranscriptional regulation of targets particularly relevant for protection of genomic integrity and gene regulation, thus concurring to airway epithelial inflammatory responses related to oxidative stress and accelerated aging. Exosomal-associated AUF-1 may in turn preserve bound RNA targets and sustain their function, participating to spreading of inflammation and senescence to neighbouring cells