"Canine first technique" in maxillary impacted canines: analysis of the treatment duration and the success of therapy.

Background: The "canine first technique" consists in the innovative surgical-orthodontic approach for the impacted canine before starting the fixed-orthodontic treatment. The procedure is a united surgical-orthodontic treatment that provide the eruption of the impacted canine moving first of all the crown of impacted canine away from the roots of incisors with cantilever and skeletal anchorage.The primary objective of the study is to analyze the eruption time of the maxillary impacted canines treated by «Canine First» technique and to evaluate the success rate. It has been investigated the possibility that certain clinical and radiographic variables of our interest may influence the results achieved. Methods: 103 patients, for a total of 131 impacted canines were treated. Alpha angle, sectors of Erickson&Kurol and the age have been studied to assess the difficulty of canine eruption. All the canines have been dealt with through the approach "canine first". The variables of interest were analyzed using descriptive statistics. The median follow-up time was evaluated using Kaplan Meier's inverse procedure. The primary outcome (canine eruption time) was analyzed using the Kaplan-Meier curves. The curve comparison between the different known risk factors was made using the test log-rank. The median eruption time (95% CI) was calculated for each result. The statistical analysis was conducted by the statistical software R-3.6.0. Results: The 58.2% of subjects were women, in the 51% of cases were people younger than 16 y.o.In the 66.4% the canine was placed palatally and positioned in the Sector 3 (30.16%). The median alpha angle was 38.7°. In the 88.9% of cases, we had the eruption of the canines, median time of eruption was 4.2months. We found a statistically significant difference in alpha angle >/< 22° able to influence the eruption time. For sectors and age, we have not found a statistically significant difference in eruption time Conclusion: the current results show that the canine first technique is effective for the eruption of impacted canine and that the alpha angle <22°can be considered a favourable prognostic factor

Exact controllability of infinite dimensional systems with controls of minimal norm

The paper deals with the exact controllability of a semilinear system in a separable Hilbert space. A bounded linear part is considered and a linear control introduced. The state space is compactly embedded in a Banach space and the nonlinear term is continuous in its state variable in the norm of the Banach space. An infinite sequence of finite dimen- sional controllability problems is introduced and the solution is obtained by a limiting procedure. To the best of our knowledge, the method is new in controllability theory. An application to an integro-differential system in euclidean spaces completes the discussion

Local Lipschitz continuity for energy integrals with slow growth and lower order terms

We consider integral functionals with slow growth and explicit dependence on u of the lagrangian; this includes many relevant examples, as, for instance, in elastoplastic torsion problems or in image restoration problems. Our aim is to prove that the local minimizers are locally Lipschitz continuous. The proof makes use of recent results concerning the Bounded Slope Conditions

Effect of somatosensory amplification and trait anxiety on experimentally induced orthodontic pain

The perception of pain varies considerably across individuals and is affected by psychological traits. This study aimed to investigate the combined effects of somatosensory amplification and trait anxiety on orthodontic pain. Five-hundred and five adults completed the State Trait Anxiety Inventory (STAI) and the Somatosensory Amplification Scale (SSAS). Individuals with combined STAI and SSAS scores below the 20th percentile (LASA group: five men and 12 women; mean age ± SD = 22.4 ± 1.3 yr) or above the 80th percentile (HASA group: 13 men and seven women; mean age ± SD = 23.7 ± 1.0 yr) were selected and filled in the Oral Behaviors Checklist (OBC). Orthodontic separators were placed for 5 d in order to induce experimental pain. Visual analog scales (VAS) were administered to collect ratings for occlusal discomfort, pain, and perceived stress. Pressure pain thresholds (PPT) were measured. A mixed regression model was used to evaluate pain and discomfort ratings over the 5-d duration of the study. At baseline, the LASA group had statistically significantly higher PPT values for the masseter muscle than did the HASA group. During the experimental procedure, the HASA group had statistically significantly higher discomfort and pain. A significant difference in pain ratings during the 5 d of the study was found for subjects in the HASA group. Higher OBC values were statistically significantly positively associated with pain. Somatosensory amplification and trait anxiety substantially affect experimentally induced orthodontic pain

A cholinergic-sympathetic pathway primes immunity in hypertension and mediates brain-to-spleen communication

The crucial role of the immune system in hypertension is now widely recognized. We previously reported that hypertensive challenges couple the nervous drive with immune system activation, but the physiological and molecular mechanisms of this connection are unknown. Here, we show that hypertensive challenges activate splenic sympathetic nerve discharge to prime immune response. More specifically, a vagus-splenic nerve drive, mediated by nicotinic cholinergic receptors, links the brain and spleen. The sympathetic discharge induced by hypertensive stimuli was absent in both coeliac vagotomized mice and in mice lacking α7nAChR, a receptor typically expressed by peripheral ganglionic neurons. This cholinergic-sympathetic pathway is necessary for T cell activation and egression on hypertensive challenges. In addition, we show that selectively thermoablating the splenic nerve prevents T cell egression and protects against hypertension. This novel experimental procedure for selective splenic denervation suggests new clinical strategies for resistant hypertension

Targeting interleukin-1β protects from aortic aneurysms induced by disrupted transforming growth factor β signaling

Aortic aneurysms are life-threatening conditions with effective treatments mainly limited to emergency surgery or trans-arterial endovascular stent grafts, thus calling for the identification of specific molecular targets. Genetic studies have highlighted controversial roles of transforming growth factor β (TGF-β) signaling in aneurysm development. Here, we report on aneurysms developing in adult mice after smooth muscle cell (SMC)-specific inactivation of Smad4, an intracellular transducer of TGF-β. The results revealed that Smad4 inhibition activated interleukin-1β (IL-1β) in SMCs. This danger signal later recruited innate immunity in the adventitia through chemokine (C-C motif) ligand 2 (CCL2) and modified the mechanical properties of the aortic wall, thus favoring vessel dilation. SMC-specific Smad4 deletion in Il1r1- or Ccr2-null mice resulted in milder aortic pathology. A chronic treatment with anti-IL-1β antibody effectively hampered aneurysm development. These findings identify a mechanistic target for controlling the progression of aneurysms with compromised TGF-β signaling, such as those driven by SMAD4 mutations

Auditory cortex hypoperfusion: a metabolic hallmark in Beta Thalassemia

Abstract Background Sensorineural hearing loss in beta-thalassemia is common and it is generally associated with iron chelation therapy. However, data are scarce, especially on adult populations, and a possible involvement of the central auditory areas has not been investigated yet. We performed a multicenter cross-sectional audiological and single-center 3Tesla brain perfusion MRI study enrolling 77 transfusion-dependent/non transfusion-dependent adult patients and 56 healthy controls. Pure tone audiometry, demographics, clinical/laboratory and cognitive functioning data were recorded. Results Half of patients (52%) presented with high-frequency hearing deficit, with overt hypoacusia (Pure Tone Average (PTA) > 25 dB) in 35%, irrespective of iron chelation or clinical phenotype. Bilateral voxel clusters of significant relative hypoperfusion were found in the auditory cortex of beta-thalassemia patients, regardless of clinical phenotype. In controls and transfusion-dependent (but not in non-transfusion-dependent) patients, the relative auditory cortex perfusion values increased linearly with age (p < 0.04). Relative auditory cortex perfusion values showed a significant U-shaped correlation with PTA values among hearing loss patients, and a linear correlation with the full scale intelligence quotient (right side p = 0.01, left side p = 0.02) with its domain related to communication skills (right side p = 0.04, left side p = 0.07) in controls but not in beta-thalassemia patients. Audiometric test results did not correlate to cognitive test scores in any subgroup. Conclusions In conclusion, primary auditory cortex perfusion changes are a metabolic hallmark of adult beta-thalassemia, thus suggesting complex remodeling of the hearing function, that occurs regardless of chelation therapy and before clinically manifest hearing loss. The cognitive impact of perfusion changes is intriguing but requires further investigations

Risk factors for endocrine complications in transfusion-dependent thalassemia patients on chelation therapy with deferasirox: a risk assessment study from a multicentre nation-wide cohort

Transfusion-dependent patients typically develop iron-induced cardiomyopathy, liver disease, and endocrine complications. We aimed to estimate the incidence of endocrine disorders in transfusion-dependent thalassemia (TDT) patients during long-term iron-chelation therapy with deferasirox (DFX).We developed a multicentre follow-up study of 426 TDT patients treated with once-daily DFX for a median duration of 8 years, up to 18.5 years. At baseline, 118, 121, and 187 patients had 0, 1, or ≥2 endocrine diseases respectively. 104 additional endocrine diseases were developed during the follow-up. The overall risk of developing a new endocrine complication within 5 years was 9.7% (95%CI=6.3-13.1). Multiple Cox regression analysis identified 3 key predictors: age showed a positive log-linear effect (adjusted HR for 50% increase=1.2, 95%CI=1.1-1.3, P=0.005), the serum concentration of thyrotropin (TSH) showed a positive linear effect (adjusted HR for 1 mIU/L increase=1.3, 95%CI=1.1-1.4, P