Efficacy of three different irrigation techniques in the removal of smear layer and organic debris from root canal wall: A scanning electron microscope study

Abstract Aim Aim of this study was to compare the removal of smear layer and organic debris within the tooth canal among conventional needle irrigation, EndoVac and Endoactivator. Methodology Eighty single-rooted extracted human teeth were prepared with rotary NiTi instrumentation and randomly separated into 4 groups. Twenty teeth were used as positive control (Group 1), irrigated with only saline. Teeth assigned to Group 2 ( n = 20) received irrigation with a conventional syringe and a 30-gauge needle (NaviTip, Ultradent, South Jordan, UT); samples in Group 3 ( n = 20) were rinsed with an irrigation device based on apical negative pressure (EndoVac, Discus Dental, Culver City, CA) and teeth in Group 4 ( n = 20) were treated with a sonic irrigation system (EndoActivator, Dentsply Tulsa Dental, Tulsa, OK, USA). The amount of residual smear layer and debris was evaluated under a scanning electron microscope, and a semi-quantitative score was assigned to each root at the coronal, middle and apical thirds; the chi-square test was used to compare the results of the S.E.M. analysis. Results EndoActivator performed the best cleansing for both smear layer and organic debris in all root canal thirds, followed by EndoVac and conventional irrigation ( p > 0.001). EndoVac and conventional irrigation showed better cleaning in the coronal area, whereas EndoActivator performed an homogeneous cleansing at all levels. Conclusions The EndoVac system and the EndoActivator system demonstrated significantly more efficacy in cleansing root canal walls than conventional needle irrigation

Dedifferentiated Melanoma: A Diagnostic Histological Pitfall! Review of the Literature with Case Presentation

Dedifferentiated melanoma is a particular form of malignant melanoma with a progressive worsening of the patient's clinical outcome. It is well known that melanoma can assume different histo-morphological patterns, to which specific genetic signatures correspond, sometimes but not always. In this review we address the diagnostic difficulties in correctly recognizing this entity, discuss the major differential diagnoses of interest to the dermatopathologist, and conduct a review of the literature with particular attention and emphasis on the latest molecular discoveries regarding the dedifferentiation/undifferentiation mechanism and more advanced therapeutic approaches

A case of fetal hydrops: prenatal diagnosis and neonatal management

Hydrops fetalis (HF) is a serious fetal condition defined as an abnormal fluid accumulation in fetal extravascular compartments and body cavities caused by either immune or non immune conditions. Immune hydrops is caused by fetal hemolysis medi¬ated by circulating maternal antibodies to fetal red blood cell antigens. Its most common determinant is rhesus incompatibility. Systemic Lupus Eritematosus (SLE) is another rare cause of immune fetal hydrops, when the pregnancy is complicated by the presence of a third degree congenital heart block (CHB). The Neonatal Lupus Syndrome occurs with a prevalence of 2%. We reported the case of severe fetal hydrops in a 31 weeks pregnant woman affected by mild maternal D alloimmunization and SLE. Despite fetal hydrops and a mild positive indirect Coombs’ test, the flow-rate study with the Systolic Peak Velocity (PSV) of the MCA excluded a fetal anemia. At birth, blood gas showed a condition of severe metabolic and respiratory acidosis (pH 6.43, pO2 9.9 mmHg, pCO2 206 mmHg, Base Excess (BE) -35 mmol/l, HCO3- 2.7 mmol/l) and a mild anemia (Hemoglobin 10.3 g/dl). ECG revealed a normal sinus rhythm and a CHB was excluded. Despite the critical clinical condition, no cardiorespiratory or neurological adverse outcomes occurred in the newbor

I mobility scooter: da ausili per la mobilità di disabili e anziani a nuovi veicoli per una mobilità sostenibile?

I mobility scooter, in particolare quelli cabinati, sono potenzialmente un ausilio formidabile per la mobilità a breve e medio raggio delle persone sia abili che disabili, con innegabili benefici anche per il traffico urbano e l’ambiente, ma a condizione di una drastica revisione normativa. La modifica all’art. 46 del Codice della Strada intervenuta nel 2010, che ha demandato genericamente la definizione delle “macchine per uso di invalidi” (non considerate veicoli) a “vigenti disposizioni comunitarie” (che invece equiparano i mobility scooter ad autoveicoli), sembra aver sortito un risultato opposto al suo intento chiarificatore, con implicazioni finanche inquietanti per quanto riguarda la possibilità che i mobility scooter siano effettivamente ammessi a circolare in aree aperte al pubblico. Il recente decreto per la sperimentazione su strada dei dispositivi per la micromobilità elettrica, che ha ignorato il dispositivo obiettivamente più versatile, sicuro e “serio”, ha perso una grande occasione, ma si può ancora rimediare. La loro classificazione come “veicoli” adatti sia agli abili che ai disabili – anche ai sensi dell’orientamento comunitario – ed una specifica regolamentazione della loro circolazione nelle aree pubbliche attraverso una serie di modifiche al Codice della Strada, al suo Regolamento di attuazione ed al decreto per la sperimentazione su strada dei dispositivi di micromobilità elettrica, nonché l’individuazione di un organismo di controllo e informazione, porrebbero facilmente fine ad un pericoloso vuoto normativo ed alla confusione e disinformazione che ne sono derivate, favorendo finalmente la meritata diffusione dei mobility scooter: ciò contribuirebbe anche ad abbattere i costi d’acquisto dei moderni e versatili scooter cabinati, ancora relativamente elevati seppur inferiori a quelli di un’autovettura elettrica, a tutto vantaggio delle categorie spesso non abbienti per cui questi dispositivi sono stati originariamente concepiti

FISSIT (Fistula Surgery in Italy) study: A retrospective survey on the surgical management of anal fistulas in Italy over the last 15 years

Background: Surgical treatment of anal fistulas is still a challenge. The aims of this study were to evaluate the adoption and healing rates for the different surgical techniques used in Italy over the past 15 years. Methods: This was a multicenter retrospective observational study of patients affected by simple and complex anal fistulas of cryptoglandular origin who were surgically treated in the period 2003-2017. Surgical techniques were grouped as sphincter-cutting or sphincter-sparing and as technology-assisted or techno-free. All patients included in the study were followed for at least 12 months. Results: A total of 9,536 patients (5,520 simple; 4,016 complex fistulas) entered the study. For simple fistulas, fistulotomy was the most frequently used procedure, although its adoption significantly decreased over the years (P < .0005), with an increase in sphincter-sparing approaches; the overall healing rate in simple fistulas was 81.1%, with a significant difference between sphincter-cutting (91.9%) and sphincter-sparing (65.1%) techniques (P = .001). For complex fistulas, the adoption of sphincter-cutting approaches decreased, while sphincter-sparing techniques were mildly preferred (P < .0005). Moreover, there was a significant trend toward the use of technology-assisted procedures. The overall healing rate for complex fistulas was 69.0%, with a measurable difference between sphincter-cutting (81.1%) and sphincter-sparing (61.4%; P = .001) techniques and between techno-free and technology-assisted techniques (72.5% and 55.0%, respectively; P = .001). Conclusion: Surgical treatment of anal fistulas has changed, with a trend toward the use of sphincter-sparing techniques. The overall cure rate has remained stable, even if the most innovative procedures have achieved a lower success rate

SINEUPs are modular antisense long non-coding RNAs that increase synthesis of target proteins in cells

Despite recent efforts in discovering novel long non-coding RNAs (lncRNAs) and unveiling their functions in a wide range of biological processes their applications as biotechnological or therapeutic tools are still at their infancy. We have recently shown that AS Uchl1, a natural lncRNA antisense to the Parkinson's disease-associated gene Ubiquitin carboxyl-terminal esterase L1 (Uchl1), is able to increase UchL1 protein synthesis at post-transcriptional level. Its activity requires two RNA elements: an embedded inverted SINEB2 sequence to increase translation and the overlapping region to target its sense mRNA. This functional organization is shared with several mouse lncRNAs antisense to protein coding genes. The potential use of AS Uchl1-derived lncRNAs as enhancers of target mRNA translation remains unexplored. Here we define AS Uchl1 as the representative member of a new functional class of natural and synthetic antisense lncRNAs that activate translation. We named this class of RNAs SINEUPs for their requirement of the inverted SINEB2 sequence to UP-regulate translation in a gene-specific manner. The overlapping region is indicated as the Binding Doman (BD) while the embedded inverted SINEB2 element is the Effector Domain (ED). By swapping BD, synthetic SINEUPs are designed targeting mRNAs of interest. SINEUPs function in an array of cell lines and can be efficiently directed toward N-terminally tagged proteins. Their biological activity is retained in a miniaturized version within the range of small RNAs length. Its modular structure was exploited to successfully design synthetic SINEUPs targeting endogenous Parkinson's disease-associated DJ-1 and proved to be active in different neuronal cell lines. In summary, SINEUPs represent the first scalable tool to increase synthesis of proteins of interest. We propose SINEUPs as reagents for molecular biology experiments, in protein manufacturing as well as in therapy of haploinsufficiencies

Effect of Lockdowns on Hospital Staff in a COVID Center: A Retrospective Observational Study

At the onset of the SARS-CoV-2 pandemic, individual and social measures were strengthened through restrictive non-pharmaceutical interventions, labelled with the term "lockdown". In Italy, there were two lockdowns (9 March 2020-3 May 2020 and 3 November 2020-27 March 2021). As part of preventive measures, healthcare workers and the administrative staff population of Policlinico A. Gemelli underwent nasopharyngeal swab tests from 1 March 2020 to 9 February 2022, a long time interval that includes the two aforementioned lockdowns. The population included 8958 people from 1 March 2020 to 31 December 2020; 8981 people from 1 January 2021 to 31 December 2021; and 8981 people from 1 January 2022 to 9 February 2022. We then analysed pseudo-anonymized data, using a retrospective observational approach to evaluate the impact of the lockdown on the incidence of SARS-CoV-2 infections within the population. Given the 14 day contagious period, the swab positivity rate (SPR) among the staff decreased significantly at the end of the first lockdown, every day prior to 18 May 2020, by 0.093 (p < 0.0001, CI = (-0.138--0.047)). After the fourteenth day post the end of the first lockdown (18 May 2020), the SPR increased daily at a rate of 0.024 (p < 0.0001, 95% CI = (0.013-0.034)). In addition, the SPR appeared to increase significantly every day prior to 17 November 2020 by 0.024 (p < 0.0001, CI = (0.013-0.034)). After the fourteenth day post the start of the second lockdown (17 November 2020), the SPR decreased daily at a rate of 0.039 (p < 0.0001, 95% CI = (-0.050--0.027)). These data demonstrate that, in our Institution, the lockdowns helped to both protect healthcare workers and maintain adequate standards of care for COVID and non-COVID patients for the duration of the state of emergency in Italy

Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments

The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations

Oltre il Segno/OltreMare

La realizzazione di un volume contenente le incisioni scelte all’interno della Scuola di Grafica d’Arte dell’Accademia di Belle Arti di Palermo, coordinata dai Proff. Giovanni D’Alessandro e Riccardo Mazzarino rappresenta motivo di orgoglio e di soddisfazione per la nostra Istituzione che costruisce i percorsi didattici dei propri corsi a partire dall’esperienza laboratoriale. L’incisione grafica è tra le tecniche artistiche più antiche ma nel contempo più contemporanee. La gestualità intrinseca al segno, che si manifesta nella carta, svela universi della visione inaspettati.(Mario Zito - Direttore dell’Accademia di Belle Arti di Palermo) Il segno è il risultato di un gesto a volte deciso, a volte contorto, a volte leggero, i cui risultati spesso sono inattesi e sorprendenti. Il volume contiene esemplari di incisioni fortemente caratterizzanti della scuola di Grafica d’Arte che vanta all’interno del proprio corso di studi docenti-artisti che consapevoli della ricchezza del loro bagaglio esperienziale offrono agli studenti gli strumenti necessari per far sì che l’arte del saper fare artigianale, si trasformi in mera poetica artistica