Complex Implant-Prosthetic Rehabilitation Following Sports Trauma with 14 Years of Follow-Up: Case Report

: Tooth loss after traumatic dental injuries (TDI) often requires rehabilitation with a multidisciplinary treatment plan. In growing patients, the therapeutic approach may be different than in adults; the scientific literature offers alternative solutions even if they involve long, complex and uncomfortable treatments. Among the possible therapeutic options, implant-prosthetic treatment through the use of mini-implants is presented in this complex case report with a 14-year follow-up

Electrical transport properties of microcrystalline silicon grown by PECVD

The dark conductivity and Hall mobility of hydrogenated silicon films deposited varying the silane concentration f=SiH4/(SiH4+H2) in a conventional plasma enhanced chemical vapor deposition system have been investigated as a function of temperature, taking into account their structural properties. The electrical properties have been studied in terms of a structural two-phase model. A clear transition from the electrical transport governed by a crystalline phase, in the range 1%3%, has been evidenced. Some metastable effects of the dark conductivity have been noticed

Facial lipohypertrophy in HIV-infected subjects who underwent autologous fat tissue transplantation.

Of 41 HIV-infected patients with facial lipoatrophy who underwent autologous fat transplantation, disfiguring facial lipohypertrophy at the graft site occurred at the same time as recurrent fat accumulation at the tissue harvest site in 4 patients who had had fat transferred from the dorsocervical fat pad or from subcutaneous abdominal tissue

Executive Functions and Deafness: Results in a Group of Cochlear Implanted Children

Objects: This study aimed to evaluate the Executive Function (EF) domains in a group of profoundly deaf children treated with cochlear implant (CI) in comparison to normal hearing (NH) children. The secondary aim was to evaluate the influence exerted by the age at cochlear implant activation on EFs. Materials and Methods: 32 children were enrolled into two groups: group A of 17 CI users with a mean age of 8.78 years and group B of 15 NH subjects with a mean age of 7.99 years (SD + 2.3). All subjects were tested using the following tests: the subtests for working memory of the neuropsychological evaluation battery for the developmental age (Batteria di valutazione neuropsicologica per l’età evolutive), inhibition and control of the impulsive response—CAF, and the tower of London test. Results: No children with CIs scored within the normal range in the tests administered for the evaluation of EF domains. The same scores were significantly lower when compared with scores obtained by NH children. Children with younger age at CI activation showed better executive performances in planning, working memory (backward digit span), and cognitive flexibility (categorical fluency). Conclusion: The results of this study highlight that cochlear implantation plays a role in improving hearing and consequently influences the development of EFs in deaf children

Models of hospital care during COVID-19 pandemic in Italy: results from a survey of physicians

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Performance evaluation of the (1,3)-\u3b2-D-glucan detection assay in non-intensive care unit adult patients

Objectives: To assess the performance of the (1,3)-\u3b2-D-glucan (BDG) detection assay in a large cohort of patients with suspected candidemia who were admitted to non-intensive care unit hospital wards. Methods: This observational, retrospective cohort study was conducted in a 1,100-bed university hospital in Rome, where an infectious disease consultation team has been operational. Two groups of patients were included in the analysis: Group 1, patients with Candida bloodstream infection (BSI) who had at least one BDG test performed \ub148 hours from the first positive blood culture (Candida BSI Group) and Group 2, patients with risk factors for candidemia who had at least one BDG test but had negative blood cultures (Control Group). Both Group 1 and Group 2 did not receive prior antifungal therapy. Different BDG cutoff values were considered: 80, 200, 300, 400, and 65500 pg/mL. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve were calculated. Results: A total of 1,296 patients were studied. Of them, 100 patients (candidemic) were in Group 1 and the remaining 1,196 patients (controls) were in Group 2. There were no differences in demographic characteristics between patients of the two groups. According to the above cutoff values, sensitivity (%) and specificity (%) of the BDG assay ranged from 91 to 60.7 and 87.7 to 97.8, respectively, whereas the PPV (%) and NPV (%) ranged from 38.2 to 68.3 and 99.1 to 97.0, respectively. Conclusion: Serum BDG has a very high NPV in a population with~10% prevalence of candidemia. This NPV may support decisions to discontinue antifungal therapy in those patients who were empirically treated because of the suspect of candidemia

Incidence of bloodstream infections, length of hospital stay and survival in patients with recurrent Clostridioides difficile infection treated with fecal microbiota transplantation or antibiotics: a prospective cohort study

Background: Clostridioides difficile infection (CDI) is a risk factor for bloodstream infections (BSI). Fecal microbiota transplantation (FMT) is more effective than antibiotics in treating recurrent CDI, but its efficacy in preventing CDI-related BSI is uncertain. Objective: To assess incidence of primary BSI in patients with recurrent CDI treated with FMT compared with patients treated with antibiotics. Design: Prospective cohort study. FMT and antibiotic treated patients were matched using propensity score. Setting: Single academic medical center. Patients: 290 inpatients with recurrent CDI; 57 patients per treatment in matched cohort. Interventions: FMT or antibiotics. Measurements: Our primary outcome was the development of primary BSI within a 90-day follow-up. Secondary outcomes were length of hospitalization, and overall survival (OS) at 90 days. Results: 109 patients were treated with FMT, and 181 received antibiotics. Five patients in the FMT group and 40 in the antibiotic group developed BSI. Due to differences in the patients treated with FMT and antibiotics in a number of baseline characteristics including the number of recurrences and CDI severity, comparative analyses were limited to the matched cohort. Subjects in the FMT group experienced a 23% lower risk of developing BSI (95% confidence interval 10-35%), 14 fewer days of hospitalization (95% confidence interval 9-20 days), and a 32% increase in OS (95% confidence interval 16-47%) compared with the antibiotic group. Limitations: Non-randomized study with potential for unmeasured/residual confounding. Limited generalizability of the propensity score-matched cohort. Conclusion: In a propensity score-matched cohort, patients with recurrent CDI treated with FMT were less likely to develop primary BSI

Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia

The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ (n = 601), the agreement between patients and their informants on CAI ratings, to explore patients' insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet's agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients' and informants' ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative

The association between insight and depressive symptoms in schizophrenia: Undirected and Bayesian network analyses

Background. Greater levels of insight may be linked with depressive symptoms among patients with schizophrenia, however, it would be useful to characterize this association at symptom-level, in order to inform research on interventions. Methods. Data on depressive symptoms (Calgary Depression Scale for Schizophrenia) and insight (G12 item from the Positive and Negative Syndrome Scale) were obtained from 921 community-dwelling, clinically-stable individuals with a DSM-IV diagnosis of schizophrenia, recruited in a nationwide multicenter study. Network analysis was used to explore the most relevant connections between insight and depressive symptoms, including potential confounders in the model (neurocognitive and social-cognitive functioning, positive, negative and disorganization symptoms, extrapyramidal symptoms, hostility, internalized stigma, and perceived discrimination). Bayesian network analysis was used to estimate a directed acyclic graph (DAG) while investigating the most likely direction of the putative causal association between insight and depression. Results. After adjusting for confounders, better levels of insight were associated with greater self-depreciation, pathological guilt, morning depression and suicidal ideation. No difference in global network structure was detected for socioeconomic status, service engagement or illness severity. The DAG confirmed the presence of an association between greater insight and self-depreciation, suggesting the more probable causal direction was from insight to depressive symptoms. Conclusions. In schizophrenia, better levels of insight may cause self-depreciation and, possibly, other depressive symptoms. Person-centered and narrative psychotherapeutic approaches may be particularly fit to improve patient insight without dampening self-esteem