Subcutaneous emphysema during root canal therapy: endodontic accident by sodium hypoclorite

Cervicofacial subcutaneous emphysema is defined as the abnormal introduction of air in the subcutaneous tissues of the head and neck. It is mainly caused by trauma, head and neck surgery, general anesthesia, and coughing or habitual performance of Valsalva manoeuvre. The occurrence of subcutaneous emphysema after dental treatment is rare, and diffusion of gas into the mediastinum is much rarer, especially when the procedure is a nonsurgical treatment. Presented here is a case of subcutaneous emphysema that occurred after sodium hypochlorite irrigation during endodontic treatment, and the description of its etiologies and prevention during nonsurgical endodontic treatment. Endodontic success can be essentially achieved via good debridement of a root canal, and an ideal endodontic irrigant is effective in removing the smear layer, opening the dentinal tubules, and producing a clean surface for closer obturation

PIC developing from odontogenic cysts: Clinical and radiological considerations on a series of 6 cases

Abstract Purpose The purpose of this work is to describe the peculiarities of clinical and radiological behavior in SCCs arising from odontogenic cyst (PIOSCC). Material & methods Our computer based records were retrospectively reviewed looking for patients who underwent radical surgery for PIOSCC from December 2001 to January 2016 with a minimum post-operative follow-up of 2 years. Information obtained from radiological findings and treatment outcome were collected. Results From 2001 to 2016, 6 out of 560 SCC's patients (1,07%) were diagnosed PIOSCC. 5 females and 1 male, mean age was 55,2 years (range, 28–82 years). 4 PIOSCC were located in the mandible while 2 in the maxilla. Orthopantomography (OPT) has not given specific signs of malignancy. CT methods (msCT/CONE BEAM-CT/contrast-enhanced CTs) provided more information: unilocular lesions with multiple and excessive cortical interruptions, periosteal reaction far beyond the lesion in all directions, dislocation or disappearance of the IAN, intense peripheral remineralization. In all cases, the treatment involved incisional biopsy of the suspect lesions and subsequent surgical excision of the primary tumor with neck dissection in continuity in the mandibular PIOSCC and in discontinuity in PIOSCC of the maxilla. Recurrence or distant metastases was not observed until now (follow-up from 48 months to 168 months) Conclusions Carcinomas on cysts have radiological "red flag" characteristics (bone erosion, large dimension, involvement of IAN..) that must be taken into consideration in order to perform an early diagnosis and a correct treatment. Accurate radiological study can reduce misdiagnosis and improper treatment. PIOSCC have a progression of the disease and a different prognosis from real intraosseus carcinomas (PIC) and although it is a rare entity it must be considered in the differential diagnosis of larger osteolytic lesions

Indagine sulle lesioni da cinghiale nel cane

RIASSUNTO Gli autori hanno esaminato 118 cani che avevano riportato, in totale, 170 ferite da cinghiale (21 soggetti con ferite multiple). Lo scopo di questo studio clinico è stato di descrivere la localizzazione ed il tipo di lesione. Le ferite esaminate erano prevalentemente profonde (57%) e coinvolgevano, soprattutto, la regione della coscia e della spalla. Altro tipo di ferita riscontrata frequentemente è stata quella penetrante in torace. La caratteristica peculiare delle ferite da cinghiale è l’effetto “iceberg”. SUMMARY The authors examined 118 dogs with wild pig wounds, 170 lesions in total (21 of these with multiple wounds). The aim of this clinical study is to describe the localization and type of lesion. Most of the examined wounds were deep (57%) and, in particular, involving thigh and shoulder regions. Another type of wound frequently observed is the thoracic penetrating one. The main feature of wild pig wounds is the “iceberg” effect

The Psychoanalytic Anthropology of Third-Millennium Medicine

High-tech surgical interventions involving the implantation of external prostheses or internal devices are increasingly frequent in contemporary medicine. These operations restore or improve physical function, but healthcare providers and patients often do not focus on dependent variables that do not affect the outcome. This work aims to observe the psychological dynamics following these modern treatments which actually alter personal identity. The Bionic-Prosthetic Paradigm, a new psychoanalytic model, is offered as a helpful tool for comprehending the subjective reaction to the modification of the body and its subjective self-perception. Starting from the distinction between patients with internal devices and patients with external prostheses, this article aims to define an innovative anthropological vision at the service of medicine that can conceive the composite and mutant personal identity. Specifically, this new perspective is capable of broadening concepts of acceptance or non-acceptance of the object, rejection, and compliance

Novel TRIM32 mutation in sarcotubular myopathy

Tripartite motif-containing protein 32 (TRIM32) is a member of the TRIM ubiquitin E3 ligases which ubiquitinates different substrates in muscle including sarcomeric proteins. Mutations in TRIM32 are associated with Limb-Girdle Muscular Dystrophy 2H. In a 66 old woman with disto-proximal myopathy, we identified a novel homozygous mutation of TRIM32 gene c.1781G > A (p. Ser594Asn) localised in the c-terminus NHL domain. Mutations of this domain have been also associated to Sarcotubular Myopathy (STM), a form of distal myopathy with peculiar features in muscle biopsy, now considered in the spectrum of LGMD2H. Muscle biopsy revealed severe abnormalities of the myofibrillar network with core like areas, lobulated fibres, whorled fibres and multiple vacuoles. Desmin and Myotilin stainings also pointed to accumulation as in Myofibrillar Myopathy. This report further confirms that STM and LGMD2H represent the same disorder and suggests to consider TRIM32 mutations in the genetic diagnosis of Sarcotubular Myopathy and Myofibrillar Myopathy

Frequent detection of high human papillomavirus DNA loads in oral potentially malignant disorders

Human papillomavirus (HPV) is estimated to be the cause of 40-80% of the squamous cell carcinoma of the oropharynx but only of a small fraction of the oral cavity cancers. The prevalence of oral HPV infection has significantly increased in the last decade, raising concerns about the HPV role in progression of oral potentially malignant disorders (OPMD) toward squamous cell carcinomas. We sought to study HPV infection in patients with oral lesions, and in control individuals, using non-invasive and site-specific oral brushing and sensitive molecular methods. HPV DNA positivity and viral loads were evaluated in relation to patient data and clinical diagnosis. We enrolled 116 individuals attending Dental Clinics: 62 patients with benign oral lesions (e.g. fibromas, papillomatosis, ulcers) or OPMD (e.g. lichen, leukoplakia) and 54 controls. Oral cells were collected with Cytobrush and HPV-DNA detected with quantitative real-time PCR (qPCR) for the more common high-risk (HR) and low-risk (LR) genotypes. HPV detection rate, percentage of HR HPVs and HPV-DNA loads (namely HPV16 and in particular, HPV18) were significantly higher in patients than in controls. Lichen planus cases had the highest HPV positive rate (75.0%), hairy leukoplakia the lowest (33.3%). This study detected unexpectedly high rates of HPV infection in cells of the oral mucosa. The elevated HR HPV loads found in OPMD suggest the effectiveness of qPCR in testing oral lesions. Prospective studies are needed to establish whether elevated viral loads represent a clinically useful marker of the risk of malignant progression

Talking about sex: erectile dysfunction in the oncology patient

: Cancer-related diagnosis and treatments can profoundly affect every aspect of an individual's life. The negative impact on the sexual sphere can manifest with onset or worsening of the most frequent male form of sexual dysfunction, that is the erectile dysfunction (ED), with an estimated incidence ranging from 40 to 100% in patients living with cancer. Cancer and ED are strictly related for many reasons. First, the psychological distress, the so-called 'Damocles syndrome', afflicting cancer patients contributes to ED onset. Second, all cancer therapies can variably lead to sexual dysfunction, even more than the disease itself, having both direct or indirect effects on sexual life. Indeed, alongside pelvic surgery and treatments directly impairing the hypothalamus-pituitary-gonadal axis, the altered personal-body-image frequently experienced by people living with cancer may represent a source of distress contributing to sexual dysfunction. It is undeniable that sexual issues are currently neglected or at least under-considered in the oncological setting, mainly due to the subjective lack of preparation experienced by healthcare professionals and to scant information provided to oncological patients on this topic. To overcome these management problems, a new multidisciplinary medical branch called 'oncosexology' was set up. The aim of this review is to comprehensively evaluate ED as an oncology-related morbidity, giving new light to sexual dysfunction management in the oncological setting

Repairing folding-defective \u3b1-sarcoglycan mutants by CFTR correctors, a potential therapy for Limb Girdle Muscular Dystrophy 2D

Limb Girdle Muscular Dystrophy type 2D (LGMD2D) is a rare autosomal-recessive disease, affecting striated muscle, due to mutation of SGCA, the gene coding for \u3b1-sarcoglycan. Nowadays more than 50 different SGCA missense mutations have been reported. They are supposed to impact folding and trafficking of \u3b1-sarcoglycan because the defective polypeptide, although potentially functional, is recognized and disposed of by the quality control of the cell. The secondary reduction of \u3b1-sarcoglycan partners, \u3b2-, \u3b3- and \u3b4-sarcoglycan, disrupts a key membrane complex that, associated to dystrophin, contributes to assure sarcolemma stability during muscle contraction. The complex deficiency is responsible for muscle wasting and the development of a severe form of dystrophy.Here, we show that the application of small molecules developed to rescue \u394F508-CFTR trafficking, and known as CFTR correctors, also improved the maturation of several \u3b1-sarcoglycan mutants that were consequently rescued at the plasma membrane. Remarkably, in myotubes from a patient with LGMD2D, treatment with CFTR correctors induced the proper re-localization of the whole sarcoglycan complex, with a consequent reduction of sarcolemma fragility. Although the mechanism of action of CFTR correctors on defective \u3b1-sarcoglycan needs further investigation, this is the first report showing a quantitative and functional recovery of the sarcoglycan-complex in human pathologic samples, upon small molecule treatment. It represents the proof of principle of a pharmacological strategy that acts on the sarcoglycan maturation process and we believe it has a great potential to develop as a cure for most of the patients with LGMD2D

Congenital cystic adenomatoid malformation of the lung associated with bronchial atresia involving a different lobe in an adult patient: a case report

<p>Abstract</p> <p>Introduction</p> <p>Congenital cystic adenomatoid malformation of the lung is an uncommon cause of respiratory distress in neonates and babies. The disorder is usually diagnosed in the neonatal period and the first two years of life. This anomaly has been described in association with bronchopulmonary sequestration, extralobar intra-abdominal sequestration or bronchial atresia in live and stillborn babies. It is rarely encountered in adults, in whom the diagnosis is made incidentally from mass lesion features seen on chest radiographs. The oldest patients recorded with this malformation have been about 35 years old, and only 10% of primary diagnoses are made after the first year of life. Delayed diagnosis can be related to infection or serendipitous discovery.</p> <p>Case presentation</p> <p>We describe the radiological findings of a 34-year-old Caucasian woman with a clinical history of recurrent pneumonia, intermittent anterior pleuritic chest pain and haemoptysis. Congenital cystic adenomatoid malformation of the lung associated with bronchial atresia involving a different lobe was discovered.</p> <p>Conclusion</p> <p>Although rare in adults, congenital cystic adenomatoid malformation should be suspected in adult patients who suffer from recurrent or persistent non-productive coughs. The discovery of an association of congenital cystic adenomatoid malformation with bronchial atresia in adulthood is rare but possible, even in different lobes.</p

Ln(III) Complexes Embedded in Biocompatible PLGA Nanoparticles as Potential Vis-to-NIR Optical Probes

In this contribution, we present the spectroscopic study of two NIR emitting hydrophobic heteroleptic (R,R)-YbL1(tta) and (R,R)-NdL1(tta) complexes (with tta = 2-thenoyltrifluoroacetonate and L1 = N,N0 -bis(2-(8-hydroxyquinolinate)methylidene)-1,2-(R,R or S,S)-cyclohexanediamine), both in methanol solution and embedded in water dispersible and biocompatible poly lactic-co-glycolic acid (PLGA) nanoparticles. Thanks to their absorption properties in a wide range of wavelengths extending from the UV up to the blue and green visible regions, the emission of these complexes can be effectively sensitized using visible radiation, which is much less harmful to tissues and skin than the UV one. The encapsulation of the two Ln(III)-based complexes in PLGA allows us to preserve their nature, making them stable in water and to test their cytotoxicity on two different cell lines, with the aim of using them in the future as potential bioimaging optical probes