Analysis of the Common Ignition Sources in the Milling Industry

In the summer of 2007, in Fossano, Italy, one of the most catastrophic and famous dust explosions in Italy, caused by flour dust, occurred in Molino Cordero, a historic cereal milling and flour storage plant. The explosion happened during the pneumatic unloading operation of a tank truck, previously accidentally overfilled. Five people lost their lives, and the building was partially destroyed by the powerful explosion. The forensic reconstruction and investigation of this accident were carried out years after the explosion. This paper has presented an assessment of the main potential ignition sources that can be expected in a flour mill, taking into account the typical equipment that is normally installed in this process. The target is to provide the employer and the users of flour mill plants with basic information that can be helpful in carrying out the specific explosion risk assessment, necessary for every single process. Possible improvements, which could be implemented to reduce the risk of explosion to a tolerable level, will be highlighted

First patellar dislocation: from conservative treatment to return to sport

Treatment of first patellar dislocation is usually conservative and the subsequent rehabilitation program is based on specifically formulated objectives, which can be divided into different stages: stage 1: resolution of pain, swelling and inflammation; stage 2: recovery of joint motion and flexibility; stage 3: recovery of muscle strength; stage 4: recovery of motor patterns and coordination; and stage 5: recovery of the sportspecific athletic action and return to sporting activity. The aim, in the management of a patient affected by first patellar dislocation, is to achieve the best possible functional recovery: since this is a condition often affecting young athletes, this means returning them to their pre-injury conditions, both in terms of fitness and the level of sporting activity practiced. By proceeding through functional stages, the risk of recurrence of the dislocation can be reduced. The “go-ahead” to resume sporting activity can only be given in the presence of normal results on sport-specific functional tests

Dental implant failure associated with a residual maxillary cyst

A 53-year-old male underwent oral implantation including bone grafting to substitute tooth 12. Three months post-operatively, the implant migrated apically into a cyst cavity. The implant, cyst and bone graft were removed. This report regards the migration of an implant into a residual cyst; some anatomical, clinical and pathological considerations arise from this case

Bone Temperature Variation Using a 3D-Printed Surgical Guide with Internal Irrigation

Bone overheating is a possible cause of implants early failure. When a surgical guide is used, the risk of heat injury is greater due to the reduced efficacy of the irrigation. The aim of this ex vivo study was to evaluate the effect of an additional built-in irrigation on bone temperature variation during implant osteotomy. Twelve bovine ribs were used. Cone beam computerized tomography (CBCT) was performed and a 3D-printed surgical guide with additional built-in irrigation tubes was produced for each rib. A total of 48 osteotomies were prepared, to compare the supplementary internal irrigation system (Group A) with external irrigation alone (Group B), no irrigation (Group C) and with free-hand surgery with external irrigation (Group D). Temperature was measured by three thermocouples placed at depths of 1.5, 7, and 12 mm. The largest temperature variation at each thermocouple showed median values of 3.0 degrees C, 1.9 degrees C, and 2.3 degrees C in Group 1; 2.3 degrees C, 1.7 degrees C, and 0.9 degrees C in Group 2; 3.2 degrees C, 1.6 degrees C, and 2.0 degrees C in Group 3; 2.0 degrees C, 2.0 degrees C, and 1.3 degrees C in Group 4, respectively. No differences were found among the four groups. In general, the highest temperature increase was observed with the use of the first drill (cortical perforator). Post-experimental CBCT revealed the presence of radiopaque material clogging the aperture of the internal irrigation channels. Additional internal irrigation was not found to significantly contribute to decrease bone temperature in this ex vivo setting

Toward the validation of visual analogue scale for anxiety.

Anxiety is a relevant problem in dental practice. The Visual Analogue Scale for Anxiety (VAS-A), introduced in dentistry in 1988, has not yet been validated in large series. The aim of this study is to check VAS-A effectiveness in more than 1000 patients submitted to implantology. The VAS-A and the Dental Anxiety Scale (DAS) were administered preoperatively to 1114 patients (459 males and 655 females, age 54.7 \ub1 13.1 years). Statistical analysis was conducted with Pearson correlation coefficient, the receiver operating characteristic (ROC) curve, and McNemar tests. A close correlation between DAS and VAS-A was found (r \u200a=\u200a 0.57, P < .0001); the VAS-A thresholds of dental anxiety and phobia were 5.1 and 7.0 cm, respectively. Despite a significant concordance of tests in 800 cases (72%), disagreement was found in the remaining 314 cases (28%), and low DAS was associated with high VAS-A (230 cases) or vice versa (84 cases). Our study confirms that VAS-A is a simple, sensitive, fast, and reliable tool in dental anxiety assessment. The rate of disagreement between VAS-A and DAS is probably due to different test sensitivities to different components of dental anxiety. VAS-A can be used effectively in the assessment of dental patients, using the values of 5.1 cm and 7.0 cm as cutoff values for anxiety and phobia, respectively

Influence of Crown-to-Implant Ratio on Long-Term Marginal Bone Loss Around Short Implants.

PURPOSE To evaluate the influence of the crown-to-implant ratio (CI) on marginal bone loss (MBL) around short dental implants placed in the posterior mandible. MATERIALS AND METHODS All patients treated with short implants (7 mm length) in the posterior mandible between 1994 and 2003 at the Dental Clinic of the Department of Neuroscience of the University of Padua (Italy) were retrospectively included in the analysis. MBL and clinical CI (cCI) were measured on the radiographs. Implant characteristics including implant diameter, prosthetic type, retention mode, antagonist type, veneering material, and implant surfaces were retrieved from local medical records. A generalized linear mixed model was estimated to identify the predictors of MBL. RESULTS A total of 108 dental implants placed in 51 patients were included in the analysis. Mean follow-up was 16 years (range: 11 to 20 years). Mean cCI was 2.21 (SD = 0.31) with a mean crown height of 10.86 mm (SD = 0.99). Mean MBL was 1.42 mm (SD = 0.38). At multivariable analysis, cCI ≥ 2 was associated with higher MBL (regression coefficient: 0.27; 95% CI: 0.15 to 0.40), while implant characteristics, follow-up, and site were not associated with MBL. The effect of a cCI ≥ 2 was estimated in an increase of 0.28 mm in MBL (95% CI: 0.14 to 0.43 mm). CONCLUSION Higher cCI was associated with greater MBL of implant-supported fixed dental prostheses in short dental implants placed in the posterior mandible, while implant characteristics, follow-up, and site were not associated with MBL. However, the increase of 0.28 mm of MBL in patients with a cCI ≥ 2 may be not clinically relevant

Management of esophageal cancer in patients aged over 80 years.

Background: Important advances in the management of cancer of the esophagus and esophagogastric junction have occurred in the last decades, making treatment possible even in elderly patients. Unfortunately there is little information on management of esophageal cancer in octogenarian patients. The aim of this study was to evaluate the treatment results of esophageal and esophagogastric junction cancer in a single institution over a 14-year period in patients ≥80 years of age. Methods: Clinicopathological characteristics and management strategies were studied in patients ≥80 years old with cancer of the esophagus or esophagogastric junction, referred to our department and treated between 1992 and 2005. Results: There were 62 patients ≥80 years: 12 underwent surgical resection and 50 were not resected. There were no perioperative deaths. The morbidity rate was 33%. Most non-resected patients had an endoscopic prosthesis. The median survival for the overall group was 5.4 months: 14.6 and 5.1 in resected and non-resected patients, respectively. Conclusions: Even in octogenarian patients - with limited comorbidities and fit for surgery - esophagectomy may be regarded as a valid treatment option. Unfortunately this remains possible only in a small minority of 80-90-year old patients. In the remainder, endoscopic treatments - namely prosthesis placements, with chemoradiotherapy when possible - are the alternatives. © 2007 European Association for Cardio-Thoracic Surgery

Modified dental anxiety scale: Validation of the Italian version

AIM: Anxiety is a relevant problem in dental practice. The Modified Dental Anxiety Scale (MDAS) is a brief, simple questionnaire consisting of five questions with a total score ranging from 5 to 25, the Italian version of which is not available yet. The aim of the study was to provide an Italian version of the MDAS and check its reliability in oral surgery, which is a major cause of dental anxiety due to the expected perception of pain and suffering. METHODS: The Italian version of the test was administered to 230 patients (98 male and 132 female patients, ages 14-88 years) undergoing oral surgery. Further recorded data were: American Society of Anaesthesiologists physical status classification (ASA-PS), frequency of visiting the dentist and any previous distressing experiences in dental or medical setting. RESULTS: The internal consistency of the test was high, with a Cronbach's alpha=0.92. The MDAS score was significantly higher in females (P<0.0001) and in patients with previous distressing experiences in medical and/or dental settings (P<0.0001); the correlation with age (P=0.01) and frequency on visiting the dentist (P=0.02) were also significant. CONCLUSIONS: The patients' selection (oral surgery only) may be a limit of the study, which might not provide an estimation of anxiety prevalence in the general dental population; however our result agree with those of studies performed in other Countries in the generic population, suggesting the absence of major differences with respect to the surgical setting and show the reliability and manageability of the Italian version of MDAS