Use of porcine collagen matrix (Mucograft®) to promote the wound healing in the oral cavity

The aim of this study was to evaluate the use of a new collagen matrix (Mucograft®; Geistlich Pharma AG, Wol- husen, Switzerland) in the soft tissue reconstruction after excisional biopsy. The healing of soft tissues after bioptical excision tends to heal by secondary intention. To avoid this, the soft tissue grafts can be harvested from the palate, retromolar pad, or (if available) edentulous site. Disadvantages of harvesting the graft from the retromolar pad and edentulous site are minimal amount of tissue availability and thinner grafts are obtained. The use of collagen matrix is also reported in literature and could represent an optimal solution in the future. Mucograft® is a pure collagen type I and III matrix of porcine origin without further cross-linking. Mucograft® consists of pure porcine collagen obtained by standardized, controlled manufacturing processes. The product made up of porcine collagen has a bilayer structure. The compact layer consists of compact collagen fibers which has cell occlusive properties and allows tis- sue adherence as a prerequisite for favourable wound healing. This layer protects against bacterial infiltration in open healing situations and has appropriate elastic properties to accommodate suturing. A second layer consists of a thick, porous collagen spongious structure. In this paper, we report about a case of surgical site healing after biopti- cal excision proliferative verrucous leukoplakia of the hard palate

Biomasa individual y poblacional de arbustos dominantes en estepas patagónicas pastoreadas

269-279Estimating aboveground biomass of vegetation is essential for population, community and ecosystem studies. In systems dominated or co-dominated by woody species, biomass estimation is difficult, and rapid and non-destructive methods are needed. In this study, we describe biomass distribution in different components (i.e., wood, leaves) and how this changes with shrub size for the three dominant species of shrubs in the Occidental District of the Patagonian steppe. We also describe the population size structure of the three species in grazed fields and estimate their contribution to total abundance and biomass through a non-destructive method. We developed allometric equations to estimate aboveground biomass components of individual shrubs from structural descriptors (i.e., diameter and height of the crown), sampling individual plants of different sizes. The variable that best predicted biomass of the three species was the sum of the height and the average diameter of the crown (calculated with the largest diameter and its perpendicular). Allometric models for each species explained more than 83 percent of the variability of individual aboveground biomass. At the individual level, species had different proportions of wood, leaves and specific wood weight. Increasing shrub size was accompanied by changes in the proportion of leaves to wood, and in some cases, the percentage of dead crown. At the population level, the three species differed in size distribution in moderately grazed fields. Development of allometric models from a population perspective is important to study demographic processes that drive community and ecosystem responses to environmental and land-use changes

Stomatitis and vR-TkI: a review of current literature in 4369 patients

the following review was performed to answer to the question \u201cWhat is the rate of incidence of oral stomatitis in patients treated with VegF tKis?\u201

ORAL LESIONS DUE TO ACINETOBACTER BAUMANNII INFECTION IN A PATIENT AFFECTED BY AUTOIMMUNE HEMOLYTIC ANEMIA (AIHA): FIRST CLINICAL REPORT

Aim. Acinetobacter Baumannii (coming from the Greek “akinetos,” i.e. non-motile) is an opportunistic bacterial pathogen primarily associated with hospital-acquired infections. Commonly associated with aquatic environments, A. Baumannii easily contaminates the surrounding environment and it colonizes acute ill patients in which can survive for several days. Generally, A. Baumannii is able to damage mucous membranes or exposed skin after accident or injury; it may be responsible of many diseases such as pneumonia, bacteremia, meningitis, urinary tract infections, peritonitis and infections of skin and soft tissues. Tissues infected by A. Baumannii initially present “orange peel” appearance followed by sandpaper-like presentation, when there is a disruption, hemorrhagic bullae can be seen with a visible necrotizing process followed by bacteremia. Current therapy is based on intravenous administration of tigecycline 100-200 mg (first dose) and 50-100 mg every 12 h for up to 14 days, unless complications. If untreated, this infection can lead to septicemia and death. The mortality rate of this infection is high, especially in case of bacteremia (52%) and pneumonia (23–73%). A. Baumannii is resistant to many drugs and represents an important nosocomial pathogen that particularly infects critically ill patients. At the best of our knowledge, no case of oral infection has been reported. to present the first one case characterized by oral soft tissue infection due to A. Baumannii responsive to imipenem. Materials and methods. a 78 years male was hospitalized in August of 2013 at the Hematology unit of the A.O.U.P. “P. Giaccone” of Palermo with a diagnosis of autoimmune hemolytic anemia (AIHA). He was treated per os with corticosteroids (Prednisone) and immunosuppressants (Rituximab and Cyclophosphamide), also IVIG (Intra Venous Immuno-Globulin) was administreted. In November 2013, the patient was treated with piperacillin IV (Tazocin) for treating an urinary tract infection; four days after, multiple oral ulcerative bullous lesions on the lingual and buccal mucosa and crusted lesions on the lip vermilion appeared, associated with intense pain. An oral swab for bacteria research was carried out; topical therapy (chlorhexidine rinses and hyaluronic acid gel) has been prescribed and piperacillin therapy was stopped. Oral swab outcome resulted positive for A. Baumannii and Enterococcus Faecalis, both sensitive only to imipenem, that was administrated (500 mg IV every 8h) for 10 days. The patient was immediately isolated in a single room for preventing and controlling the spread of A. Baumannii. Results. From diagnosis, every 3 days clinical examination of the oral cavity was performed, revealing the progressive regression within thirty days until complete healing without leaving scars. After, a second oral swab confirmed the absence of any bacteria. Conclusions. The World Health Organization has recently identified antimicrobial resistance as one of the three most important problems facing human health and among the most common and serious pathogens, including A. Baumannii. It is an emerging potentially drug-resistant micro-organism and its isolation must alert physicians to carry on all preventive measures for avoiding contamination of other patients, especially those immunosuppressed, at risk for severe persistent infections or death. This precaution should be continued for all the duration of hospitalization and until the negativization of culture samples was obtained. It is important that physicians and dentists recognize suspicious lesions in unusual locations, such as oral mucosa, in absence of other known etiological factors in a timely manner before the diffusion among other patients in order to avoid the spread of a nosocomial outbreak

First Report of Tomato Leaf Curl New Delhi Virus Causing Yellow Leaf Curl of Pepper in Europe

Tomato leaf curl New Delhi virus (ToLCNDV), a bipartite begomovirus (family Geminiviridae) with two circular ssDNA genome components (DNA-A and DNA-B), is transmitted in a circulative nonpropagative manner by the whitefly Bemisia tabaci (Gennadius). Although it was first reported in Asia on tomato and other solanaceous crops such as eggplant, potato, and chilli pepper in the Mediterranean basin, this virus was mainly detected on cucurbits and only sporadically on tomato and on two wild solanaceous species, Datura stramonium L. and Solanum nigrum L. (Juárez et al. 2019). In 2018, separate surveys were carried out in protected cultivations of sweet pepper (Capsicum annuum L.) in two Italian regions: Lazio and Campania. The greenhouses were in areas with high density of B. tabaci and where ToLCNDV outbreaks occurred on cucurbits since 2016 (Panno et al. 2019). Some plants showing symptoms of yellowing and leaf curling were found in both regions, whereas fruit symptoms were neither observed nor reported by farmers. This disease syndrome, known as yellow leaf curl disease (YLCD), can be caused in pepper by several begomoviruses, as reported recently in a review listing the viruses causing YLCD in peppers in Thailand (Chiemsombat et al. 2018). Symptomatic leaves were collected during late summer 2018 from different pepper plants as well as from the neighboring zucchini cultivations, showing the typical symptomatology induced by ToLCNDV. Total DNA was extracted (DNeasy Plant Mini kit, Qiagen, Germany), and the presence of ToLCNDV was ascertained by PCR with the specific primers ToLCNDV-CP1 and ToLCNDV-CP2 (Panno et al. 2019; Parrella et al. 2018). ToLCNDV infection was further ascertained in three symptomatic leaf samples from Campania by using specific ToLCNDV ImmunoStrips (Agdia, Elkhart, IN). Successively, one symptomatic pepper sample from each greenhouse was selected and amplified by rolling circle amplification technique (RCA; Inoue-Nagata et al. 2004). The amplicons were cloned, and the DNA-A and DNA-B were full-length sequenced. The sequences were deposited in GenBank NCBI database (MK732932 DNA-A and MK732933 DNA-B, pepper sample from Campania; MK756106 DNA-A and MK756107 DNA-B, pepper sample from Lazio). The RCA analysis was performed also on a ToLCNDV-infected zucchini sample collected in the same area in Lazio region (MK756108 DNA-A and MK756109 DNA-B). The analysis of the ToLCNDV sequences showed a low level of genetic variability between the two pepper isolates from Lazio and Campania regions (rate of substitutions: 0.016 for DNA-A and 0.023 for DNA-B). A high genetic similarity was recorded between the zucchini isolate and both the pepper isolates from Campania (0.019 for DNA-A and 0.023 for DNA-B) and Lazio (0.003 for both DNA-A and B). The three characterized isolates showed a high sequence homology also with both the DNA-A (MH577751 from a melon isolate) and DNA-B (MH577673 from a zucchini isolate) of the ToLCNDV-ES genotype (Fortes et al. 2016), which differed in 15 and 13 nucleotide substitutions from pepper sample from Lazio, 29 and 51 substitutions from Campania sample, and 10 and 5 substitutions from zucchini sample. High homology was also identified compared with the other Spanish isolates collected since the first appearance of the virus (2014) and to the Tunisian (2015) and Moroccan (2018) isolates, confirming the hypothesis that the Mediterranean population of ToLCNDV is highly conserved (Juárez et al. 2019). To our knowledge, this is the first report of ToLCNDV infection on pepper in Europe and indicates that sweet pepper could also act as a reservoir of the virus for further spread to other solanaceous plants and cucurbits

RESTITUTIO AD INTEGRUM IN A CASE OF ONJ RELATED TO BEVACIZUMAB

Aim. Bevacizumab is a humanized recombinant monoclonal antibody that blocks vascular endothelial growth factor (VEGF). The activity of VEGF is the ability to promote the vascular endothelial cells proliferation inducing the formation of new blood vessels. Bevacizumab is used in the treatment of selected advanced colon, lung, renal and central nervous system tumours and plays a developing role in the management of breast and ovarian cancers. It is also injected intraocularly for treatment of macular degeneration. Recently, bevacizumab has been reported as responsible of drug-related osteonecrosis of the jaw (ONJ), showing a histological pattern similar to bisphosphonate-related ONJ. Moreover, it may increase the risk for osteonecrosis of the jaw when administered in isolation or when given concurrently with bisphosphonates. Materials and methods. Only few case reports in literature have been reported describing ONJ after bevacizumab administration. In June 2011, a 57-year-old female patient was referred to our department for pain in the left posterior mandibular region. She reported the following anamnestic data: in 2002, for the diagnosis of breast cancer, she underwent to left quadrantectomy and radiant treatment; from October 2010, she was receiving multimodal chemotherapy containing bevacizumab. No previous treatment with bisphosphonates, or other known local and systemic risk factors were reported. Intraoral examination showed a painful area of bone exposure in the left posterior lingual mandible. The surrounding soft tissue was erythematous with purulent discharge and with swelling of the extraoral soft tissue of the left mandible. After interaction with her oncologist, bevacizumab has been suspended and systemic antibiotic (ampicillina/sulbactam intramuscularly twice daily for 8 days and metronidazole 250mg per os twice daily for 8 days), local antiseptics (chlorhexidine 0.2% mouth rinses and 0.5% chlorhexidine gel) were administered. Results. After 15 days, she showed a complete healing after spontaneous sequestration of a necrotic bone fragment. Conclusions. The antiangiogenic and antiresorptive effects of bevacizumab are dose-dependent and time-dependent. Probably this implies that angiogenesis, bone remodelling and healing processes should restart after drug cessation. The present case supports the necessity to apply BRONJ prevention protocol also in patients in therapy with bevacizumab

Working length transfer in the endodontic clinical practice: A comparative study

8The present paper evaluated the accuracy of two different methods for transferring working length (WL) between manual endodontic instruments and nickel–titanium (NiTi) shaping files. Thirty root canals of extracted permanent teeth were used. Root canals were divided according to canal length (CL) and canal curvature (CC). The reference cusp and the root end were flattened to provide reproducible and accurate measurements. During shaping, the WL measurements were obtained with manual k-files (KF) and transferred to WaveOne (W1) NiTi reciprocating files using the traditional method with the endodontic ruler (method I) and an alternative clinical procedure based on the comparison of the instruments side by side from tip to shank (method II). For each file and each tested method, two measures were taken by two examiners using Rhino (ver. 4.0, McNeel, Seattle, WA, USA) software for a total of 360 (30 × 3 × 2 × 2) measures. Analysis of variance was performed by taking the difference in length (Delta WL, DWL) between files used for the same canal. The difference between methods I and II for WL transfer was found to be statistically significant (df = 1; F = 71.52; p < 0.001). The DWL absolute values obtained with method II were found to be closer to 0 mm (i.e., same length as corresponding KF) than those obtained with method I. Both CL (df = 2; F = 1.27; p = 0.300) and CC (df = 1; F = 2.22; p = 0.149) did not significantly influence WL measurements. With respect to WL transfer, method II seemed to better preserve the correct WL transfer between instruments during the clinical endodontic procedures.openopenMario Alovisi; Mario Dioguardi; Massimo Carossa; Giuseppe Troiano; Maria Chiara Domini; Davide Salvatore Paolino; Giorgio Chiandussi; Elio BeruttiAlovisi, Mario; Dioguardi, Mario; Carossa, Massimo; Troiano, Giuseppe; Chiara Domini, Maria; Paolino, DAVIDE SALVATORE; Chiandussi, Giorgio; Berutti, Eli