Pain in Pancreatic Cancer: Does Drug Treatment Still Play a Role?

No abstract available

Valutazione delle anomalie dentarie in soggetti con differenti tipi di schisi orofacciali

Background and aim: Subjects with nonsyndromic cleft lip and/or palate (CLP) present high frequency of hypodontia, both inside and outside the cleft region, which may represent a complicating factor for the dental management. Our aim was to evaluate the prevalence of tooth agenesis in a large sample of cleft subjects and to evaluate the relation with gender, cleft type and sidedness. Materials and methods: Tooth agenesis was identified from serial panoramic radiographs of 293 subjects (123 female, 170 male) with unilateral (66%), bilateral CLP (17%) and isolated cleft palate (17%). Association between tooth agenesis and the different variables was assessed by chi-square test and Poisson regression model (P<0.05). Odds Ratio (OR) was calculated for the different cleft types. Results: A hypodontia prevalence of 50,17% (excluding third molars) was found for the overall cleft group. A considerably higher incidence of missing teeth was found in the maxilla compared with the mandible. The highest rates of agenesis were observed in the anterior region on the cleft sides. Upper lateral incisor and upper and lower second premolars were missing most frequently. Bilateral CLP showed a statistically significant difference in the prevalence of agenesis (P<0,001) and a higher risk of simultaneous agenesis of both maxillary incisors (OR=47). Conclusions: There is a high prevalence of tooth agenesis associated with orofacial clefts. Missing maxillary lateral incisors and second premolars were found more frequently, and occurred mainly in the cleft area

Conservative Treatment

No abstract available.Image: Acute pancreatitis treatment

Risk Factors of Chronic Pancreatitis

Chronic pancreatitis (CP) still remains a challenging clinical problem with many controversial issues regarding pathogenesis, outcome, and treatment. The disease comprises a spectrum of disorders that culminate as a final step in the destruction of the pancreas. Complex interaction does exist between genetic, environmental and immunologic factors leading to development of the disease. Multiple risk factors interact in a multiple-step model; the pancreatic injury may occur through different mechanisms with transition between an acute pancreatitis condition to recurrent pancreatitis and, finally, to CP. Most patients have multiple risk factors and the overall risk is a product of all risk factors in additive or multiplicative fashion. Susceptibility to develop CP in alcoholics depends on the expression of single gene mutation or is derived from complex genetic polymorphism; in addition, smoking habit can influence the risk of pancreatic calcifications and severity in alcoholic and idiopathic CP. Alteration of the immune response induced by gene mutations and/or environmental factors represents the main determinant of pancreatic fibrosis, the end-stage histologic feature from all CP etiologies

Smoking as a cofactor for causation of chronic pancreatitis: a meta-analysis.

OBJECTIVES: To assess the evidence for tobacco smoking as a risk factor for the causation of chronic pancreatitis. METHODS: We performed a meta-analysis with random-effects models to estimate pooled relative risks (RRs) of chronic pancreatitis for current, former, and ever smokers, in comparison to never smokers. We also performed dose-response, heterogeneity, publication bias, and sensitivity analyses. RESULTS: Ten case-control studies and 2 cohort studies that evaluated, overall, 1705 patients with chronic pancreatitis satisfied the inclusion criteria. When contrasted to never smokers, the pooled risk estimates for current smokers was 2.8 (95% confidence interval [CI], 1.8-4.2) overall and 2.5 (95% CI, 1.3-4.6) when data were adjusted for alcohol consumption. A dose-response effect of tobacco use on the risk was ascertained: the RR for subjects smoking less than 1 pack per day was 2.4 (95% CI, 0.9-6.6) and increased to 3.3 (95% CI, 1.4-7.9) in those smoking 1 or more packs per day. The risk diminished significantly after smoking cessation, as the RR estimate for former smokers dropped to a value of 1.4 (95% CI, 1.1-1.9). CONCLUSIONS: Tobacco smoking may enhance the risk of developing chronic pancreatitis. Recommendation for smoking cessation, besides alcohol abstinence, should be incorporated in the management of patients with chronic pancreatitis

Cyst-like periapical lesion healing in an orthodontic patient: A case report with five-year follow-up

Abstract Aim To report the orthodontic movement of two central incisors through the healing site of a maxillary cyst-like lesion of endodontic origin after nonsurgical treatment. Case summary This report shows the treatment of a 18-year old patient, male, with a Class II division 2 malocclusion. He came to our attention seeking for orthodontic treatment. Radiographic examinations revealed a large cyst-like lesion in the maxillary anterior area, extending from the mesial surface of tooth 12 to the distal surface of tooth 21. The two upper incisors were nonresponsive to pulp sensitivity tests. Endodontic treatment was performed first. One week after root canal treatment had been completed with gutta-percha fillings, orthodontic treatment was started while the bone lesion healing was still underway. At the end of the orthodontic treatment, incisor retroclination was corrected, periapical lesion healing was completed and there were no signs of root resorption. The five-year follow-up revealed that occlusal relationship and dental alignment were kept stable and excellent radiographic resolution of the periapical lesion was obtained

Effect of pH on in vitro biocompatibility of orthodontic miniscrew implants

BACKGROUND: Although the clinical use of miniscrews has been investigated on a large scale, little is known about their biocompatibility. Since low pH can affect corrosion resistance, the aim of this study was to evaluate the cytotoxic effect of orthodontic miniscrews in different pH conditions. METHODS: Four orthodontic miniscrews of stainless steel and grade IV and grade V titanium were immersed in a pH 7 and pH 4 saline solution for 1, 7, 14, 21, 28, and 84 days. Human osteogenic sarcoma cells (U2OS), permanent human keratinocytes (HaCat), and primary human gingival fibroblasts (HGF) were exposed to eluates, and the mitochondrial dehydrogenase activity was measured after 24 h to assess the cytoxicity. The results were analyzed using the Mann-Whitney U test (P < 0.05). RESULTS: When exposed to pH 7-conditioned eluates, the cell lines showed an even greater viability than untreated cells. On the contrary, the results revealed a statistically significant decrease in U2OS, HaCat, and HGF viability after exposure to eluates obtained at pH 4. Among the cell lines tested, HGF showed the most significant decrease of mitochondrial activity. Interestingly, grade V titanium miniscrews caused highest toxic effects when immersed at pH 4. CONCLUSIONS: The results suggested that at pH 7, all the miniscrews are biocompatible while the eluates obtained at pH 4 showed significant cytotoxicity response. Moreover, different cell lines can produce different responses to miniscrew eluates

Le malattie infiammatorie immuno-mediate (IMID) di interesse internistico: fisiopatologia, aspetti clinici e prospettive di terapia

Le IMID: inquadramento introduttivo A. Fontanella, G. Uomo Infiammazione e IMID T. d’Errico, M. Laccetti Malattia IgG4-relata C. Mastrobuoni, G. Uomo IMID in ematologia F. Rezzonico, A. Mazzone IMID in reumatologia A. Parisi, R. Buono, R. Russo, G. Uomo IMIDs in neurologia G.T. Maniscalco, C. Florio IMID in diabetologia R. Nicosia, C. Ricordi IMIDs in endocrinologia M.R. Poggiano, V. Nuzzo Malattie infiammatorie intestinali M. Salice, L. Calandrini, C. Praticò, M. Mazza, A. Calafiore, G. Carini, C. Calabrese, A. Belluzzi, F. Rizzello, P. Gionchetti, M. Campieri La malattia celiaca nel terzo millennio: nuove prospettive su patogenesi, clinica, diagnosi e terapia G. Caio, F. Giancola, R. De Giorgio, U. Volta Malattie epato-biliari autoimmuni M. Visconti, L. Fontanella, G. Marino Marsilia Pancreatiti autoimmuni P.G. Rabitti, R. Boni IMID e tumori F. Gallucci La sindrome infiammatoria da ricostruzione immune I. Ronga, G. Uomo Le malattie autoinfiammatorie M. Gattorno, A. Brucato Il rischio cardio-vascolare nelle IMIDs A. Fontanella, P. Gnerre, R. Nardi Quale ruolo degli inibitori delle PCSK9 in Medicina Interna nella prevenzione cardio-vascolare in alternativa alle terapie tradizionali? P. Gnerre, P. Zuccheri, M. Campanini, G. Pinna, R. Nardi Trombo-embolismo venoso e malattie autoimmuni sistemiche A. Fontanella, P. Gnerre, R. Nardi IMID nell’anziano: cenni sul trattamento M. Masina Farmaci biosimilari e farmaci innovativi in reumatologia: quale futuro? M. Todoerti, C. Montecucc