Pleomorphic adenoma rehabilitative treatment in growing up patient: a 20-years follow-up

OBJECTIVE: Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. Most of the maxillary tumors are surgically treated through either a total or partial maxillectomy. However, surgical defects lead to both clinical and psychologic disorders for the patient. A postoperative obturator prosthesis is a good option in patients who underwent maxillectomy. It allows to restore both masticatory and speaking functions, as well as aesthetic appearance. When reconstruction of the surgical site is possible, an implant-supported prosthesis can be considered to guarantee a better function and aesthetic's rehabilitation. CASE REPORT: This clinical report presents the prosthetic rehabilitation of a patient who underwent maxillectomy because of a pleomorphic adenoma of hard palate minor salivary glands. The patient was treated with a palatal obturator prosthesis first and with an implant-supported prosthesis after surgical site's reconstruction and complete healing. CONCLUSIONS: The rehabilitation of the patient after maxillectomy through both these devices was an excellent option and provided clinical benefits, improving the patient's quality of life, allowing the patient's reinsertion into societ

Designing a Regulatory and Supervisory Framework for Integrated Financial Markets

The financial crisis that started in 2007 casts doubt about the ability of national laws and competent authorities to manage the stability of the financial system and to protect investors. This is due to the relevant evolving features of financial intermediation, like the cross-border strategies in banking, with many M&A undertaken, especially in Europe, and more in general the globalization of finance, also through the many recent operations among exchanges. The associated regulatory and supervisory challenges have proved to be difficult to tackle. An international perspective is needed on single banking regulatory instruments, even if it is impossible at this stage to imagine unique rules and single international authorities managing capital ratios, deposit insurance, reserve requirements and lending of last resort, as well as other tools for providing financial markets stability. However, some common principles on regulation and the structure of supervision may be stated both in US and in Europe: we suggest a “four peak” approach to the matter.The financial crisis that started in 2007 casts doubt about the ability of national laws and competent authorities to manage the stability of the financial system and to protect investors. This is due to the relevant evolving features of financial intermediation, like the cross-border strategies in banking, with many M&A undertaken, especially in Europe, and more in general the globalization of finance, also through the many recent operations among exchanges. The associated regulatory and supervisory challenges have proved to be difficult to tackle. An international perspective is needed on single banking regulatory instruments, even if it is impossible at this stage to imagine unique rules and single international authorities managing capital ratios, deposit insurance, reserve requirements and lending of last resort, as well as other tools for providing financial markets stability. However, some common principles on regulation and the structure of supervision may be stated both in US and in Europe: we suggest a “four peak” approach to the matter.Refereed Working Papers / of international relevanc

Pain-motor integration in the primary motor cortex in Parkinson's disease

In Parkinson's disease (PD), the influence of chronic pain on motor features has never been investigated. We have recently designed a technique that combines nociceptive system activation by laser stimuli and primary motor cortex (M1) activation through transcranial magnetic stimulation (TMS), in a laser-paired associative stimulation design (Laser-PAS). In controls, Laser-PAS induces long-term changes in motor evoked potentials reflecting M1 long-term potentiation-like plasticity, arising from pain-motor integration

From Farkas’ lemma to linear programming: An exercise in diagrammatic algebra

Farkas’ lemma is a celebrated result on the solutions of systems of linear inequalities, which finds application pervasively in mathematics and computer science. In this work we show how to formulate and prove Farkas’ lemma in diagrammatic polyhedral algebra, a sound and complete graphical calculus for polyhedra. Furthermore, we show how linear programs can be modeled within the calculus and how some famous duality results can be proved

Controlled optimal black start procedures in smart grids for service restoration in presence of electrical storage systems

This paper presents an optimisation problem to determine the optimal reclosure order of remotely operable switches deployed in a smart grid consisting in a distribution network equipped with one or more Energy Storage Systems (ESS). The proposed solution integrates nonlinear real and reactive power flow equations, by reconducting them to a set of conic constraints, together with several network operator requirements, such as network radiality and ampacity limits. A numerical simulation validates the approach and concludes the work

What is a Gene? A Two Sided View

The need to account for all currently available experimental observations concerning the gene nature, has reshaped the concept of gene turning it from the essentially mechanistic unit, predominant during the '70s, into a quite abstract open and generalized entity, whose contour appears less defined as compared to the past. Here we propose the essence of the gene to be considered double faced. In this respect genotypic and phenotypic entities of a gene would coexist and mix reciprocally. This harmonizes present knowledge with current definitions and predisposes for remodelling of our thinking as a consequence of future discoveries. A two sided view of the gene also allows to combine the genetic and epigenetic aspects in a unique solution, being structural and functional at the same time and simultaneously able to include the different levels in an overlapping unicum

Laser irradiated foam targets: absorption and radiative properties

An experimental campaign to characterize the laser radiation absorption of foam targets and the subsequent emission of radiation from the produced plasma was carried out in the ABC facility of the ENEA Research Center in Frascati (Rome). Different targets have been used: plastic in solid or foam state and aluminium targets. The activated different diagnostics allowed to evaluate the plasma temperature, the density distribution, the fast particle spectrum and the yield of the X-Ray radiation emitted by the plasma for the different targets. These results confirm the foam homogenization action on laser-plasma interaction, mainly attributable to the volume absorption of the laser radiation propagating in such structured materials. These results were compared with simulation absorption models of the laser propagating into a foam target

Ambulatory surgery for perianal Crohn’s disease. Study of feasibility

Background. One-third of Crohn’s disease (CD) patients present perianal fistula. The gold standard in the diagnosis and treatment of symptomatic perianal disease (PAD) in CD is the exploration of the anal canal and distal rectum under anesthesia (EUA). This procedure is mainly conducted as a day case surgery. Unfortunately, it is not always possible to proceed within the ideal timing and any delay may well represent a relevant clinical issue. The aim of this study was to evaluate the feasibility of outpatient treatment of symptomatic perianal fistulas in CD patients. Methods. All CD patients under regular follow-up at our inflammatory bowel disease referral center, presenting with symptomatic perianal fistulas, were offered surgical consultation. The data of patients were prospectively collected for three years (February 2014 to February 2017) for the purpose of the study. All clinical information, including previous EUA and/or records from MRI and endoscopic ultrasound, was included. Outpatient anal canal and distal rectum exploration and treatment (OE) were undertaken during the specialist surgical consultation. Fistulas were classified according to Parks’s classification; the type of outpatient treatment and compliance of patients were recorded. Pain was assessed by VAS at the time of the procedure and during the first control. Patients were followed up in the surgical clinic in relation to the study. Results. Ninety-two CD patients with symptomatic perianal fistulas had surgical consultation during the study period. OE was offered to all but 18 patients who fulfilled the exclusion criteria or had an extremely severe disease; six patients refused the OE (8.11%). Of the 68 patients undergoing OE, eleven (16.18%) had previous surgery for perianal disease. The OE was accomplished in sixty-one patients (89.71%), while in 7 patients, it was abandoned for scarce compliance. Nine patients (14.75%) underwent drainage of perianal abscess; in 3 of them, it was possible to probe the fistula tract, find the internal orifice, and pass a loose seton. Overall, setonage was performed in 50 patients (81.97%). Rectovaginal setons were placed in 3 patients and more than one seton (up to 3) in 6 cases. Fistulotomy was performed in 4 simple subcutaneous fistulous tracts. Concordance with the preoperative findings was found in 54 out of 61 patients. EUA was scheduled at the time of OE for the 7 patients who did not complete the procedure. All sixty-one patients who had the OE were followed up for a minimum of 12 months. Conclusions. This preliminary study indicates that OE in CD patients with symptomatic perianal fistulas is safe and feasible in a high-volume referral center. It might provide several benefits, including patients’ logistics, reduce or remove patients’ symptoms and discomfort, allow for a timely start of medical therapy, and avoid further complications