9 research outputs found
Treatment options for oral Leukoplakia: a review
No full textAim: the aim of this work was to highlight the most important findings regarding treatment options for oral leucoplakia, a white lesion with a potentially malignant evolution. There are several forms of oral leukoplakia with a various rate of malignant transformation, related to alcohol and tobacco consumption, gender, population, lesion size and type and level of dysplasia.
Methods: two databases (Medline via PubMed, Web of Science) were searched up to July 2022 and the most relevant papers on the topic were selected. Hand search was carried out too focusing on new and promising techniques regarding oral leukoplakia management options. Only papers written in English or Spanish were included in the research.
Results: the management options for oral leukoplakia are varied and diverse, they may involve a regime of observation with use of new and promising salivary biomarkers, a topical or systemic use of drugs, a surgical approach including laser ablation or a non-surgical approach using photodynamic therapy (PDT). There is a rising interest in PDT, which proved to be an interesting minimally invasive approach for oral leukoplakia, reducing lesions size or removing the lesion in its totality, de-pending on the histopathological stage of the lesions and other variables linked to the type of PDT and the number of sessions. PDT works through the interaction between a light source and a chemical dye or photosensitizer in the presence of oxygen resulting in the formation of reactive oxygen species (ROS), which cause oxidative damage.
Conclusions: despite promising results, longer clinical trials are required in order to define a protocol, evaluate potential side effects of PDT and demonstrate its effectiveness
Germectomy of the third molar in orthodontics: a review of the literature
No full textAim: germectomy is a surgical treatment defined as the removal of a tooth at the beginning of its development, when it has no contacts with the surrounding anatomical structures. The aim of the work is to present an in-ternational literature re-view to offer an overview on indications and ideal timing for this practice.
Methods: a literature review has been done on PubMed database [www.ncbi.nim.nih.gov/pubmed] looking for the articles dealing with indications, contraindications, and discussions about this technique. Among the arti-cles found, those ones published between 2013 and 2023 were selected.
Results: germectomy is a convenient, rapid, atraumatic technique without important post-surgical side effects. It's executable in local anaesthesia and it's much less invasive than the traditional surgery of the third molar: for this reason, a lot of authors are favorable to this practice. Among the authors, the debate about the ideal timing to operate is still open.
Conclusions: despite the conflicting opinions found in the literature, it's univocally recognized the importance of a careful evaluation of each single patient, in order to establish/decide the real need of germectomy and the right period to operate
Direct acting antivirals treatment for hepatitis C virus infection does not increase the incidence of de novo hepatocellular carcinoma occurrence: Results from an Italian real-life cohort (LINA cohort)
No full textThe effectiveness of direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection is ascertained. However, some authors raised the issue of an increased incidence of de novo hepatocellular carcinoma (HCC) in patients treated with DAAs. Aim of the study was to evaluate the rate of HCC occurrence in a real-life cohort of patients who received anti-HCV treatment with DAAs.A prospective multicentre study was conducted. All adult patients with HCV infection who received treatment between March 2015 and December 2017 in 4 hospital of Campania region (South Italy) with at least 6 months of follow-up were enrolled.A total of 323 patients were included in the study. Most patients had HCV genotype 1b (61.8%). The overall SVR12 rate was 95.5%. Median time of observation was 10 months. The incidence rate of HCC was 0.2 per 100 person-months (crude incidence rate 3.4%, 95 confidence interval: 1.5%-5.3%). The median time for HCC occurrence was 11 months. HCC occurrence rate was significantly higher among patients who did not achieve SVR12 compared with patients who did (28.6% vs 2.8%, P<0.05). No patient with F0-F3 fibrosis developed HCC. Among patients with cirrhosis, at the multivariate time-to-event analysis, no covariates were independently associated with the risk of HCC occurrence.Treatment with DAAs did not increase the risk of HCC occurrence. Patients who achieved SVR12 had a lower rate of HCC occurrence. Further studies are needed to estimate the incidence and the risk for HCC in the long-term follow-up among patients undergoing treatment with DAAs
Le nuove frontiere della responsabilità civile: i danni punitivi
No full text2016 - 2017Il costante dialogo posto in essere tra Corti superiori e internazionali ha contribuito negli ultimi decenni
a ridisegnare i contorni della disciplina della responsabilità civile, la cui natura monofunzionale si
rivela ormai concetto anacronistico. In tale dimensione evolutiva si inserisce l’istituto dei punitive
damages di origine anglosassone che ha, in parte, contribuito a sgretolare la cristallizzata prospettiva
meramente ristorativa del risarcimento del danno. Tale forma di liquidazione ultracompensativa nata in
Inghilterra al fine di ristorare i danni morali, illo tempore non oggetto di risarcimento, ha trovato
privilegiata sede applicativa nella materia dei torts d’oltreoceano e ciò per ragioni di ordine processuale
e sostanziale. Da un lato l’assenza di un principio della soccombenza, per regolare le spese di giudizio,
e la presenza costante della giuria nei processi civili, oltre che in quelli penali, dall’altro la mancanza di
una riserva di legge penale in grado di tracciare un netto confine con l’universo civilistico, nonché
l’evoluzione delle scuole di analisi economica del diritto, hanno contribuito ad irrobustire una
concezione di responsabilità non solo protesa alla compensazione del danno, bensì asservita a funzioni
sanzionatorie e punitive.
Un simile strumento si presenta prima facie in attrito con il sistema italiano che, relegando la funzione
deterrente e punitiva all’interno dell’universo penalistico, ravvede nel risarcimento del danno una
forma di ripristino dello status quo ante a livello patrimoniale, priva di qualunque connotazione
sanzionatoria.
Sostenere, però, che sussista un vera e propria incompatibilità giuridica tra il sistema italiano e i danni
puntivi di common law rappresenta un azzardo: si intravedono, infatti, in discipline settoriali e ipotesi
eccezionali, forme di risarcimento del danno che presentano una ratio ultronea rispetto a quella
meramente compensativa.
Pertanto, al fine di verificare come i punitive damages interagiscano con l’ordinamento italiano, anche
alla luce della presa di posizione della Corte di Cassazione nel luglio 2017, imprescindibile è
fotografare l’evoluzione della responsabilità civile, che fin dall’introduzione della disciplina del danno
non patrimoniale ha fatto scricchiolare il fondamento monofunzionale dell’illecito.
Lungi dall’effettuare una (quasi) sterile opera di verifica relativa alla trasposizione dell’istituto sassone
nel contesto italiano, in parte già realizzata dalla giurisprudenza di legittimità, certamente più
interessante si rivela indagare come componenti punitive e deterrenti si siano insinuate nel sistema
civilistico della responsabilità. Un’analisi approfondita, infatti, lascia trasparire che la difficile
interazione tra sanzione e liquidazione risarcitoria trova la sua ragion d’essere non in aprioristiche
etichette giuridiche, bensì in valutazioni dal sapore politico-economico, avvalorate dal latente timore di
un collasso dell’universo assicurativo, la cui trama non si presenta pervasiva come, invece, negli States. [a cura dell'Autore]This Phd thesis focuses on the evolution of tort law and on the concept of punitive damages. In order to analyse how the civil liability nowadays acts, worth noting is to investigate how different forms of
ultra-compensative restoration are able to operate in a system which supports a monofunctional liability perspective. The interesting metamorphosis undergone by italian contest represents the research base which allows investigation in new prospective: the forced dialogue between italian and international Courts, the innovative approach to studies of “Economic analysis of law” and the intention to repel the jheringhiano brocardo “nullum crimen sine culpa” are factors which contribute to review italian tort law framework. After the Court of Cassation ruled about the compatibility of punitive damages with the system (sent. 16601/2017), bacame manifest what doctrinal tradition argued for a long time, when glimpsed shades of prevention, deterrence and punishment, also in tort law and civil law. [edited by Author]XVI n.s. (XXX ciclo
Direct acting antivirals treatment for hepatitis C virus infection does not increase the incidence of de novo hepatocellular carcinoma occurrence
No full textOrbital Infarction Syndrome as a Rare Complication After Mechanical Thrombectomy in Ischemic Stroke
No full textAnticoagulation in acute ischemic stroke patients with mechanical heart valves: To bridge or not with heparin. The ESTREM study
No full textIntroduction: The best therapeutic strategy for patients with mechanical heart valves (MHVs) having acute ischemic stroke during treatment with vitamin K antagonists (VKAs) remain unclear. Being so, we compared the outcomes for: (i) full dose heparin along with VKA (bridging therapy group) and (ii) restarting VKA without heparin (nonbridging group). Patients and methods: For this multicenter observational cohort study, data on consecutive acute ischemic stroke patients with MHV was retrospectively collected from prospective registries. Propensity score matching (PSM) was adopted to adjust for any treatment allocation confounders. The primary outcome was the composite of stroke, systemic embolism, symptomatic cerebral bleeding, and major extracerebral bleeding at 90 days. Results: Overall, 255 out of 603 patients (41.3%) received bridging therapy: 36 (14.1%) had combined outcome, compared with 28 (8.0%) in the nonbridging group (adjusted OR 1.83; 95% CI 1.05-3.18; p = 0.03). Within the bridging group, 13 patients (5.1%) compared to 12 (3.4%) in the nonbridging group had an ischemic outcome (adjusted OR 1.71; 95% CI 0.84-3.47; p = 0.2); major bleedings were recorded in 23 (9.0%) in the bridging group and 16 (4.6%) in the nonbridging group (adjusted OR 1.88; 95% CI 0.95-3.73; p = 0.07). After PSM, 36 (14.2%) of the 254 bridging patients had combined outcome, compared with 23 (9.1%) of 254 patients in the nonbridging group (OR 1.66; 95% CI 0.95-2.85; p = 0.07). Conclusion: Acute ischemic stroke patients with MHV undergoing bridging therapy had a marginally higher risk of ischemic or hemorrhagic events, compared to nonbridging patients
Anticoagulation in acute ischemic stroke patients with mechanical heart valves: To bridge or not with heparin. The ESTREM study
No full textIntroduction: The best therapeutic strategy for patients with mechanical heart valves (MHVs) having acute ischemic stroke during treatment with vitamin K antagonists (VKAs) remain unclear. Being so, we compared the outcomes for: (i) full dose heparin along with VKA (bridging therapy group) and (ii) restarting VKA without heparin (nonbridging group). Patients and methods: For this multicenter observational cohort study, data on consecutive acute ischemic stroke patients with MHV was retrospectively collected from prospective registries. Propensity score matching (PSM) was adopted to adjust for any treatment allocation confounders. The primary outcome was the composite of stroke, systemic embolism, symptomatic cerebral bleeding, and major extracerebral bleeding at 90 days. Results: Overall, 255 out of 603 patients (41.3%) received bridging therapy: 36 (14.1%) had combined outcome, compared with 28 (8.0%) in the nonbridging group (adjusted OR 1.83; 95% CI 1.05-3.18; p = 0.03). Within the bridging group, 13 patients (5.1%) compared to 12 (3.4%) in the nonbridging group had an ischemic outcome (adjusted OR 1.71; 95% CI 0.84-3.47; p = 0.2); major bleedings were recorded in 23 (9.0%) in the bridging group and 16 (4.6%) in the nonbridging group (adjusted OR 1.88; 95% CI 0.95-3.73; p = 0.07). After PSM, 36 (14.2%) of the 254 bridging patients had combined outcome, compared with 23 (9.1%) of 254 patients in the nonbridging group (OR 1.66; 95% CI 0.95-2.85; p = 0.07). Conclusion: Acute ischemic stroke patients with MHV undergoing bridging therapy had a marginally higher risk of ischemic or hemorrhagic events, compared to nonbridging patients
Anticoagulation in acute ischemic stroke patients with mechanical heart valves: To bridge or not with heparin. The ESTREM study.
No full textThe best therapeutic strategy for patients with mechanical heart valves (MHVs) having acute ischemic stroke during treatment with vitamin K antagonists (VKAs) remain unclear. Being so, we compared the outcomes for: (i) full dose heparin along with VKA (bridging therapy group) and (ii) restarting VKA without heparin (nonbridging group).
For this multicenter observational cohort study, data on consecutive acute ischemic stroke patients with MHV was retrospectively collected from prospective registries. Propensity score matching (PSM) was adopted to adjust for any treatment allocation confounders. The primary outcome was the composite of stroke, systemic embolism, symptomatic cerebral bleeding, and major extracerebral bleeding at 90 days.
Overall, 255 out of 603 patients (41.3%) received bridging therapy: 36 (14.1%) had combined outcome, compared with 28 (8.0%) in the nonbridging group (adjusted OR 1.83; 95% CI 1.05-3.18; p = 0.03). Within the bridging group, 13 patients (5.1%) compared to 12 (3.4%) in the nonbridging group had an ischemic outcome (adjusted OR 1.71; 95% CI 0.84-3.47; p = 0.2); major bleedings were recorded in 23 (9.0%) in the bridging group and 16 (4.6%) in the nonbridging group (adjusted OR 1.88; 95% CI 0.95-3.73; p = 0.07). After PSM, 36 (14.2%) of the 254 bridging patients had combined outcome, compared with 23 (9.1%) of 254 patients in the nonbridging group (OR 1.66; 95% CI 0.95-2.85; p = 0.07).
Acute ischemic stroke patients with MHV undergoing bridging therapy had a marginally higher risk of ischemic or hemorrhagic events, compared to nonbridging patients
