23 research outputs found
Periodontal Healing of a Human Intrabony Defect Treated by Autogenous Periosteal Barrier Membrane and Bone Graft: A Clinical and Histologic Case Report
No full textIntroduction: The aim of this case report is to clinically and histologically evaluate the healing of a deep intrabony
defect treated with a combination therapy using autogenous periosteal membrane and autogenous bone graft.
Case Presentation: A 45-year-old female was scheduled for hemisection of tooth #30, affected by a degree III furcation
involvement, with the extraction of the mesial root. The root was associated with a 6-mm intrabony defect. The patient
volunteered to have the defect treated by a regenerative technique before the extraction. A notch was placed at the level of
the crestal bone on the root surface to serve as reference for histologic evaluation. The intrabony defect was filled by autogenous
bone chips and covered by an autogenous periosteal barrier membrane obtained from the palate. One year after
regenerative treatment, a block biopsy containing the root with some of the surrounding soft and hard tissues was sampled
during the tooth hemisection procedure and processed for histologic evaluation. At the 12-month examination, a 7-mm
probing depth decrease and a 4-mm clinical attachment gain were observed. The radiographic examination showed the
complete filling of the defect. Histologic evaluation showed the formation of new cellular cementum with inserting collagen
fibers from the base of the defect to the notch level. Newly formed bone was also observed.
Conclusion: Our results suggest that the adjunctive use of autogenous bone graft and periosteal barriermembrane may
represent a promising surgical technique for periodontal regeneration in clinical practice
Treatment of Supra-Alveolar-Type Defects by a Simplified Papilla Preservation Technique for Access Flap Surgery With or Without Enamel Matrix Proteins
No full textBackground: In this study, we compare the effectiveness of enamel matrix derivative (EMD) associated with a simplified papilla preservation flap (SPPF) technique to SPPF alone when surgically treating supra-alveolar-type defects. Methods: Fifty patients, from 54 initially selected, presenting horizontal bone loss around 4 adjacent teeth, were treated by an SPPF technique; 25 participants also received EMD (test group) and 25 patients underwent flap surgery alone (control group). A complete clinical and radiographic examination was performed at baseline and 12 months after treatment. Pre- and post-therapy probing depth (PD), clinical attachment level (CAL), gingival recession (GR), and radiographic bone level (BL) were compared between treatments. Results: After 12 months, PD, CAL, and GR in both groups showed significant differences from baseline (P <0.001). No differences in BL scores were observed within the groups at the 12-month examination. After 1 year, the test group showed significantly (P <0.001) greater PD reduction (3.4 +/- 0.7 mm) and CAL gain (2.8 +/- 0.8 mm) and a smaller GR increase (0.6 +/- 0.4 mm) compared to the control group (PD, 2.2 +/- 0.8 mm; CAL, 1.0 +/- 0.6 mm; GR, 1.2 +/- 0.7 mm.) BL changes did not significantly differ between the experimental groups. Conclusion: The results of this study suggest that combining EMD and SPPF in the treatment of suprabony defects may lead to a greater clinical improvement compared to SPPF alone
Metabolic-associated enthesitis: a review on pathophysiology, clinical relevance, diagnostic challenges, and perspective on target treatments
No full textEntheses are specialized tissues that connect ligaments and tendons to the bone surface and are frequently involved in seronegative spondyloarthritis. Enthesitis can also be detected in patients with metabolic disorders (MD), regardless of baseline autoimmune rheumatic disease, posing real diagnostic challenges. The present review discusses the pathophysiology of enthesitis and metabolic-associated enthesitis, the clinical relevance of metabolic disorders on enthesitis-related outcomes, diagnostic challenges for adequate differential diagnosis, and possible therapeutic strategies to improve clinical outcomes. PubMed/MEDLINE and the Cochrane Library were searched for original articles, systematic reviews, and meta-analyses. References were screened according to a hierarchical analysis of studies by title, abstract, and full text, collected, presented, and discussed. Metabolic-associated enthesitis is attributable to mechanical stress/overload due to weight excess typically observed in metabolic disorders (MD), such as overweight/obese comorbid patients, metabolic syndrome (MS), and type 2 diabetes (T2D). Interleukin 1β, 6, 17, 18, and 23 and tumor necrosis factor-α play a crucial role in initiating and maintaining entheseal inflammation. Chronic hyperglycemia and insulin resistance lead to a vicious circle as they stimulate, upon activated, specialized T cells to produce these specific cytokines, thus maintaining entheseal inflammation chronically. MD is associated with more severe clinical presentation, worse response to pharmacological treatments, and poor entheseal outcomes also in patients with existing seronegative spondyloarthritis. Non-immune-mediated metabolic-associated enthesitis poses a real diagnostic challenge, possibly underestimating cases and potential misdiagnoses. From a therapeutic viewpoint, glucose control improvement and weight loss are associated with relevant amelioration of entheseal-related outcomes. Pharmacological and non-pharmacological interventions aiming to reduce body weight, improve glucose control and insulin sensitivity, and attenuate inflammation are desirable to achieve the therapeutic target. Glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter type 2 inhibitors, in add-on to non-steroidal anti-inflammatory drugs and immunomodulators when necessary, may have a therapeutic rationale in patients with metabolic-associated enthesitis. Awareness of metabolic-associated enthesitis is essential to improve the accuracy of differential diagnosis in patients with MD and prescribe appropriate therapeutic strategies. However, basic and clinical research is needed to understand the role of “antihyperglycemic” agents in better managing metabolic-associated enthesitis
Predicting Factors of Worse Prognosis in COVID-19: Results from a Cross-sectional Study on 52 Inpatients Admitted to the Internal Medicine Department
No full textBackground: The initial phases of the COVID-19 pandemic posed a real need for clinicians to identify patients at risk of poor prognosis as soon as possible after hospital admission. Aim: The study aimed to assess the role of baseline anamnestic information, clinical parameters, instrumental examination, and serum biomarkers in predicting adverse outcomes of COVID-19 in a hospital setting of Internal Medicine. Methods: Fifty-two inpatients consecutively admitted to the Unit of Internal Medicine "Baccelli," Azienda Ospedaliero - Universitaria Policlinico of Bari (February 1 - May 31, 2021) due to confirmed COVID-19 were grouped into two categories based on the specific outcome: good prognosis (n=44), patients discharged at home after the acute phase of the infection; poor prognosis, a composite outcome of deaths and intensive care requirements (n=8). Data were extracted from medical records of patients who provided written informed consent to participate. Results: The two study groups had similar demographic, anthropometric, clinical, and radiological characteristics. Higher interleukin 6 (IL-6) levels and leucocyte count, and lower free triiodothyronine (fT3) levels were found in patients with poor than those with good prognosis. Higher IL-6 levels and leucocyte count, lower fT3 concentration, and pre-existing hypercholesterolemia were independent risk factors of poor outcomes in our study population. A predicting risk score, built by assigning one point if fT3 < 2 pg/mL, IL-6 >25 pg/mL, and leucocyte count >7,000 n/mm3, revealed that patients totalizing at least 2 points by applying the predicting score had a considerably higher risk of poor prognosis than those with scoring <2 points [OR 24.35 (1.32; 448), p = 0.03]. The weight of pre-existing hypercholesterolemia did not change the risk estimation. Conclusion: Four specific baseline variables, one anamnestic (pre-existing hypercholesterolemia) and three laboratory parameters (leucocyte count, IL-6, and fT3), were significantly associated with poor prognosis as independent risk factors. To prevent adverse outcomes, the updated 4-point score could be useful in identifying at-risk patients, highlighting the need for specific trials to estimate the safety and efficacy of targeted treatments
Stock ownership and political behavior: evidence from demutualizations
No full textA natural experiment in which customer-owned mutual companies converted to publicly listed firms created a plausibly exogenous shock to the stock market participation status of tens of thousands of people. We find the shock changed the way people vote in the affected areas, with a 10% increase in share-ownership rate being followed by a 1.3%–3.1% increase in right-of-center vote share. The institutional details and additional tests suggest that wealth, liquidity, and tax-related incentives cannot fully explain the results. A plausible explanation is that the associated increase in the salience of stock ownership causes a shift in voters’ attention
The Submerged Dyslexia Iceberg: How Many School Children Are Not Diagnosed? Results from an Italian Study
No full textBackground:Although dyslexia is one of the most common neurobehavioral disorders affecting children, prevalence is
uncertain and available data are scanty and dated. The objective of this study is to evaluate the prevalence of dyslexia in an
unselected school population using clearly defined and rigorous diagnostic criteria and methods.
Methods:Cross sectional study. We selected a random cluster sample of 94 fourth grade elementary school classes of Friuli
Venezia Giulia, a Region of North Eastern Italy. We carried out three consecutive levels of screening: the first two at school
and the last at the Neuropsychiatry Unit of a third level Mother and Child Hospital. The main outcome measure was the
prevalence of dyslexia, defined as the number of children positive to the third level of screening divided by the total
number of children enrolled.
Results:We recruited 1774 children aged 8–10 years, of which 1528 received parents’ consent to participate. After applying
exclusion criteria, 1357 pupils constituted the final working sample. The prevalence of dyslexia in the enrolled population
ranged from 3.1% (95% CI 2.2–4.1%) to 3.2% (95% CI 2.4–4.3%) depending on different criteria adopted. In two out of three
children with dyslexia the disorder had not been previously diagnosed.
Conclusions:This study shows that dyslexia is largely underestimated in Italy and underlines the need for reliable
information on prevalence, in order to better allocate resources both to Health Services and School
Clinical Comparison of Platelet‐Rich Fibrin and a Gelatin Sponge in the Management of Palatal Wounds After Epithelialized Free Gingival Graft Harvest: A Randomized Clinical Trial
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