101 research outputs found
Atypical odontalgia and trigeminal neuralgia: psychological, behavioral and psychopharmacological approach in a dental clinic – an overview of pathologies related to the challenging differential diagnosis in orofacial pain
No full textOrofacial pain represents a challenge for dentists, especially if it does not have an odontogenic origin. Orofacial neuropathic pain may be chronic, is arduous to localize and may develop without obvious pathology. Comorbid psychiatric disorders, such as anxiety and depression, coexist and negatively affect this condition. This article presents one case of atypical odontalgia and one of trigeminal neuralgia treated with psychological and psychopharmacological tailored and adapted therapies, after conventional medications had failed. Additionally, an overview of the pathologies related to the challenging differential diagnosis in orofacial pain is given. A 68-year-old man complained of chronic throbbing and burning pain in a maxillary tooth, which worsened upon digital pressure. Symptoms did not abate after amitriptyline therapy; psychological intervention along with antianxiety drug were supplemented and antidepressant agent dosage were incremented. The patient reported improvement and satisfaction with the multidisciplinary approach to his pathology. A 72-year-old man complained of chronic stabbing, intermittent, sharp, shooting and electric shock-like pain in an upper tooth, radiating and following the distribution of the trigeminal nerve. Pain did not recur after psychological intervention and a prescription of antidepressant and antianxiety agents, while carbamazepine therapy had not been sufficient to control pain. Due to concerns with comorbid psychiatric disorders, we adopted a patient-centered, tailored and balanced therapy, favorably changing clinical outcomes. Comorbid psychiatric disorders have a negative impact on orofacial pain, and dentists should consider adopting tailored therapies, such as psychological counselling and behavioral and psychopharmacologic strategies, besides conventional treatments. They also must be familiar with the signs and symptoms of orofacial pain, obtaining a comprehensive view of the pathologies concerning the differential diagnosis. A prompt diagnosis may prevent pain chronicity, avoiding an increase in complexity and a shift to orofacial neuropathic pain and legal claims
A case series analysing patients with dental anxiety : A patient-centered model based on psychological profiling
No full textAnxiety and distress can jeopardize dental care experience of patients and may affect the clinical result. Although a wide range of sedation and analgesia techniques are currently available to relieve distress and pain during dental procedures, operative models to choose the most effective sedation-analgesic strategies are still insufficient. This case series proposes a patient-centered model to optimize patients' cooperation during dental care delivery. We describe how to achieve correct anaesthesia by using the least sedative procedure, accounting for the dental procedure needed and patient's psychological profile. Five patients were considered as paradigmatic to show the balance between patients' subjective experiences and the clinical procedures: a patient with low stress, good compliance (case 1); a patient with moderate stress and reduction in compliance (case 2); anxious patient (case 3); a patient with acute anxiety and emotional distress (case 4); anguished patient (case 5). A multimodal treatment of emotional and behavioural condition and a patient-centered model approach contributed to achieve the best patient satisfaction in the five cases detailed here
A patient with meningeal melanomatosis treated for periodontal disease with a bone regeneration procedure and dental implants: clinical and behavioral management to support medical compliance
No full textDuring the last three decades dental implants have become increasingly used in partially edentulous periodontally
compromised patients. The type of bacteria in the
peri-implant sulcus is influenced by the periodontal bacteria present on the surfaces of the remaining teeth. Peri-implant sulci of partially edentulous individuals harbour more motile rods and spirochetes than those of fully edentulous individuals. If Peri-implantitis arises, it may lead to implant failure. This complication occurs more frequently in patients with poor oral hygiene. This is a site-specific bacterial infection similar to that caused by periodontal bacteria around teeth and it should be prevented. This study was conducted to radiographically evaluate hard tissue response around 6 implants, over a 2-year period, in a previously surgically treated patient affected by severe chronic periodontitis. Psychological considerations and behavioral management of the patient are described. A complex implant-perio-prosthodontic case of a 54-year-old man affected by meningeal melanomatosis with a history of generalized severe chronic periodontitis was recruited. A comprehensive periodontal examination around teeth was accomplished before periodontal and implant treatment. After diagnostic work-up, compromised teeth from 1.3 to 2.3 and from 3.2 to 4.2 were extracted. Tooth 1.7 was also extracted. Afterwards fixed provisional
restoration rehabilitated all the natural dentition and the missing teeth. Endodonthic therapies were conducted on all the teeth due to high dentinal sensitivity and
pre-prosthodontic crown reconstructions performed. Periodontal surgery with modified Widman flaps were then accomplished on all the teeth. Three months later four maxillary implants in position 1.3,1.1,2.1,2.3 and two mandibular implants in position 4.2,3.2 were inserted. During mandibular implants positioning, the mental mussels were isolated and detached to achieve proper guided bone regeneration. During implant surgery, due to systemic conditions concern, the patient underwent intravenous sedation. Five months later the implants and the teeth were rehabilitated with fixed metal-ceramic bridges. Regarding the upper prosthetic rehabilitation, the incisors marginal edges were kept vertical to the nasal spine, due to lack of previous reference points. According to the reference points previously determined, the difference in bone level between radiographs taken at implants insertion and at the maintenance appointments was calculated. The health of the periodontally treated teeth resulted greatly enhanced. The mean alveolar bore loss was 0,30 mm after a 2-year observation period. The control of the periodontal disease before implant insertion in patients with severe chronic periodontitis is of paramount importance, as well as a regular maintenance program is essential for the health of the periodontal and peri-implant tissues. The management of patients with complex needs requires a multidisciplinary team designed to meet all the patient’s needs on various levels
Carbon-free production of hydrogen via the solar powered hybrid sulfur cycle: The SOL2HY2 project
No full textThis paper presents an overview of the activities carried out during the first half of the SOL2HY2 project. In particular, this paper is focused on the activities carried out by ENEA within the consortium, namely: elaboration of general plant concepts, integration of the hydrogen production plant with a concentrated solar power (CSP) plant, development of the catalyst for SO3 decomposition and selection and design of balance of plant (BoP) units. Copyright © 2015, AIDIC Servizi S.r.l
Microstructural damage assessment of pultruded materials by Synchrotron light tomography
No full textMicrostructural damage assessment of pultruded materials by Synchrotron light tomograph
Techno-economic comparison between CSP plants presenting two different heat transfer fluids
No full textThe employment of parabolic trough solar power plants (PT-CSP) for electrical power and process heat generation is one of the most promising technologies for carbon free energy production. The selection of thermal fluids, both for the heat transfer (heat transfer fluid, HTF) and the storage (heat storage material, HSM), is a crucial point for increasing CSP efficiency and cost effectiveness. In this paper two different PT-CSP configurations, both presenting a double tanks storage system, are compared.In particular, two different medium size (50 MWe) plant schemes, presenting two different working fluids as HTF, are described and analysed. In the first scheme a "binary" molten salt mixture, composed of sodium and potassium nitrate, is considered, while, in the second one, the employment, as HTF, of a "ternary" mixture, consisting of sodium potassium and lithium nitrates, is investigated. In both cases, the binary mixture is used for thermal storage (HSM).The first scheme represents the configuration developed by ENEA and already used for the Archimede plant in Priolo Gargallo (Sicily-Italy). The second one is an innovative proposal, which aims to improve CSP plants performances and to reduce operating costs. In particular, since the ternary mixture has a considerably lower freezing temperature than the binary one, this solution allows to keep the system at a lower temperature overnight, so reducing thermal energy losses.In first instance, it is necessary to characterize the binary and ternary mixtures respect to their thermo-physical features.The two CSP configurations are then sized and, by a techno/economic evaluation, compared with respect to the calculated unit cost of electricity production
Comparing the effectiveness of ring and block-vaccination strategies on networks
No full text: Vaccination is vital for preventing disease spread, as demonstrated by its role played in recent outbreaks such as measles, COVID-19, and the 2014 West Africa Ebola crisis. Classical ring vaccination-targeting individuals near infected cases to form protective clusters-has become of interest due to its effectiveness, yet it is strongly influenced by the quality of contact tracing and availability of medical resources. Here, we model the efficiency of a family of ring vaccination-inspired strategies that address these limiting factors and disentangle them from the structure of the contact patterns. In particular, we evaluate scenarios that consider a vaccination radius r, used to vaccinate nodes in the network up to r contacts away (block vaccination) or exactly r contacts away (ring vaccination) from nodes of interest. Each one of these is tested under two further scenarios: the preventive one, where individuals are vaccinated before the epidemic takes place, and the containment one, where vaccination occurs during an outbreak to limit disease spread. They are tested in synthetic networks, where we find that in the preventive scenario, ring outperforms block vaccination, reducing the size of the epidemic and, in some cases, even preventing it from happening. On the other hand, in the containment scenario, we find that both strategies perform slightly similarly in reducing the impact of the diseases but block vaccination using fewer resources. As a case study, the proposed strategies are used to create epidemiological risk maps by employing the spatial position of olive trees in the Salento region in Italy, which recently suffered the impact of the bacterium Xylella fastidiosa
GENETIC POLYMORPHISMS OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM AND RENAL INSUFFICIENCY IN ESSENTIAL HYPERTENSION
No full textObjective The renin–angiotensin–aldosterone system
(RAAS) plays an important role in the control of renal
function both in physiological and pathological conditions.
The aim of the present study was to evaluate the relation
between four genetic polymorphisms of the RAAS and renal
insufficiency in a population of patients with essential
hypertension living in north-east Italy.
Design and methods Eighty-six hypertensive patients with
renal insufficiency and 172 hypertensive patients without
renal damage matched for age and hypertension duration to
within 2 years were evaluated. Genotyping for insertion/
deletion of angiotensin-converting enzyme (ACE I/D),
angiotensinogen (AGT) M235T, angiotensin II type 1
receptor (AT1R) A1166C and aldosterone synthase
(CYP11B2) –344C/T polymorphisms were performed using
polymerase chain reaction, with further restriction analysis
when required.
Results Each of the genetic polymorphisms of the RAAS
genes was associated with renal failure; the adjusted odds
ratios were 1.47 and 1.89 for ACE D allele, assuming a co
dominant and a recessive mode of inheritance, respectively;
1.51 for AGT T235 allele assuming a co dominant, and 1.98
assuming a recessive, pattern of inheritance; 1.79 for AT1R
C1166 allele considering a dominant pattern; and 3.89 for
CYP11B2 S344C allele as a recessive effect. However,
CYP11B2 genotypes were not in Hardy–Weinberg
equilibrium among controls. The associations AGT TT–
AT1R AC and CYP11B2 CC–ACE DD showed a possible
positive interaction in the development of renal insufficiency
among hypertensive subjects. The association AGT MM–
AT1R AA and AGT MM–AT1R AA–CYP11B2 TT or TC
combinations were associated with a reduced risk for renal
failure.
Conclusions Our findings suggest that in patients with
essential hypertension an unfavorable genetic pattern of
RAAS may contribute to the increased risk for the
development of renal failure
Performance of an indirect packed bed reactor for chemical energy storage
No full textChemical systems for thermal energy storage are promising routes to overcome the issue of solar irradiation discontinuity, helping to improve the cost-effectiveness and dispatchability of this technology. The present work is concerned with the simulation of a configuration based on an indirect-packed bed heat exchanger, for which few experimental and modelling data are available about practical applications. Since air shows advantages both as a reactant and heat transfer fluid, the modelling was performed considering a redox oxide based system, and, for this purpose, it was considered a pelletized aluminum/manganese spinel. A symmetrical configuration was selected and the calculation was carried out considering a heat duty of 125 MWth and a storage period of 8 h. Firstly, the heat exchanger was sized considering the mass and energy balances for the discharging step, and, subsequently, air inlet temperature and mass flow were determined for the charging step. The system performances were then modelled as a function of the heat exchanger length and the charging and discharging time, by solving the relative 1D Navier-Stokes equations. Despite limitations in the global heat exchange efficiency, resulting in an oversize of the storage system, the results showed a good storage efficiency of about 0.7
Influence of ACE and alpha-adducin (ADDI) polymorphisms on ACE activity in cultured human skin fibroblasts
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