Search

Background: Odontomas are the most common odontogenic tumours, often considered hamartomas rather than true neoplasms. These mixed tumours consist of fully differentiated dental tissues, including enamel, dentin, cementum, and pulp. Odontomas can be classified into compound and complex types. While typically asymptomatic, they are often discovered during routine radiographic examinations for delayed tooth eruption. The management of odontomas generally involves surgical removal, which is effective in resolving associated dental impactions., Case Report: We present the case of a healthy 4-year-old child who presented with the absence of the lower left deciduous canine (tooth 7.3) in the dental arch. Radiographic examination revealed multiple radiopaque masses indicative of a compound odontoma associated with the unerupted deciduous canine. Following detailed imaging and surgical planning, the odontoma was successfully enucleated under conscious sedation with nitrous oxide. The surgical procedure was performed without extracting the retained canine. Post-operative follow-up at two weeks showed excellent healing, and at seven months, partial eruption of the canine was observed, confirming the odontoma's role in impeding its eruption., Conclusion: This case underscores the importance of early diagnosis and management of odontomas to prevent potential impaction of associated teeth. The successful surgical removal of the odontoma facilitated the spontaneous eruption of the lower left deciduous canine, highlighting the effectiveness of early intervention. Conscious sedation with nitrous oxide proved to be a valuable tool in managing the young patient, ensuring cooperation and comfort during the procedure. Early identification and treatment of odontomas are crucial for promoting normal dental development and preventing future malocclusions.

Background: An early approach to Class III malocclusions is crucial. From diagnosis to treatment, the aim is be to correct and harmonise maxillary and mandibular growth as quickly as possible., Case Report: A new treatment protocol for the early treatment of Class III malocclusions to be used in children in deciduous teething and/or early mixed teething was proposed. Ten children, 6 females and 4 males, with an overall average age of 6.5 years (6 years and 6 months) at time T0 were included in this experimental study. Twelve months orthopaedic interceptive therapy using two protraction facemasks (Delaire and Petit mask) and two types of extraoral elastic bands (8 and 16 oz) were given. Parents/guardians were involved as much as possible to increase compliance with the treatment., Conclusion: The orthopaedic-interceptive treatment for Class III malocclusion intends to provide a potential improvement of the growth response so that significant results can be achieved quickly. The motivational role of the parent can positively influence the child's treatment cooperation. The clinician should then try to make parents understand the importance of early treatment of Class III malocclusion thus obtaining a full cooperation with the parent/ guardian and a good compliance from the child.

Objectives: The aim of this study was to report the outcomes of open or hybrid repair of failed thoraco-abdominal aortic aneurysm endovascular treatment with Multilayer Flow Modulator (MFM) stents., Methods: All patients who underwent open or hybrid repair of a failed MFM aortic treatment were retrospectively analysed. Perioperative and postoperative data, as well as midterm survival, were assessed., Results: Between 2013 and 2020, 39 patients received an open or hybrid conversion after endovascular treatment. Five of them [13%; 4 males; median age 68 years (interquartile range 66-76)] were previously treated with aortic MFM stents (Cardiatis, Isnes, Belgium). Among these, the median interval between index repair and conversion was 84 months (interquartile range 75-84). The median aneurysm diameter was 9.6 cm (interquartile range 8-10). Renovisceral vessels steno-occlusion was highly prevalent: 2 renal arteries were occluded; 3 coeliac trunks, 2 renal arteries and 1 superior mesenteric artery had a >70% ostial stenosis. Open standard thoraco-abdominal aneurysm conversion was performed in 3 fit patients, while a hybrid approach with visceral debranching and tube endografting was performed in 2 high-risk patients. Two patients (2 open repairs) died intraoperatively, and 1 (hybrid repair) postoperatively. The 2 successfully treated patients are alive at 4- and 34-month follow-up, respectively, with patent visceral branches., Conclusions: Open or hybrid thoraco-abdominal aortic aneurysm treatment after failed endovascular aortic repair with MFM stents might be the only surgical option to address sac enlargements and ruptures or branch-related failures. However, both procedures had a poor prognosis due to both the impaired preoperative patient's status and the surgical complexity in the presented series., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Although influenza is a major public health concern, little is known about the use of spray live attenuated influenza vaccine (LAIV) among adults. For this reason, we conducted a systematic review and meta-analysis to investigate the efficacy and safety of LAIV, especially in adults with/without clinical conditions and children <2 years, with the final aim of possibly extending the clinical indications. PubMed/MEDLINE and Scopus were the two databases consulted through February 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A critical appraisal was conducted. Analyses were performed by using ProMeta3 software. Twenty-two studies were included, showing that LAIV was associated with a higher probability of seroconversion when compared with a placebo and considering the A/H1N1 serotype (pooled OR = 2.26 (95% CI = 1.12-4.54), p -value = 0.022; based on 488 participants, without heterogeneity (I2 = 0.0%)). The meta-analysis also confirmed no significant association with systemic adverse events. Only rhinorrhea, nasal congestion, and sore throat were significantly associated with LAIV compared to the placebo. Despite limited available evidence, LAIV has proved to be a safe and effective flu vaccination, also due to its very low invasiveness, and our review's results can be considered a starting point for guiding future research and shaping forthcoming vaccination campaigns.

Diabetic patients are at higher risk of developing infectious diseases and severe complications, compared to the general population. Almost no data is available in the literature on influenza immunization in people with type 1 diabetes mellitus (T1DM). As part of a broader project on immunization in diabetic patients, we conducted a cross-sectional study to: (i) report on seasonal influenza coverage rates in T1DM patients, (ii) explore knowledge, attitudes, and practices (KAPs) towards seasonal influenza in this population, and (iii) identify factors associated with vaccine uptake, including the role of family doctors and diabetologists. A survey was administered to 251 T1DM patients attending the Diabetes Clinic at San Raffaele Research Hospital in Milan, Italy and individual-level coverage data were retrieved from immunization registries. Self-reported seasonal influenza immunization coverage was 36%, which decreased to 21.7% when considering regional immunization registries, far below coverage target of 75%. More than a third (36.2%) of T1DM patients were classified as pro-vaccine, 30.7% as hesitant, 17.9% as uninformed, and 15.1% as anti-vaccine. Diabetologists resulted to be the most trusted source of information on vaccines' benefits and risks (85.3%) and should be more actively involved in preventive interventions. Our study highlights the importance of developing tailored vaccination campaigns for people with diabetes, including hospital-based programs involving diabetes specialists.

Objective: The objective of this study was to evaluate the performance of percutaneous femoral access with large-bore sheaths (>21F outer diameter) mainly employed for thoracic and thoracoabdominal aortic endovascular treatment and to stratify the outcomes on the basis of the introducer size., Methods: Between December 2015 and December 2018, all consecutive patients who received endovascular repair through a percutaneous approach with a suture-mediated vascular closure device (VCD) and the preclose technique were included in a retrospective single-center study called Totally Percutaneous Approach to Endovascular Treatment of Aortic Aneurysms (PEVAR-PRO). The morphologic characteristics of the access vessels and patients' demographics were recorded, and 30-day closure success was defined as the primary end point. Analysis of the closure success comparing large-bore sheaths vs small-bore sheaths (≤21F outer diameter) was performed after 1:1 propensity score matching of preoperative confounding variables., Results: The closure success rate of the entire study cohort was 94% (622 femoral accesses in 360 patients; median age, 74 years; 84% male). Univariate analysis identified eight different factors associated with failure, but only two remained significant on multivariate analysis: diabetes (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.3-6.2; P = .011) and common femoral artery stenosis >50% (OR, 4.5; 95% CI, 1.3-13.7; P = .019). After propensity score matching (1:1, 172 femoral accesses per group), closure success rate was not significantly different between large-bore and small-bore sheaths (90.7% vs 93.0%; P = .43). Multivariate analysis of the large-sheath group identified two factors associated with failure: small (<9 mm) femoral arteries (OR, 6.9; 95% CI, 1.5-31.6; P = .13) and access vessel calcifications involving more than one-third of the circumference (OR, 7.9; 95% CI, 2.1-29.4; P = .002). Neither previous femoral cutdown (44 accesses [23%]) nor percutaneous closure with VCDs (38 accesses [20%]) affected the closure success rate in the large-sheath group. Closure failure did not significantly increase the need for postoperative blood transfusions or hospital length of stay., Conclusions: Off-label use of VCDs and the preclose technique for percutaneous approach with large-bore sheaths needed for complex aortic endovascular procedures is safe and feasible. Closure success rate is not significantly different from that obtained with on-label application of VCDs with smaller sheaths., (Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Background and Aim of the Work: To reflect on content, trends and quality of scientific publishing on COVID-19. In particular, to report on the systematic screening, quantitative assessment and critical appraisal of the first 10,000 scientific papers published on COVID-19 and to compare how scientific outputs matched identified research priorities and public health needs., Methods: A comprehensive research strategy was developed to systematically retrieve on a daily basis all studies published on COVID-19. From included studies we extracted: bibliometric parameters, country of studies' implementation and study design. We assigned papers to 25 a priori defined COVID-19-related topics and we described scientific outputs in relation to countries' academic publishing ranking, as well as COVID-19 burden., Results: 10,000 scientific articles were published on COVID-19 between 20th January and 7th May 2020,  accounting for 2.3% of total scientific production over the study period. One third (33%) focused on COVID-19 clinical management, with little adherence to identified research priorities.   Over sixty per cent of papers were opinion pieces not reporting original data. Papers were published on 1881 different journals but with half of scientific production included in 8% of journals. The US accounted for one fourth of total scientific production, followed by China (22.2%) and Italy (9%)., Conclusions: Never before in the history of academic publishing such a great volume of research focused on a single topic, this being likely to introduce major changes in the way science is produced and communicated, at the risk of  bringing it far from its ultimate aim: informing clinical and public health practice and decision making.

Objective: The aim of this study was to evaluate the safety and effectiveness of endovascular occlusion of the prevertebral subclavian artery (SA) using an Amplatzer vascular plug after prophylactic revascularization with carotid-subclavian bypass (CSB) in the setting of endovascular thoracic stent grafting or open arch repair with frozen elephant trunk., Methods: All patients who underwent SA plug embolization (SAPE) and CSB from September 2009 to December 2018 were enrolled in a registered study (SAPE study: clinicaltrials.govNCT03620006). The primary end point was technical success, defined as complete occlusion of the origin of the SA, and how it was influenced by SA anatomy. The secondary end points were access vessel complications, cerebrovascular events, and CSB patency., Results: The 101 SAPE procedures were performed using a type I (35 patients) or a type II (66 patients) Amplatzer vascular plug. A percutaneous ipsilateral upper extremity access was used in 66% of patients and a radial artery access was used in 50% of procedures. The 30-day primary technical success rate was 95% (five patients received an additional plug during the index); five type IC endoleaks were observed and successfully treated either with surgical ligation (in open arch repair procedures) or secondary embolization procedure (thoracic endovascular aneurysm repair group). Three access vessel complications (3%) were recorded with percutaneous brachial approach. At a median follow-up time of 11 months (range, 2-19 months), no new-onset type IC endoleak was observed, and the CSB patency rate was 97%., Conclusions: SAPE after CSB is feasible and safe, and has low incidence of type IC endoleaks. Further device developments are needed to better adapt to the subclavian anatomy., (Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to investigate the molecular mechanism by which eicosapentaenoic acid (EPA) may exert neuroprotective effects through an "EPA-cyclic AMP response element-binding protein (CREB)" signaling pathway. The current study reveals that EPA modulates the exquisite interplay of interaction of CREB1 with the inhibitor of DNA binding (ID) and E2A family members, thereby delivering mechanistic insights into specific neural differentiation program. In this scenario, our work provides evidence for the capability of CREB1 to sequester ID:E2A family members in brain tissues and neural differentiating mouse embryonic stem cells (mESCs) through formation of a [CREB1] 2 :ID2:E47 tetrameric complex.In essence, the molecular function of CREB1 is to dynamically regulate the location-specific assembly or disassembly of basic-helix-loop-helix (bHLH):HLH protein complexes to mediate the activation of neural/glial target genes. Together, these findings support the one-to-many binding mechanism of CREB1 and indicate that EPA treatment potentiates the integration of CREB dependent signaling with HLH/bHLH transcriptional network, adding specificity to the CREB1-mediated gene regulation during neural/glial differentiation. Our current research on the EPA-CREB axis could reveal new molecular targets for treating neurogenerative disease., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Soil erosion is a Europe-wide problem, causing both loss of soil fertility and pollution due to nutrient transport into water bodies. This process is particularly important in the Mediterranean area, where the climate, characterised by long periods of drought followed by intense precipitation, favours soil erosion. Research carried out in this field has amply described this process, showing that climate and land use/land cover (LU/LC) are the two main factors regulating this phenomenon. However, the interaction between these factors is complex and experimental research is needed to understand the nutrient loads deriving from different land uses. This paper shows the results of a long-term monitoring project carried out in the Lake Vico basin (central Italy), using high resolution data and runoff samples to determine the phosphorus (P) export from four different LU/LC classes resulting from the same climatic event. The results highlight the fundamental role that LU/LC plays in terms of phosphorus load. Furthermore, the results appear to indicate that the maximum rainfall registered for 30' (I 30, max), rather than the total quantity of precipitation, has the greatest effect on levels of erosion, and consequently on the migration of nutrients rather than the total quantity of precipitation can affect on erosion and therefore the migration of nutrients. These data could contribute to scientific planning support for land management choices aimed at controlling water pollution from non-point pollution sources.

Glial cells play a pivotal role in brain fatty acid metabolism and membrane biogenesis. However, the potential regulation of lipogenesis and cholesterologenesis by fatty acids in glial cells has been barely investigated. Here, we show that physiologically relevant concentrations of various saturated, monounsaturated, and polyunsaturated fatty acids significantly reduce [1-(14)C]acetate incorporation into fatty acids and cholesterol in C6 cells. Oleic acid was the most effective at depressing lipogenesis and cholesterologenesis; a decreased label incorporation into cellular palmitic, stearic, and oleic acids was detected, suggesting that an enzymatic step(s) of de novo fatty acid biosynthesis was affected. To clarify this issue, the activities of acetyl-coenzyme A carboxylase (ACC) and FAS were determined with an in situ digitonin-permeabilized cell assay after incubation of C6 cells with fatty acids. ACC activity was strongly reduced ( approximately 80%) by oleic acid, whereas no significant change in FAS activity was observed. Oleic acid also reduced the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR). The inhibition of ACC and HMGCR activities is corroborated by the decreases in ACC and HMGCR mRNA abundance and protein levels. The downregulation of ACC and HMGCR activities and expression by oleic acid could contribute to the reduced lipogenesis and cholesterologenesis.