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OBJECTIVE: COVID-19 is an extremely contagious illness caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), that will keep broadly circulating and evolving. Collected evidence revealed the clinical profile of COVID-19 patients as a potential predictor of their outcome. The aim of this study was to investigate the causal relationship between poor outcomes and laboratory parameters in hospitalized COVID-19 patients, in this sense observing how SARS-CoV-2 infection affects other organs. PATIENTS AND METHODS: We retrospectively evaluated a cohort of 133 patients, positive for SARS-CoV-2, aged between 30 to 94 years, between January 12th and April 25th, 2021. Discharge from the hospital, transferral to the ordinary ward or nursing home, intensive care unit (ICU) admission, and in-hospital mortality were recorded, along with demographic, laboratory and clinical parameters. The whole sample was summarized by median (interquartile range) for quantitative data, and absolute and relative percentage frequencies for qualitative variables. Univariable logistic regression models were performed to assess the association between all the parameters of interest and COVID-19 adverse outcomes, single (in-hospital mortality) and composite (in-hospital mortality and ICU admission). Hence, a multivariable model was fitted to identify potential independent predictors of the composite outcome. The accuracy of the model was assessed through appropriate fitting indices, such as the C-statistic and Hosmer-Lemeshow test. Moreover, to detect multicollinearity, the variance inflation factor (VIF) was used. RESULTS: Our study sample had a median age of 72 years old (59.0-83.0). The most common comorbidities were hypertension (63.7%), cardiovascular disease (41.9%), diabetes (33.6%), and cerebrovascular disease (21.5%); while as the most common symptoms, we observed dry cough (32.5%), dyspnoea (50.8%), and fatigue (29.8%). Totally, 18 patients died during hospitalization (13.5%), 10 required ICU admission (7.5%), 78 (58.6%) were discharged from the hospital, and 27 (20.3%) were transferred to either ordinary wards or nursing homes. We disclosed an association of older age with both composite [OR 1.06, 95% CI 1.02-1.09; p=0.003] and single outcome [OR 1.10, 95% CI 1.04-1.16; p=0.001]. A higher oxygen saturation (SpO2) was associated with a better outcome [OR 0.75, 95% CI 0.60-0.93; p=0.009 and OR 0.76, 95% CI 0.61-0.95, p=0.009]. Among laboratory parameters, higher levels of neutrophils increased the risk of a poor outcome [OR 1.05, 95% CI 1.00-1.10; p=0.043]; while higher levels of lymphocytes seem associated with a better outcome [OR 0.94, 95% CI 0.88-0.99; p=0.043]. Higher levels of creatinine were associated with a higher risk of both adverse outcomes [OR 6.20, 95% CI 2.16-17.81; p<0.001 and OR 19.90, 95% CI 5.07-78.06; p<0.001, respectively]. Higher levels of sodium (Na) were associated with a higher risk of adverse events [OR 1.15, 95% CI 1.03-1.28; p=0.014 and OR 1.14, 95% CI 1.01-1.27]. Similar findings were also observed for C-reactive protein (CRP) levels [OR 1.01, 95% CI 1.00-1.02; p=0.010 and OR 1.01, 95% CI 1.00-1.02; p=0.024]. Conversely, being positive to IgM and IgG decreases the risk of adverse outcomes [IgM: OR 0.33, 95% CI 0.14-0.77; p=0.011 and OR 0.23, 95% CI 0.08-0.66; p=0.006. IgG: OR 0.30 95% CI 0.13-0.72; p=0.007 and OR 0.22 95% CI 0.07-0.66; p=0.007]. Hence, a multivariable model was fitted to identify potential independent laboratory predictors of the composite outcome, with laboratory parameters that showed an association with composite outcome. The model can be considered accurate according to Hosmer-Lemeshow test and C-statistic [p>0.83, C-stat=0.90]. CONCLUSIONS: Our findings confirm that COVID-19 is a multiorgan disease. In fact, the analysis of laboratory parameters has revealed a strong relationship between poorer outcomes and multiple organ dysfunction, particularly established by higher levels of neutrophils, creatinine, sodium, and CRP. Alongside, cerebrovascular diseases, chronic kidney disease and older age supported this finding. Of note, higher levels of SpO2, and lymphocytes, as well as positivity to IgM and IgG were associated with a lower risk of a poor outcome. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Bisphosphonates, the most common anti-resorptive medications, are internalized by osteoclasts, where they inhibit the macrophage colony-stimulating factor (M-CSF) pathway, preventing their differentiation, inhibiting anchorage to the cell membrane, and inducing apoptosis. In patients undergoing oral bisphosphonate therapy, oral surgery involves a high risk of developing drug-related osteonecrosis of the jaws (BRONJ/MRONJ), among the possible complications. MATERIALS AND METHODS: A systematic search was carried out on the PubMed, Scopus and Cochrane Library search engines, using the keywords “oral bisphosphonates AND tooth extraction”, “third molar extraction AND oral bisphosphonates”. In addition, we manually evaluated the articles included in references from other sources and an analysis of the Gray Literature was performed. A secondary outcome was to evaluate the assessment of pharmacological (antibiotics) use in the BRONJ/MRONJ management. The revision protocol followed the indications of the Cochrane Handbook, and was registered in the INPLASY database, while the drafting of the manuscript was based on PRISMA. RESULTS: The results of the systematic review, after the study identification and selection process, included a total of 7 studies: 4 retrospective studies, 2 prospective studies and 1 case report. The main complication was represented by osteonecrosis of the jaws, which appears to be related to the duration of treatment with bisphosphonates; in addition, data regarding the anatomical location of post-extraction sites, the sex and age of patients, comorbidities and various systemic risk factors were extrapolated. The most frequent post-extraction complication in patients treated with oral bisphosphonates is osteonecrosis of the jaws, with a significant prevalence in the posterior region of the mandible. In some cases, delayed healing of the surgical wound was also found; moreover, the duration of exposure to oral bisphosphonates influences the onset of complications. CONCLUSIONS: Ongoing studies continue to unravel the role of the oral environment response in alveolar bone homeostasis and how it might contribute to the induction of BRONJ/MRONJ. Approaching the problem from this perspective could provide new directions for the prevention of BRONJ/MRONJ and expand our understanding of the unique oral microenvironment. [ABSTRACT FROM AUTHOR]

Data collection has suggested a complex correlation between the gut microbiota (GM) and bone homeostasis involving host-microbiota crosstalk. Although the GM is known to affect bone metabolism, the mechanisms linked with these effects remain unclear. The aim of this review is to current insight advances regarding how gut-derived hormones regulate bone homeostasis in humans, emphasizing gut-bone axis and bone regeneration. The GM may be engaged in bone metabolism and fracture risk. Additional investigations of the fundamental microbiota-related pathways in bone metabolism may uncover treatment strategies and enable the prevention of osteoporosis. A better knowledge of gut hormones' action on bone homeostasis may lead to new strategies for preventing and treating skeletal frailty related to age. [ABSTRACT FROM AUTHOR]

Purpose. Numerous studies in the literature confirm the importance of the use of probiotics in inflammatory states of the prostate in humans. Our pilot study aimed to test probiotics strains ability to improve urinary bacterial load in male subjects. Methods. Twenty healthy men aged 55-65 years, with recurrent urinatory infections were enrolled and randomized into 2 groups. Urine culturing to detect Enterobacteriaceae (Escherichia Coli and Enterococcus faecalis) was performed at baseline and at 12 weeks after the starting of the study. Results. We found that taking the probiotic reduces the bacterial load of E. coli and E. faecalis in urine cultures. The use of the probiotic in these inflammatory states does not affect the change in weight in the tested subjects. Conclusions. Our data confirm and improve the main results reported in the scientific literature on the importance of taking probiotics in prostatitis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: A new pandemic coronavirus causing coronavirus disease-2019 (COVID-19), initially called 2019-nCoV and successively named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The COVID-19 refers to the disease while the SARS-CoV-2 refers to the virus and is characterized by a rapid contagious capacity able to spread worldwide in a very short time. The rise in the number of infected patients and deaths is of great concern especially because symptoms are vague and similar to other forms of flu infection and corona syndrome infections characterized by fever, fatigue, dry cough, and dyspnea. According to the latest guidelines published by the World Health Organization (WHO), the diagnosis of COVID-19 must be confirmed by quantitative reverse transcription polymerase chain reaction (rRT-PCR) or gene sequencing of specimen obtained from throat, sputum and blood samples. However, the limitations due to logistics, as well as low sensitivity and specificity diagnostic tools currently available have been reported as the main cause of high incidence of either false-negative or positive results. PATIENTS AND METHODS: The purpose of the present translational research protocol is to discuss and present the original findings from our research team on new diagnostic technique to detect four Coronaviridae family members (SARS-CoV-2, SARS-CoV, HCoV and MERSCoV), highlighting the methodology, the procedure and the possible advantages. Moreover, the authors review the current epidemiology, precautions and safety measures for health personnel to manage patients with known or suspected COVID-19 infection. RESULTS: Implementation of an effective and rapid plan of diagnosing, screening and checking is a key factor to reduce and prevent further transmission. This procedure based on rRT-PCR could be of great help to decisively validate the results obtained from more conventional diagnostic procedures such as chest computed tomography (CT) imaging and chest ultrasound. [ABSTRACT FROM AUTHOR]

Purpose. Stress is a multifactorial and complex pathway, gaining growing attention from the healthcare community. Surgeons are subjected to higher levels of stress, due to surgical procedures that are demanding and repetitive; unfortunately, high-stress levels may also cause side-effects, as surgical mistakes. This study aimed to evaluate the efficacy of specific probiotics strains formula on stress levels in oral and maxillofacial surgeons, to improve their quality of life. Methods. We have investigated the hormonal (salivary Cortisol; sC), immune (salivary Immunoglobulin A; sIgA) and cardiovascular (Heart rate, HR, and systolic blood pressure, SBP) responses induced by stress conditions in 40 oral surgeons, randomly selected and allocated, according to their experience level, in three categories: senior, expert, and junior. Results. The results described how the number of heartbeats/ minute and SBP are slightly raised in all surgeons at different timepoints. Such data allow us to assess that work-related stress can induce an increase in cardiovascular parameters, even if they are not significantly modified by the use of probiotics. On the other hand, our data indicate that 10 weeks of probiotic integration may induce the improvement of other stress-related physiological parameters in oral surgeons with different degrees of surgical experience, such as the salivary cortisol levels, even under stress conditions. Moreover, in the test group (probiotics administration), the immunoglobulin levels were higher than the control (placebo administration) group: this happens as a consequence of the regular use of probiotics, which may induce an increased number of IgA producing cells. Conclusions. our data indicated that 10 weeks of probioticsenriched diet modify some stress-related physiological parameters in oral surgeons with different degrees of surgical experience, but it does not impact on the overall cardiovascular risk. [ABSTRACT FROM AUTHOR]

Purpose. It has been customary to explain the dentally beneficial effects of xylitol and certain other natural compound as lysozyme and seas salt in terms of microbiological effects only. Several studies have tested the use of natural ingredients, alcohol and fluoride free, in mouthwashes. The purpose of this study was to evaluate a combined mouthwash formulation containing natural antibiofilm agents in oral care wound healing after routinely oral surgery (extraction) procedures. Methods. Patients were assigned following a blinded randomized controlled trial and divided into two groups, an experimental group (I = 15) and a control (placebo) group (II = 15). Any infectious complications, wound healing, plaque accumulation in the stitches, and presence of trismus and inflammation were evaluated at ten and thirty days after extraction procedure. Pain and swelling were evaluated using the well-known visual analogue scale (VAS) scale throughout study period following extraction. The mean difference in Pre and Post values were compared among the groups. The change in pre-post score was analyzed using the paired t test. Results. An appreciable wound healing was seen in the experimental group when compared to the control sites, with no reported adverse effects. Four weeks postoperative patient's satisfaction level, to subjective and objective outcome measurements in documenting the result of a mouthwash treatment showed an interesting difference between groups. Conclusions. Since combined mouthwash formulations, containing natural/bioactive substances, could provide a cheap, safe and acceptable alternative in oral care, further studies will also be required to study these effects and their mechanism of action in detail. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Head and neck region is involved in a high percentage of malignant lesions, and oral squamous cell carcinoma (OSCC) is undoubtedly the most frequently found, accounting for over 90% of malignant tumors. Hormone receptor overexpression, like Estrogen Receptor (ER), Progesterone Receptor (PR) and Endothelial Growth Factor Receptor (EGFR), and signaling have been related to the pathogenesis of OSCC. For metastasis of OSCC, Cancer Stem Cells (CSCs) undergo epithelial to mesenchymal transition (EMT) under the influence of growth factors, cytokines, and regulation of cadherins from the tumor's microenvironment. In this context, the stem cells may become a potential therapeutic target for OSCC through modulation of cytokines and RAS pathway, which is involved in intracell signal transduction. The objective of this study was to suggest an experimental steroidogenic model for OSCC in translational research. PATIENTS AND METHODS: Dental-derived Stem Cells (D-dSCs) have been obtained from apical papilla tissue that surrounds the developing tooth of healthy donors and cultured in vitro. The cells have been exposed to different concentrations of Estradiol (E2 - 10 nM and 40 nM) in order to verify their response. The number of cells and cell viability has been evaluated up to 96 hours of treatment. RESULTS: The results showed that cell growth was increased under estradiol treatments compared with cells maintained without estradiol. Moreover, no significant difference in cell death levels was detected among treatments. CONCLUSIONS: This work underlines as D-dSCs could represent a useful steroidogenic model for the development of the target and gene therapies in OSCC. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Recent advances in the translational research showed that dietary nutrients have critical importance to the microbioma balance in the gastrointestinal tract. Therefore, the alteration of the intestinal microbiota in order to achieve, restore, and maintain favorable balance in the ecosystem, and the activity of microorganisms present in the gastrointestinal tract is necessary for the improved health condition of the host. The objective of this translational study was to evaluate, in a pediatric population, the efficacy and safety of prophylactic probiotics for a better nutritional absorption capacity in the view to enhance their overall health and immunity. PATIENTS AND METHODS: A total of 40 pediatric patients between the ages of 14 and 18 years were enrolled in the study and divided under two categories (treated/active group and placebo group). Three-time points clinical evaluations were performed: a baseline assessment (Time 0), a second evaluation at 5 weeks after the start of probiotic use (Time 1), and a final evaluation at the timeline after 10 weeks (Time 2). In the initial phase of the study, the recruited subjects underwent a panel of initial T0 clinical tests. For each of the patients, a blood sample was taken in order to evaluate the following biochemical measurements: Vitamin D, Vitamin A, Calcium, Zinc, and Iron. Moreover, an initial nutritional evaluation was carried out through which the nutritionist estimated the body composition of the subject (weight and body mass index), the caloric needs and dietary behaviour of each recruited patient. RESULTS: Eligible participants were randomized into placebo (n = 20) or treated/active (n = 20) treatment conditions by random allocation using a computerized random number generator, ensuring all investigators remained blind to the treatment distribution. The data were compared within and between groups using statistical methods. The results confirmed that the probiotic supplementation was effective in increasing the overall blood biomarkers levels of vitamins, calcium, and mineral absorption from baseline to 10 weeks of treatment, compared with the placebo. CONCLUSIONS: Probiotics may be suggested as supplements to improve biomarkers serum concentration if administered for a period of at least ≥ 5 weeks. However, further studies are required for optimal recommendations in patient treatment. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the different behavior of two different human adult adipocytes derived stem cells (hASCs) during proliferation and osteogenic differentiation. PATIENTS AND METHODS: Human adult adipocytes stem cells (hAT-SCs) from visceral (hAV-SCs) and subcutaneous (hAS-SCs) sites were obtained after surgery procedures of seven patients. All samples were fully investigated and the different proliferation rates were evaluated. All MSCs clusters were cultured with an osteogenic and adipogenic differentiation medium. Homogeneous pools of Mesenchymal Stem Cells (MSCs) were confirmed by Flow-Cytometry Analysis (FACS) and Spectrophotometric Assay. The differentiated cells were eventually assessed for the expression of Alkaline Phosphatase (ALP), Alizarin Red (AR) and Oil Red-O (OR-O) detection, and analyzed by the Spectrophotometric Assay. After osteogenic differentiation, the cell clusters were incubated and analyzed with Real Time-Polymerase Chain Reaction (qRT-PCR) and fluorescence microscopy. RESULTS: The F ACS a nalysis p erformed on hAT-SCs confirmed the homogenous presence of MSCs in all samples. The ALP, AR stain confirmed the osteogenic differentiation capacity of MSCs towards osteoblast-like-cells. The colorimetric cell metabolic activity (MTS) assay showed an increase in the proliferation rate with different values in both sets hAS-SCs vs. hAV-SCs. CONCLUSIONS: These in vitro findings of both hAS-SCs and hAV-SCs suggested an important role of these stem cells for future clinical use in bone regeneration. Indeed, the final outcomes suggested a better performance of cells coming from subcutaneous adipose tissue vs. those from visceral fat tissue. [ABSTRACT FROM AUTHOR]

Cleft of the lip, palate and alveolus are congenital oro-maxillofacial malformation with an established treatment protocol. At present, there is great interest in the alveolar bone grafting procedures that involve the use of platelet-rich-plasma (PRP), to enhance bone formation and specifically to promote bone graft healing in head and neck tissues regeneration. The aim of this retrospective case report study was to assess the condition and viability of the standard bone grafting in association with PRP (platelet rich plasma) to enhance osteogenesis and maintain osteointegration in alveolar cleft with a follow up of eight years from the surgical procedure. The viability of bone grafts was documented by means of head bone scintigraphy (99mTc-MDP). The scintigrams revealed the decreased uptake at the cleft region and the increased uptake at the adjacent alveolus of the cleft. From these findings we suggest that platelet concentrates decrease the need of further surgical intervention in cleft palate patients. In addition, scintigraphy may be useful to evaluate postoperative bone formation in the alveolar cleft. [ABSTRACT FROM AUTHOR]

The provision of structural base and soft tissue support in dental implantology still remains a complex task. In the present study a new technique was introduced, which employs Bone-Albumin allograft and Concentrated Growth Factors (CGFs) integrated in a 1-stage immediate implant placement. The allograft is transformed from cubic to cylindrical shape by means of bone cutting forceps, followed by central osteotomy for screwing the implant within the allograft. The implant/graft combination promotes graft union, increases dental stability and minimizes graft resorption. The successful outcome of the proposed technique is evaluated by means of clinical and radiographic data. In conclusion, the proposed method provides a successful immediate dental implantation in terms of osseo-integration, stability and aesthetic results. [ABSTRACT FROM AUTHOR]