Analisi della morfologia radicolare e canalare di molari superiori ed inferiori in una popolazione Caucasica: studio in vivo alla CBCT

AimTo investigate the root and canal morphology of maxillary and mandibular permanent molar teeth in a Caucasian population by using Cone Beam Computed Tomography (CBCT).MethodsA total of 596 permanent molars were included. The number of roots, the number of canals per root and the root canal configurations according to the method of Vertucci were recorded.ResultsAlmost all of maxillary first molars (95.7%) had three separate roots; however, 40.3% of mesiobuccal roots had two canals (MB2). Of 157 maxillary second molars, 88.5% had three roots. Among the mesiobuccal roots, 15.1% had two canals. The majority of mandibular molars (100% of first molars, 89.4% of second molars) had two separate roots. Most distal roots had a simple type I configuration, whereas mesial roots had more complex canal systems, with more than one canal.ConclusionsCBCT is an efficient method of studying root canal systems.     

Testosterone and heart failure

Testosterone deficiency is a generalized phenomenon seen in the course of chronic heart failure (CHF). Reduction in circulating testosterone level is a predictor of deterioration of functional capacity over time, underscoring the role of testosterone deficiency in CHF. Anabolic hormones are determinants of exercise capacity and circulating levels of anabolic hormones strongly determine muscle mass and strength. Testosterone deficiency is involved in the pathophysiology of CHF, contributing to some features of this syndrome, such as the reduced muscle mass, abnormal energy handling, fatigue, dyspnea and, finally, cachexia. This review summarizes current knowledge on the role of testosterone deficiency in the pathophysiology of CHF, gaining insights from the potential implications of testosterone as supplementation therapy.     

Subcutaneous adipose tissue blood flow and vasomotion in morbidly obese patients: long term effect of gastric bypass surgery

Since recent findings suggest a relationship between reduction in adipose tissue blood flow (ATBF) and metabolic or vascular complications in obese patients (Ob-pts), increase in ATBF may be considered as a further goal in the treatment of obesity, besides fat mass reduction. Therefore, this preliminary study aimed at assess subcutaneous ATBF and vasomotion in morbidly obese patients and whether sustained weight loss induced by Roux-en-Y gastric bypass (RYGB) affects the same parameters. Using laser-Doppler flowmetry (LDF) and spectral Fourier analysis, subcutaneous ATBF was measured and subcutaneous ATBF oscillations (ATBF-O) were analyzed - within three frequency intervals related to vasomotion - in 16 Ob-pts, before and about one year after RYGB, and in 10 lean, healthy control subjects (CS). Before RYGB, Ob-Pts showed an important reduction in subcutaneous ATBF compared to CS (4.8 ± 2.7 PU vs 79.9 ± 34.5 PU, respectively; p < 0.0001), as well as higher normalized power spectral density (N-PSD) values of subcutaneous ATBF-O, - related to vasomotion. One year after RYGB, sustained weight loss in Ob-pts was associated with a slight but significant increase in subcutaneous ATBF (10.0 ± 6.6 PU, p < 0.05) and with almost complete normalization in N-PSD values of ATBF-O, related to vasomotion, compared to before RYGB. The slight subcutaneous ATBF increase, we observed in Ob-pts after sustained weight loss, moves toward a desirable goal. This finding suggests verifying whether an even more sustained weight loss in Ob-pts could determine a greater increase in subcutaneous ATBF and/or, more importantly, it could also determine a significant increase in visceral ATBF.     

Seeking huntington disease biomarkers by multimodal,cross‐sectional basal ganglia imaging

Neurodegeneration of the striatum in Huntington disease (HD) is characterized by loss of medium‐spiny neurons, huntingtin nuclear inclusions, reactive gliosis, and iron accumulation. Neuroimaging allows in vivo detection of the macro‐ and micro‐structural changes that occur from presymptomatic stages of the disease (preHD). The aim of our study was to evaluate the reliability of multimodal imaging as an in vivo biomarker of vulnerability and development of the disease and to characterize macro‐ and micro‐structural changes in subcortical nuclei in HD. Macrostructure (T₁‐weighted images), microstructure (diffusion tensor imaging), and iron content (R relaxometry) of subcortical nuclei and medial temporal lobe structures were evaluated by a 3 T scanner in 17 preHD carriers, 12 early‐stage patients and 29 matched controls. We observed a volume reduction and microstructural changes in the basal ganglia (caudate, putamen, and globus pallidus) and iron accumulation in the globus pallidus in both preHD and symptomatic subjects; all these features were significantly more pronounced in patients, in whom degeneration extended to the other subcortical nuclei (i.e., thalamus and accumbens). Mean diffusivity (MD) was the most powerful predictor in models explaining more than 50% of the variability in HD development in the caudate, putamen, and thalamus. These findings suggest that the measurement of MD may further enhance the well‐known predictive value of striatal volume to assess disease progression as it is highly sensitive to tissue microimpairment. Multimodal imaging may detect brain changes even in preHD stages. Hum Brain Mapp, 2013. © 2012 Wiley Periodicals, Inc.     

Eight weeks of <Emphasis Type="Italic">Capoeira</Emphasis> progressive training program increases flexibility of beginners

Background

No study has investigated the alterations in the flexibility of beginners using an experimental protocol with basic techniques of Capoeira.

Purpose

To analyze the effects of 8 weeks of Capoeira progressive training program on the flexibility of beginners.

Methods

Twenty-one individuals divided in two groups (Capoeira: n = 13; 26.1 ± 7.2 years; 22.7 ± 2.7 kg m^2(?1) and control: n = 08; 27.1 ± 0.5 years; 24.3 ± 3.3 kg m^2(?1)) participated in the study. The Capoeira group performed 8 weeks of Capoeira progressive training program (two sessions per week lasting 60 min each). The experimental protocol used was exclusively based on the basic techniques of a programmed Capoeira training system. Before and after the intervention, measurements were performed aiming to analyze (1) trunk flexion flexibility through a sit-and-reach test using a Wells’ Bench (WB_tf), (2) passive tension (PT_hf), and (3) maximum amplitude of hip flexion (MA_hf) through goniometry.

Results

A two-way ANOVA revealed a main effect of group by time interaction to PT_hf (F = 11.797; P = 0.003; η _p ²  = 0.383) and MA_hf (F = 9.650; P = 0.006; η _p ²  = 0.337). No significant main effect of group by time interaction occurred to WB_tf (F = 3.320; P = 0.084; η _p ²  = 0.149). The relative changes (? %) before and after the intervention in both groups showed that the Capoeira group significantly differed to the control group in the PT_hf (Capoeira: 46.2 ± 29.9 % vs. control: 5.7 ± 27.6 %; P = 0.003) and MA_hf (Capoeira: 22.4 ± 24.5 % vs. control: ?6.1 ± 13.1 %; P = 0.006).

Conclusion

Eight weeks of Capoeira progressive training program resulted in a significant improvement in angular flexibility for beginners.

     

Pharmacological Modulation of Ischemic-Reperfusion Injury during Pringle Maneuver in Hepatic Surgery. A Prospective Randomized Pilot Study

Background

The Pringle maneuver, which is performed during liver surgery to reduce blood loss, may result in liver ischemia/reperfusion injury resulting in metabolic, immunological, and microvascular changes, which may lead to hepatocellular damage. The aim of this study was the investigation of the effects of N-acetylcysteine (NAC) and methylprednisolone (MET) in the modulation of liver warm ischemia during hepatic resection.

Methods

Forty-eight patients were enrolled in a pilot double-blind, randomized clinical trial. The patients received either NAC, MET, or placebo. The primary endpoint was the reduction in postoperative alanine aminotransferase and bilirubin. The secondary endpoint was the difference in morbidity and mortality.

Results

All the 48 patients had liver resection with no mortality. Morbidity was observed in 8 (16 %) patients equally distributed among the groups. There was a significant favorable recovery of liver function tests in patients treated with NAC or MET compared with the placebo when the Pringle maneuver exceeded 70 min.

Conclusions

The administration of NAC or MET prior to the Pringle maneuver during hepatic resection is associated with lower postoperative aberration in liver function tests compared with placebo when the Pringle maneuver exceeded 70 min. Larger studies are required to validate our findings and to investigate the specific role of NAC and MET in liver surgery.

     

Effect of treatment with myo-inositol on semen parameters of patients undergoing an IVF cycle: in vivo study

Introduction: Myo-inositol (MI) is a precursor for the synthesis of phosphatidylinositol polyphosphates (PIPs). The aim of the study is to evaluate the effect of its administration on semen parameters of male patients undergoing an in vitro fertilization cycles.

Methods: In vivo study. Samples were semen of 62 patients divided into three different groups: healthy fertile patients (Group A); patients with oligoasthenospermia (OA) (Group B); control group (CTR). The collected samples were analyzed by optic microscopy in order to evaluate semen’s volume, spermatozoa’s number and motility before and after density-gradient separation method. These parameters were evaluated before and after administration of 4000?mg/die of MI and 400?µg of folic acid for 2 months. The results were analyzed statistically with Student's t-test.

Results: After treatment there was a significant increase of basal and after density-gradient separation method spermatozoa concentration in Group B, and a significant increase of spermatozoa count after density-gradient separation method in Group A. The motility values were higher in healthy men than patients with OA before treatment, but there was no improvement in both groups after treatment.

Conclusions: Exogenous administration of MI significantly improves semen’s parameters both in patients with OA and in normal fertile men.     

Are work return and leaves of absence predictable after an unstable pelvic ring injury?

Background

Resuming work after surgical treatment of an unstable pelvic ring injury is often impeded because of residual disability. The aim of this study was to test which factors influence return to work, ability to return to the same job function as before the injury, leaves of absence, and incapacitation after sustaining a pelvic fracture.

Materials and methods

We performed a retrospective study on patients with surgically treated pelvic fractures. Medical records were reviewed to document patients’ demographic data, the extent of follow-up care, diagnosis of the injury (according to the Tile system of classification), type of surgical treatment, injury severity, and the time from trauma to definitive surgery. We also recorded the classification of patients’ physical status according to the American Society of Anesthesiologists (ASA) and details about admission to the intensive care unit (ICU). Patients were interviewed to note the number of days before returning to work and their ability to maintain their previously held jobs.

Results

Fifty patients were included in the study, and their mean age was 46.3 ± 12.6 years. The median time to return to work was 195 days. Twelve patients (24 %) lost their jobs and 17 (34 %) resumed their previous job with a change of tasks. ICU admission and time from trauma to definitive surgery were negatively correlated with return to the previously held job. Returning to the same job tasks was not associated with any of the factors investigated. Polytrauma, ICU admission, and time from trauma to definitive surgery were associated with longer leaves of absence.

Conclusions

Work reintegration after pelvic ring injuries is a major issue for patients and health care systems: 58 % of patients were not able to return to or lost their job. Factors correlated with leaves of absence were injury severity, delayed definitive fixation, and ICU admission.

Level of evidence

IV (case series).

     

Electrodiagnostic evidence of phrenic nerve demyelination in Charcot-Marie-Tooth disease 1A

OBJECTIVE: To determine whether neurophysiologic findings correlate to clinical respiratory signs or spirometric abnormalities in patients with hereditary motor and sensory neuropathy type 1 (Charcot-Marie-Tooth disease). DESIGN: A total of 11 patients with hereditary motor and sensory neuropathy type 1A, genetically identified, (age range, 10-58 yr) were included and studied by physical pulmonary examination, chest radiography, respiratory function tests, and bilateral transcutaneous phrenic nerve conduction. RESULTS: No patient complained of respiratory symptoms or revealed abnormal spirometric or maximal respiratory pressure data, despite a phrenic nerve conduction significantly slower (P < 0.0001; median conduction time, 18.6 msec; 95th percentile, 31.97 msec) than that recorded in the control group of healthy subjects (median, 6.05 msec; 95th percentile, 8.82 msec); the amplitudes of compound muscle action potentials were not statistically different from the controls. CONCLUSIONS: Our study confirms a dramatic phrenic nerve involvement in absence of clinical and laboratory evidence of diaphragmatic weakness; further studies and an adequate follow-up are necessary to discover whether the disease progress might encompass respiratory dysfunction at later stages.