Mauro Capocci

Medication-related osteonecrosis of the jaws (MRONJ) and quality of life evaluation: a pilot study

BACKGROUNDnMRONJ (medication related osteonecrosis of the jaws) is a well-known side effect of certain drugs, which are used to influence bone metabolism for the cure of osteo-metabolic or cancer diseases. The aim of this study is to assess the quality of life (QOL) under a physical and mental point of view in patients affected by MRONJ compared with the general population.nnnMETHODSnThe study has been accomplished through the administration of the SF-12 questionnaire: 30 patients of the MRONJ group were evaluated.nnnRESULTSnSignificant differences based on the level of education and age of the subjects, on the location and finally on the stage of necrosis of the jaw have been identified. In this pilot study the test sample shows how MRONJ can aggravate the conditions of patients, above all under a physical point of view.nnnCONCLUSIONSnPrevention of MRONJ and its symptoms as dysphagia, oral pain, immunological compromission and the need of frequent antibiotic therapies is a crucial part of modern oral pathology and dentistry, above all for oncologic patients who already have a general decrease of physical and mental activities, leading to a poor quality of life.

The “CROMa” Project: A Care Pathway for Clinical Management of Patients with Bisphosphonate Exposure

Aim. To describe 7 years of activity of “CROMa” (Coordination of Research on Osteonecrosis of the Jaws) project of “Sapienza” University of Rome. Materials and Methods. A preventive and therapeutic care pathway was created for patients with bisphosphonates (BPs) exposure. Demographic, social, behavioural, pharmacological, and clinical variables were registered in a dedicated database. Results. In the project, 502 patients, 403 females and 99 males, were observed. Bone pathologies were 79% osteometabolic diseases (OMD) and 21% metastatic cancer (CA). Females were 90% in OMD group and 41% in CA. BP administration was 54% oral, 31% IV, and 11% IM; 89% of BPs were amino-BP and 11% non-amino-BP. Consistently with bone pathology (OMD/CA), alendronate appears to be prevalent for OMD (40% relative), while zoledronate was indicated in 92% of CA patients. Out of 502 cases collected, 28 BRONJ were detected: 17 of them were related to IV BP treatment. Preventive oral assessment was required for 50% of CA patients and by 4% of OMD patients. Conclusions. The proposed care pathway protocols for BP exposed patients appeared to be useful to meet treatment and preventive needs, in both oncological and osteometabolic diseases patients. Patients and physicians prevention awareness can be the starting point of a multilevel prevention system.

Making biomedicine in twentieth-century Italy: Domenico Marotta (1886–1974) and the Italian Higher Institute of Health

This paper focuses on the role played by Domenico Marotta, director of the ISS (Higher Institute of Health) for over twenty-five years, in the development of twentieth-century Italian biomedicine. We will show that Marotta aimed to create an integrated centre for research and production able to interact with private industry. To accomplish this, Marotta shifted the original mission of the ISS, from public health to scientific research. Yet Mussolinis policy turned most of the ISS resources towards controls and military tasks, opposing Marottas aspiration. By contrast, in the post-war years Marotta was able to turn the ISS into the most important Italian biomedical research institution, where research and production fruitfully cohabited. Nobel laureates, such as Ernst Chain, and future Nobel laureates, such as Daniel Bovet, were hired. The ISS built up an integrated research and production centre for penicillin and antibiotics. In the 1960s, Marottas vision was in accord with the new centre-left government. However, he pursued his goals by ruling the ISS autocratically and beyond any legal control. This eventually led to his downfall and prosecution. This also marked the decline of the ISS, intertwined with the weakness of the centre-left government, who failed to achieve structural reforms and couple the modernization of the country with the democratization of its scientific institutions.

Treatments of the oral leukoplakia by laser

Oral leukoplakia is catalogued under the group of “potentially malignant disorders”. In daily practice, the World Health Organization definition “white patch or plaque that cannot be characterized clinically or histologically as any other disease” is completed by including the observation that it cannot be removed by simple scraping, thereby distinguishing it from pseudo-membranous candidiasis. The aim of this study is to find a definitive treatment of oral leukoplakia, because of its recurrence and its potentiality to the malignant transformation. There are currently different approaches to oral leukoplakia: scalpel surgery, systemic therapy (carotenoids, vitamins, etc.), electro-cauterization, cryotherapy and the use of the laser. In every lesion, biopsy and histological analysis has been performed to identify the stage and classification of the oral leukoplakia. Laser can be used for the complete excision of the lesion (which is more effective, but also more invasive), for the photodynamic therapy (non-invasive procedure, which requires several applications) or for the vaporization of the lesion (very precise treatment and relatively easy to perform). Laser treatments have shown better healing, less soft tissues retraction and less post-operative pain, comparing with traditional surgery. The use of systemic therapies and smoking habit interruption (where present) has been also useful to reduce the lesions before the clinical treatments. The treatment has always to be supported by histological analysis to identify the risk and consequently planning the clinical approach.

The life and times of Ferruccio Ritossa

Ferruccio Ritossa wrote these lines only a few months before he died, as a preface to a book he wanted to write and that, unfortunately, we will never be able to read. It was to be the story of his life, an amazing story indeed. With this article, we want to take a picture of Ferruccio’s life, a mosaic of events, facts, ideas, hopes, and memories linked in a way that they will not go away, even after “a stroll in our brain.”