Roberta Calcaterra

Avenins from different cultivars of oats elicit response by coeliac peripheral lymphocytes

Objective. The avoidance of oats in coeliac patients is still controversial. If oats is confirmed to be safe, it would be a valuable component and offer more variation in a gluten-free diet. The aim of this work was to evaluate whether avenins from different varieties of oats show different abilities in the activation of coeliac peripheral lymphocytes. Material and methods. In order to assess whether the immunogenic effect of oats varies according to the cultivar, peripheral lymphocytes from 10 coeliac children were exposed to avenins from four different oats varieties: Lampton, Astra, Ava and Nave. Lymphocyte proliferation and interferon-gamma (IFN-γ) release in the culture medium were measured as indexes of immune activation. Results. All the varieties of oats tested were immunogenic, with Lampton and Ava avenins inducing lymphocyte activation similar to that activated by wheat gliadin, while Astra and Nave avenins showed less immunogenicity, but still with a measurable effect. Conclusions. There are still concerns about the suitability of including oats in a gluten-free diet. Coeliac patients consuming oats-containing food should be carefully monitored, until there is more evidence to show the safety of oats and varieties of low-toxicity oats.

Microbiological evaluation of bacterial and mycotic seal in implant systems with different implant-abutment interfaces and closing torque values

Objective:The aim of this study was to evaluate the possible leakage of 3 species of bacteria (Streptococcus sanguinis, Fusobacterium nucleatum, and Actinomyces odontolyticus) and of Candida albicans and Candida glabrata in osseointegrated implants with different implant-abutment interface (IAI) geometry. Materials and Methods:Two groups of implants, (1) implant-abutment unit with a tube-in-tube interface and (2) implant-abutment unit with a flat-to-flat interface closed with different torque values, were compared in the study. In the first phase, the implants were assembled and cultured in vitro for 7 days. The implants and abutments were disconnected and samples were taken and cultured. In the second phase, the internal part of each implant was inoculated with 0.1 µL of microbial broth and then connected to the respective abutments. Afterward, medium samples were taken and cultured. Results:The group 1 implants were more resistant to colonization than those of group 2 (P < 0.05). The intragroup difference was significant between the implant-abutment units assembled with the recommended torque values and those with lower torque values (P < 0.01) for both the groups. Conclusion:IAI geometry influences both bacterial and yeast colonization inside the implants as well as the torque value used to connect abutments to implants.

Epidemiology of Skin Disorders in Ethiopian Children and Adolescents: An Analysis of Records from the Italian Dermatological Centre, Mekelle, Tigray, Ethiopia, 2005 to 2009

Abstract:  Skin disorders are an important problem in children living in developing countries, but only a few epidemiologic investigations on pediatric dermatoses are available in the literature. Our study is an analysis of the range and frequency of skin diseases presenting to the Italian Dermatological Center in a pediatric Ethiopian population. A retrospective analysis was performed on 17,967 medical records of children aged 0 to 18 years attending the Italian Dermatological Centre in Mekele (Ethiopia) from January 2005 to December 2009. Infections and infestations accounted for 47% of the disorders seen; fungal infections were the most common (44.1%), followed by bacterial and parasitic diseases. Dermatitis constituted the second most common diagnostic category (24.7%) of the disorders seen, and contact dermatitis was the most common diagnosis (48.8%). Pigmentary disorders and disorders of skin appendages were more common in girls, whereas fungal and parasitic infections were more common in boys. Bacterial and parasitic infections were more common in children younger than 1 year old, fungal infections in those aged 1 to 5.9, and disorders of skin appendages and pigmentary disorders in those aged 15 to 18. These findings demonstrate that most of the disorders seen could be easily managed in clinical practice with appropriate skill development. It is crucial to ensure that training of medical students and pediatricians focuses on accurate recognition, diagnosis, and management of these common skin diseases and that families, teachers, health workers, and nurses be educated about the most common signs of prevalent skin diseases to help facilitate appropriate care.

Role of magnified ileoscopy in the diagnosis of cases of coeliac disease with predominant abdominal symptoms

Objective. Less severe histological changes have sometimes been reported in the terminal ileum (TI) of coeliac patients. The aim of this work was to assess whether magnified ileoscopy and the corresponding biopsy could be used when diagnosing coeliac disease (CD). This would be of clinical value in coeliac patients who show predominant abdominal symptoms and who undergo colonoscopy with ileoscopy as first clinical examination. Material and methods. All patients underwent conventional and magnified ileoscopy, along with histological examination of macroscopic mucosal abnormalities, if present. Patients whose ileoscopy with biopsy suggested CD underwent a blood test for quantitative determination of anti-transglutaminase antibodies and upper gastrointestinal endoscopy with corresponding duodenal biopsy. Results. Out of 143 patients enrolled, 21 had a TI mucosal lesion, and 10 of these showed villous atrophy at ileoscopy only after magnification. Six showed a count of intra-epithelial lymphocytes (IELs) >25/100 enterocytes and upper intestinal lesions, confirming the diagnosis of CD. Finally, of four patients diagnosed with Crohns disease, TI mucosal aftoid lesions were seen in two only in magnified view. Conclusions. Magnified ileoscopy reliably recognizes the presence of mucosal villous subtotal or total atrophy at TI. This finding, even if not specific to CD, can address the diagnosis of CD. Magnification in the course of ileoscopy could also be useful in the diagnosis of Crohns disease.

Female Genital Mutilation and Risk for Transmission of STIs

Female genital mutilation (FGM) is a traditional cultural practice, but also a form of violence against girls, which affects their lives as adult women. FGM comprises a wide range of procedures: the excision of the prepuce; the partial or total excision of the clitoris (clitoridectomy) and labia; or the stitching and narrowing of the vaginal orifice (infibulation). The number of girls and women who have been subjected to FGM is estimated at around 137 million worldwide and 3 million girls per year are considered at risk. Most of the females who have undergone mutilation live in 28 African countries.

Clinical features of acne vulgaris in 444 patients with ethnic skin

Dear Editor, The demographics of Europe reflect a constantly changing mixture of people of various ethnic groups, in particular Italy represents one of the European countries with high numbers of migrant people. This phenomenon has had a significant impact on the practice of medicine, mainly dermatology. The observation of people with ethnic skin in our outpatients’ department is increasing daily. Acne vulgaris is the most frequent dermatosis encountered in the general population and in ethnic groups. Acne represents the most common motivation leading patients to the dermatologist in the black population in the USA, accounting for 28% of the dermatoses seen in black individuals. This percentage reaches 14% and 30% in the UK and France, respectively. Acne vulgaris is also the most common dermatological disease in the Latino population and the second most common dermatological disease in Asiatic individuals. In recent years, the published work has begun to acknowledge ethnicity, and patients’ skin color has been considered a key factor in acne management. We have observed 444 cases of acne vulgaris among patients with ethnic skin between 1 January 2005 and 31 December 2008. We classified patients according to the area of origin and the Fitzpatrick skin phototype, because we consider the classification on the basis of race to be out-of-date. In addition, this classification allows us to identify patients coming from the same geographic area, but that can have different skin colors. For example, people coming from North Africa have a lighter skin color compared to those coming from sub-Saharan Africa. In fact, skin color is determined by the amount and type of melanin, and variation in skin color is largely due to genetics. As a general

Bone level changes around platform switching and platform matching implants: a systematic review with meta-analysis.

The amount of marginal bone loss is considered an important criterion to evaluate the implant therapy outcome and to predict the prognosis of the implant rehabilitation. The purpose of this systematic review was to examine the available literature comparing clinical and radiological outcomes like the implant failure rates and marginal bone loss around platform switching dental implants versus platform matching ones. English randomized controlled human clinical trials, comparing one or more PS groups with one or more PM groups, with at least 12 months of follow-up after loading and 10 implants, providing carefully the number of PS- and PM- implants used as well as implant survival and data concerning bone level changes or marginal bone loss around implants, were included. Fifteen publications, involving a total of 1439 implants and 642 patients, were eligible. More studies showed less mean marginal bone loss around PS implants and none of them showed differences in terms of implant failure rates. This review confirmed a great effectiveness of platform switching technique to prevent marginal bone resorption. Nevertheless, this result should be interpreted cautiously because of the heterogeneity of the included studies.

3D X-RAY MICROSCOPIC ANALYSYS ON A PROSTHETICALLY LOADED IMPLANT WITH PLATFORM-SWITCHING AND CONICAL CONNECTION: A CASE REPORT

The histological and histomorphometrical examination were the gold standard in the qualitative and quantitative analyses of the peri-implant tissue around the implant. In recent years, the field of microscopy has witnessed a considerable enhancement of the performance of microscopes that have very high resolution performance and allowing very sophisticated analysis even larger than traditional preparations. The possibility to have an affordable analyses of whole implant with the surrounding different tissues (soft and hard tissues) without the traditional pre-treatment necessary for the histological analysis may represent a goal to describe material properties and behaviors or simply to visualize structural details. The aim of the present study were to evaluate a 3D X-ray microscopic analysis of peri-implant tissue compared to a traditional histological and histomorphometrical analysis of the peri-implant tissues around an implant with a conical connection associated with platform-switching in order to assess the validity of the new analysis technique.

Histological and Histomorphometrical Analysis on a Loaded Implant With Platform-Switching and Conical Connection: A Case Report

&NA; The association of Morse taper implant‐abutment design with the use of a smaller abutment diameter (platform switching) may improve dental implant success rate and prevent peri‐implant bone loss. The aim of the present study was to histologically and histomorphometrically evaluate the behavior of peri‐implant tissues around an implant with a conical connection associated with platform switching. A platform‐switched Morse‐cone connection implant was inserted in the left posterior mandible of a 61‐year‐old patient. The implant was inserted at the level of the alveolar crest. After 11 months from placement and 6 months of loading, the implant was retrieved for psychological reasons and processed for histological evaluation. The retrieved implant was wholly surrounded by bone tissue, except for a small area in the apical portion. At higher magnification, in the coronal portion of the implant, it was possible to observe bone directly at the implant platform level. No resorption of the coronal bone was present, except for 0.2 mm on the vestibular aspect. Crestally, bone remodeling with areas of newly formed bone was detected; the bone‐implant contact was 73.9%. Apposition of bone was detected even upon the platform. Peri‐implant crestal bone preservation can be achieved with the combination of Morse taper conical internal implant‐abutment connection with the use of a smaller abutment diameter (platform‐switching).

Preservation of extraction socket in immediate implant placement: A clinical study

AIM The objective of this study was to compare different approaches temporary restoration in an immediate implant placement. To determine the respective influence of each parameter, two treatment groups were formed; a strict and standardized study protocol was applied to minimize the influence of bias and confounding factors. The Pink Esthetic Score (PES) - the esthetic out-come of soft tissue appearance was evaluated. MATERIAL AND METHODS Sixteen patients with a single failing tooth in the maxilla and a natural contralateral site were randomly distributed into two groups. Treatment variations affected the provisional restorative in detail, group 1 with immediate implant placement and immediate temporary restoration with the simulation of the first three mm of the root and the seal of the socket, group 2 with immediate implant placement and immediate temporary restoration without the seal of the socket. All patients received the final prosthetic restoration 10-12 weeks after implant placement. Standardized photographs were taken eight months after tooth extraction. Five competent observers analyzed the esthetic outcome according to the PES. RESULTS The overall scores of the four treatment groups revealed PES values of 8.47 (SD 2.08, group 1), 6.62 (SD 3.24, group 2). The differences between groups 1 and 2 and were statistically significant (P=0.015 and P=0.047). The single parameter analysis displayed a certain range of fluctuation and heterogeneity. CONCLUSIONS Immediate implant placement and restoration appear to be a suitable alternative to early implant placement if an experienced surgeon is entrusted with the implantation procedure.