Premature loss of primary molars in children: space recovery through molar distalisation. A literature review

AIM

The integrity of primary dentition is essential in the development of the jaws and permanent occlusion. The consequences of a premature loss of primary molars are: space loss, crowding, risk of impaction of the permanent teeth, ectopic eruption, anomalous inclination of the teeth adjacent to the loss molar, reduction of arch length. The mesial displacement of the posterior permanent teeth during eruption can cause a loss of space, which can be regained with orthodontic appliances. Therefore, a careful diagnosis is of great importance to be able to decide what appliance is indicated to recover from this situation. Molar distalisation consists in displacing permanent molars distally, allowing them to reach class I relationship and to recover the correct space for the second bicuspids when the second deciduous molar has been lost early.

METHODS

The aim of this study is to carry out a narrative literature review regarding the different appliances and their effectiveness in regaining space after premature loss of the upper primary molars.

CONCLUSION

The paediatric dentist should be aware of the advantages and disadvantages related to each device and select the most appropriate distalisation appliance based on an individual plan of diagnosis and a careful treatment. The distalisation of the upper molar must be adequately stabilised and so it is important to consider also some retainers such as Nance's appliance, the Palatal Plate, the extraoral traction, the utility arch, or II Class elastic bands.

The perception of the relationship between environment and health according to data from Italian Behavioural Risk Factor Surveillance System (PASSI)

"OBJECTIVES: to identify groups of people in relation to the perception of environmental risk and to assess the main characteristics using data collected in the environmental module of the surveillance network Italian Behavioral Risk Factor Surveillance System (PASSI).

METHODS

perceptive profiles were identified using a latent class analysis; later they were included as outcome in multinomial logistic regression models to assess the association between environmental risk perception and demographic, health, socio-economic and behavioural variables.

RESULTS

the latent class analysis allowed to split the sample in "worried", "indifferent", and "positive" people. The multinomial logistic regression model showed that the "worried" profile typically includes people of Italian nationality, living in highly urbanized areas, with a high level of education, and with economic difficulties; they pay special attention to their own health and fitness, but they have a negative perception of their own psychophysical state.

CONCLUSIONS

the application of advanced statistical analysis enable to appraise PASSI data in order to characterize the perception of environmental risk, making the planning of interventions related to risk communication possible. ".

Cancer screening uptake: association with individual characteristics, geographic distribution, and time trends in Italy

BACKGROUND

In Italy, organized screening programmes invite the vast majority of the population for cervical and breast cancer, and about one half of the population for colorectal cancer. Programme activity and quality are closely monitored. Nevertheless, there is a vast spontaneous activity, both public and private, for which information on service and coverage is missing. To estimate actual population coverage for the three types of screening the extent of spontaneous screening needs to be known.

METHODS

PASSI is a national telephone-interview surveillance system that continuously collects information about behavioural health risk factors and the diffusion of preventive health interventions. From 2010 to 2013, more than 151,000 18- to 69-year-olds were interviewed. During 2013, 136 out of 147 Italian local health authorities participated in the survey. Information about screening includes: test uptake (Pap smear, HPV, mammography, faecal occult blood test, colonoscopy), date of the last test, provider of the last test (whether paid or for free, proxy of the organized screening programme), reason for not participating in screening, and screening promotion/recommendation received. Individual information on socio-economic characteristics is available.

RESULTS

Seventy-seven percent of the 25-64 year-old women interviewed said they had undergone a Pap smear or HPV test in the three years before the interview, 40%within the screening programme, 37% spontaneously and paying. Seventy percent of the 50-69 year-old women interviewed reported having had a mammography in the two years before the interview, 51% within the screening programme, 19% spontaneously and paying. Thirty-eight percent of the 50-69 year olds interviewed reported having undergone colorectal screening in the two years before the interview, 31% within the screening programme, 7% spontaneously and paying. All three screening programmes showed a decreasing North-South trend in coverage. From 2010 to 2013, coverage increased for all types of screening; the trend was stronger in the South; the increase was mostly due to the tests performed within the organized programmes. People with low education, economic problems, and immigrants from high migration pressure countries had lower coverage levels. In regions with well-implemented organized screening programmes, test coverage was higher and differences for socio-economic factors were smaller than in regions with incomplete programme activation.

Melioidosis in a Traveller from Thailand: Case Report

A 42-year old Italian male with type 2 diabetes and HCV-related chronic hepatitis spent 6 months in Thailand. After his return in June 2002 he was admitted to the Infectious Diseases Unit of the Hospital of Livorno (Italy) because of fever, chest pain and skin abscesses in the legs. Chest X-rays and CT scan revealed multiple bilateral cavitary lesions in the lungs. Ultrasonography and CT scan showed numerous subcentimetric spleen abscesses. Burkholderia pseudomallei was isolated from the cutaneous lesions and sputum and thus melioidosis was diagnosed. A 6-week course of i.v. ceftazidime plus oral doxycycline was given during the acute phase of the illness. The in vitro susceptibility testing showed that long-term (20 weeks) antimicrobial therapy with doxycycline and moxifloxacin was required. Complete resolution of pulmonary and spleen lesions was obtained within 6 weeks of therapy and of cutaneous abscesses in 10 weeks. No significant side effects were noted during the follow-up period using this scheme of antimicrobial therapy.

[Top medical management and levels of knowledge about the application of the D.lgs. 626/94]

The incorporation into Italian legislation of the European Community directives on the improvement of health and safety at work imposes new duties on the department heads of hospital departments. Their level of knowledge and information on several safety problems--occupational infections, exposure to chemical agents, use of antineoplastic and antiviral drugs, use of protective garments and devices, exposure to ionizing and non ionizing radiations, use of electric devices, lifting and loading, fire prevention--was surveyed in a large teaching hospital in northern Italy, via a check-list derived from Italian and international experience. Both knowledge and information resulted rather low, with particular regard to chemical, electric and fire hazards. The ignorance of department heads about common safety and prevention procedures in hospital work does not allow them to carry out their role according to the new requirements of Italian legislation. However, as they "must" know and have criminal responsibility in case of accidents or diseases due to their unawareness, appropriate courses are needed to fulfil law and safety requirements.

[Yersinia enterocolitica: biotypes and serotypes isolated from horticultural products]

A survey has been carried out for the presence of Yersinia enterocolitica (Y.e.) in horticultural products. 100 samples of these vegetables have been examined among the families of Compositae (lettuce, prickly lettuce, cabbage lettuce, common chicory, artichoke), Umbrelliferae (curly parsley, carrot, celery, fennel), Cruciferae (garden cabbage, red radish), Liliaceae (onion), and Solanaceae (tomato). 12 strains have been recorded in carrots (serotype 0:6.30), 1 strain in curly parsley (0:4.32), 3 in celery (0:7.8 and 0:6.30), and 1 in red radish (NAG). 0:6.30--the most commonly serotype found in the horticultural products--can be of special significance in human pathology, since the reference strain (IP 102) has been first isolated from man; besides, 0:6.30 has been recovered from four cases of human infection, and represents the most frequently isolated serotype from humans in Canada, together with 0:3, 0:5.27 and 0:9. According to other Authors, in can be assumed that "environmental" strains of Y.e. may also acquire virulence and cause infection in man. Moreover, a high number of environmental biotypes in foods may mask the presence and recovery of such strains involved in human pathology.

[Cases of endocrinological psychiatry. Hypothalamic primary amenorrhea with paraphrenia]

A case of association between hypothalamic primary amenorrhea, obesity and paraphrenia is presented in a 53 old woman. Neurological investigations, showing a diencenphalic involvement possibly on a malformative basis, lead to the hypothesis of a common pathogenesis for both endocrinological and psychiatric features of the syndrome.