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Vaira LA, Lechien JR, Abbate V, Allevi F, Audino G, Beltramini GA, Bergonzani M, Boscolo-Rizzo P, Califano G, Cammaroto G, Chiesa-Estomba CM, Committeri U, Crimi S, Curran NR, di Bello F, di Stadio A, Frosolini A, Gabriele G, Gengler IM, Lonardi F, Maglitto F, Mayo-Yáñez M, Petrocelli M, Pucci R, Saibene AM, Saponaro G, Tel A, Trabalzini F, Trecca EMC, Vellone V, Salzano G, De Riu G. Validation of the Quality Analysis of Medical Artificial Intelligence (QAMAI) tool: a new tool to assess the quality of health information provided by AI platforms. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08710-0. [PMID: 38703195 DOI: 10.1007/s00405-024-08710-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/27/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The widespread diffusion of Artificial Intelligence (AI) platforms is revolutionizing how health-related information is disseminated, thereby highlighting the need for tools to evaluate the quality of such information. This study aimed to propose and validate the Quality Assessment of Medical Artificial Intelligence (QAMAI), a tool specifically designed to assess the quality of health information provided by AI platforms. METHODS The QAMAI tool has been developed by a panel of experts following guidelines for the development of new questionnaires. A total of 30 responses from ChatGPT4, addressing patient queries, theoretical questions, and clinical head and neck surgery scenarios were assessed by 27 reviewers from 25 academic centers worldwide. Construct validity, internal consistency, inter-rater and test-retest reliability were assessed to validate the tool. RESULTS The validation was conducted on the basis of 792 assessments for the 30 responses given by ChatGPT4. The results of the exploratory factor analysis revealed a unidimensional structure of the QAMAI with a single factor comprising all the items that explained 51.1% of the variance with factor loadings ranging from 0.449 to 0.856. Overall internal consistency was high (Cronbach's alpha = 0.837). The Interclass Correlation Coefficient was 0.983 (95% CI 0.973-0.991; F (29,542) = 68.3; p < 0.001), indicating excellent reliability. Test-retest reliability analysis revealed a moderate-to-strong correlation with a Pearson's coefficient of 0.876 (95% CI 0.859-0.891; p < 0.001). CONCLUSIONS The QAMAI tool demonstrated significant reliability and validity in assessing the quality of health information provided by AI platforms. Such a tool might become particularly important/useful for physicians as patients increasingly seek medical information on AI platforms.
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43/B, 07100, Sassari, Italy.
- PhD School of Biomedical Science, Biomedical Sciences Department, University of Sassari, Sassari, Italy.
| | - Jerome R Lechien
- Department of Laryngology and Bronchoesophagology, EpiCURA Hospital, Mons School of Medicine, UMONS. Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
- Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
| | - Vincenzo Abbate
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Fabiana Allevi
- Maxillofacial Surgery Department, ASSt Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giovanni Audino
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Giada Anna Beltramini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillofacial and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michela Bergonzani
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, USA
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Giovanni Cammaroto
- ENT Department, Morgagni Pierantoni Hospital, AUSL Romagna, Forlì, Italy
| | - Carlos M Chiesa-Estomba
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - Umberto Committeri
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Salvatore Crimi
- Operative Unit of Maxillofacial Surgery, Policlinico San Marco, University of Catania, Catania, Italy
| | - Nicholas R Curran
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Francesco di Bello
- Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Arianna di Stadio
- Otolaryngology Unit, GF Ingrassia Department, University of Catania, Catania, Italy
| | - Andrea Frosolini
- Department of Maxillofacial Surgery, University of Siena, Siena, Italy
| | - Guido Gabriele
- Department of Maxillofacial Surgery, University of Siena, Siena, Italy
| | - Isabelle M Gengler
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Fabio Lonardi
- Department of Maxillofacial Surgery, University of Verona, Verona, Italy
| | - Fabio Maglitto
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Miguel Mayo-Yáñez
- Otorhinolaryngology, Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
| | - Marzia Petrocelli
- Maxillofacial Surgery Operative Unit, Bellaria and Maggiore Hospital, Bologna, Italy
| | - Resi Pucci
- Maxillofacial Surgery Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - Alberto Maria Saibene
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, University of Milan, Milan, Italy
| | - Gianmarco Saponaro
- Maxillo-Facial Surgery Unit, IRCSS "A. Gemelli" Foundation-Catholic University of the Sacred Heart, Rome, Italy
| | - Alessandro Tel
- Clinic of Maxillofacial Surgery, Department of Head and Neck Surgery and Neuroscience, University Hospital of Udine, Udine, Italy
| | - Franco Trabalzini
- Department of Otorhinolaryngology, Head and Neck Surgery, Meyer Children's Hospital, Florence, Italy
| | - Eleonora M C Trecca
- Department of Otorhinolaryngology and Maxillofacial Surgery, IRCCS Hospital Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
| | | | - Giovanni Salzano
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43/B, 07100, Sassari, Italy
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Abdul NS, Shivakumar GC, Sangappa SB, Di Blasio M, Crimi S, Cicciù M, Minervini G. Applications of artificial intelligence in the field of oral and maxillofacial pathology: a systematic review and meta-analysis. BMC Oral Health 2024; 24:122. [PMID: 38263027 PMCID: PMC10804575 DOI: 10.1186/s12903-023-03533-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/11/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Since AI algorithms can analyze patient data, medical records, and imaging results to suggest treatment plans and predict outcomes, they have the potential to support pathologists and clinicians in the diagnosis and treatment of oral and maxillofacial pathologies, just like every other area of life in which it is being used. The goal of the current study was to examine all of the trends being investigated in the area of oral and maxillofacial pathology where AI has been possibly involved in helping practitioners. METHODS We started by defining the important terms in our investigation's subject matter. Following that, relevant databases like PubMed, Scopus, and Web of Science were searched using keywords and synonyms for each concept, such as "machine learning," "diagnosis," "treatment planning," "image analysis," "predictive modelling," and "patient monitoring." For more papers and sources, Google Scholar was also used. RESULTS The majority of the 9 studies that were chosen were on how AI can be utilized to diagnose malignant tumors of the oral cavity. AI was especially helpful in creating prediction models that aided pathologists and clinicians in foreseeing the development of oral and maxillofacial pathology in specific patients. Additionally, predictive models accurately identified patients who have a high risk of developing oral cancer as well as the likelihood of the disease returning after treatment. CONCLUSIONS In the field of oral and maxillofacial pathology, AI has the potential to enhance diagnostic precision, personalize care, and ultimately improve patient outcomes. The development and application of AI in healthcare, however, necessitates careful consideration of ethical, legal, and regulatory challenges. Additionally, because AI is still a relatively new technology, caution must be taken when applying it to this industry.
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Affiliation(s)
- Nishath Sayed Abdul
- Department of OMFS & Diagnostic Sciences, College of Dentistry, Riyadh Elm, University, Riyadh, Saudi Arabia
| | - Ganiga Channaiah Shivakumar
- Department of Oral Medicine and Radiology, People's College of Dental Sciences and Research Centre, People's University, Bhopal, 462037, India.
| | - Sunila Bukanakere Sangappa
- Department of Prosthodontics and Crown & Bridge, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Marco Di Blasio
- Department of Medicine and Surgery, University Center of Dentistry, University of Parma, 43126, Parma, Italy.
| | - Salvatore Crimi
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, CT, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, CT, Italy
| | - Giuseppe Minervini
- Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai, India.
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Minervini G, Franco R, Crimi S, Di Blasio M, D'Amico C, Ronsivalle V, Cervino G, Bianchi A, Cicciù M. Pharmacological therapy in the management of temporomandibular disorders and orofacial pain: a systematic review and meta-analysis. BMC Oral Health 2024; 24:78. [PMID: 38218874 PMCID: PMC10787959 DOI: 10.1186/s12903-023-03524-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/10/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Temporomandibular disorders (TMD) are manifested by soreness in the jaw joint area and jaw muscles, clicks or creaks when opening or closing the mouth. All these symptoms can be disabling and occur during chewing and when the patient yawns or speaks. Several classes of drugs are used to treat symptoms. This review aims to assess which drug suits the different signs. METHODS Pubmed, Web of Science and Lilacs were systematically searched until 01/02/2023. Clinical trials were selected that dealt with drugs used in temporomandibular dysfunction RESULTS: Out of 830 papers, eight studies were included. The Meta-Analysis with Continuous Outcomes with Pre-Calculated Effect Sizes resulted in the rejection that there is intergroup variability (p.0.74). CONCLUSIONS Treatment of orofacial pain is still a significant challenge for dentistry. We can conclude that there is no drug of first choice in the treatment of temporomandibular pain. However, the clinician must distinguish the type of pain and the aetioloic cause of the pain so that the patient can be treated and managed pharmacologically.
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Affiliation(s)
- Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Via Luigi De Crecchio 6, 80138, Naples, Italy.
| | - Rocco Franco
- Department of Biomedicine and Prevention, University of University of Rome "Tor Vergata", 00100, Rome, Italy
| | - Salvatore Crimi
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, CT, Italy
| | - Marco Di Blasio
- Department of Medicine and Surgery, University Center of Dentistry, University of Parma, 43126, Parma, Italy.
| | - Cesare D'Amico
- School of Dentistry Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - Vincenzo Ronsivalle
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, CT, Italy
| | - Gabriele Cervino
- School of Dentistry Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - Alberto Bianchi
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, CT, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, CT, Italy
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Marra PM, Fiorillo L, Cervino G, D'Amico C, Crimi S, Meto A, Minervini G, Cicciù M. Dental problems in children with autism: a 5-year study. J Clin Pediatr Dent 2024; 48:26-31. [PMID: 38239153 DOI: 10.22514/jocpd.2024.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/06/2023] [Indexed: 01/23/2024] Open
Abstract
Caries experience of children and complex clinical circumstances are an actual challenge for any healthcare professional. To investigate the early childhood caries (ECC) in autistic and non autistic children (≤4 years of age) evaluating the amount of dental damage and the treatments carried out in both groups. Data regarding the oral health status of 40 patients (≤4 years of age) were assembled. The sample group was constituted of 20 autistic children (12 males with a mean age of 2.5 years and 8 females with a mean age of 3.2 years) whereas 20 patients without the autistic spectrum represented the control group (11 males with a mean age of 3 and 9 females with a mean age of 3.3 years). There were no significant differences between the two groups as regards both the extent of dental damage and the treatments carried out. About the frequency, in the autistic group, the most frequent caries were the white spots and enamel proximal lesions (2.2%), followed by only white spots (1.2%) and brown-black cavities and root stumps (0.6%). In the control group, the brown-black cavities and root stumps represented the most frequent findings (2.2%), followed by white spots and enamel proximal lesions (1.4%) and white spots (0.4%). Regarding the treatments, the most repeated management of dental damage among autistic patients was composite restorations (2.2%) while in nonautistic patients were tooth extractions (2%).
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Affiliation(s)
- Paola Martina Marra
- Complex Operative Unit of Stomatological surgery in Developmental age, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Dentistry, Messina University, 98100 Messina, Italy
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy
- Department of Prosthodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, 411018 Pune, India
- Department of Dentistry, University of Aldent, 1000 Tirana, Albania
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Dentistry, Messina University, 98100 Messina, Italy
| | - Cesare D'Amico
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Dentistry, Messina University, 98100 Messina, Italy
| | - Salvatore Crimi
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy
| | - Aida Meto
- Department of Dentistry, University of Aldent, 1000 Tirana, Albania
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, 600007 Chennai, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80121 Naples, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy
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Stilo G, Lo Faro C, Pollicina I, Falcone L, Campagna P, Felis S, Crimi S, La Mantia I, Leonardi R, Bianchi A. Mood, Behavioral Impairment, and Sleep Breathing Disorders in Obstructive Sleep Apnea Syndrome Patients Treated with Maxillomandibular Advancement: Reflection on a Case Series and Review of Literature. J Pers Med 2023; 13:1425. [PMID: 37888036 PMCID: PMC10607968 DOI: 10.3390/jpm13101425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/07/2023] [Accepted: 09/13/2023] [Indexed: 10/28/2023] Open
Abstract
The correlation between depressive and cognitive symptoms and OSAS (obstructive sleep apnea syndrome) is between 5 and 63%. We reported the case of two patients with severe OSAS and its associated depressive symptoms that were intolerant to continuous positive airway pressure (C-PAP) and underwent maxillomandibular advancement (MMA) surgery. The severity of cognitive and depressive symptoms was assessed using validated questionnaires (Beck Depression Inventory, Beck Anxiety Inventory, Epworth Sleepiness Scale, and quality of life), medical observation, and patient-reported symptoms. We performed pre- and post-treatment polysomnography. Six months after treatment, the value of the apnea-hypopnea index (AHI) had returned to the normal range and, together with it, the depressive component was considerably reduced and the patients' overall quality of life (BDI, BAI, ESS, and qol) improved. Conclusion: We described significant improvement in all the analyzed parameters, such as physical and mental functioning, and depression and anxiety rates.
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Affiliation(s)
- Giovanna Stilo
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (G.S.); (I.P.); (S.F.); (I.L.M.)
| | - Carmelo Lo Faro
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (G.S.); (I.P.); (S.F.); (I.L.M.)
| | - Isabella Pollicina
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (G.S.); (I.P.); (S.F.); (I.L.M.)
| | - Loredana Falcone
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (L.F.); (P.C.)
| | - Paola Campagna
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (L.F.); (P.C.)
| | - Silvia Felis
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (G.S.); (I.P.); (S.F.); (I.L.M.)
| | - Salvatore Crimi
- Department of General Surgery, Section of Maxillo Facial Surgery of Polyclinic “G. Rodolico-San Marco” University Hospital, University of Catania, 95100 Catania, Italy; (S.C.); (R.L.); (A.B.)
| | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (G.S.); (I.P.); (S.F.); (I.L.M.)
| | - Rosalia Leonardi
- Department of General Surgery, Section of Maxillo Facial Surgery of Polyclinic “G. Rodolico-San Marco” University Hospital, University of Catania, 95100 Catania, Italy; (S.C.); (R.L.); (A.B.)
| | - Alberto Bianchi
- Department of General Surgery, Section of Maxillo Facial Surgery of Polyclinic “G. Rodolico-San Marco” University Hospital, University of Catania, 95100 Catania, Italy; (S.C.); (R.L.); (A.B.)
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Battaglia S, Crimi S, Piombino E, Villari L, Maugeri C, Minervini G, Cicciù M, Bianchi A. Nodal frozen section + elective neck dissection as an alternative to sentinel lymph node biopsy for the management of cT1-2N0 oral squamous cell carcinoma patients: a viability and accuracy study. J Cancer Res Clin Oncol 2023; 149:10465-10471. [PMID: 37278829 PMCID: PMC10423153 DOI: 10.1007/s00432-023-04941-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/24/2023] [Indexed: 06/07/2023]
Abstract
PURPOSE Oral Squamous Cell Carcinoma (OSCC) is characterized by a high aggressiveness and a tendency to metastasize. The management of the neck in cT1-2N0 patients c follows three strategies: watchful waiting, elective neck dissection (END) or sentinel lymph node biopsy (SLNB). The aim was to assess the viability of intraoperative frozen sections of the nodes of cT1-2N0 to spot occult metastases as an alternative to SLNB, performing a modified radical neck dissection (MRND) in intraoperatively positive patients. METHODS The patients were treated at the Maxillo-Facial Surgery Unit of Policlinico San Marco of Catania between 2020 and 2022. END was performed in all patients, including frozen section examination of at least one clinically suspicious node per level. In case of positivity after frozen section examination, neck dissection was extended to levels IV and V. RESULTS All frozen sections were compared with a definitive test after paraffin inclusion. During surgery, 70 END were performed, and 210 nodes were analyzed with frozen sections. Among the 70 END, 52 were negative after frozen Sects. (156 negative nodes), and surgery was ended. Five of the 52 negative ENDs resulted in pN + after paraffin inclusion (9.6%), which underwent postoperative adjuvant treatment. The sensibility of our END + frozen section method was 75%, while the specificity of our test was 94%. The negative predictive value was 90,4%. CONCLUSIONS Elective neck dissection + intraoperative frozen section could be an alternative to SLNB to spot occult nodal metastases in cT1-2N0 OSCC due to the opportunity to perform a one-step diagnostic/therapeutic procedure.
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Affiliation(s)
- Salvatore Battaglia
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, CT Italy
| | - Salvatore Crimi
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, CT Italy
| | - Eliana Piombino
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, CT Italy
- Pathology Unit San Marco Hospital, San Marco Hospital, Catania, Italy
| | - Loredana Villari
- Pathology Unit San Marco Hospital, San Marco Hospital, Catania, Italy
| | - Claudia Maugeri
- Division of Maxillofacial Surgery Surgical Science dpt., Città Della Salute e Delle Scienze Hospital, University of Turin, Turin, Italy
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, CT Italy
| | - Alberto Bianchi
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, CT Italy
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Minervini G, Franco R, Crimi S, Basili M, Chaturvedi S, Cicciù M, Bianchi A, Cervino G. Assessment of fully digitalized workflow for implant-prosthetic rehabilitation in temporomandibular disorders patients: A clinical study. Saudi Dent J 2023; 35:684-691. [PMID: 37817790 PMCID: PMC10562120 DOI: 10.1016/j.sdentj.2023.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/21/2023] [Accepted: 05/24/2023] [Indexed: 10/12/2023] Open
Abstract
Digitalized workflow eliminates the need for the tray, impression materials, its decontamination, packaging and shipping, pouring with plaster, cast fabrication, mounting in an articulator, reducing storage spaces, and the risks of any loss or fracture of the plaster model is overcome by archiving on the computer. This clinical investigation aimed to evaluate the effectiveness of the fully digitalized rehabilitation [implant-supported prosthesis] method in partially edentulous patients and with TMD, using advanced software. Twelve patients requiring implant-supported prosthesis in the mandibular molar area with Temporomandibular disorders [TMD] were selected. The fully digitalized rehabilitation method with advanced software was used for rehabilitation. For each subject, Optical impressions, CBCT scan, and Digital recording of jaw movement data. Guided implant surgery and digitalized prosthetic rehabilitation; were performed. The effectiveness of the digitalized workflow was assessed by evaluating the changes in the joint symptoms before and after the end of the treatment, changes in the electromyographic tracings, the precision of the prosthetic artefact, assessed through the amount of chair adjustment operating time and the number of retouching/ modifications to be carried out before the completion of the work. The results showed that the mean operative time required in 12 patients was 9.42 min, significantly less than the time recorded in previous studies when the medium mean was 16.00 min. The mean number of touch-ups [adjustments] was less than 3, most of which were on the interproximal surfaces. There were no significant changes recorded in the electromyography tracings. There were also no changes in joint symptoms. It was found that this way of working was entirely reliable and significantly reduced operating times and the number of appointments. Digital flow is beneficial ei dysfunctional patients, not about improvements in temporomandibular symptoms but in times of operability and prosthetic retouching.
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Affiliation(s)
- Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Rocco Franco
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome 00100, Italy
| | - Salvatore Crimi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Manuele Basili
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome 00100, Italy
| | - Saurabh Chaturvedi
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Gabriele Cervino
- School of Dentistry Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, 1, 98125 Messina, Italy
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Vaira LA, Lechien JR, Abbate V, Allevi F, Audino G, Beltramini GA, Bergonzani M, Bolzoni A, Committeri U, Crimi S, Gabriele G, Lonardi F, Maglitto F, Petrocelli M, Pucci R, Saponaro G, Tel A, Vellone V, Chiesa-Estomba CM, Boscolo-Rizzo P, Salzano G, De Riu G. Accuracy of ChatGPT-Generated Information on Head and Neck and Oromaxillofacial Surgery: A Multicenter Collaborative Analysis. Otolaryngol Head Neck Surg 2023. [PMID: 37595113 DOI: 10.1002/ohn.489] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/16/2023] [Accepted: 07/14/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To investigate the accuracy of Chat-Based Generative Pre-trained Transformer (ChatGPT) in answering questions and solving clinical scenarios of head and neck surgery. STUDY DESIGN Observational and valuative study. SETTING Eighteen surgeons from 14 Italian head and neck surgery units. METHODS A total of 144 clinical questions encompassing different subspecialities of head and neck surgery and 15 comprehensive clinical scenarios were developed. Questions and scenarios were inputted into ChatGPT4, and the resulting answers were evaluated by the researchers using accuracy (range 1-6), completeness (range 1-3), and references' quality Likert scales. RESULTS The overall median score of open-ended questions was 6 (interquartile range[IQR]: 5-6) for accuracy and 3 (IQR: 2-3) for completeness. Overall, the reviewers rated the answer as entirely or nearly entirely correct in 87.2% of cases and as comprehensive and covering all aspects of the question in 73% of cases. The artificial intelligence (AI) model achieved a correct response in 84.7% of the closed-ended questions (11 wrong answers). As for the clinical scenarios, ChatGPT provided a fully or nearly fully correct diagnosis in 81.7% of cases. The proposed diagnostic or therapeutic procedure was judged to be complete in 56.7% of cases. The overall quality of the bibliographic references was poor, and sources were nonexistent in 46.4% of the cases. CONCLUSION The results generally demonstrate a good level of accuracy in the AI's answers. The AI's ability to resolve complex clinical scenarios is promising, but it still falls short of being considered a reliable support for the decision-making process of specialists in head-neck surgery.
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- Biomedical Sciences Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - Jerome R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS, Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
- Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
| | - Vincenzo Abbate
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Fabiana Allevi
- Maxillofacial Surgery Department, ASSt Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giovanni Audino
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Giada Anna Beltramini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillofacial and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michela Bergonzani
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Alessandro Bolzoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Umberto Committeri
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Salvatore Crimi
- Operative Unit of Maxillofacial Surgery, Policlinico San Marco, University of Catania, Catania, Italy
| | - Guido Gabriele
- Department of Maxillofacial Surgery, University of Siena, Siena, Italy
| | - Fabio Lonardi
- Department of Maxillofacial Surgery, University of Verona, Verona, Italy
| | - Fabio Maglitto
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Marzia Petrocelli
- Maxillofacial Surgery Operative Unit, Bellaria and Maggiore Hospital, Bologna, Italy
| | - Resi Pucci
- Maxillofacial Surgery Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - Gianmarco Saponaro
- Maxillo-Facial Surgery Unit, IRCSS "A. Gemelli" Foundation-Catholic, University of the Sacred Heart, Rome, Italy
| | - Alessandro Tel
- Department of Head and Neck Surgery and Neuroscience, Clinic of Maxillofacial Surgery, University Hospital of Udine, Udine, Italy
| | | | | | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Giovanni Salzano
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
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Crimi S, Battaglia S, Maugeri C, Mirabella S, Fiorillo L, Cervino G, Bianchi A. Does Age Affect the Rate of Spinal Nerve Injury after Selective Neck Dissection? Age as a Prognostic Factor of Spinal Nerve Injury after Selective Neck Dissection. J Pers Med 2023; 13:1082. [PMID: 37511696 PMCID: PMC10381417 DOI: 10.3390/jpm13071082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE The objective of this study is to investigate whether age is a significant risk factor for spinal nerve injury following selective neck dissection (SND) in patients with head and neck cancer. METHODS A retrospective cohort study was conducted on patients who had undergone SND for head and neck cancer at a tertiary hospital between 2020 and 2022. The primary outcome was the incidence of spinal nerve injury after SND. The secondary outcomes included the types and severity of spinal nerve injury and the impact of age on these outcomes. RESULTS A total of 78 patients were included in the study and subdivided into two groups. Two shoulder-specific questionnaires (the Shoulder Pain and Disability Index (SPADI) and the Shoulder Disability Questionnaire (SDQ)) were administered to assess shoulder morbidity postoperatively. Twelve patients showed shoulder impairment following surgery. We divided the sample into two age-based groups; the older group showed a higher rate of SAN injury and the younger group showed a lower rate of improvement over time. CONCLUSION This study suggests that age is a significant risk factor for spinal nerve injury following SND in patients with head and neck cancer. Older patients are more likely to experience spinal nerve injury after SND than younger patients. The findings of this study may help in the development of strategies to prevent spinal nerve injury in older patients undergoing SND for head and neck cancer.
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Affiliation(s)
- Salvatore Crimi
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy
| | - Salvatore Battaglia
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy
| | - Claudia Maugeri
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e Delle Scienze Hospital, University of Turin, 10024 Turin, Italy
| | - Sergio Mirabella
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri 411018, India
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy
| | - Alberto Bianchi
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy
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Bianchi A, Seidita F, Giudice R, Pironi M, Battaglia S, Crimi S, Marchetti C. Hybrid mandibular Bologna midline distractor in combination with surgically assisted rapid maxillary expansion for transverse facial expansion: clinical and cephalometric results. Int J Oral Maxillofac Surg 2023; 52:686-690. [PMID: 36220684 DOI: 10.1016/j.ijom.2022.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 05/02/2023]
Abstract
Transverse maxillomandibular hypoplasia can be treated with surgically assisted rapid maxillary expansion (SARME) in association with mandibular symphyseal distraction (MSD). This paper introduces a hybrid mandibular Bologna midline distractor (BMD); the effectiveness of the distractor in combination with SARME for the treatment of transverse skeletal deficiency was evaluated. This two-centre study included 10 patients with a transverse arch width deficit>7 mm and dental crowding, in both the maxilla and mandible, treated with SARME and MSD. The study design was partly retrospective (seven patients) and partly prospective (three patients). Frontal and lateral cephalometric analyses, as well as measurements on dental models, were performed at three different times: before treatment, after the distraction, and 6 months after postoperative orthodontic treatment. The cephalometric analyses and measurements on dental impressions confirmed a balanced and stable skeletal and dental mandibular expansion. An average symphyseal expansion of 7.8 mm was obtained, resolving dental crowding without dental extractions. In conclusion, mandibular expansion performed with the BMD in combination with SARME appears to be a viable surgical approach to transverse maxillomandibular hypoplasia. This technique allows the surgeon to obtain a balanced skeletal and dental expansion, with a low level of relapse.
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Affiliation(s)
- A Bianchi
- Maxillofacial Surgery Unit, Policlinico-San Marco University Hospital, Catania, Italy
| | - F Seidita
- Maxillofacial Surgery Unit, Policlinico-San Marco University Hospital, Catania, Italy.
| | - R Giudice
- Orthodontist in Private Practice, Catania, Italy
| | - M Pironi
- Orthodontist in Private Practice, Bologna, Italy
| | - S Battaglia
- Maxillofacial Surgery Unit, Policlinico-San Marco University Hospital, Catania, Italy
| | - S Crimi
- Maxillofacial Surgery Unit, Policlinico-San Marco University Hospital, Catania, Italy
| | - C Marchetti
- Maxillofacial Surgery Unit, Sant'Orsola University Hospital, Bologna, Italy
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11
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Bianchi A, Seidita F, Badiali G, Lusetti L, Saporosi C, Pironi M, Marchetti C, Crimi S. Is Beauty a Matter of Volume Distribution? Proposal of a New Aesthetic Three-Dimensional Guide in Orthognathic Surgery. J Pers Med 2023; 13:936. [PMID: 37373925 PMCID: PMC10301536 DOI: 10.3390/jpm13060936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/17/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Orthognathic surgery is a multidisciplinary surgery in which the aesthetic results have become increasingly important, and consequently, also the predictability of the surgical outcomes. In this paper, we analyzed the volumetric distribution of the lower two-thirds of the face, in patients operated by orthognathic surgery and selected for their attractiveness. Our goal was to analyze the aesthetic volumetric distribution for gender and to propose our operating philosophy, that a normative distribution of facial volumes could be used like a new 3D aesthetic guide in orthognathic planning. METHODS A group of 46 orthognathic patients (26 females, 20 males) with the best postoperative aesthetic score was selected by a jury of plastic surgeons, orthodontists, and journalists. The mean soft tissue volumes of the malar, maxillary, mandibular, and chin regions were analyzed. RESULTS Overall, we measured a mean female facial volume distribution of 38.7%, 29%, 27.6%, and 4.7%, respectively, in the malar, maxillary, mandibular, and chin regions, while in males, it was 37%, 26%, 30%, and 6%, respectively. CONCLUSIONS In this paper, the expansion of facial volumes in orthognathic surgery is proposed as a key point for facial harmonization. Beauty could be scientifically interpreted as a balanced distribution of facial volumes, and the virtual study of this distribution can become an important part of the preoperative analysis, such as a "volumetric" 3D cephalometry, where the surgeon could use average values of aesthetic volumetric distribution as preoperative surgical references.
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Affiliation(s)
- Alberto Bianchi
- Maxillofacial Surgery Unit, “Policlinico-San Marco” University Hospital, Viale Azeglio Ciampi, 95121 Catania, Italy; (A.B.); (S.C.)
| | - Francesco Seidita
- Maxillofacial Surgery Unit, “Policlinico-San Marco” University Hospital, Viale Azeglio Ciampi, 95121 Catania, Italy; (A.B.); (S.C.)
| | - Giovanni Badiali
- Maxillofacial Surgery Unit, “Sant’Orsola” University Hospital, Via Giuseppe Massarenti 9, 40138 Bologna, Italy; (G.B.); (C.M.)
| | - Laura Lusetti
- Plastic Surgery Unit, “Policlinico di Modena” Hospital, Via del Pozzo 71, 41100 Modena, Italy
| | | | | | - Claudio Marchetti
- Maxillofacial Surgery Unit, “Sant’Orsola” University Hospital, Via Giuseppe Massarenti 9, 40138 Bologna, Italy; (G.B.); (C.M.)
| | - Salvatore Crimi
- Maxillofacial Surgery Unit, “Policlinico-San Marco” University Hospital, Viale Azeglio Ciampi, 95121 Catania, Italy; (A.B.); (S.C.)
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Massarelli O, Vaira LA, Crimi S, Salzano G, Latini L, Bianchi A, Gennaro P, De Riu G. Tongue Reconstruction with Buccinator Myomucosal Island Flaps: Technical Considerations, Oncologic Safety, Functional Outcomes and QoL Assessment-A Retrospective Observational Study. J Pers Med 2023; 13:879. [PMID: 37373868 DOI: 10.3390/jpm13060879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/17/2023] [Accepted: 05/21/2023] [Indexed: 06/29/2023] Open
Abstract
The objective of this study was to investigate the effectiveness of buccinator myomucosal island flaps for tongue reconstruction following malignant tumor resections. A retrospective study was performed on 52 patients who underwent tongue reconstructions with buccinator myomucosal island flaps between 2012 and 2020. We reviewed the flap type and size, harvesting time, recipient- and donor-site complications, postoperative oncologic outcomes, functional recovery and QoL assessment. All of the flaps were transposed successfully without any total flap loss. Neither in the primary site nor in the neck were cancer relapses observed. An evaluation of the sensitivity revealed that 96.1% of patients experienced a recovery of touch, two-point and pain sensations. There were significant differences between the flap and the native mucosa in terms of the tactile (p < 0.001), pain (p < 0.001) and two-point (p < 0.001) thresholds. The average swallowing score recorded was 6.1 out of 7, with only minor complaints. The quality of life assessments demonstrated high scores across physical (24.5 out of 28), social (25.8 out of 28), emotional (20.3 out of 24) and functional (25 out of 28) aspects. The present study showed how buccinator myomucosal island flaps represent an effective and functional tongue reconstructive option, requiring a short operative time with a low rate of donor site morbidity, and with evidence of long-term oncologic safety and high quality of life.
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Affiliation(s)
- Olindo Massarelli
- Maxillofacial Surgery Operative Unit, Department of Mental Health and Sense Organs, Santa Maria Le Scotte, University Hospital of Siena, 53100 Siena, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
| | - Salvatore Crimi
- Maxillofacial Surgery Unit, University Hospital "Policlinico San Marco" of Catania, 95124 Catania, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples "Federico II", 80131 Naples, Italy
| | - Linda Latini
- Maxillofacial Surgery Operative Unit, Department of Mental Health and Sense Organs, Santa Maria Le Scotte, University Hospital of Siena, 53100 Siena, Italy
| | - Alberto Bianchi
- Maxillofacial Surgery Unit, University Hospital "Policlinico San Marco" of Catania, 95124 Catania, Italy
| | - Paolo Gennaro
- Maxillofacial Surgery Operative Unit, Department of Mental Health and Sense Organs, Santa Maria Le Scotte, University Hospital of Siena, 53100 Siena, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
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Minervini G, Franco R, Marrapodi MM, Crimi S, Badnjević A, Cervino G, Bianchi A, Cicciù M. Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis. J Clin Med 2023; 12:jcm12072652. [PMID: 37048735 PMCID: PMC10095000 DOI: 10.3390/jcm12072652] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Background: Temporomandibular disorders (TMDs) are a series of disorders that affect the muscles and joint. Symptoms include joint pain, muscle pain, and limitation of mouth opening. One of several multifactorial diseases, temporomandibular dysfunction has mostly been linked to five etiological factors: occlusion, trauma, severe pain stimuli, parafunctional activities, and psychological elements, including stress, anxiety, and depression. The position of the human body as it is displayed in space is referred to as posture. Several nerve pathways regulate posture, and through ligaments, TMD and posture affect each other. The purpose of this study is to evaluate the possible correlation between posture and TMD through a meta-analysis of the literature; Methods: A literature search was performed on PubMed, Lilacs, and Web of science, and articles published from 2000 to 31 December 2022 were considered, according to the keywords entered. The term “temporomandibular disorders” has been combined with “posture”, using the Boolean connector AND; Results: At the end of the research, 896 studies were identified from the search conducted on the 3 engines. Only three were chosen to draw up the present systematic study summarizing the article’s main findings. The meta-analysis showed through forest plot analysis a correlation between posture and TMD Conclusions: This literature meta-analysis showed a correlation between posture and TMD. Nerve pathways probably regulate both body posture and mandibular posture. Further clinical studies will be needed to confirm this hypothesis and to indicate the main conclusions or interpretations.
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Affiliation(s)
- Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
| | - Rocco Franco
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00100 Rome, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
| | - Salvatore Crimi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Almir Badnjević
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, 71000 Sarajevo, Bosnia and Herzegovina
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Dentistry, University of Messina, Via Consolare Valeria, 1, 98125 Messina, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
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Certo F, Altieri R, Crimi S, Gurrera G, Cammarata G, Visocchi M, Bianchi A, Barbagallo GMV. Image-Guided Surgery in Complex Skull Base and Facial Fractures: Initial Experience on the Role of Intra-Operative Computer Tomography. Acta Neurochir Suppl 2023; 135:61-67. [PMID: 38153450 DOI: 10.1007/978-3-031-36084-8_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Surgery of fractures involving the skull base and the facial skeleton often presents challenges that should be addressed to prevent secondary brain injuries (i.e., cerebro-spinal fluid leak), preserve visual functioning, and guarantee a good esthetic result. Complex craniofacial reconstruction can be aided by navigation and pre-operative planning. In recent years, computerized planning of surgical reconstruction drastically increased the safety and efficacy of surgery, but the impact of intraoperative high quality image devices such as an intraoperative computed tomography (CT) scan has not been investigated yet. This case-control study reports the institutional preliminary experience of using intraoperative CT scans in the surgical management of complex cranio-facial fractures. The results in terms of accuracy of bony reconstruction and neurological or surgical complications have been analyzed in 12 consecutive patients treated with (6 cases) or without (6 cases) i-CT. Comparative analysis demonstrated a greater accuracy of reconstruction in patients treated with the assistance of i-CT. Intraoperative CT is a useful tool with a promising role in a multidisciplinary surgical approach to complex cranio-facial surgery.
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Affiliation(s)
- Francesco Certo
- Department of Medical and Surgical Sciences and Advanced Technologies (G.F. Ingrassia), Neurological Surgery, Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
- Department of Neurological Surgery, Policlinico "G. Rodolico" University Hospital, Catania, Italy
| | - Roberto Altieri
- Department of Medical and Surgical Sciences and Advanced Technologies (G.F. Ingrassia), Neurological Surgery, Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
| | - Salvatore Crimi
- Department of General Surgery, Section of Maxillo Facial Surgery Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
| | - Giorgio Gurrera
- Department of General Surgery, Section of Maxillo Facial Surgery Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
| | - Giacomo Cammarata
- Department of Medical and Surgical Sciences and Advanced Technologies (G.F. Ingrassia), Neurological Surgery, Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
| | | | - Alberto Bianchi
- Department of General Surgery, Section of Maxillo Facial Surgery Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
| | - Giuseppe M V Barbagallo
- Department of Medical and Surgical Sciences and Advanced Technologies (G.F. Ingrassia), Neurological Surgery, Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
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Cammarata G, Altieri R, Certo F, Petrella L, Basile A, Pizzo A, Crimi S, Battaglia S, Bianchi A, Barbagallo G. Post-traumatic intra-orbital meningoencephalocele in adults: technical note on a rare entity and review of the literature. Neurosurg Rev 2022; 46:6. [PMID: 36471011 DOI: 10.1007/s10143-022-01906-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Post-traumatic orbital meningoencephaloceles related to orbital roof fractures are a challenging clinical entity because of their rarity and difficult differential diagnosis. We report a case of post-traumatic intra-orbital meningoencephalocele in a 69-year-old man, secondary to a likely trapdoor mechanism, treated with a modified one-piece orbitozygomatic craniotomy. We also performed an extensive literature review of traumatic Intra-Orbital Encephalocele related to Orbital Roof Fracture focused on adult patients on electronic databases including Scopus, MEDLINE/PubMed, and Google Scholar. Patient well recovered after surgery with immediate exophthalmos resolution and discharged without visual or neurological deficits. The literature review included 22 papers with a total of 28 patients: 22 males (78.6%) and 6 females (21.4%), with a median age of 34.7 years. Twenty-six patients (92.9%) reported ocular injuries, with associated intracranial complications in 16 cases (61.5%). Twenty-seven patients (96.4%) were surgically treated, 18 of those underwent unilateral or bilateral frontal approach. Most orbital roof fractures can be managed nanoperatively if asymptomatic. Indeed, when the intra-orbital volume decreases, for example due to an encephalocele, the intra-orbital pressure could increase and determine an orbital compartment syndrome. In our case, we performed a one-piece modified orbitozygomatic approach, which has several advantages in comparison to the frequent unilateral or bilateral frontal craniotomy like the better exposure of the brain and orbit and a minimum brain retraction.
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Affiliation(s)
- Giacomo Cammarata
- Department of Neurological Surgery, Polyclinic "G. Rodolico-S. Marco" University Hospital, Viale Carlo Azeglio Ciampi 1, 95121, Catania, Italy.
| | - Roberto Altieri
- Department of Neurological Surgery, Polyclinic "G. Rodolico-S. Marco" University Hospital, Viale Carlo Azeglio Ciampi 1, 95121, Catania, Italy
- Interdisciplinary Research Center On Brain Tumors Diagnosis and Treatment, University of Catania, Catania, Italy
- PhD Program at Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Francesco Certo
- Department of Neurological Surgery, Polyclinic "G. Rodolico-S. Marco" University Hospital, Viale Carlo Azeglio Ciampi 1, 95121, Catania, Italy
- Interdisciplinary Research Center On Brain Tumors Diagnosis and Treatment, University of Catania, Catania, Italy
| | - Luca Petrella
- Department of Neurological Surgery, Polyclinic "G. Rodolico-S. Marco" University Hospital, Viale Carlo Azeglio Ciampi 1, 95121, Catania, Italy
| | - Angelo Basile
- Department of Neurological Surgery, Polyclinic "G. Rodolico-S. Marco" University Hospital, Viale Carlo Azeglio Ciampi 1, 95121, Catania, Italy
| | - Aurora Pizzo
- Department of Neurological Surgery, Polyclinic "G. Rodolico-S. Marco" University Hospital, Viale Carlo Azeglio Ciampi 1, 95121, Catania, Italy
| | - Salvatore Crimi
- Department of General Surgery, Section of Maxillo Facial Surgery of Polyclinic "G. Rodolico - San Marco" University Hospital, University of Catania, Catania, Italy
| | - Salvatore Battaglia
- Department of General Surgery, Section of Maxillo Facial Surgery of Polyclinic "G. Rodolico - San Marco" University Hospital, University of Catania, Catania, Italy
| | - Alberto Bianchi
- Department of General Surgery, Section of Maxillo Facial Surgery of Polyclinic "G. Rodolico - San Marco" University Hospital, University of Catania, Catania, Italy
| | - Giuseppe Barbagallo
- Department of Neurological Surgery, Polyclinic "G. Rodolico-S. Marco" University Hospital, Viale Carlo Azeglio Ciampi 1, 95121, Catania, Italy
- Interdisciplinary Research Center On Brain Tumors Diagnosis and Treatment, University of Catania, Catania, Italy
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Gissi DB, Morandi L, Colella G, De Luca R, Campisi G, Mauceri R, Romeo U, Tenore G, Mignogna MD, Adamo D, Oteri G, Marcianò A, Vescovi P, Meleti M, Serpico R, Di Stasio D, Pentenero M, Santarelli A, Bianchi A, Crimi S, Marchetti C, Tarsitano A, Foschini MP, Montebugnoli L. Clinical validation of 13-gene DNA methylation analysis in oral brushing samples for detection of oral carcinoma: Italian multicenter study. Head Neck 2021; 43:1563-1573. [PMID: 33511711 DOI: 10.1002/hed.26624] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/27/2020] [Accepted: 01/15/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The aim of this Italian multicenter study was to evaluate the diagnostic performance of a minimally invasive method for the detection of oral squamous cell carcinoma (OSCC) based on 13-gene DNA methylation analysis in oral brushing samples. METHODS Oral brushing specimens were collected in 11 oral medicine centers across Italy. Twenty brushing specimens were collected by each center, 10 from patients with OSCC, and 10 from healthy volunteers. DNA methylation analysis was performed in blindness, and each sample was determined as positive or negative based on a predefined cutoff value. RESULTS DNA amplification failed in 4 of 220 (1.8%) samples. Of the specimens derived from patients with OSCC, 93.6% (103/110) were detected as positive, and 84.9% (90/106) of the samples from healthy volunteers were negative. CONCLUSION These data confirmed the diagnostic performance of our novel procedure in a large cohort of brushing specimens collected from 11 different centers and analyzed in blindness.
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Affiliation(s)
- Davide B Gissi
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Luca Morandi
- Functional MR Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania "L. Vanvitelli", Naples, Italy
| | - Roberto De Luca
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological, and oral Sciences, Sector of Oral Medicine "Valerio Margiotta", University of Palermo, Palermo, Italy
| | - Rodolfo Mauceri
- Department of Surgical, Oncological, and oral Sciences, Sector of Oral Medicine "Valerio Margiotta", University of Palermo, Palermo, Italy
| | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Gianluca Tenore
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Michele D Mignogna
- Oral Medicine Complex Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences - Head & Neck Clinical Section, "Federico II" University of Naples, Naples, Italy
| | - Daniela Adamo
- Oral Medicine Complex Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences - Head & Neck Clinical Section, "Federico II" University of Naples, Naples, Italy
| | - Giacomo Oteri
- Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Antonia Marcianò
- Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Paolo Vescovi
- Oral Medicine and Laser Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marco Meleti
- Oral Medicine and Laser Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania "L. Vanvitelli", Naples, Italy
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania "L. Vanvitelli", Naples, Italy
| | - Monica Pentenero
- Oral Medicine and Oral Oncology Unit, Department of Oncology, University of Turin, Turin, Italy
| | - Andrea Santarelli
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy
| | - Alberto Bianchi
- Section of Maxillo-Facial Surgery, Department of General Surgery, Policlinico - San Marco, University of Catania, Catania, Italy
| | - Salvatore Crimi
- Section of Maxillo-Facial Surgery, Department of General Surgery, Policlinico - San Marco, University of Catania, Catania, Italy
| | - Claudio Marchetti
- Section of Maxillo-Facial Surgery at Policlinico S. Orsola-Malpighi, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Achille Tarsitano
- Section of Maxillo-Facial Surgery at Policlinico S. Orsola-Malpighi, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maria Pia Foschini
- Section of Anatomic Pathology at Bellaria Hospital, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Lucio Montebugnoli
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
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Piombino P, Troise S, Vargas M, Marra A, Buonanno P, Fusetti S, Apolloni F, Crimi S, Bianchi A, Mariniello D, Califano L. A systematic review of the literature on the role of tracheostomy in COVID-19 patients. Eur Rev Med Pharmacol Sci 2021; 24:12558-12574. [PMID: 33336776 DOI: 10.26355/eurrev_202012_24053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) is a viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which emerged in East Asia and spread around the world from December 2019. The most severe stage of COVID-19 pathology is characterized by respiratory distress requiring intubation. In specific cases, tracheostomy is indicated to ensure the safety of the procedure. The aim of our study was to analyze the scientific literature identifying the indications for tracheostomy and safety precautions to reduce contamination. We analyzed the literature from February 2003 to April 2020, including papers on pandemics of other coronaviruses, such As Severe Acute Respiratory Syndrome Coronavirus 1 and Middle East Respiratory Syndrome Coronavirus, to obtain a variety of relevant information. We focused on indications for tracheostomy in patients affected by COVID-19 or related viruses and the measures adopted to perform a safe procedure. We included 35 papers, of which 24 (68.57%) discussed guidelines for tracheostomy indications. All 35 studies discussed the procedures for performing tracheostomy safely. Data obtained indicated that the authors generally agreed on safety measures but expressed different opinions about indications. Therefore, we provided guidelines addressing safety recommendations. After the pandemic has been resolved, we plan to conduct an international retrospective study to identify the criteria for tracheostomy indications.
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Affiliation(s)
- P Piombino
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Research Unit, University "Federico II" of Naples, Naples, Italy.
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Crimi S, Falzone L, Gattuso G, Grillo CM, Candido S, Bianchi A, Libra M. Droplet Digital PCR Analysis of Liquid Biopsy Samples Unveils the Diagnostic Role of hsa-miR-133a-3p and hsa-miR-375-3p in Oral Cancer. Biology (Basel) 2020; 9:biology9110379. [PMID: 33172167 PMCID: PMC7694750 DOI: 10.3390/biology9110379] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/29/2020] [Accepted: 11/04/2020] [Indexed: 12/13/2022]
Abstract
Simple Summary Despite the availability of screening programs, oral cancer is often diagnosed due to the lack of effective biomarkers. Therefore, the identification of new effective diagnostic and late prognostic biomarkers is of fundamental importance for the management of this tumor type. In our previous computational study, we have identified a set of microRNAs (miRNAs) significantly dysregulated in oral cancer and with a potential diagnostic and prognostic significance for oral cancer patients. Starting from our preliminary bioinformatics results, the aim of the present study was to validate the diagnostic potential of four selected miRNAs, hsa-miR-133a-3p, hsa-miR-375-3p, hsa-miR-503-5p and hsa-miR-196a-5p, in liquid biopsy samples obtained from oral cancer patients and healthy donors. For this purpose, the expression levels of the selected miRNAs were determined in plasma samples by using specific miRNA probes and droplet digital PCR (ddPCR). The ddPCR results showed that the hsa-miR-133a-3p and hsa-miR-375-3p were significantly down-regulated in oral cancer and their evaluation in liquid biopsy samples can predict the risk of oral cancer development with high sensitivity and specificity. Finally, the computational analysis of miRNA expression and clinical-pathological features of patients allowed us to establish the functional role and prognostic significance of the two validated miRNAs. Abstract Despite the availability of screening programs, oral cancer deaths are increasing due to the lack of diagnostic biomarkers leading to late diagnosis and a poor prognosis. Therefore, there is an urgent need to discover novel effective biomarkers for this tumor. On these bases, the aim of this study was to validate the diagnostic potential of microRNAs (miRNAs) through the analysis of liquid biopsy samples obtained from ten oral cancer patients and ten healthy controls. The expression of four selected miRNAs was evaluated by using droplet digital PCR (ddPCR) in a pilot cohort of ten oral cancer patients and ten healthy donors. Bioinformatics analyses were performed to assess the functional role of these miRNAs. The expression levels of the predicted down-regulated hsa-miR-133a-3p and hsa-miR-375-3p were significantly reduced in oral cancer patients compared to normal individuals while no significant results were obtained for the up-regulated hsa-miR-503-5p and hsa-miR-196a-5p. ROC analysis confirmed the high sensitivity and specificity of hsa-miR-375-3p and hsa-miR-133a-3p. Therefore, both miRNAs are significantly down-regulated in cancer patients and can be used as biomarkers for the early diagnosis of oral cancer. The analysis of circulating miRNAs in a larger series of patients is mandatory to confirm the results obtained in this pilot study.
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Affiliation(s)
- Salvatore Crimi
- Department of General Surgery, Section of Maxillo Facial Surgery, Policlinico San Marco, University of Catania, 95123 Catania, Italy; (S.C.); (A.B.)
| | - Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori “Fondazione G. Pascale”, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-095-478-1271
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (S.C.); (M.L.)
| | - Caterina Maria Grillo
- Otolaryngology Unit, Department of Medical Sciences, Surgical and Advanced Technologies, University of Catania, 95123 Catania, Italy;
| | - Saverio Candido
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (S.C.); (M.L.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
| | - Alberto Bianchi
- Department of General Surgery, Section of Maxillo Facial Surgery, Policlinico San Marco, University of Catania, 95123 Catania, Italy; (S.C.); (A.B.)
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (G.G.); (S.C.); (M.L.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
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Cervino G, Cicciù M, De Stefano R, Falcomatà D, Bianchi A, Crimi S, Laino L, Herford AS, Gaeta M, Fiorillo L. Oral health in patients with Marfan syndrome. Arch Oral Biol 2020; 116:104745. [PMID: 32446937 DOI: 10.1016/j.archoralbio.2020.104745] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/03/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The role of this study is to highlight a correlation between patients with Marfan syndrome and oral health status by evaluating and reviewing the relevant scientific literature. The syndrome is characterized by an abnormal production of the fibrillin1 protein. The manifestations of Marfan syndrome affect organs that contain connective tissue such as the skeletal system, the eyes, the heart and the blood vessels, the lungs and the fibrous membranes that cover the brain and the spine. The facial bony and soft structures can therefore be affected, influencing the stage of tooth formation and the structure of the teeth, we also want to analyze in this study, the periodontal complications and the management of the latter, with the use of surgical techniques that include the use of biomaterials. MATERIALS AND METHODS A comprehensive review of the literature was conducted according to PRISMA guidelines. After a careful analysis of the work obtained by two independent academics, there have been 18. All data from the studies were compared and many of these highlighted the presence of abnormalities in the oral district. RESULTS The studies taken into consideration a whole series of oral manifestations related to the Marfan syndrome. Oral mucosa, periodontal, dental abnormalities, bone abnormalities or joint dysfunction are frequently involved in patients affected by this disease. CONCLUSIONS All the research have given positive results in terms of dental or oral anomalies. This information may be essential to limit and intervene early improving the oral health of syndromic patients.
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Affiliation(s)
- Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, ME, Italy
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, ME, Italy
| | - Rosa De Stefano
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, ME, Italy
| | - Domenico Falcomatà
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, ME, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy
| | - Salvatore Crimi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy
| | - Luigi Laino
- Department of Biomedical and Surgical, Biomedical Sciences Naples University, Naples, NA, Italy
| | - Alan Scott Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92354, USA
| | - Michele Gaeta
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, ME, Italy
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, ME, Italy.
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Cicciù M, Fiorillo L, D’Amico C, Gambino D, Amantia EM, Laino L, Crimi S, Campagna P, Bianchi A, Herford AS, Cervino G. 3D Digital Impression Systems Compared with Traditional Techniques in Dentistry: A Recent Data Systematic Review. Materials (Basel) 2020; 13:E1982. [PMID: 32340384 PMCID: PMC7215909 DOI: 10.3390/ma13081982] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 12/13/2022]
Abstract
The advent of new technologies in the field of medicine and dentistry is giving improvements that lead the clinicians to have materials and procedures able to improve patients' quality of life. In dentistry, the last digital techniques offer a fully digital computerized workflow that does not include the standard multiple traditional phases. The purpose of this study is to evaluate all clinical trials and clinical randomized trials related to the digital or dental impression technique in prosthetic dentistry trying to give the readers global information about advantages and disadvantages of each procedure. Data collection was conducted in the main scientific search engines, including articles from the last 10 years, in order to obtain results that do not concern obsolete impression techniques. Elsevier, Pubmed and Embase have been screened as sources for performing the research. The results data demonstrated how the working time appears to be improved with digital workflow, but without a significant result (P = 0.72596). The papers have been selected following the Population Intervention Comparison Outcome (PICO) question, which is related to the progress on dental impression materials and technique. The comparison between dentists or practitioners with respect to classic impression procedures, and students open to new device and digital techniques seem to be the key factor on the final impression technique choice. Surely, digital techniques will end up supplanting the analogical ones altogether, improving the quality of oral rehabilitations, the economics of dental practice and also the perception by our patients.
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Affiliation(s)
- Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (D.G.); (E.M.A.); (G.C.)
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (D.G.); (E.M.A.); (G.C.)
| | - Cesare D’Amico
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (D.G.); (E.M.A.); (G.C.)
| | - Dario Gambino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (D.G.); (E.M.A.); (G.C.)
| | - Emanuele Mario Amantia
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (D.G.); (E.M.A.); (G.C.)
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy;
| | - Salvatore Crimi
- Department of General Surgery and Medical Surgery Specialties, University of Catania, 95100 Catania, Italy; (S.C.); (P.C.); (A.B.)
| | - Paola Campagna
- Department of General Surgery and Medical Surgery Specialties, University of Catania, 95100 Catania, Italy; (S.C.); (P.C.); (A.B.)
| | - Alberto Bianchi
- Department of General Surgery and Medical Surgery Specialties, University of Catania, 95100 Catania, Italy; (S.C.); (P.C.); (A.B.)
| | - Alan Scott Herford
- Department of Oral and Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92354, USA;
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (D.G.); (E.M.A.); (G.C.)
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Cervino G, Fiorillo L, Monte IP, De Stefano R, Laino L, Crimi S, Bianchi A, Herford AS, Biondi A, Cicciù M. Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies. Materials (Basel) 2019; 12:ma12091524. [PMID: 31075947 PMCID: PMC6540095 DOI: 10.3390/ma12091524] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Nowadays, patients involved in antiplatelet therapy required special attention during oral surgery procedures, due to the antiplatelet drugs assumption. The motivations of the assumption may be different and related to the patient's different systemic condition. For this reason, accordingly to the current international guidelines, different protocols can be followed. The aim of this work is to analyze how the dentist's approach to these patients has changed from the past to the present, evaluating the risk exposure for the patients. METHODS This review paper considered different published papers in literature through quoted scientific channels, going in search of "ancient" works in such a way as to highlight the differences in the protocols undertaken. The analyzed manuscripts are in the English language, taking into consideration reviews, case reports, and case series in such a way as to extrapolate a sufficient amount of data and for evaluating the past therapeutic approaches compared to those of today. RESULTS Colleagues in the past preferred to subject patients to substitution therapy with low molecular weight anticoagulants, by suspending antiplatelet agents to treatment patients, often for an arbitrary number of days. The new guidelines clarify everything, without highlighting an increased risk of bleeding during simple oral surgery in patients undergoing antiplatelet therapy. CONCLUSION Either patients take these medications for different reasons, because of cardiovascular pathologies, recent cardiovascular events, or even for simple prevention, although the latest research shows that there is no decrease of cardiovascular accidents in patients who carry out preventive therapy. Surely, it will be at the expense of the doctor to assess the patient's situation and risk according to the guidelines. For simple oral surgery, it is not necessary to stop therapy with antiplatelet agents because the risk of bleeding has not increased, and is localized to a post-extraction alveolus or to an implant preparation, compared to patients who do not carry out this therapy. From an analysis of the results it emerges that the substitutive therapy should no longer be performed and that it is possible to perform oral surgery safely in patients who take antiplatelet drugs, after a thorough medical history. Furthermore, by suspending therapy, we expose our patients to more serious risks, concerning their main pathology, where present.
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Affiliation(s)
- Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina ME, Italy.
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina ME, Italy.
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy.
| | - Ines Paola Monte
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy.
| | - Rosa De Stefano
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina ME, Italy.
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy.
| | - Salvatore Crimi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy.
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy.
| | - Alan Scott Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92354, USA.
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy.
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina ME, Italy.
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Crimi S, Tarsitano A, Esposito F, Bianchi A, Marchetti C, De Ponte F. Clinical applications of a high-definition three-dimensional exoscope in maxillo facial surgery. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bianchi A, Badiali G, Costabile E, Crimi S, Pironi M, Marchetti C. A statistical model for volumetric evaluation of three-dimensional facial changes in orthognathic surgery. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Falzone L, Lupo G, La Rosa GRM, Crimi S, Anfuso CD, Salemi R, Rapisarda E, Libra M, Candido S. Identification of Novel MicroRNAs and Their Diagnostic and Prognostic Significance in Oral Cancer. Cancers (Basel) 2019; 11:cancers11050610. [PMID: 31052345 PMCID: PMC6562527 DOI: 10.3390/cancers11050610] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/28/2019] [Accepted: 04/30/2019] [Indexed: 02/07/2023] Open
Abstract
Background: Oral cancer is one of the most prevalent cancers worldwide. Despite that the oral cavity is easily accessible for clinical examinations, oral cancers are often not promptly diagnosed. Furthermore, to date no effective biomarkers are available for oral cancer. Therefore, there is an urgent need to identify novel biomarkers able to improve both diagnostic and prognostic strategies. In this context, the development of innovative high-throughput technologies for molecular and epigenetics analyses has generated a huge amount of data that may be used for the identification of new cancer biomarkers. Methods: In the present study, GEO DataSets and TCGA miRNA profiling datasets were analyzed in order to identify miRNAs with diagnostic and prognostic significance. Furthermore, several computational approaches were adopted to establish the functional roles of these miRNAs. Results: The analysis of datasets allowed for the identification of 11 miRNAs with a potential diagnostic role for oral cancer. Additionally, eight miRNAs associated with patients' prognosis were also identified; six miRNAs predictive of patients' overall survival (OS) and one, hsa-miR-let.7i-3p, associated with tumor recurrence. Conclusion: The integrated analysis of different miRNA expression datasets allows for the identification of a set of miRNAs that, after validation, may be used for the early detection of oral cancers.
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Affiliation(s)
- Luca Falzone
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
| | - Gabriella Lupo
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy.
| | - Giusy Rita Maria La Rosa
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95125 Catania, Italy.
| | - Salvatore Crimi
- Department of Surgical and Biomedical Sciences, University of Catania, 95123 Catania, Italy.
| | - Carmelina Daniela Anfuso
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy.
| | - Rossella Salemi
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
| | - Ernesto Rapisarda
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95125 Catania, Italy.
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy.
| | - Saverio Candido
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy.
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Fiorillo L, De Stefano R, Cervino G, Crimi S, Bianchi A, Campagna P, Herford AS, Laino L, Cicciù M. Oral and Psychological Alterations in Haemophiliac Patients. Biomedicines 2019; 7:biomedicines7020033. [PMID: 31010003 PMCID: PMC6631232 DOI: 10.3390/biomedicines7020033] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 04/17/2019] [Accepted: 04/19/2019] [Indexed: 02/04/2023] Open
Abstract
Haemophiliacs are hereditary coagulopathies whose basic anomaly consists of the quantitative or qualitative alteration of one or more plasma proteins in the coagulation system. The objective of this review is to analyse all risk factors, predispositions and alterations to the oral-maxillofacial district in patients with haemophilia. The broader assessment also includes the psychological aspects that could affect the treatment and maintenance of oral conditions. The study takes into consideration all the works in the literature in the last 10 years. Works that present oral, dental and psychological changes in haemophilia patients have been combined. A total of 16 studies were analysed carefully evaluating and explaining all the alterations and risk factors that this disease provides. The aim of the review is to report all the anomalies reported in the literature for these patients, and to direct and update the clinician in the treatment of haemophilia patients.
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Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy.
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy.
| | - Rosa De Stefano
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy.
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy.
| | - Salvatore Crimi
- Department of Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy.
| | - Alberto Bianchi
- Department of Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy.
| | - Paola Campagna
- Department of Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy.
| | - Alan Scott Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92354, USA.
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy.
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy.
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Leonardi R, Muraglie S, Crimi S, Pirroni M, Musumeci G, Perrotta R. Morphology of palatally displaced canines and adjacent teeth, a 3-D evaluation from cone-beam computed tomographic images. BMC Oral Health 2018; 18:156. [PMID: 30180892 PMCID: PMC6123994 DOI: 10.1186/s12903-018-0617-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 08/17/2018] [Indexed: 11/22/2022] Open
Abstract
Background The goal of this study was to investigate in patients with unilateral palatally displaced canine (PDC) the morphology of maxillary teeth from cone-beam computed tomography (CBCT) scans both on the PDC side and non-PDC side using a “surface matching” technique. Methods CBCT images from 28 patients (mean age 16.04 ± 1.77 years) with unilateral PDC were selected. Each tooth in this study was segmented and then rendered into a 3D model using Mimics Research software and the root length was measured. Afterwards, 3D deviation analysis between the PDC and non-PDC side was carried out using Geomagic Control X software. Results Statistically significant differences (p ≤ 0.001) were obtained when comparing the root lengths and volumes of lateral incisors from the PDC side, non-PDC side and control group. In accordance with the findings of 3D deviation analysis, statistically significant differences between the patients and control group were obtained for the lateral incisors and canines (p ≤ 0.0001) and greater differences were found for the tooth crowns and root tips. Conclusions Lateral incisors adjacent to PDCs have shorter roots than contra-lateral lateral incisors. Furthermore, there were morphological differences between lateral incisors and canines in subjects with unilateral PDCs.
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Affiliation(s)
- Rosalia Leonardi
- Department of Orthodontics, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy.
| | - Simone Muraglie
- Department of Orthodontics, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
| | - Salvatore Crimi
- Department of Maxillofacial Surgery Policlinico G Martino, University of Messina, Messina, Italy
| | | | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy
| | - Rosario Perrotta
- Department of Plastic Surgery, Director of the Master's Degree in Plastic Surgery, University of Catania, Catania, Italy
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Fiorillo L, Cervino G, Herford AS, Lauritano F, D'Amico C, Lo Giudice R, Laino L, Troiano G, Crimi S, Cicciù M. Interferon Crevicular Fluid Profile and Correlation with Periodontal Disease and Wound Healing: A Systemic Review of Recent Data. Int J Mol Sci 2018; 19:E1908. [PMID: 29966238 PMCID: PMC6073775 DOI: 10.3390/ijms19071908] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 01/26/2023] Open
Abstract
The purpose of the present study was to see if there is a correlation between the effect of interferons in crevicular fluid and periodontitis, evaluating literature. Interferon gamma (IFN-γ) is an immunoregulatory cytokine that, when activated by its receptor, plays an important role in the activation of inflammatory processes, which are the basis of periodontal disease. Stem cells in the periodontal ligament, like stem cells from other tissues, have immunomodulatory capacity and are regulated by some cytokines such as interferon-γ (IFN-γ). The study searched MEDLINE databases from 2008 to 2018. Clinical human in vitro and in vivo studies had reported a correlation between interferon and periodontitis. The initial search obtained 359 citations. After screening and determination of eligibility, nine articles were included in the review. Significant (p < 0.05) increases in IFN-γ gene expression were observed in some studies in the chronic periodontitis group. In some cases it was suggested that molecular mechanisms underlie the possible roles of IFN-γ in the inhibition of osteoclastogenesis. Neopterin belongs to the chemical group known as pteridines. It is synthesised by human macrophages upon stimulation with the interferon-gamma. Neopterin concentrations in body fluids are high in the case of infections, immune diseases or graft rejection. In the chronic periodontitis group, this marker is significantly higher. These studies underlined the clinical evidence between interferons in the crevicular fluid and inflammatory response of periodontitis. However, there is a lack of scientific evidence that could lead the clinician to an interferon-modulated therapy because of periodontitis.
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Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98122 Messina, Italy.
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98122 Messina, Italy.
| | - Alan Scott Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92354, USA.
| | - Floriana Lauritano
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98122 Messina, Italy.
| | - Cesare D'Amico
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98122 Messina, Italy.
| | - Roberto Lo Giudice
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98122 Messina, Italy.
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania, Luigi Vanvitelli, 80121 Naples, Italy.
| | - Giuseppe Troiano
- Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy.
| | - Salvatore Crimi
- Department of Surgical and Biomedical Sciences, Catania University, 95124 Catania, Italy.
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98122 Messina, Italy.
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Runci M, De Ponte FS, Falzea R, Bramanti E, Lauritano F, Cervino G, Famà F, Calvo A, Crimi S, Rapisarda S, Cicciù M. Facial and Orbital Fractures: A Fifteen Years Retrospective Evaluation of North East Sicily Treated Patients. Open Dent J 2017; 11:546-556. [PMID: 29238415 PMCID: PMC5712659 DOI: 10.2174/1874210601711010546] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/22/2017] [Accepted: 10/18/2017] [Indexed: 11/22/2022] Open
Abstract
Background: Orbital fractures are classified as diseases usually related to common midface trauma. It represents the most challenging treatment due to the complex anatomy, physiology, and aesthetic role. A midface trauma involves also the zygomatic complex and the nose, however the orbit fracture seems to be a more frequent disease due to its anatomical features. Objective: The purpose of this work is to retrospectively evaluate and record the frequency of the midfacial traumas and orbital fractures observed in the North Eastern Sicily. The results of the present data may be useful for the clinicians in order to recognize the kind of fracture just from the first general visit having a quick diagnosis and management. Methods: In the years between 2001 and 2016, about 1200 patients with midfacial trauma and about 100 patients involving the orbital floor have been evaluated. All those patients underwent the surgical fracture reduction and a CT scan follow up control at one month, three months, six months and one year. Results: Data showed high percentage of orbital floor, nose and mandibular body and ramus fractures; moreover the most frequent causes of fractures seem to be related to motor vehicle accident, followed by assaults, work and fall. Conclusion: The results have highlighted the changing trends in the causes of facial injuries, particularly the increasing incidence of assaults and the falling incidence of motor vehicle accidents in developed countries. The quick diagnosis and management proved fundamental for the successful treatment. Clinicians should be able to recognize the first symptoms in order to avoid possible complications.
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Affiliation(s)
- Michele Runci
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
| | - Francesco Saverio De Ponte
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
| | - Roberto Falzea
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
| | - Ennio Bramanti
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
| | - Floriana Lauritano
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
| | - Gabriele Cervino
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
| | - Fausto Famà
- Department of Human Pathology, University of Messina, Messina, Italy
| | - Alessandro Calvo
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
| | - Salvatore Crimi
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
| | - Silvia Rapisarda
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
| | - Marco Cicciù
- Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, University of Messina, Messina, Italy
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Conti A, Pontoriero A, Iatì G, Esposito F, Siniscalchi EN, Crimi S, Vinci S, Brogna A, De Ponte F, Germanò A, Pergolizzi S, Tomasello F. Frameless Stereotactic Radiosurgery for Treatment of Multiple Sclerosis-Related Trigeminal Neuralgia. World Neurosurg 2017; 103:702-712. [PMID: 28454993 DOI: 10.1016/j.wneu.2017.04.102] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 04/15/2017] [Accepted: 04/17/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Trigeminal neuralgia (TN) affects 7% of patients with multiple sclerosis (MS). In such patients, TN is difficult to manage either pharmacologically and surgically. Radiosurgical rhizotomy is an effective treatment option. The nonisocentric geometry of radiation beams of CyberKnife introduces new concepts in the treatment of TN. Its efficacy for MS-related TN has not yet been demonstrated. METHODS Twenty-seven patients with refractory TN and MS were treated. A nonisocentric beams distribution was chosen; the maximal target dose was 72.5 Gy. The maximal dose to the brainstem was <12 Gy. Effects on pain, medications, sensory disturbance, rate, and time of pain recurrence were analyzed. RESULTS Median follow-up was 37 (18-72) months. Barrow Neurological Institute pain scale score I-III was achieved in 23/27 patients (85%) within 45 days. Prescription isodose line (80%) accounting for a dose of 58 Gy incorporated an average of 4.85 mm (4-6 mm) of the nerve and mean nerve volume of 26.4 mm3 (range 20-38 mm3). Seven out of 27 patients (26%) had mild, not bothersome, facial numbness (Barrow Neurological Institute numbness score II). The rate of pain control decreased progressively after the first year, and only 44% of patients retained pain control 4 years later. CONCLUSIONS Frameless radiosurgery can be effectively used to perform retrogasserian rhizotomy. Pain relief was satisfactory and, with our dose/volume constraints, no sensory complications were recorded. Nonetheless, long-term pain control was possible in less than half of the patients. This is a limitation that CyberKnife radiosurgery shares with other techniques in MS patients.
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Affiliation(s)
- Alfredo Conti
- Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy.
| | - Antonio Pontoriero
- Unit of Radiation Oncology, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Giuseppe Iatì
- Unit of Radiation Oncology, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Felice Esposito
- Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Enrico Nastro Siniscalchi
- Unit of Maxillo-Facial Surgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Salvatore Crimi
- Unit of Maxillo-Facial Surgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Sergio Vinci
- Unit of Neuroradiology, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Anna Brogna
- Unit of Medical Physics, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Francesco De Ponte
- Unit of Maxillo-Facial Surgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Antonino Germanò
- Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Stefano Pergolizzi
- Unit of Radiation Oncology, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Francesco Tomasello
- Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
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Crimi S, Tarsitano A, Battaglia S, Ciocca L, Scotti R, Nastro E, De Ponte F, Marchetti C. Viability of computer-aided design/computer-aided manufacturing surgery in mandibular reconstruction. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Esposito F, Cappabianca P, Angileri FF, Cavallo LM, Priola SM, Crimi S, Solari D, Germanò AF, Tomasello F. Gelatin-thrombin hemostatic matrix in neurosurgical procedures: hemostatic effectiveness and economic value of clinical and surgical procedure-related benefits. J Neurosurg Sci 2016; 64:158-164. [PMID: 27456032 DOI: 10.23736/s0390-5616.16.03771-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Gelatin-thrombin hemostatic matrix (FloSeal®) use is associated with shorter surgical times and less blood loss, parameters that are highly valued in neurosurgical procedures. We aimed to assess the effectiveness of gelatin-thrombin in neurosurgical procedures and estimate its economic value. METHODS In a 6-month retrospective evaluation at 2 hospitals, intraoperative and postoperative information were collected from patients undergoing neurosurgical procedures where bleeding was controlled with gelatin-thrombin matrix or according to local bleeding control guidelines (control group). Study endpoints were: length of surgery, estimated blood loss, hospitalization duration, blood units utilized, intensive care unit days, postoperative complications, and time to recovery. Statistical methods compared endpoints between the gelatin-thrombin and control groups and resource utilization costs were estimated. RESULTS Seventy-eight patients (38 gelatin-thrombin; 40 control) were included. Gelatin-thrombin was associated with a shorter surgery duration than control (166±40 versus 185±55 minutes, P=0.0839); a lower estimated blood loss (185±80 versus 250±95 mL; P=0.0017); a shorter hospital stay (10±3 versus 13±3 days; P<0.001); fewer intensive care unit days (10 days/3 patients and 20 days/4 patients); and shorter time to recovery (3±2.2 versus 4±2.8 weeks; P=0.0861). Fewer gelatin-thrombin patients experienced postoperative complications (3 minor) than the control group (5 minor; 3 major). No gelatin-thrombin patient required blood transfusion; 5 units were administered in the control group. The cost of gelatin-thrombin (€ 268.40/unit) was offset by the shorter surgery duration (difference of 19 minutes at € 858/hour) and the economic value of improved the other endpoint outcomes (i.e., shorter hospital stay, lesser blood loss/lack of need for transfusion, fewer intensive care unit days, and complications). CONCLUSIONS The use of gelatin-thrombin hemostatic matrix in patients undergoing neurosurgical procedures was associated with better intra- and postoperative parameters than conventional hemostasis methods, with these parameters having substantial economic benefits.
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Affiliation(s)
- Felice Esposito
- Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy -
| | - Paolo Cappabianca
- Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Filippo F Angileri
- Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Luigi M Cavallo
- Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Stefano M Priola
- Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Salvatore Crimi
- Division of Maxillo-Facial Surgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Domenico Solari
- Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Antonino F Germanò
- Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Francesco Tomasello
- Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
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Tarsitano A, Battaglia S, Crimi S, Ciocca L, Scotti R, Marchetti C. Is a computer-assisted design and computer-assisted manufacturing method for mandibular reconstruction economically viable? J Craniomaxillofac Surg 2016; 44:795-9. [DOI: 10.1016/j.jcms.2016.04.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 02/29/2016] [Accepted: 04/05/2016] [Indexed: 10/21/2022] Open
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Leonardi R, Perrotta RE, Loreto C, Musumeci G, Crimi S, Dos Santos JN, Rusu MC, Bufo P, Barbato E, Pannone G. Toll-like receptor 4 expression in the epithelium of inflammatory periapical lesions. An immunohistochemical study. Eur J Histochem 2015; 59:2547. [PMID: 26708181 PMCID: PMC4698613 DOI: 10.4081/ejh.2015.2547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/15/2015] [Accepted: 10/01/2015] [Indexed: 01/20/2023] Open
Abstract
Toll-like receptors (TLR) are essential for the innate immune response against invading pathogens and have been described in immunocompetent cells of areas affected by periapical disease. Besides initiating the inflammatory response, they also directly regulate epithelial cell proliferation and survival in a variety of settings. This study evaluates the in situ expression of TLR4 in periapical granulomas (PG) and radicular cysts, focusing on the epithelial compartment. Twenty-one periapical cysts (PC) and 10 PG were analyzed; 7 dentigerous non-inflamed follicular cyst (DC) served as control. TLR4 expression was assessed by immunohistochemistry. TLR4 immunoreaction products were detected in the epithelium of all specimens, with a higher percentage of immunostained cells in PG. Although TLR4 overexpression was detected in both PG and PC, there were differences that seemed to be related to the nature of the lesion, since in PG all epithelial cells of strands, islands and trabeculae were strongly immunoreactive for TLR4, whereas in PC only some areas of the basal and suprabasal epithelial layers were immunostained. This staining pattern is consistent with the action of TLR4: in PG it could promote formation of epithelial cell rests of Malassez and in epithelial strands and islands the enhancement of cell survival, proliferation and migration, whereas in PC TLR4 could protect the lining epithelium from extensive apoptosis. These findings go some way towards answering the intriguing question of why many epithelial strands or islands in PG and the lining epithelium of apical cysts regress after non-surgical endodontic therapy, and suggest that TLR4 plays a key role in the pathobiology of the inflammatory process related to periapical disease.
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Tumminia A, Crimi S, Sciacca L, Buscema M, Frittitta L, Squatrito S, Vigneri R, Tomaselli L. Efficacy of real-time continuous glucose monitoring on glycaemic control and glucose variability in type 1 diabetic patients treated with either insulin pumps or multiple insulin injection therapy: a randomized controlled crossover trial. Diabetes Metab Res Rev 2015; 31:61-8. [PMID: 24816997 DOI: 10.1002/dmrr.2557] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 04/26/2014] [Accepted: 04/29/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND The aim of this study was to determine the efficacy of real-time continuous glucose monitoring in T1D patients treated with insulin pump therapy or multiple daily insulin therapy. METHODS Twenty adult patients (ten insulin pump therapy and ten multiple daily insulin) with poor glycaemic control (HbA1c > 8.0%) were randomized into two groups for 6 months: the continuous glucose monitoring arm (using real-time continuous glucose monitoring) and the SMBG arm. After 2 months of wash-out, the participants crossed over. The primary outcome was HbA1c reduction. The secondary outcomes were hypoglycaemia and hyperglycaemia risk assessment (area under the curve < 70 mg/dL/day and AUC > 200 mg/dL/day, respectively) and glucose variability. RESULTS Fourteen patients (eight multiple daily insulin, six insulin pump therapy) used continuous glucose monitoring appropriately (at least 40% of the time). In these patients, the improvement in glycaemic control was more evident during the real-time continuous glucose monitoring period (7.76% ± 0.4 vs 8.54% ± 0.4, p < 0.05) than during the self-monitoring of blood glucose period (8.42% ± 0.4 vs 8.56% ± 0.5, p = 0.2). Better results with continuous glucose monitoring were observed in patients using multiple daily insulin with greater improvement in both glycaemic control (7.71% ± 0.2 vs 8.58% ± 0.2, p < 0.05) and glucose variability and with a marked reduction in the risk of both hypoglycaemia and hyperglycaemia. CONCLUSIONS Appropriate use of real-time continuous glucose monitoring improved glycometabolic control in T1D patients. The effects of continuous glucose monitoring were more evident in patients under multiple daily insulin treatment, compared with insulin pump therapy. Glucose variability, in addition to glycaemic control, was improved in compliant diabetic patients.
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Affiliation(s)
- Andrea Tumminia
- Endocrinology, Department of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, Italy
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Leonardi R, Crimi S, Almeida LE, Pannone G, Musumeci G, Castorina S, Rusu MC, Loreto C. ADAMTS-4 and ADAMTS-5 expression in human temporomandibular joint discs with internal derangement, correlates with degeneration. J Oral Pathol Med 2014; 44:870-5. [DOI: 10.1111/jop.12295] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Rosalia Leonardi
- Department of Orthodontics and Orofacial Pain; University of Catania; Catania Italy
| | - Salvatore Crimi
- Department of Maxillofacial Surgery; University of Messina; Messina Italy
| | | | - Giuseppe Pannone
- Department of Surgical Sciences; Institute of Pathology and Cytopathology; University of Foggia; Foggia Italy
| | - Giuseppe Musumeci
- Department of Bio-Medical Sciences; Anatomy Section; University of Catania; Catania Italy
| | - Sergio Castorina
- Department of Bio-Medical Sciences; Anatomy Section; University of Catania; Catania Italy
| | - Mugurel Constantin Rusu
- Division of Anatomy; Faculty of Dental Medicine; ‘Carol Davila’ University of Medicine and Pharmacy; Bucharest Romania
| | - Carla Loreto
- Department of Bio-Medical Sciences; Anatomy Section; University of Catania; Catania Italy
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Lunetta M, Barbagallo A, Crimi S, Di Mauro M, Sangiorgio L, Mughini L. Hypertension and related risk factors in type 2 diabetes mellitus. MINERVA ENDOCRINOL 1999; 24:45-50. [PMID: 10941422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
METHODS The correlation between hypertension and related risk factors has been studied in 733 type 2 diabetic patients. Hypertension was more frequent in women (65.35%) than in men (50.35%) (p < 0.0001). RESULTS Hypertensive patients showed older age (p < 0.0001) and greater Body Mass Index (BMI) (p < 0.03) than normotensive. In the diabetic group on diet only basal insulinaemia was higher (p < 0.05) in hypertensive than in normotensive diabetic men, but not in women. Such a difference, was not seen in patients of both sexes treated with oral hypoglycaemic agents; besides there was no difference in fasting C-peptide levels between hypertensive and normotensive insulin treated patients. In both sexes hypertension was independently correlated with age, BMI, increased urinary albumin excretion, triglycerides. The strongest correlation was with the family history of hypertension. On the contrary there was no correlation between hypertension and waisthip ratio. CONCLUSIONS In conclusion, the association between hypertension and type 2 diabetes depends on various risk factors, but a relationship with insulin levels is not surely demonstrable.
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Affiliation(s)
- M Lunetta
- Department of Internal Medicine, Endocrinology and Metabolism, University of Catania
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Lunetta M, Barbagallo A, Crimi S, Di Mauro M, Sangiorgio L, Mughini L. Hypertension and related risk factors in type 2 diabetes mellitus. Panminerva Med 1998; 40:169-73. [PMID: 9785910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
METHODS The correlation between hypertension and related risk factors has been studied in 733 type 2 diabetic patients. Hypertension was more frequent in women (65.35%) than in men (50.35%) (p < 0.0001). RESULTS Hypertensive patients showed older age (p < 0.0001) and greater Body Mass Index (BMI) (p < 0.03) than normotensive. In the diabetic group on diet only basal insulinaemia was higher (p < 0.05) in hypertensive than in normotensive diabetic men, but not in women. Such a difference, was not seen in patients of both sexes treated with oral hypoglycaemic agents; besides there was no difference in fasting C-peptide levels between hypertensive and normotensive insulin treated patients. In both sexes hypertension was independently correlated with age, BMI, increased urinary albumin excretion, triglycerides. The strongest correlation was with the family history of hypertension. On the contrary there was no correlation between hypertension and waist-hip ratio. CONCLUSIONS In conclusion, the association between hypertension and type 2 diabetes depends on various risk factors, but a relationship with insulin levels is not surely demonstrable.
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Affiliation(s)
- M Lunetta
- Department of Internal Medicine, Endocrinology and Metabolism, University of Catania, Italy
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Lunetta M, Barbagallo A, Attardo T, Crimi S, Sangiorgio L. Coronary heart disease in type 2 diabetic patients: common and different risk factors in men and women. Diabetes Metab 1997; 23:230-1. [PMID: 9234001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Lunetta M, Barbagallo A, Attardo T, Crimi S, Sangiorgio L. Frequency of coronary heart disease and related risk factors in a diabetic and nondiabetic population: a comparative study. Panminerva Med 1996; 38:211-6. [PMID: 9063028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim of the study was to evaluate the frequency of Coronary Heart Disease (CHD) and some related risk factors since as hyperlipidemia, hypertension, obesity and visceral distribution of adipose tissue on 733 type 2 diabetic patients in ambulatory care compared to 3500 nondiabetic subjects, matched for age and sex. The frequency of CHD, hyperlipidemias, hypertension, obesity and visceral distribution of adipose tissue was significantly higher in diabetic than in nondiabetic subjects. The risk for CHD was greater in diabetic vs nondiabetic women (4.22) as compared to diabetic vs nondiabetic men (2.6). CHD was mostly associated (over 50% of cases) with hypertension, hyperlipidemia and visceral distribution of adipose tissue. Both cholesterol and triglyceride values, such as CHD frequency, were higher in diabetic patients with poor glycemic control with respect to those with acceptable glycemic, especially in women.
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Affiliation(s)
- M Lunetta
- Department of Internal Medicine, Endocrinology and Metabolism University of Catania, Italy
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Crimi S, Cipolli D, Infantone E, Infantone L, Lunetta M. Microalbuminuria and severity of diabetic retinopathy in type 1 diabetic patients: association and relationship with some risk factors. Diabete Metab 1995; 21:440-5. [PMID: 8593926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
To investigate the relationship between microalbuminuria and severity of retinal damage, we studied 86 Albustix-negative insulin-dependent diabetic patients whose disease duration was more than 5 years (age 31.9 +/- 10.9 years; duration 14.7 +/- 7.1 years). Retinopathy was evaluated by fluorescein angiography in four groups of patients: a) 37 (43%) without retinopathy, b) 29 (34%) with background retinopathy, c) 10 (12%) with pre-proliferative retinopathy and d) 10 (12%) with proliferative retinopathy. Microalbuminuria (urinary albumin excretion > 30 mg/24 h) was calculated from timed 24-h urine collection and measured by a radioimmunoassay method. Microalbuminuria was found in 20 patients (23%); 16 of whom showed both retinopathy and microalbuminuria. Diabetic retinopathy was more frequent than microalbuminuria (57% vs 23%). The prevalence of microalbuminuria was significantly higher in the proliferative retinopathy group compared to the group without retinopathy (p < 0.0005) and the background retinopathy group (p < 0.007). The frequency of diabetic retinopathy was significantly higher (p < 0.04) in patients with than without microalbuminuria. These results indicate that microalbuminuria is associated with the presence and severity of diabetic retinopathy in insulin-dependent diabetic patients.
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Affiliation(s)
- S Crimi
- Istituto di Medicina Interna, Endocrinologia e Metabolismo, Ospedale Garibaldi, Catania, Italy
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Abstract
The aim of this study was to determine the glycaemic indices (GIs), peak incremental indices (PI), and time of peak increment (TPI) of eight kinds of fruits and their relationship with the type and amount of simple sugars directly assayed in the fruits. Sixty-one type 2 diabetic patients randomized into eight groups--one for each category of fruit--participated in the study. GIs consisted of the following: pears = 60 +/- 4.9; apples = 63 +/- 8.3; oranges = 68 +/- 6.5; grapes = 70 +/- 7.5; plums = 75 +/- 8.4; peaches = 80 +/- 7.4; apricots = 82 +/- 9.1; bananas = 83 +/- 8.5. The PI values (mmol I-1) were the following: grapes = 2.52 +/- 0.26; apples = 3.13 +/- 0.75; pears = 3.48 +/- 0.55; oranges = 4.02 +/- 0.42; peaches = 4.07 +/- 0.38; apricots = 4.08 +/- 0.47; plums = 4.2 +/- 0.45; bananas = 4.45 +/- 0.39. There was no statistical differences in GI, and PI, within the different fruits. TPI of grapes (43.3 +/- 5.2 min), oranges (45 +/- 5.6 min), and peaches (45 +/- 5.6 min) were statistical different (p < 0.01) in respect to apricots (81.4 +/- 5.5 min). GIs were positively correlated with total glucose contained in the fruits (p < 0.05) and with PI (p < 0.0002); negatively with fructose both free (p < 0.02) and total (sum of free and present in sucrose (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Lunetta
- Istituto Medicina Interna, Universita di Catania, Italy
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Lunetta M, di Mauro M, Crimi S, Sudano L, Mughini L. Miscibility of semisynthetic human ultralente insulin with short-acting insulin in insulin-dependent diabetic patients. Acta Diabetol Lat 1988; 25:263-9. [PMID: 3071068 DOI: 10.1007/bf02624822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In 15 insulin dependent diabetics (IDDM), treated with human monocomponent insulin, the absorption of Actrapid HM mixed with Ultratard HM was evaluated. Thirty U of Ultratard HM and 10 U of Actrapid HM were injected separately or together immediately after mixing. Free insulin and plasma glucose (PG) were measured four hours after the administration. Free insulin levels were significantly higher after 15 (2p less than 0.01), 60 (2p less than 0.05) and 90 min (2p less than 0.005) when the two insulins were injected separately. PG values were significantly lower (2p less than 0.05) (7.63 +/- 4.06 mmol/l) at 120 min when the two insulins were injected separately compared to the mixture (9.45 +/- 4.22 mmol/l). In conclusion, mixing Ultratard HM and Actrapid HM 3:1, we observed a decrease of early Actrapid absorption and a slower lowering of PG values.
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Affiliation(s)
- M Lunetta
- II Istituto di Patologia Medica e Malattie del Ricambio dell'Università, Catania, Italy
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