Haemorheological and endothelial-dependent alterations in heart failure after ACE inhibitor, calcium antagonist and beta blocker.

The aim of our study was to evaluate endothelium-dependent dilatation induced by an ACE-inhibitor, calcium antagonist and beta blocker in patients suffering from heart failure (NYHA class II and III). We studied 34 patients (19M, 15F, mean age 76.96+/-8.82) in pharmacological wash-out for at least one week, divided into 3 groups: Group A (15 patients, 9M and 6F) taking ramipril (5 mg/die); Group B (10 patients, 6M and 4F) taking amlodipine (10 mg/die), Group C: (9 patients, 4M and 5F) taking carvedilole (25 mg/die). The groups were homologous for NYHA class and instrumental echographic parameters (mean EF=22.5+/-6.7 and mean sAPP 38.4+/-8.7). At the beginning and after 3 weeks of therapy, we performed a clinical and instrumental assessment; we studied endothelial function by determination of L-arginine and L-citrulline (amino acids of the nitric oxide metabolic pathway), the L-citrulline/L-arginine ratio (an index of NOS activity) and VCAM-1 (endothelial dysfunction index); haemorheological parameters (blood viscosity, plasma fibrinogen and erythrocyte morphology); coagulative/fibrinolytic parameters (PT, aPTT, fibrinogen and PAI-1). The results show that L-citrulline and L-arginine increase, while VCAM-1 decreases. The L-citrulline/L-arginine ratio increases in a statistically significant way. This trend is maintained in each group. These results demonstrate that the drugs used induce an improvement of endothelium-dependent dilatation. In addition, there is progressive haemorheological and fibrinolytic improvement, with a reduction of PAI-1 and blood viscosity.

[Ultrastructural aspects of root planing: scanning electron microscopy (S.E.M.)]. / Aspetti ultrastrutturali della levigatura radicolare al microscopio elettronico a scansione (S.E.M.).

The basis of Periodontal treatment is represented by scaling and root planing. The aim of this study was to compare root morphology after the use of three currets: a new Hu Friedy Gracey 7/8, a semi-new Hu Friedy Gracey 7/8, a worn Hu Friedy Gracey 7/8. The research indicates that manual treatment with the new curette is effective in removing tartar but can cause excoriations on the enamel of the tooth. In contrast, the use of the semi-new curette is less damaging and obtains the same results removing tartar without injuring the enamel surface.

[Squamous cell epithelioma: retrospective analysis of a multidisciplinary approach with surgical treatment and periodontal treatment]. / Epitelioma squamocellulare: analisi retrospettiva di un approccio multidisciplinare fra trattamento chirurgico e trattamento parodontale.

Retrospective analysis of a multidisciplinary approach between surgery treatment a periodontal treatment. In our experience the surgery treatment of the squamous cell carcinoma has been completed by periodontal treatment to eliminate the secondary consequences such as bleeding and salivating++ from the labial chyme.

[The crevicular fluid in diabetics before and after initial periodontal treatment]. / Studio del fluido sulculare in pazienti diabetici prima e dopo trattamento parodontale iniziale.

In this study gingival crevicular fluid was used as a parameter to estimate the efficacy of initial treatment in diabetic patients. The patients with diabetes had significantly more gingival inflammation before initial treatment than after. A Periotron with Periopaper was used to measure gingival crevicular fluid.

[Case of cleft palate]. / Considerazioni su un caso di palatoschisi.

The present paper briefly outlines the pathogenesis of cleft palate and proposes a classification system for cleft palate since both are considered essential for the understanding and assessment of its sequelae. The Authors describe one case of cleft palate. Cleft palate patients present functional and aesthetic alterations in the maxillomandibular area that often require prosthetic correction. Given the features of these malformations therapy and rehabilitation should be programmed as soon as possible after birth and the plastic surgeon should be informed of the factors that cause the malformations and influence the growth of such patients.

[Gingival changes in pregnancy]. / Alterazioni gengivali in gravidanza.

Pregnancy represent a particular sistemic condition able to induce, because the tissutal metabolism is upset, an increase replay of the gingival tissues, caused by local factors as plaque and tartar. In this study are described effects determined from the increment ormone on the periodontal tissues, the alterations of the salivar components in pregnancy and the therapy to follow to reach as soon as possible the recovery.

[Paget's degeneration of the juxta-alveolar portion of the mandible in subjects with generalized osteoporosis. Clinical study]. / Degenerazione pagetoide della prozione iuxta-alveolare della mandibola in soggetto affetto da osteoporosi generalizzata. Contributo clinico.

After the description of the etiopathogenetic aspects and of the pathologic anatomy lesion more typical of the Paget's disease, the A.A. describe a interesting case of the mandible's degeneration in a patient with chronic osteoporosis. The patient does not masticate. The treatment has been to remodelling of the mandible. We made a scrupulous check of laboratory research and the radiographical, biological and histological reports to exclude osteosarcoma and gigantic cells tumour.

[Oral respiration. Diagnosis and physiopathology]. / Respirazione di tipo orale. Clinica e fisiopatologia.

The oral breathing can change the functional connections during the development of the facial bones of the children. All this causes an abnormal growth of the facial bones and of the dental structures. This work developed a new discipline to remove this problem.

[Validity of the first morning urine collection for screening for microalbuminuria in the diabetic]. / Validità della raccolta urinaria del primo mattino per lo screening della microalbuminuria nel diabete.

With the aim of evaluating the reliability of morning urine collection, compared to the overnight period, in the assessment of microalbuminuria, we measured albumin and creatinine concentration in overnight and morning urine of 125 diabetic outpatients. The overnight albumin excretion rate resulted in relation to morning albumin concentration and morning albumin/creatinine ratio. The sensitivity of this method of urine collection, compared to the overnight sample, was 55.5%, the specificity 96.6% and the predictive value 43% using, as a measure, the albumin concentration. These values improved by correcting albumin for creatinine concentration. Concerning high risk albuminuria (overnight excretion rate greater than 30 micrograms/min), we found a sensitivity and predictive value of the first morning collection highly improved by the albumin/creatinine ratio. It is concluded that the first morning urine collection can be used in the diagnosis of microalbuminuria in diabetic patients, especially when we calculate the albumin/creatinine ratio. This simple and reliable method allows the identification of microalbuminuric subjects and of the patients at risk to develop clinical nephropathy with a good sensitivity.

[Initial preparation for periodontal therapy]. / Preparazione iniziale nella terapia parodontale.

The purpose of the present investigation was to test concept that initial treatment is effectual to maintain gingival health. The principal local aging factor is represented by plaque accumulation and gingival inflammation. The results of this study have proved that initial treatment is effectual only on pockets measuring less than 4 mm to periodontal probing. Instead a surgical periodontal treatment is requested and more indicated on pocket depths measuring about or more than 6 mm to periodontal probing.

[Granulosa cell myoblastoma of the chin: clinical study]. / Mioblastoma a cellule granulose della regione mentoniera: contributo clinico.

An interesting of granular-cell Myoblastoma occurred on the chirny area of a patient bearer of an inferior dental prosthesis gives the starting point for a revision of all Histopathogenetic theory about the true origin of these rare and discussed neoformations mostly sealed on the oral cavity.