Covid-19 pandemic and clinical activity stop: oral health study in a group of children.

AIM: Public and private health services, which provide both preventive and health promotion interventions, were forced to suddenly stop their activities to limit the risk of infections during the pandemic emergency. Oral health administration, including that of children, was affected by these planned medical service closures, from both therapeutic and preventive perspectives. This study aims to analyse the consequences, at the oral cavity level, of failures to treat patients of childhood age, considering the impact of carious pathology on quality of life and incorrect eating and oral hygiene habits, which may occur in this age group. METHODS: This is a cross-sectional, single-center, observational study. One hundred patients from the Odontostomatological University Center (C.O.U.) of Perugia were randomly enrolled. CONCLUSION: Oral health status of the examined sample is satisfactory overall, considering the clinic's interruption of treatments with the resulting long period of no follow-up and the emotional and economic stress generated by the pandemic condition for both the young patients and their caregivers.

Do patients' and referral centers' characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register.

BACKGROUND: Multiple sclerosis (MS) is characterized by phenotypical heterogeneity, partly resulting from demographic and environmental risk factors. Socio-economic factors and the characteristics of local MS facilities might also play a part. METHODS: This study included patients with a confirmed MS diagnosis enrolled in the Italian MS and Related Disorders Register in 2000-2021. Patients at first visit were classified as having a clinically isolated syndrome (CIS), relapsing-remitting (RR), primary progressive (PP), progressive-relapsing (PR), or secondary progressive MS (SP). Demographic and clinical characteristics were analyzed, with centers' characteristics, geographic macro-areas, and Deprivation Index. We computed the odds ratios (OR) for CIS, PP/PR, and SP phenotypes, compared to the RR, using multivariate, multinomial, mixed effects logistic regression models. RESULTS: In all 35,243 patients from 106 centers were included. The OR of presenting more advanced MS phenotypes than the RR phenotype at first visit significantly diminished in relation to calendar period. Females were at a significantly lower risk of a PP/PR or SP phenotype. Older age was associated with CIS, PP/PR, and SP. The risk of a longer interval between disease onset and first visit was lower for the CIS phenotype, but higher for PP/PR and SP. The probability of SP at first visit was greater in the South of Italy. DISCUSSION: Differences in the phenotype of MS patients first seen in Italian centers can be only partly explained by differences in the centers' characteristics. The demographic and socio-economic characteristics of MS patients seem to be the main determinants of the phenotypes at first referral.

Autism spectrum disorder and paediatric dentistry: A narrative overview of intervention strategy and introduction of an innovative technological intervention method.

AIM: When treating patients with Autism Spectrum Disorder (ASD) the doctor-patient relationship can be very challenging. The dentist is often forced to work under general anaesthesia or conscious sedation. Children with ASD are patients with an increased risk of caries due to poor oral hygiene, a cariogenic diet and the use of xerostomal drugs. In this work therapeutic strategies used to treat this kind of patients are evaluated and a new method to treat children with ASD is presented in order to increase awareness about this condition in the dental field. METHODS: The Atlas Center (a non-profit organisation in Peurgia, Italy) has developed a software, called paINTeraction, that allows these special children to immerse themselves in a virtual reality with the help of an operator. Through this system the child can explore the dental office (and all its sounds and noises) before the real dental visit, thus connecting to the dental professional, achieving greater compliance and reducing anxiety. CONCLUSION: paINTeraction, with the use of digital technology tools, may be particularly well suited to introduce patients to the therapeutic environment, particularly in the dental setting.

Index of Orthodontic Treatment Need (IOTN) and distribution of malocclusion traits in a population of growing patients attending a public orthodontic service in Perugia (Italy).

AIM: Malocclusions are widespread all over the world with high prevalence values and represent a social vulnerability and health problem because of the important burden of orthodontic treatment for both families and the public health service. The Italian Ministry of Health identified the principles for priority setting in dental care, i.e. patients with IOTN (Index of Orthodontic Treatment Need) 4-5 and those in particular conditions of health or social vulnerability. METHODS: A retrospective study was carried out to assess the IOTN and malocclusion in a population attending the public Orthodontic Health Service of Perugia (Italy) from September 2018 to February 2020. Medical charts, social income information, study models, photos and lateral cephalograms were examined to assess the orthodontic treatment need. CONCLUSION: Orthodontic health service in Italy tends to have many patients on the waiting list, while the 72% of subject under orthodontic treatment are not part of the orthodontic priority (IOTN grade 4-5). This study suggests the heath system to guarantee a priority of need for orthodontic treatment for patients with health vulnerabilities.

Health risk perceptions in the era of the new coronavirus: are the Italian people ready for a novel virus? A cross-sectional study on perceived personal and comparative susceptibility for infectious diseases.

OBJECTIVES: This study aims to evaluate the impact of psychological and sociodemographic variables on perceived personal and comparative susceptibility to diseases caused by a novel, unknown virus. STUDY DESIGN: Cross-sectional study. METHODS: A total of 438 adults (200 male and 238 female) were interviewed in the waiting rooms of three primary care medicine outpatient clinics. The participants completed three validated questionnaires: the Italian Adjustment of Risk Perception of Infectious Diseases questionnaire, the General Self-Efficacy (GSE) scale, and the Italian Version of Personality Inventory (ITAPI). RESULTS: Only 5% of the respondents believed it likely that they would contract a disease caused by a novel virus in the following months, even though 5.9% considered this probability higher than that of other people of the same age and gender. Gender (P < .04), age (P = .002), and marital status (P = .002) significantly affected the perceived risk of getting a disease caused by a novel virus. Self-efficacy (P < .001), imagination (P < .001), and empathy (P < .001) were significant predictors of perceived personal susceptibility. Self-efficacy (P = .04) and imagination (P = .04) were predictive of perceived comparative susceptibility. CONCLUSIONS: Adequate psycho-educational interventions are necessary to empower the population in adopting the necessary prevention and containment measures aimed at limiting the spread of novel diseases such as COVID-19 and avoiding disastrous consequences both at the health and economic level.

Biological effects of resin monomers on oral cell populations: descriptive analysis of literature.

AIM: Recently, the application of restorative materials containing metacrilate monomers in the conservative and paediatric dentistry has focused on the possible negative effects due to the use of these composites. In particular the release of monomers from reconstructions as a result of an insufficient polymerisation, can spread along the mucosal and dental tissues with potential immunological ed cytotoxic effects. Regarding to the importance of this issue, the aim of this study is to provide a descriptive review of the literature on potential local and systemic interactions of metacrylic and acrylic monomers with the immune system, both in vitro and in vivo. RESULTS: The most highly used monomers in composite materials applied in conservative dentistry include: 2-hydroessietil- methacrylate (HEMA), triethylene glycol-dimethacrylate (TEGDMA), bisphenol A glycidyl-methacrylate (BisGMA) and urethane- dimethacrylate (UDMA). Different investigations have been performed for better understanding of the potential side effects of metacrylic monomers on immune system cells. Different factors such as cell population, exposure time and parameters more strictly connected to these materials, such as molecular weight, chemical composition and mechanical characteristics, seem to be directly involved in these reactions.

Antimicrobial potential of Sicilian honeys against commensal Escherichia coli and pathogenic Salmonella serovar infantis.

INTRODUCTION: The purpose of this study was to investigate the antibacterial effect of 71 locally produced honeys from different botanical sources collected from apiarist's open markets in Sicily. METHODS: Antimicrobial activity was determined against Escherichia coli (ATCC 25922) and Salmonella serovar Infantis (ATCC 1523) by an agar-diffusion assay from the estimation of the diameter of the inhibition zone produced by the honeys. Statistically) significant differences (P < .000) regarding inhibition were observed for the honeys tested. RESULTS: The chestnut and polyfloral honey samples exhibited the largest and highest inhibition (diameter of the inhibition zone > 25 mm) against both E. coli and S. Infantis. The honey of oregano origin showed intermediate or low activity against E. coli and S. Infantis, respectively. Prickly pear and erica honeys showed no antimicrobial activity against the two reference strains. DISCUSSION: The results may partially suggest the usefulness of the Sicilian honeys on treating multi-resistant enterobacteria. In light of the enormous potential for application of honey in the clinical practice, it is important that research continues not only into those honeys well recognized as antimicrobial, but also into other locally produced and yet untested honeys.

Attitudes of Italian dental and dental hygiene students toward tobacco-use cessation.

OBJECTIVE: The aim of this study was to investigate the smoking habits of Italian dental and dental hygiene students and to assess their knowledge on the health effects of cigarette smoking and their attitudes toward tobacco-use cessation (TUC) in dental practice. MATERIALS AND METHODS: Data was collected from 220 students attending the Dental and Dental Hygiene Schools (DS and DHS, respectively) at the University of Palermo (Italy). RESULTS: The percentage of smokers amongst DS and DHS students was similar (32.78% vs. 32.5%) with 67.77% of DS students and 77.5% of DHS agreeing that the damages to health caused by smoking were covered in their didactic course work. A high percentage of DS (63.33%) and DHS (67.5%) students reported the relationship between smoking and a number of associated health conditions. Both DS and DHS students showed poor knowledge of TUC interventions. Both DS and DHS students reported to be conscious of their own role as a counsellor, with DHS students feeling more comfortable in approaching counselling in clinical practice. Although DS and DHS students reported a positive attitude toward TUC interventions, almost half of the students had some concerns about the effectiveness of smoking cessation activities. DISCUSSION: The introduction of a comprehensive tobacco education curriculum in DS and DHS programs could further improve students' perceptions and attitudes and provide knowledge and clinical experience which would lead to the incorporation of TUC into subsequent professional practice.

[Quality of life of hospitalized children: a survey]. / Qualità di vita dei bambini in ospedale: risultati di una indagine.

Knowledge of the negative effects that hospitalization can have on the psychological wellbeing of children can be useful to plan prevention programs. The aim of this study was to evaluate children's perceived quality of life during their hospital stay. Overall 270 children (132 boys and 138 girls) aged 3-14 years, hospitalized in one of four hospitals in Catania (Italy) in the first trimester of 2007 were interviewed. Approximately 68% of interviewed children reported being satisfied with the hospital appearance and 74% with their room. However, 80% complained of the lack of a cafeteria and 31% reported that the quality of food was poor. Ninety-one percent of children were satisfied or extremely satisfied with play opportunities, almost 98% had the possibility of watching television and 66% used a computer during their hospital stay. Only 53% of interviewed children had not interrupted their schooling. In addition, only 34% had no difficulty in understanding what was said to them by healthcare personnel. The results of this study show the need to improve communication skills of healthcare personnel and promote opportunities for sharing mealtimes in a common environment in order to reduce the discomforts of hospitalization.

Plasmid-mediated multiple antibiotic resistance of Escherichia coli in crude and treated wastewater used in agriculture.

A total of 273 Escherichia coli isolates from raw and treated municipal wastewaters were investigated to evaluate the frequency and persistence of antibiotic resistance and to detect the occurrence of conjugative R plasmids and integrons. The highest resistance rates were against ampicillin (22.71%), tetracycline (19.41%), sulfamethoxazole (16.84%) and streptomycin (14.28%). Multiple antibiotic resistance was present in 24.17% of the isolates. Several multiple antibiotic-resistant isolates proved to be able to transfer en bloc their resistance patterns by conjugative R plasmids with different molecular sizes and restriction profiles. Class 1 integrons of 1 or 1.5 kbp were found in 5 out of 24 representative multiresistant E. coli isolates. Although wastewater treatments proved to be effective in eliminating Salmonella spp. and in reaching WHO microbiological standards for safe use of wastewater in agriculture, they were ineffective in reducing significantly the frequency of plasmid-mediated multiple antibiotic resistance in surviving E. coli. Since multiple antibiotic-resistant bacteria carrying integrons and conjugative R plasmids can constitute a reservoir of antibiotic-resistance genes in wastewater reclaimed for irrigation, risks for public health should be considered. Bacterial strains carrying R plasmids and integrons could contaminate crops irrigated with reclaimed wastewater and transfer their resistances to the consumers' intestinal bacteria.

Persistent oral and urinary Candida spp. carriage in Italian HIV-seropositive asymptomatic subjects.

The aim of the present study was to ascertain frequency and persistence of Candida spp. oral and urinary carriage in asymptomatic, HAART-naive HIV-seropositive subjects who had not undergone therapy with antimycotic drugs, and whose CD4+ lymphocyte count was greater than 200/microl. Oral carriage was the most common Candida spp. carriage (63.0% of the subjects), while candiduria was more rarely observed (6.5%). C. albicans was recovered from the majority of the subjects examined (56.5%), followed by C. krusey (4.3%), C. tropicalis (2.2%) and C. dubliniensis (2.2%). C. albicans was also isolated from two urinary carriers (4.3%) and C. glabrata from another one (2.2%). The same C. albicans clone was repeatedly isolated from 14 out of 15 oral carriers while the same clone of C. dubliniensis was repeatedly isolated from one carrier, as shown by the persistence of RAPD fingerprint of serial isolates during one year of follow-up. Since persistence of Candida spp. carriage may influence the development of clinical candidiasis in immunocompromised hosts, monitoring of the carrier status could be useful for preventing clinical thrush in HIV-seropositive subjects.

Knowledge of HIV infection, risk perception, and sexual behaviour of undergraduates. May female medical students act as peer educators?

This paper is aimed to verify whether the knowledge and beliefs of female medical freshmen about HIV infection, their personal risk perception, and their sexual behaviour differs from their female peers, in view of the possibility of female medical student-based peer education. A purposive, theoretical quota sampling method was used to recruit the target population. A self-administered anonymous questionnaire was delivered to both female medical and non medical freshmen during March 2004 (n = 266: 124 medical students and 142 non medical students) in Catania (Sicily). The data were analysed for the whole sample and for the two groups of students individually. The Chi-square test was used to compare data from the two groups of students. Results showed that knowledge and risk perception about HIV infection were higher for medical students when compared with non medical students. Moreover, a lower rate of sexually active medical students and a higher rate of condom use was found among them. Since female medical students seem more sensitive to risk perception and aware of healthier lifestyles, they could be useful in peer sexual education and appropriate prevention programmes against HIV infection.

Ultrasonographic and spiral CT evaluation of simple and complicated acute cholecystitis: diagnostic protocol assessment based on personal experience and review of the literature.

PURPOSE: The aim of this study was to identify and classify the ultrasonographic and computed tomography (CT) signs of simple and complicated acute cholecystitis and to define the correct diagnostic protocol. MATERIALS AND METHODS: We retrospectively reviewed 35 patients (23 men and 12 women; mean age 66.6 years) presenting with acute cholecystitis who were assessed by emergency ultrasonography (US) (30/35 cases) and spiral CT (12/35 cases); all patients underwent emergency surgery. The US signs were analysed and classified as major criteria (wall thickening and stratification, distension, Murphy's sign), minor criteria (bile stones, sludge, and biliary tract dilatation), and complication signs (gas collections, aerobilia, fluid collection, difficult or missed identification of the gallbladder). Imaging results were compared with histological findings (gold standard), and accuracy, sensitivity, specificity, and positive and negative predictive values (PPVs and NPVs) were assessed for each modality. Concordance between the US and CT findings was also evaluated for cases undergoing both examinations; additional findings provided by one or the other modality were also assessed. RESULTS: US had an accuracy of 66.6%, a sensitivity of 37.5%, a specificity of 70%, a PPV of 100%, and an NPV of 58.3%. CT had 100% accuracy, sensitivity, and specificity. Concordance between US and CT was observed for diagnosis of complications, but CT provided additional findings in all cases. The majority of complicated cases undergoing US examination (68.7%) revealed more than two major criteria and one minor criterion or at least one sign of complication. CONCLUSIONS: If more than two major signs associated with one minor sign or at least one sign of complication are present at US, CT is mandatory to recognise and thoroughly evaluate the type of complication and indicate appropriate treatment.

[Legionella contamination in the hospital environment: monitoring of the hot water distribution systems of three hospitals in Catania (Italy)]. / La contaminazione da legionelle in ambiente ospedaliero. Risultati del monitoraggio delle reti di distribuzione dell'acqua calda in una Azienda ospedaliera.

This study evaluated the presence and extent of contamination with Legionella spp. in the hot water distribution systems of three hospitals in Catania (Italy). In total, 291 hot water samples were collected between September 2002 and August 2005 and these were examined in order to monitor the hospital distribution systems and evaluate the efficacy of decontamination measures. L. pneumophila was detected at variable concentrations up to over 10000 UFC/L at several collection sites in some hospital buildings and branches of the water distribution system while other buildings/branches were found to be free of contamination. The most frequently isolated serogroup was L. pneumophila serogroup 3, occasionally associated with serogroups 4, 5 and 6. Molecular typing of Legionella strains by pulsed-field gel electrophoresis of genomic DNA restriction fragments identified four different genotypes, each recovered from a different branch of the distribution system. Decontamination procedures, including shock hyperchloration and two different thermal shock methods, performed between October 2003 and August 2005, led to only temporary reductions in contamination. In fact, previous concentrations of the same L. pneumophila serogroup were found within 3 to 8 months of decontamination. In order to prevent and monitor Legionella infections, sterilizing filters were installed in water taps of all wards with high-risk patients and urinary antigen testing was performed on all patients diagnosed with nosocomial pneumonia. No cases of Legionella pneumonia were identified in 2005.

[Domestic injuries in childhood. Results of a survey carried out in a Sicilian area]. / Incidenti domestici nell'infanzia. Risultati di un'indagine condotta nell'area etnea.

A retrospective investigation was performed with an anonymous questionnaire administered to the mothers of 2208 children aged between 3 and 11 years, randomly selected from the residents of three target areas: a country town, a residential and a popular quarter of a chief town (Catania, Sicily). Of the 2208 mothers in the three areas, 1151 completed the questionnaire with an overall response rate of 52.12%. In the last 6 months a large number of children (17.29%) suffered at least one accident at home. Predominating injuries were falls (71.86%) followed by cutting or stab-wounds (13.57%). The more frequent lesions were contusions (42.13%), wounds (29.95%) and fractures (14.22%). Almost the half of children victims of injuries required hospital care (44.72%). The majority of domestic accidents occurred in the bathroom (17.10%), in the kitchen (15.10%) and in the bedroom (10.55%). Fractures and wounds were more frequent among children aged 6-11 and 3-5 years, respectively. The highest frequency of domestic accidents among children of all ages living in the popular quarter (20.89%) and in the country town (19.18%) compared with those living in the residential quarter (11.67%) (chi2= 12,768, P<0.01) could be related to their lower socio-economic condition.

Prenatal testicular torsion: sonographic appearance in the newborn infant.

The prenatal diagnosis of spermatic cord torsion is often really difficult and the diagnosis is usually retrospective. Herein, we report a case of a male newborn baby who presented at delivery with an enlarged, swollen and tender scrotum. US showed an enlarged right testis, with dishomogeneous texture, fluid collection between the testis and the tunica vaginalis and large hydrocele. Differential diagnosis included hydrocele complicated by infection or hemorrhage, testicular tumor or postnatal testicular torsion. Color and power Doppler did not reveal any flow signal, and the diagnosis of antenatal torsion with initial necrosis was made. The role of color Doppler US is emphasized in directing the patient to emergency surgical exploration, when testicular salvage may be possible. Delayed surgical treatment can be proposed, when the diagnosis of antenatal torsion has a high degree of certainty. However, the Doppler examination of a newborn baby's testis is a very difficult challenge even for an experienced radiologist.

Contrast-enhanced color Doppler US in malignant portal vein thrombosis.

PURPOSE: To assess the role of contrast-enhanced color Doppler US in the differential diagnosis of benign and malignant portal vein thrombosis. MATERIAL AND METHODS: Fifty-six patients with portal vein thrombosis underwent color and power Doppler US examination before and after i.v. injection of galactose-palmitic acid suspension. The criterion for diagnosing the presence and extension of thrombosis was the lack of visualization of portal vein flow in a segment of the portal vein. The criterion for diagnosing malignant portal vein thrombosis was the detection of pulsatile arterial flow, either hepatopetal or hepatofugal, in the thrombus. The US data were correlated with the types of portal vein thrombosis. RESULTS: Among the 56 patients, there were 40 benign and 16 malignant portal thromboses. Unenhanced Doppler US detected continuous blood flow in 24 benign thromboses and pulsatile in 3 malignant thromboses. No flow, either continuous or pulsatile, was detected in 16 cases with benign thrombosis and in 13 cases with malignant thrombosis. Contrast-enhanced Doppler US allowed to assess pulsatile flow in 15 cases with malignant thrombosis (94%). The use of pulsatile flow as diagnostic criterion of malignant thrombosis yielded a sensitivity of 57% and a specificity of 95% with conventional Doppler US, whereas contrast-enhanced US achieved a sensitivity of 94% and a specificity of 100%. CONCLUSION: Contrast-enhanced Doppler US is a reliable diagnostic tool for assessing malignant portal vein thrombosis.