Efficacy of Biosilicate Glass-ceramic and Fluoride Varnish in the Treatment of Dentin Hypersensitivity-A Randomized Controlled Clinical Trial.

OBJECTIVE: The objective of this study was to compare the efficacy of Biosilicate and Duraphat in the treatment of dentin hypersensitivity (DH). METHODS AND MATERIALS: This clinical trial was conducted with young adults presenting DH. A visual analogue scale (VAS) was used to assess the level of pain, using volatile and tactile tests. Forty participants presenting two teeth with DH were included, and these teeth were divided into two groups according to the treatment: Biosilicate or Duraphat. Each product was randomly applied on one tooth per participant once a week for 4 weeks and evaluated every 15 days for 60 days after the last application. RESULTS: The mean and standard deviation (SD) of VAS values for the initial volatile sensitivity evaluation were 6.18 (1.99) and 6.08 (1.98) for the Biosilicate and Duraphat groups, respectively, and at the fourth week 0.48 (1.5) and 0.83 (1.58). After 60 days, the volatile sensitivity showed the following values: 0.63 (1.19) for Biosilicate and 1.03 (1.07) for Duraphat. The intragroup comparison showed a significant reduction of mean VAS values for DH-related pain assessed by volatile testing for both groups (p<0.001), and the assessment at the 60-day follow-up showed mean values statistically similar to those obtained at the end of treatment. Initial tactile sensitivity observed was 1.48 (2.39) for the Biosilicate and 1.4 (2.2) for the Duraphat group and at the 60-day follow-up 0.23 (0.73) and 0.15 (0.36), respectively, with significant statistical difference (p<0.002). When the reduction in tactile and volatile sensitivities between both groups was compared, no statistically significant difference was observed. CONCLUSION: This study indicated that both products were able to promote an important reduction in dentin hypersensitivity with similar results within a 60-day follow-up.

The impact of COVID-19 pandemic control on vaccine-preventable invasive bacterial diseases in Piedmont (Italy).

PURPOSE: The impact of SARS-CoV-2 pandemic on other pathogens is largely unknown. We aimed to compare the prevalence of vaccine-preventable invasive bacterial infections before and during the pandemic in Piedmont (Italy). METHODS: We defined the monthly incidence of S. pneumoniae, H. influenzae and N. meningitides-invasive diseases from January 2010 to June 2021. Then, we compared the mean monthly cases during the previous 5 years (2015-2019) and the monthly cases in 2020 or 2021. RESULTS: We found significant reductions for invasive pneumococcal diseases (IPDs) in adults and H. influenzae-invasive diseases in 2020 and 2021 in comparison to the previous years, but not for invasive meningococcal diseases and IPDs in children. CONCLUSIONS: Further data are needed to confirm these findings and define possible post-pandemic evolutions in the epidemiology of vaccine-preventable invasive bacterial diseases.

Biocompatibility, induction of mineralization and antimicrobial activity of experimental intracanal pastes based on glass and glass-ceramic materials.

AIM: To evaluate the biocompatibility, induction of mineralization and antimicrobial activity of experimental intracanal pastes based on two glass and glass-ceramic materials. Calcium hydroxide (Ca(OH)2 ) paste was used as the positive control. METHODOLOGY: The glass-ceramic powder [two-phased Biosilicate (BS-2P)] and F18 bioactive glass were mixed with distilled water (ratio 2 : 1), inserted in polyethylene tubes and implanted in the subcutaneous tissues of 16 rats. Empty tubes were used as negative control. After 7 and 30 days (n = 8), the rats were euthanized for haematoxylin-eosin, von Kossa, polarized light and osteopontin (OPN) immunolabeling analysis. Direct contact tests using a suspension of each paste were performed with Enterococcus faecalis planktonic cells to evaluate antimicrobial activity (24 h of contact), in a pilot study. The number of CFU mL-1 was calculated for each group. The antimicrobial analysis data were submitted to one-way anova and Tukey tests, whilst biocompatibility and immunohistochemical data were submitted to the Kruskal-Wallis and Dunn tests (P < 0.05). RESULTS: Most specimens of the control, BS-2P and Ca(OH)2 groups were associated with moderate inflammation seven days following implantation, whilst F18 was associated with moderate to severe inflammation, without differences amongst the groups (P > 0.05). At 30 days, most specimens of control, F18 and BS-2P groups had mild inflammation, whilst Ca(OH)2 had mild to moderate inflammation; however, no differences were determined amongst the groups (P > 0.05). The fibrous capsule was thick at 7 days, becoming thin at 30 days. All pastes induced von Kossa-positive structures and were birefringent to polarized light. At seven days, the BS-2P group had significantly more OPN immunolabeling compared to the control and Ca(OH)2 groups (P < 0.05). At 30 days, the F18 group had significantly more OPN immunolabeling compared to the control and Ca(OH)2 groups (P < 0.05). All pastes reduced the total number of E. faecalis; however, the reduction was only significant when comparing BS-2P and Ca(OH)2 groups to the control (P < 0.05). Only calcium hydroxide eliminated E. faecalis. CONCLUSIONS: Experimental BS-2P and F18 pastes were biocompatible, stimulated biomineralization and induced significant OPN immunolabeling compared to Ca(OH)2 . Only the BS-2P paste demonstrated antimicrobial activity comparable to Ca(OH)2 .

Marine collagen scaffolds and photobiomodulation on bone healing process in a model of calvaria defects.

INTRODUCTION: Collagen from marine esponges has been used as a promising material for tissue engineering proposals. Similarly, photobiomodulation (PBM) is able of modulating inflammatory processes after an injury, accelerating soft and hard tissue healing and stimulating neoangiogenesis. However, the effects of the associated treatments on bone tissue healing have not been studied yet. In this context, the present study aimed to evaluate the biological temporal modifications (using two experimental periods) of marine sponge collagen or sponging (SPG) based scaffold and PBM on newly formed bone using a calvaria bone defect model. MATERIAL AND METHODS: Wistar rats were distributed into two groups: SPG or SPG/PBM and euthanized into two different experimental periods (15 and 45 days post-surgery). A cranial critical bone defect was used to evaluate the effects of the treatments. Histology, histomorfometry and immunohistological analysis were performed. RESULTS: Histological findings demonstrated that SPG/PBM-treated animals, 45 days post-surgery, demonstrated a higher amount of connective and newly formed bone tissue at the region of the defect compared to CG. Notwithstanding, no difference among groups were observed in the histomorphometry. Interestingly, for both anti-transforming growth factor-beta (TGF-ß) and anti-vascular endothelial growth factor (VEGF) immunostaining, higher values for SPG/PBM, at 45 days post-surgery could be observed. CONCLUSION: It can be concluded that the associated treatment can be considered as a promising therapeutical intervention.

RESIST-5 O.O.K.N.V. and NG-Test Carba 5 assays for the rapid detection of carbapenemase-producing Enterobacterales from positive blood cultures: a comparative study.

We prospectively compared the performance of RESIST-5 O.O.K.N.V. and NG-Test Carba 5 assays directly from blood cultures spiked with 130 characterized Enterobacterales isolates. Overall, both assays yielded 100% sensitivity to detect KPC-type carbapenemases and OXA-48-like carbapenemases. Both assays failed to detect KPC-31 and KPC-33, D179Y point mutation variants of KPC-3 and KPC-2, that are deprived of carbapenemase activity and confer resistance to ceftazidime-avibactam. On blood culture bacterial pellets, NDM- and VIM-type carbapenemases were detected in 50.0% and 52.2%, respectively, by RESIST-5 O.O.K.N.V. vs 100% by NG-Test Carba 5. The sensitivity of RESIST-5 O.O.K.N.V. improved to 100% and 95.6%, respectively, by performing the assay on 4-h early subculture.

Effects of Bioactive Agents on Dentin Mineralization Kinetics After Dentin Bleaching.

OBJECTIVES: This study evaluated effects of Bioglass 45S5 (BG) and Biosilicate (BS) remineralization on the chemical composition and bond strength of control dentin (CD) and bleached dentin (BD) surfaces. METHODS AND MATERIALS: Dentin bleaching treatment was performed using the walking bleaching technique with 0.01 g of sodium perborate and 0.5 mL of 3% hydrogen peroxide for 14 days. Remineralization treatment was carried out by rubbing a remineralization solution (0.015 g of BG or BS diluted in 1.35 mL of distilled water) on the etched dentin surface for 30 seconds. Micro-Raman spectroscopy (MRS) was used to quantitatively analyze the mineral matrix ratios of CD and BD (n=5) after remineralization treatment with BG and BS over 15 days of incubation in artificial saliva. The CD and BD discs (n=10) with and without remineralization treatment with BG and BS were restored using a two-step etch-and-rinse adhesive system (Optibond S, Kerr) and five layers of 1-mm-thick composite resin (Filtek Z250, 3M ESPE). The restored dentin discs were sectioned into nine bonded beams with cross-sectional areas of approximately 0.9 mm2 and tested for microtensile bond strength (µTBS). The dentin surface of one fractured beam per tooth was submitted to MRS to characterize the physicochemical composition (n=10) at the interface. The data were analyzed using one-way analysis of variance and the Tukey-Kramer post hoc test (p<0.005). RESULTS: MRS bioactive analyses revealed that both BG and BS promoted increased mineral matrix ratios in the CD and BD. Significantly higher µTBS values were found after CD treatment with BG (CD: 57 MPa±11; CD-BG: 78 MPa±15) and when BG and BS were applied to the BD (BD: 42 MPa±5; BD-BG: 71 MPa±14; BD-BS: 64 MPa±11) (p<0.005). The MRS analysis of the fractured dentin beam showed that the remineralization treatment significantly increased the dentin relative mineral concentration and promoted the appearance of new interface peaks, indicating a chemical interaction (p<0.005). CONCLUSION: Remineralization of BD is an effective therapy to restore damage caused by dentin bleaching and acid conditioning. This approach not only increases dentin mineral compounds but also improves dentin's ability to interact chemically with the adhesive system.

Influence of the incorporation of marine spongin into a Biosilicate®: an in vitro study.

The combination of different biomaterials can be a promising intervention for the composites manufacture, mainly by adding functional and structural characteristics of each material and guarantee the advantages of the use of these composites. In this context, the aim of this study was to develop and evaluated the influence of the incorporation of marine spongin (SPG) into Biosilicate® (BS) in different proportions be used during bone repair. For this purpose, it was to develop and investigate different BS/SPG formulations for physico-chemical and morphological characteristics by pH, loss mass, Fourier transform infrared spectrometer (FTIR) and scanning electron microscope (SEM) analysis. Additionally, the influence of these composites on cell viability, proliferation, and alkaline phosphatase (ALP) activity were investigated. The results revealed that the pH values of all BS groups (with or without SPG) increased over time. A significant mass loss was observed in all composites, mainly with higher SPG percentages. Additionaly, SEM micrographies demonstrated fibers of SPG into BS and material degradation over time. Moreover, FTIR spectral analysis revealed characteristic peaks of PMMA, BS, and SPG in BS/SPG composites. BS/SPG groups demonstrated a positive effect for fibroblast proliferation after 3 and 7 days of culture. Additionally, BS and BS/SPG formulations (at 10% and 20% of SPG) presented similar values of osteoblasts viability and proliferation after 7 days of culture. Furthermore, ALP activity demonstrated no significant difference between BS and BS/SPG scaffolds, at any composition. Based on the present in vitro results, it can be concluded that the incorporation of SPG into BS was possible and produced an improvement in the physical-chemical characteristics and in the biological performance of the graft especially the formulation with 80/20 and 90/10. Future research should focus on in vivo evaluations of this novel composite.

Broad-spectrum bactericidal activity of a new bioactive grafting material (F18) against clinically important bacterial strains.

Infection is the most relevant surgical complication in implant or grafting procedures. Osteomyelitis and other chronic conditions pose a constant challenge in current medical practice. In this context, a grafting biomaterial that possesses antibacterial properties combined with bioactivity could have great clinical impact. Researchers at the Vitreous Materials Laboratory (LaMaV-UFSCar) recently developed a glass composition, named F18, that presents an improved workability range combined with high bioactivity. With F18, one can easily manufacture complex shapes, such as scaffolds, continuous fibres and coat implants. This biomaterial has proven to be a viable alternative for bone and skin regeneration in in vivo tests, however its antimicrobial properties have not been explored. Hence, the purpose of this study was to systematically investigate the antibacterial activity of F18 in powder and fibre forms according to the JIS Z 2801:2010 standard. Whether incorporation of silver into F18 glass could impact its antimicrobial activity was also evaluated. Four clinically relevant Gram-positive and Gram-negative pathogenic bacterial strains (Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa) were used in this study. In both powder and fibre forms, F18 presented extremely efficient bactericidal activity against all strains tested, eliminating virtually 100% of the bacterial cells after 24 h. Kinetic tests showed that silver doping further increased the bactericidal activity, leading to S. aureus eradication in only 30 min after incubation. Both doped and non-doped glasses demonstrated very high bactericidal activity, making F18 a promising infection-preventing alternative for bone and wound regeneration in clinical practice.

Biosilicate/PLGA osteogenic effects modulated by laser therapy: In vitro and in vivo studies.

The main purpose of the present work was to evaluate if low laser level therapy (LLLT) can improve the effects of Biosilicate®/PLGA (BS/PLGA) composites on cell viability and bone consolidation using a tibial defects of rats. The composites were characterized by scanning electron microscope (SEM) and reflection Fourier transform infrared spectrometer (FTIR). For the in vitro study, fibroblast and osteoblast cells were seeded in the extract of the composites irradiated or not with LLLT (Ga-Al-As, 808nm, 10J/cm2) to assess cell viability after 24, 48 and 72h. For the in vivo study, 80 Wistar rats with tibial bone defects were distributed into 4 groups (BS; BS+LLLT; BS/PLGA and BS/PLGA+LLLT) and euthanized after 2 and 6weeks. Laser irradiation Ga-Al-As (808nm, 30J/cm2) in the rats was performed 3 times a week. The SEM and FTIR results revealed that PLGA were successfully inserted into BS and the microparticles degraded over time. The in vitro findings demonstrated higher fibroblast viability in both BS/PLGA groups after 24h and higher osteoblast viability in BS/PLGA+LLLT in all periods. As a conclusion, animals treated with BS/PLGA+LLLT demonstrated an improved material degradation and an increased amount of granulation tissue and newly formed bone.

Characterization and biological evaluation of the introduction of PLGA into biosilicate®.

The aims of this study were to characterize different BS/PLGA composites for their physicochemical and morphological characteristics and evaluate the in vitro and in vivo biological performance. The physicochemical and morphological modifications were analyzed by pH, mass loss, XRD, setting time, and SEM. For in vitro analysis, the osteoblast and fibroblast viability was evaluated. For in vivo evaluations, histopathology and immunohistochemistry were performed in a tibial defect in rats. After incubation, all composites presented lower values in pH and mass loss over time. Moreover, XRD and SEM analysis confirmed that the composites degraded over time. Additionally, pore formation was observed by SEM analysis after incubation mainly in BS/PLGA groups. BS/PLGA showed significantly increased in osteoblast viability 24 h. Moreover, BS/PLGA composites demonstrated an increase in fibroblast viability in all periods analyzed when compared to BS. In the in vivo study, after 2 and 6 weeks of implantation of biomaterials, histopathological findings revealed that the BS/PLGA composites degrades over time, mainly at periphery. Moreover, can be observed the presence of granulation tissue, bone formation, Runx-2, and RANKL immunoexpression in all groups. In conclusion, BS/PLGA composites present appropriate physicochemical characteristics, stimulate the cellular viability, and enhance the bone repair in vivo. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1063-1074, 2017.

Characterization and biocompatibility of a fibrous glassy scaffold.

Bioactive glasses (BGs) are known for their ability to bond to living bone and cartilage. In general, they are readily available in powder and monolithic forms, which are not ideal for the optimal filling of bone defects with irregular shapes. In this context, the development of BG-based scaffolds containing flexible fibres is a relevant approach to improve the performance of BGs. This study is aimed at characterizing a new, highly porous, fibrous glassy scaffold and evaluating its in vitro and in vivo biocompatibility. The developed scaffolds were characterized in terms of porosity, mineralization and morphological features. Additionally, fibroblast and osteoblast cells were seeded in contact with extracts of the scaffolds to assess cell proliferation and genotoxicity after 24, 72 and 144 h. Finally, scaffolds were placed subcutaneously in rats for 15, 30 and 60 days. The scaffolds presented interconnected porous structures, and the precursor bioglass could mineralize a hydroxyapatite (HCA) layer in simulated body fluid (SBF) after only 12 h. The biomaterial elicited increased fibroblast and osteoblast cell proliferation, and no DNA damage was observed. The in vivo experiment showed degradation of the biomaterial over time, with soft tissue ingrowth into the degraded area and the presence of multinucleated giant cells around the implant. At day 60, the scaffolds were almost completely degraded and an organized granulation tissue filled the area. The results highlight the potential of this fibrous, glassy material for bone regeneration, due to its bioactive properties, non-cytotoxicity and biocompatibility. Future investigations should focus on translating these findings to orthotopic applications. Copyright © 2015 John Wiley & Sons, Ltd.

Effect of a new bioactive fibrous glassy scaffold on bone repair.

Researchers have investigated several therapeutic approaches to treat non-union fractures. Among these, bioactive glasses and glass ceramics have been widely used as grafts. This class of biomaterial has the ability to integrate with living bone. Nevertheless, bioglass and bioactive materials have been used mainly as powder and blocks, compromising the filling of irregular bone defects. Considering this matter, our research group has developed a new bioactive glass composition that can originate malleable fibers, which can offer a more suitable material to be used as bone graft substitutes. Thus, the aim of this study was to assess the morphological structure (via scanning electron microscope) of these fibers upon incubation in phosphate buffered saline (PBS) after 1, 7 and 14 days and, also, evaluate the in vivo tissue response to the new biomaterial using implantation in rat tibial defects. The histopathological, immunohistochemistry and biomechanical analyzes after 15, 30 and 60 days of implantation were performed to investigate the effects of the material on bone repair. The PBS incubation indicated that the fibers of the glassy scaffold degraded over time. The histological analysis revealed a progressive degradation of the material with increasing implantation time and also its substitution by granulation tissue and woven bone. Histomorphometry showed a higher amount of newly formed bone area in the control group (CG) compared to the biomaterial group (BG) 15 days post-surgery. After 30 and 60 days, CG and BG showed a similar amount of newly formed bone. The novel biomaterial enhanced the expression of RUNX-2 and RANK-L, and also improved the mechanical properties of the tibial callus at day 15 after surgery. These results indicated a promising use of the new biomaterial for bone engineering. However, further long-term studies should be carried out to provide additional information concerning the material degradation in the later stages and the bone regeneration induced by the fibrous material.

Incorporation of bioactive glass in calcium phosphate cement: material characterization and in vitro degradation.

Calcium phosphate cements (CPCs) have been widely used as an alternative to biological grafts due to their excellent osteoconductive properties. Although degradation has been improved by using poly(D,L-lactic-co-glycolic) acid (PLGA) microspheres as porogens, the biological performance of CPC/PLGA composites is insufficient to stimulate bone healing in large bone defects. In this context, the aim of this study was to investigate the effect of incorporating osteopromotive bioactive glass (BG; up to 50 wt %) on setting properties, in vitro degradation behavior and morphological characteristics of CPC/BG and CPC/PLGA/BG. The results revealed that the initial and final setting time of the composites increased with increasing amounts of incorporated BG. The degradation test showed a BG-dependent increasing effect on pH of CPC/BG and CPC/PLGA/BG pre-set scaffolds immersed in PBS compared to CPC and CPC/PLGA equivalents. Whereas no effects on mass loss were observed for CPC and CPC/BG pre-set scaffolds, CPC/PLGA/BG pre-set scaffolds showed an accelerated mass loss compared with CPC/PLGA equivalents. Morphologically, no changes were observed for CPC and CPC/BG pre-set scaffolds. In contrast, CPC/PLGA and CPC/PLGA/BG showed apparent degradation of PLGA microspheres and faster loss of integrity for CPC/PLGA/BG pre-set scaffolds compared with CPC/PLGA equivalents. Based on the present in vitro results, it can be concluded that BG can be successfully introduced into CPC and CPC/PLGA without exceeding the setting time beyond clinically acceptable values. All injectable composites containing BG had suitable handling properties and specifically CPC/PLGA/BG showed an increased rate of mass loss. Future investigations should focus on translating these findings to in vivo applications.

Incorporation of bioactive glass in calcium phosphate cement: An evaluation.

Bioactive glasses (BGs) are known for their unique ability to bond to living bone. Consequently, the incorporation of BGs into calcium phosphate cement (CPC) was hypothesized to be a feasible approach to improve the biological performance of CPC. Previously, it has been demonstrated that BGs can successfully be introduced into CPC, with or without poly(d,l-lactic-co-glycolic) acid (PLGA) microparticles. Although an in vitro physicochemical study on the introduction of BG into CPC was encouraging, the biocompatibility and in vivo bone response to these formulations are still unknown. Therefore, the present study aimed to evaluate the in vivo performance of BG supplemented CPC, either pure or supplemented with PLGA microparticles, via both ectopic and orthotopic implantation models in rats. Pre-set scaffolds in four different formulations (1: CPC; 2: CPC/BG; 3: CPC/PLGA; and 4: CPC/PLGA/BG) were implanted subcutaneously and into femoral condyle defects of rats for 2 and 6 weeks. Upon ectopic implantation, incorporation of BG into CPC improved the soft tissue response by improving capsule and interface quality. Additionally, the incorporation of BG into CPC and CPC/PLGA showed 1.8- and 4.7-fold higher degradation and 2.2- and 1.3-fold higher bone formation in a femoral condyle defect in rats compared to pure CPC and CPC/PLGA, respectively. Consequently, these results highlight the potential of BG to be used as an additive to CPC to improve the biological performance for bone regeneration applications. Nevertheless, further confirmation is necessary regarding long-term in vivo studies, which also have to be performed under compromised wound-healing conditions.

The direct influence of ship traffic on atmospheric PM2.5, PM10 and PAH in Venice.

The direct influence of ship traffic on atmospheric levels of coarse and fine particulate matter (PM(2.5), PM(10)) and fifteen polycyclic aromatic hydrocarbons (PAHs) has been estimated in the urban area of Venice. Data analysis has been performed on results collected at three sites over the summer, when ship traffic is at a maximum. Results indicate that monitoring of the PM daily concentrations is not sufficiently detailed for the evaluation of this contribution, even though it could be useful for specific markers such as PAHs. Therefore a new methodology, based on high temporal resolution measurements coupled with wind direction information and the database of ship passages of the Harbour Authority of Venice has been developed. The sampling sites were monitored with optical detectors (DustTrack(®) and Mie pDR-1200) operating at a high temporal resolution (20s and 1s respectively) for PM(2.5) and PM(10). PAH in the particulate and gas phases were recovered from quartz fibre filters and polyurethane foam plugs using pressurised solvent extraction, the extracts were then analysed by gas chromatography- high-resolution mass spectrometry. Our results shows that the direct contribution of ships traffic to PAHs in the gas phase is 10% while the contribution to PM(2.5) and to PM(10) is from 1% up to 8%.

The effect of a novel crystallised bioactive glass-ceramic powder on dentine hypersensitivity: a long-term clinical study.

The aim of this comparative clinical study was to evaluate a novel bioactive glass-ceramic (Biosilicate® 1-20 µm particles) to treat dentine hypersensitivity (DH). Volunteers (n = 120 patients/ 230 teeth) received the following treatments: G1-Sensodyne® , G2-SensiKill®, G3-Biosilicate® incorporated in a 1% water-free-gel and G4-Biosilicate® mixed with distilled water at 1:10 ratio. G1 and G3 were applied at home, daily for 30 days; G2 and G4 were applied once a week by a dentist (four applications). A visual analogue scale (VAS) was employed to evaluate pain for each quadrant in one sensitive tooth at baseline, weekly during treatment and during a 6-month follow-up period. Dentine hypersensitivity values (G1/n= 52), (G2/n =62), (G3/n = 59) and (G4/n = 59) were analysed with Kruskal-Wallis/Dunn tests. All the products were efficient in reducing DH after 4 weeks. Among the four materials tested, G4 demonstrated the best clinical performance and provided the fastest treatment to reduce DH pain. Distilled water proved to be an adequate vehicle to disperse Biosilicate®. Low DH scores were maintained during the 6-month follow-up period. The hypothesis that the novel bioactive glass-ceramic may be an efficient treatment for DH was confirmed.

A quantified analysis of sleep electroencephalography in anorectic adolescents.

BACKGROUND: Previous studies on sleep characteristics in anorexia nervosa have led to controversial results. This may be due to either the heterogeneity of the samples studied or to an intrinsic inadequacy of the scoring criteria. To obtain a more detailed analysis we have investigated sleep characteristics in a group of adolescents affected by anorexia nervosa using spectral analysis techniques. METHODS: After a baseline night, the sleep-electroencephalograms of 10 adolescent anorectic girls (age +/- SD = 14 +/- 2 years) and 10 age-matched control subjects were recorded and processed by a fast Fourier transformation routine. RESULTS: Anorectics showed an increased number of awakenings and wakefulness after sleep onset and a reduction of sleep efficiency and slow-wave sleep. Spectral analysis results revealed a significant reduction in the power spectral values of slow-wave activity (SWA; 0.5-4.5 Hz) band in all NREM-REM cycles of sleep and in the undisturbed and stable stage 4. Moreover the anorectic group was characterized by a concentration of SWA in the first NREM-REM cycle with an abrupt decay in the second part of the night. A positive correlation (r2 = .58, p < .01) between body mass index and the amount of SWA was found. CONCLUSIONS: Sleep of anorectic patients seems to be characterized by a weakness of SWA producing mechanisms. The positive correlation between body mass index and the amount of SWA appears to be consistent with the neurobiological consequences of the malnutrition state.

Secondary generalized epilepsy in childhood: EEG patterns and correlation with responsiveness to benzodiazepines or ACTH (preliminary note).

Secondary generalized epilepsy in childhood, characterized by absences or minor motor seizures, occurs in the forms of various syndromes, as defined by current classifications. EEG often shows continuous or subcontinuous paroxysmal activity associated with partly reversible psychomotor or mental regression. The paroxysmal activity can exhibit one of two distinct patterns: "organized" or "disorganized," although intermediate forms are common. The two patterns differ not only morphologically but also in the responsiveness to drug or hormone therapy, reactivity to stimuli, sleep changes and frequency of disordered slow rhythms. These features are illustrated by means of a survey of 10 cases.