Pleomorphic adenoma rehabilitative treatment in growing up patient: a 20-years follow-up

OBJECTIVE: Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. Most of the maxillary tumors are surgically treated through either a total or partial maxillectomy. However, surgical defects lead to both clinical and psychologic disorders for the patient. A postoperative obturator prosthesis is a good option in patients who underwent maxillectomy. It allows to restore both masticatory and speaking functions, as well as aesthetic appearance. When reconstruction of the surgical site is possible, an implant-supported prosthesis can be considered to guarantee a better function and aesthetic's rehabilitation. CASE REPORT: This clinical report presents the prosthetic rehabilitation of a patient who underwent maxillectomy because of a pleomorphic adenoma of hard palate minor salivary glands. The patient was treated with a palatal obturator prosthesis first and with an implant-supported prosthesis after surgical site's reconstruction and complete healing. CONCLUSIONS: The rehabilitation of the patient after maxillectomy through both these devices was an excellent option and provided clinical benefits, improving the patient's quality of life, allowing the patient's reinsertion into societ

Designing a Regulatory and Supervisory Framework for Integrated Financial Markets

The financial crisis that started in 2007 casts doubt about the ability of national laws and competent authorities to manage the stability of the financial system and to protect investors. This is due to the relevant evolving features of financial intermediation, like the cross-border strategies in banking, with many M&A undertaken, especially in Europe, and more in general the globalization of finance, also through the many recent operations among exchanges. The associated regulatory and supervisory challenges have proved to be difficult to tackle. An international perspective is needed on single banking regulatory instruments, even if it is impossible at this stage to imagine unique rules and single international authorities managing capital ratios, deposit insurance, reserve requirements and lending of last resort, as well as other tools for providing financial markets stability. However, some common principles on regulation and the structure of supervision may be stated both in US and in Europe: we suggest a “four peak” approach to the matter.The financial crisis that started in 2007 casts doubt about the ability of national laws and competent authorities to manage the stability of the financial system and to protect investors. This is due to the relevant evolving features of financial intermediation, like the cross-border strategies in banking, with many M&A undertaken, especially in Europe, and more in general the globalization of finance, also through the many recent operations among exchanges. The associated regulatory and supervisory challenges have proved to be difficult to tackle. An international perspective is needed on single banking regulatory instruments, even if it is impossible at this stage to imagine unique rules and single international authorities managing capital ratios, deposit insurance, reserve requirements and lending of last resort, as well as other tools for providing financial markets stability. However, some common principles on regulation and the structure of supervision may be stated both in US and in Europe: we suggest a “four peak” approach to the matter.Refereed Working Papers / of international relevanc

Pain-motor integration in the primary motor cortex in Parkinson's disease

In Parkinson's disease (PD), the influence of chronic pain on motor features has never been investigated. We have recently designed a technique that combines nociceptive system activation by laser stimuli and primary motor cortex (M1) activation through transcranial magnetic stimulation (TMS), in a laser-paired associative stimulation design (Laser-PAS). In controls, Laser-PAS induces long-term changes in motor evoked potentials reflecting M1 long-term potentiation-like plasticity, arising from pain-motor integration

What is a Gene? A Two Sided View

The need to account for all currently available experimental observations concerning the gene nature, has reshaped the concept of gene turning it from the essentially mechanistic unit, predominant during the '70s, into a quite abstract open and generalized entity, whose contour appears less defined as compared to the past. Here we propose the essence of the gene to be considered double faced. In this respect genotypic and phenotypic entities of a gene would coexist and mix reciprocally. This harmonizes present knowledge with current definitions and predisposes for remodelling of our thinking as a consequence of future discoveries. A two sided view of the gene also allows to combine the genetic and epigenetic aspects in a unique solution, being structural and functional at the same time and simultaneously able to include the different levels in an overlapping unicum

Laser irradiated foam targets: absorption and radiative properties

An experimental campaign to characterize the laser radiation absorption of foam targets and the subsequent emission of radiation from the produced plasma was carried out in the ABC facility of the ENEA Research Center in Frascati (Rome). Different targets have been used: plastic in solid or foam state and aluminium targets. The activated different diagnostics allowed to evaluate the plasma temperature, the density distribution, the fast particle spectrum and the yield of the X-Ray radiation emitted by the plasma for the different targets. These results confirm the foam homogenization action on laser-plasma interaction, mainly attributable to the volume absorption of the laser radiation propagating in such structured materials. These results were compared with simulation absorption models of the laser propagating into a foam target

The CHESS survey of the L1157-B1 bow-shock: high and low excitation water vapor

Molecular outflows powered by young protostars strongly affect the kinematics and chemistry of the natal molecular cloud through strong shocks resulting in substantial modifications of the abundance of several species. As part of the "Chemical Herschel Surveys of Star forming regions" guaranteed time key program, we aim at investigating the physical and chemical conditions of H20 in the brightest shock region B1 of the L1157 molecular outflow. We observed several ortho- and para-H2O transitions using HIFI and PACS instruments on board Herschel, providing a detailed picture of the kinematics and spatial distribution of the gas. We performed a LVG analysis to derive the physical conditions of H2O shocked material, and ultimately obtain its abundance. We detected 13 H2O lines probing a wide range of excitation conditions. PACS maps reveal that H2O traces weak and extended emission associated with the outflow identified also with HIFI in the o-H2O line at 556.9 GHz, and a compact (~10") bright, higher-excitation region. The LVG analysis of H2O lines in the bow-shock show the presence of two gas components with different excitation conditions: a warm (Tkin~200-300 K) and dense (n(H2)~(1-3)x10^6 cm-3) component with an assumed extent of 10" and a compact (~2"-5") and hot, tenuous (Tkin~900-1400 K, n(H2)~10^3-10^4 cm-3) gas component, which is needed to account for the line fluxes of high Eu transitions. The fractional abundance of the warm and hot H2O gas components is estimated to be (0.7-2)x10^{-6} and (1-3)x10^{-4}, respectively. Finally, we identified an additional component in absorption in the HIFI spectra of H2O lines connecting with the ground state level, probably arising from the photodesorption of icy mantles of a water-enriched layer at the edges of the cloud.Comment: Accepted for publication in A&A. 12 pages, 9 figures, 4 table

The Visible and Near Infrared module of EChO

The Visible and Near Infrared (VNIR) is one of the modules of EChO, the Exoplanets Characterization Observatory proposed to ESA for an M-class mission. EChO is aimed to observe planets while transiting by their suns. Then the instrument had to be designed to assure a high efficiency over the whole spectral range. In fact, it has to be able to observe stars with an apparent magnitude Mv= 9-12 and to see contrasts of the order of 10-4 - 10-5 necessary to reveal the characteristics of the atmospheres of the exoplanets under investigation. VNIR is a spectrometer in a cross-dispersed configuration, covering the 0.4-2.5 micron spectral range with a resolving power of about 330 and a field of view of 2 arcsec. It is functionally split into two channels respectively working in the 0.4-1 and 1.0-2.5 micron spectral ranges. Such a solution is imposed by the fact the light at short wavelengths has to be shared with the EChO Fine Guiding System (FGS) devoted to the pointing of the stars under observation. The spectrometer makes use of a HgCdTe detector of 512 by 512 pixels, 18 micron pitch and working at a temperature of 45K as the entire VNIR optical bench. The instrument has been interfaced to the telescope optics by two optical fibers, one per channel, to assure an easier coupling and an easier colocation of the instrument inside the EChO optical bench.Comment: 26 page

Inverse association of circulating SIRT1 and adiposity. A study on underweight, normal weight, and obese patients

Context: Sirtuins (SIRTs) are NAD+-dependent deacetylases, cellular sensors to detect energy availability, and modulate metabolic processes. SIRT1, the most studied family member, influences a number of tissues including adipose tissue. Expression and activity of SIRT1 reduce with weight gain and increase in conditions of starvation. Objective: To focus on SIRT1 plasma concentrations in different conditions of adiposity and to correlate SIRT1 with fat content and distribution, energy homeostasis and inflammation in under-weight, normal-weight, and obese individuals. Materials and Methods: 21 patients with anorexia nervosa, 26 normal-weight and 75 patients with obesity were evaluated. Body fat composition by dual-energy X-ray absorptiometry, ultrasound liver adiposity, echocardiographic epicardial fat thickness (EFT), inflammatory (ESR, CRP, and fibrinogen), and metabolic (FPG, insulin, LDL- and HDL-cholesterol, triglycerides) parameters, calculated basal metabolic rate (BMR) and plasma SIRT1 (ELISA) were measured. Results: SIRT1 was significantly higher in anorexic patients compared to normal-weight and obese patients (3.27 ± 2.98, 2.27 ± 1.13, and 1.36 ± 1.31 ng/ml, respectively). Linear regression models for each predictor variable adjusted for age and sex showed that SIRT1 concentration was inversely and significantly correlated with EFT, fat mass %, liver fat content, BMR, weight, BMI, WC, LDL-cholesterol, insulin, ESR. Stepwise multiple regression analysis revealed that age and EFT were the best independent correlates of SIRT1 (β = -0.026 ± 0.011, p = 0.025, and β = -0.516 ± 0.083, p < 0.001, respectively). Conclusions: Plasma SIRT1 shows a continuous pattern that inversely follows the whole spectrum of adiposity. SIRT1 significantly associates with EFT, a strong index of visceral fat phenotype, better than other indexes of adiposity studied here

Challenges recruiting to a proof-of-concept pharmaceutical trial for a rare disease: The trigeminal neuralgia experience

Background: This study aimed to describe recruitment challenges encountered during a phase IIa study of vixotrigine, a state and use-dependent Nav1.7 channel blocker, in individuals with trigeminal neuralgia. Methods: This was an international, multicenter, placebo-controlled, randomized withdrawal study that included a 7-day run-in period, a 21-day open-label phase, and a 28-day double-blind phase in which patients (planned n = 30) were randomized to vixotrigine or placebo. Before recruitment, all antiepileptic drugs had to be stopped, except for gabapentin or pregabalin. After the trial, patients returned to their original medications. Patient recruitment was expanded beyond the original five planned (core) centers in order to meet target enrollment (total recruiting sites N = 25). Core sites contributed data related to patient identification for study participation (prescreening data). Data related to screening failures and study withdrawal were also analyzed using descriptive statistics. Results: Approximately half (322/636; 50.6%) of the patients who were prescreened at core sites were considered eligible for the study and 56/322 (17.4%) were screened. Of those considered eligible, 26/322 (8.1%) enrolled in the study and 6/322 (1.9%) completed the study. In total, 125 patients were screened across all study sites and 67/125 (53.6%) were enrolled. At prescreening, reasons for noneligibility varied by site and were most commonly diagnosis change (78/314; 24.8%), age &gt; 80 years (75/314; 23.9%), language/distance/mobility (61/314; 19.4%), and noncardiac medical problems (53/314; 16.9%). At screening, frequently cited reasons for noneligibility included failure based on electrocardiogram, insufficient pain, and diagnosis change. Conclusions: Factors contributing to recruitment challenges encountered in this study included diagnosis changes, anxiety over treatment changes, and issues relating to distance, language, and mobility. Wherever possible, future studies should be designed to address these challenges. Trial registration: ClinicalTrials.gov, NCT01540630. EudraCT, 2010-023963-16. 07 Aug 2015