Coronavirus Disease 2019 (COVID-19) seems to affect children only marginally, as a result, there is less knowledge of its manifestations in childhood. The purpose of this retrospective ...cross-sectional study was to investigate the oral and cutaneous manifestations in children affected by COVID-19.
All the medical records of children with COVID-19 admitted to the Pediatric Clinic- ASST Spedali Civili of Brescia from March to April 2020 were reviewed. The following data were recorded: age, temperature, clinical presentation, oral mucosa lesions, taste alteration and cutaneous lesions.
The medical records of twenty-seven pediatric patients (mean age 4,2 years + 1,7) were analyzed. The clinical presentation of the disease mainly included elevated body temperature and cough. The following oral lesions were recorded: oral pseudomembranous candidiasis (7.4 %), geographic tongue (3.7%), coated tongue (7.4 %) and hyperaemic pharynx (37 %). Taste alteration was reported by 3 patients. Six patients presented cutaneous flat papular lesions.
As for our paediatric sample, COVID-19 resulted to be associated with non-specific oral and cutaneous manifestations.
Mutations of myelin protein zero gene (
MPZ
) are found in 5% of Charcot–Marie–Tooth patients. In 2004, Shy et al. identified two main phenotypes associated with them: an early-onset subtype with ...mainly demyelinating features and a late-onset subgroup with prominent axonal impairment. We evaluated whether novel
MPZ
mutations described in literature during the last 14 years could still fit with this classification. We collected and revised reports of 69 novel
MPZ
mutations. Almost 90% of them could be alternatively classified as responsible for: (a) an early-onset phenotype, with first limitations starting before 3 years (2.5 ± 0.50 years), motor milestones delays, frequently severe course and upper limb MNCVs below 15 m/s; (b) late-onset neuropathy, with mean age of onset of 42.8 ± 1.5 years and mean upper limbs motor nerve conduction velocities (MNCVs) of 47.2 ± 1.4 m/s; (c) a phenotype more similar to typical CMT1A neuropathy, with onset during the 2nd decade, MNCV in the range of 15–30 m/s and slowly progressive course. The present work confirms that P0-related neuropathies may be separated into two main distinct phenotypes, while a third, relatively small, group comprehend patients carrying
MPZ
mutations and a childhood-onset disease, substantiating the subdivision into three groups proposed by Sanmaneechai et al. (Brain 138:3180–3192,
2015
). Interestingly, during the last years, an increasing number of novel
MPZ
mutations causing a late-onset phenotype has been described, highlighting the clinical relevance of late-onset P0 neuropathies. Since the family history for neuropathy is often uncertain, due to the late disease onset, the number of patients carrying this genotype is probably underestimated.
This study aims to evaluate the effectiveness of the photobiomodulation therapy (PBMT) in the treatment of minor recurrent aphthous stomatitis (MiRAS) in children, in terms of pain relief, lesion ...size reduction and the parental satisfaction of the therapy.
This randomized controlled study was carried out on 60 children with clinical diagnosis of MiRAS. Patients were randomized into two groups: group A receiving laser therapy and group B receiving sham therapy (placebo). Laser therapy (diode laser, λ: 645 nm) was administered on day 1 (T0) for three consecutive days. Patients were evaluated also on day 4 (T1), on day 7 (T2) and on day 10 (T3). Oral aphthous lesions size was assessed through a periodontal probe to measure the diameter length (mm); pain was evaluated through the Visual Analogue Scale (VAS); parental satisfaction was assessed through a questionnaire.
The difference in the reduction of ulcers diameters between the two groups resulted statistically significant at T1 and at T2 (p<0.05). A statistically significant difference in pain reduction between two groups was found at T1 (p<0.05). No statistically significant difference between the two groups of parents was found as concerns the parental acceptance of the procedure and the discomfort for the need of multiple appointments.
PBMT is to be considered effective in the treatment of MiRAS in children and well- accepted by the parents of the children themselves.
•Detailed results of ADI response at high strain rates and different temperatures are presented an discussed.•The constitutive law for ausferrite is determined.•A unit cell model was validated with ...in situ residual stress and strain measurements.•The unit cell model results provided a possible explanation for the observed increase of ductility at high strain rates.
In this work, the uniaxial stress-strain response of austenitic ductile iron at high strain rate has been investigated. Traction tests were performed at low (0.001/s) and high rates (740/s and 1200/s) at RT and low temperature. Results showed that the strain rate has a considerable effect on work hardening and ductility. The work hardening seems to be the result of the competition of ferrite and retained austenite behavior under varying combinations of temperature and strain rate. The strain rate was found to increase the material failure strain. Numerical simulations performed with unit cell model indicated that this effect could due to strain localization along inter-spheroids ligaments supported by thermal softening.
The report describes a recent landslide occurred in San Leo (northern Italy), an outstanding village from the historical, architectural and landscape point of view. On February 27, 2014, around 6
pm
...local time, about 0.30 Mm
3
of rock detached from a sub-vertical cliff and fell into the facing valley, producing a roar and a shake, which was initially perceived by the inhabitants as an earthquake, then followed by a dust cloud produced by the fragmentation of material during the collapse. Fortunately, nobody was injured, neither the landslide damaged any relevant structure; anyhow, it is still posing a severe threat to the village and, above all, to the fortress that represents an architectural masterpiece dating back to the middle ages. An outlook of the event will be given, along with the description of the peculiar geological and geomorphological features driving the slope instability phenomena, which indeed are widely diffused in the entire region. Lastly, an overview of the landslides, which historically affected the village, is also given, showing how natural hazards can influence the history of a site.
To evaluate the clinical effectiveness of a topical sialogogue spray (malic acid, 1%) in the treatment of xerostomia in patients with chronic Graft versus Host Disease (cGVHD).
This study was ...designed as a randomized double-blind clinical study. Twenty-eight patients with cGVHD suffering from xerostomia were divided into 2 groups: the first group (14 patients) received a topical sialagogue spray containing malic acid 1% (SalivAktive®) whereas the second group (14 patients) received a placebo. Both groups received treatment for 2 weeks. Dry Mouth Questionnaire (DMQ) scores and unstimulated salivary flows rate were collected before and after treatment.
DMQ scores increased significantly from 1.3 ± 0.4 to 3.5 ± 0.4 points (p<0.05) after two weeks of treatment with malic acid, whereas in the control group DMQ scores increased from 1.2 ± 0.7 points to 1.4 ± 0.6 (p>0.05). The unstimulated salivary flow rate in patients treated with malic acid increased significantly from 0.15 ± 0.06 mL/min to 0.24± 0.08 mL/min, while that of the patients treated with placebo went from 0.16 ± 0.07 mL/min to 0.17 ± 0.09 mL/min (p>0.05).
Malic acid 1% spray can be considered effective in the treatment of GVHD induced xerostomia.
Pleomorphic adenoma (PA) mostly involves parotid glands, while extra-parotid localizations are relatively uncommon. Particularly, PAs of the cheek minor salivary glands with a size larger than 4 cm ...are exceedingly rare, with only few cases reported. Surgical treatment of PA usually consists in radical excision. However, despite a presumptive radicality, recurrences, sometimes followed by malignant transformation, may occur. Here we report a case of a large-sized (6 cm) PA of the cheek minor salivary glands in a 70 year-old female patient, successfully treated through a conservative approach, based on the use of Nd:YAG Laser (λ=1064 nm). No recurrences were observed after a 2-year follow-up. A concise review of the literature, describing the features of 14 cases is also provided. Advantages of laser treatment include a precise cut, reduction of trauma on surrounding tissues, the possibility of a very good intraoperative hemostasis. Such features may sometimes allow to avoid general anesthesia, even for removal of big lesions. Post-operative course, in terms of pain and swelling, is usually better for intervention performed with laser, when compared to traditional surgery.
Key words:
Oral surgery, oral pathology, pleomorphic adenoma, laser surgery, minor salivary glands, salivary glands tumors.
Oral carcinoma is the seventh most common malignant tumour worldwide. The main prognostic factor influencing the 5-year survival rate is tumour stage at diagnosis; therefore, early diagnosis is of ...paramount importance. Several visual diagnostic aids, such as auto-fluorescence (AF) analysis, have been developed as adjunctive tools to increase the diagnostic accuracy of the traditional diagnostic pathway (white light conventional oral examination (cOE) followed by biopsy) (1). AF directly depends on the nature, amount and microenvironment of endogenous fluorophores such as keratin, collagen, NAD(P)H, flavins, and other proteins, mainly involved in metabolic processes and structural organization of tissues (2). Fluorophores are excited by ultraviolet or blue light (Л: 375-460 nm) and they emit green AF in normal conditions. The aim of this study is to evaluate the correlation between clinical, histopathological and AF features of oral lesions suspicious for oral epithelial dysplasia (OED) and oral carcinoma (OC). 50 lesions were investigated at the Oral Medicine and Laser Surgery Unit of the University of Parma, Italy. A suitable system emitting 400-460 nm light (VELscopeVx - LED Medical Diagnostics Inc., Barnaby, Canada) was used to assess AF. Incisional or excisional biopsies, followed by histological examination, were performed in each case. Concerning their clinical appearance, the lesions were classified as red (erosive, ulcerated or atrophic areas), white (hyperkeratosis) or combined (lichenoid or leuco-erythroplastic lesions). Regarding the histological diagnosis they were graded as no dysplasia, dysplasia (mild or moderate) and carcinoma (in situ, micro-invasive, verrucous or invasive). White light and fluorescence images were acquired and a digital elaboration was performed with the software ImageJ (National Institute of Health - NIH, USA), to indirectly measure the AF intensity. We thus considered both a visual and a numerical assessment of AF, which was graded as hypo-fluorescence, normo-fluorescence and hyper-fluorescence. Considering the AF grading attribution, there was a mild discrepancy between visual and numerical evaluation, probably due to confounding factors during the observation. Red lesions were related to hypo-fluorescence, whereas white lesions were mostly related to hyper-fluorescence due to keratin. There was a statistically significant association between histological alteration (OED or carcinoma) and AF alteration considering both hypo- and hyper-fluorescence (p<0.05 for visual AF, p<0.001 for numerical AF). OED and carcinoma are particularly associated with hypo-fluorescence, excluding verrucous carcinomas, which appear hyper-fluorescent because of intense keratinization. It was also found a statistically significant difference in the AF numerical value distribution related to diagnosis, with decreasing values progressing from no dysplasia to dysplasia and carcinoma. AF alteration is statistically related to histological alteration. Note that not only hypo-fluorescence, but also hyper-fluorescence should be investigated, especially if it is associated with anamnestic and clinical suspicious features. Since this correlation is stronger with numerical AF than with visual AF, it coulc be useful adding an AF simultaneous quantification method to the mere observation. It seems that dysplastic and neoplastic progression induces important modifications to endogenous fluorophores, which result in an alteration of the normal AF pattern of the oral mucosa. Hence AF analysis is a valid adjunctive technique, when associated to the clinician experience and knowledge. AF analysis may be used to spot lesions at risk, to identify suitable sites for incisional biopsies and to define excision margins of the lesions.
Treatment of patients with hepatic metastases from colorectal cancer using hepatic artery fluorodeoxyuridine (FUDR) has been reported to induce high remission rates but also a high incidence of ...limiting hepatobiliary toxicity. In an attempt to obviate the limiting FUDR toxic effects, a phase I-II study was undertaken to establish the efficacy and tolerability of intra-hepatic 5-fluorouracil (5-FU) when given in combination with 5-methyltetrahydrofolate. Patients with colorectal liver metastases (n = 17) received escalating doses of 5-FU as a 1 h infusion with a fixed dose (100 mg/m2) of intra-hepatic 5-methyltetrahydrofolate (4 h infusion) once a week. Dose limiting toxicity was hepatic and gastrointestinal (diarrhea) and occurred at doses > or = 350 mg/m2 5-FU. Other adverse effects included nausea/vomiting and cutaneous toxicity. One patient achieved a complete response and 2 a partial response (mean duration = 9 months) while 11 had stable disease. Patients with complete or partial responses had a mean survival of 17 months, while patients with stable disease survived 13 months and those with disease progression 5.5 months on average. These results suggest that this is a well tolerated regimen although with efficacy at the lower level of the range observed with fluoropyrimidines.
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