Riabilitazione protesica ed implanto-protesica di pazienti in età evolutiva affetti da Displasia Ectodermica

Introduction. Ectodermal Dysplasias are a heterogeneous group of inherited disorders characterized by dysplasia of tissues of ectodermal origin (hair, nails, teeth, skins and glands). Clinically, it may be divided into two broad categories: the X-linked hypoidrotic form and the hidrotic form. Hypohidrotic Ectodermal Dysplasia (H.E.D) is characterized by the triad oligo-anodontia, hypotricosis, hypo-anhydrosis (Christ-Siemens-Tourane syndrome). The incidence of HED is about 1/100,000. Mutation in the actodysplasin-A (EDA) and ectodysplasin-A receptor (EDAR) genes are responsible for X-linked and autosomal HED. The clinical features include sparse, fine hair, missing or conical-shaped teeth, decreased sweat and mucous glands, hypoplastic skin, and heat intolerance with exercise or increased ambient temperature. Complete or partial anodontia and malformation of teeth are the most frequent dental findings. Incisors and canines are often conical-shaped while primarily second molars, if present, are mostly affected by taurodontism. Treatment is supportive and includes protection from heat exposure, early prosthetic rehabilitation, skin, hair ear, nose and nail care, and genetic counseling for family planning. The diagnosis of HED in the neonatal and early infancy period may be difficult since sparse hair and absent teeth are normal finding at this age. In childhood the diagnosis is more easily made on the basis of history and clinical examination. Dental abnormalities are the most common complaint. Prosthetic rehabilitation has been recommended as an essential part of the management of HED because is important from functional, esthetic, and psychological standpoint. A team approach that includes input from a pediatric dentist, an orthodontist, a prosthodontist, and an oral and maxillofacial surgeon is necessary for a successful outcome. Conventional prosthodontic rehabilitation in young patient is often difficult because of the anatomical abnormalities of existing teeth and alveolar ridges. The conical shaped teeth and “knife-edge” alveolar ridges result in poor retention and instability of dentures. Moreover, denture must permit jaws expansion and a correct pattern of growth. Materials and Methods. Complete removable dentures were provided to allow for normal physiological development and a corrected masticatory function. Initial maxillary and mandibular impressions were made with smallest stock trays and irreversible hydrocolloid and then final impressions ware made with light-bodied polysulfide rubber base impression material. A base of autopolymerizing resin was constructed and a wax rim was added to the base. The patient’s vertical dimension of occlusion was established by assessing phonetic and esthetic criteria. Preliminary occlusal relations were recorded, and the mandibular cast was mounted on the articulator. Acrylic resin teeth specific for children dentures were selected and mounted. The dentures were tried in and, after proper adjustments, were inserted. The patients were monitored clinically every month to fit prostheses. Cephalometric radiographs were taken every 6 month with the prostheses in place in order to evaluate correct pattern of growth. Cephalometric measurements were realized and used to evaluate the effect of rehabilitation on craniofacial growth. Cephalometric measurements of sound patients were compared with ED patients. After two month expander screws (three-way screw in the upper denture and two-way the lower one)were inserted in each denture in order to permit the expansion of the denture and the jaws growth. Where conical teeth were present, composite crown were realized and luted to improve the esthetic and phonesis. In order to improve retention the placement of endosseous implants was carried out. TC 3D Accuitomo was performed and a resin model of mandibular bone of the patient was realized. At the age of 11 years two implants were inserted into anterior mandible in a child with anodontia. Despite a remarkable multi-dimensional atrophy of the mandibular alveolar process, the insertion of two tapered screw implants (SAMO Smiler, diameter 3.8, length 10 mm). After a submerged healing period of two-three month, the implants were exposed. Implants were connected with an expansion guide that permits mandibular growth and prosthetic retention. The amount of mandibular growth was also evaluate dusing the expansion guide. Results. Early oral rehabilitation improve oral function, phonesis and esthetic, reducing social impairment. Treated patients showed normal cephalometric measurement. Early rehabilitation is able to prevent the prognatissm of the mandibula . The number of teeth was significantly related to several changes in craniofacial morphology. Discussion. In the present study the 5,3% of ED patients showed hypodontia, the l’89,4% di oligodontia, and the 5,3% di anodontia. The cephalometric analysis supports that ED patients showed midface hypoplasia. ED groups showed an increased pogonion to nasion measurement than sound patients, indicative of class III tendency. The present study demonstrated that number of teeth was significantly correlated with deviation of cephalometric measurements from normality. Oligoanodontia is responsible for changing of cephalometric measuraments also on sagittal plane with a class III tendency. Maxillary jaw showed a retrused position related to the presence of hypodontia.

La traduction des textes de théatre. Analyse comparée des réalités contemporaines française et italienne

The aim of the present study is to address contemporary drama translation by comparing two different scenarios, namely France and Italy. For each country, the following areas are described: publications of translated drama texts, their promotion and dissemination, the legal framework concerning copyright in publication and performance contracts. Moreover, the analysis highlights that the translation process of drama texts is part of a working cycle networking different professional figures, such as dramatic authors, directors, actors and publishers. Within this cycle, the translator is in a middle and central position at the same time, a sort of border zone between different contexts, i.e. the source language and culture and the target language and culture. As regards translation-related issues, on the basis of theoretical approaches that can be applied to drama translation, a number of translators’ opinions, statements, positions and practices are compared, thus highlighting an idea of drama translation wavering between translation and adaptation. Drama translators seem to follow these two orientations simultaneously, in compliance with translation ethics and the functional needs of target texts. Such ambivalence is due to the desire and difficulty of translating the specific nature of drama texts, i.e. translating textual elements that are linked, eventually, to stage performance. Indeed, the notion of text or form fidelity is replaced by the notion of fidelity to the theatrical value of a text, in terms of fidelity to its theatrical nature and rhythmical tension. The analysis reveals that drama translators work together with theatre operators, and that in many cases translators are authors, directors or actors themselves. These drama skills enable translators to apply relevant strategies when translating elements that generate rhythm, thus choosing from deleting, reproducing or recreating.

Nonverbal emotional regulation in psychotherapy process according to an intersubjective perspective

In recent decades fascinating studies in developmental psychology, especially in infant research (for review see Lavelli, 2007) and recent discoveries in neuroscience (Welsh, et al, 2007; Siegel, 2001; Pally, 2007) have brought great interest to study the mode of sharing subjective experiences (affective states, intentions and attentional focus) in children and adults.It therefore appears today in the clinic is a growing consensus about the fact that the psychological disorder can be read as a deficit in intersubjective processes of affect regulation (see Benecke C. et al 2005; psychodynamic Diagnostic Manual-PDM, 2006) leading many authors to assume the centrality of affect regulation in the construction of the psychotherapeutic process of change (just to name a few Tronick, Greenberg, Stern, Sander, Fonagy, Beebe, Philippot, Rimé etc..). As previously stated, this study has led us to hypothesize that the long process of therapy is to assist with the sessions continue, a growing "emotional attunement" between the communication styles of both patient and therapist. And also to speculate that this synchronization can represent the existence of a significant positive correlation between the increased level of "emotional synchronization" and increased capacity for regulation of emotions by the patient.The research results despite the limitations of small sample showed encouraging results about the verification of the existence of an increasing degree of attunement between therapist and patient long psychotherapy sessions and also showed a good degree of positive correlation between the increase the latter construct and emotional regulation through the implicit mode of expression and nonverbal communication.

Valutazione della relazione tra composizione corporea e stili di vita in soggetti di età scolare

Il lavoro svolto in questa tesi si propone di valutare la variabilità della composizione corporea nell’infanzia e nell’adolescenza, con particolare attenzione alla transizione dalla prima alla seconda, in relazione allo stato nutrizionale ed agli stili di vita. Lo studio è stato condotto eseguendo misure antropometriche presso scuole primarie e secondarie di Bologna. Sono stati analizzati inoltre dati acquisiti a partire dal 2004. Il campione analizzato comprende 3546 soggetti di età compresa tra 6 anni e 14 anni. In particolare sono state analizzate le principali misurazioni utili per il calcolo della composizione corporea, evidenziando i parametri antropometrici principali quali BMI, circonferenza vita, WHR, %F e FFM. Questi caratteri sono stati quindi messi in relazione con le informazioni inerenti l’attività sportiva extrascolastica e gli stili di vita dei soggetti esaminati. L’analisi trasversale delle principali caratteristiche antropometriche ha fornito un interessante panorama della situazione italiana e del nord Italia; lo studio longitudinale delle variabili antropometriche permette di ottenere un quadro aggiornato dei principali incrementi delle misure corporee. La valutazione della variabilità della composizione corporea in relazione all’attività sportiva e allo stile di vita durante il processo di accrescimento ha indicato come abitudini sane e propensione all’attività motoria sono sicuramente in grado di apportare miglioramenti nella modificazione della composizione corporea nel processo evolutivo specialmente se somministrate con modalità adeguate all’età e alle esigenze individuali. Questi aspetti sono certamente rilevanti e complessi, sarebbe infatti interessante in prospettiva futura riuscire ad indagare ancora più dettagliatamente sull’interazione tra i fattori che determinano e modificano la composizione corporea in un periodo della vita così particolare come la transizione dall’infanzia all’adolescenza.

La ricostruzione dell'assetto topografico della VI regio augustea di Roma dal periodo repubblicano all'età tardoantica

La VI regio augustea di Roma rappresenta uno dei settori urbani maggiormente investiti dalle modifiche radicali compiute dall’uomo nel processo di urbanizzazione della città che ne hanno modificato profondamente la situazione altimetrica e la conformazione originaria. Questi notevoli cambiamenti ebbero origine sin dall’età antica, ma si intensificarono profondamente soprattutto nel periodo rinascimentale quando a partire da Pio IV e soprattutto con Sisto V, attivo in tante altre zone della città, si svilupparono numerose opere di rinnovamento urbanistico che incisero notevolmente sul volto e sulle caratteristiche della zona in esame. A partire dal Rinascimento fino ad arrivare ai grandi scavi della fine del 1800 tutto il quartiere incominciò a “popolarsi” di numerosi edifici di grande mole che andarono ad intaccare completamente le vestigia del periodo antico: la costruzione del Palazzo del Quirinale e dei vari palazzi nobiliari ma soprattutto la costruzione dei numerosi ministeri e della prima stazione Termini alla fine dell’800 comportarono numerosi sventramenti senza la produzione di una adeguata documentazione delle indagini di scavo. Questa ricerca intende ricostruire, in un’ottica diacronica, la topografia di uno dei quartieri centrali della Roma antica attraverso l’analisi dei principali fenomeni che contraddistinguono l’evoluzione del tessuto urbano sia per quanto riguarda le strutture pubbliche che in particolar modo quelle private. Infatti, il dato principale che emerge da questa ricerca è che questa regio si configura, a partire già dal periodo tardo-repubblicano, come un quartiere a vocazione prevalentemente residenziale, abitato soprattutto dall’alta aristocrazia appartenente alle più alte cariche dello Stato romano; oltre a domus ed insulae, sul Quirinale, vennero costruiti lungo il corso di tutta l’età repubblicana alcuni tra i più antichi templi della città che con la loro mole occuparono parte dello spazio collinare fino all’età tardoantica, rappresentando così una macroscopica e costante presenza nell’ingombro dello spazio edificato.