Guidelines of Special Care Dentistry in Patients with Chromosomal and Genetic syndromes

Chromosomal and genetic syndromes are frequently associated with dental and cranio-facial alterations. The aim of our study is to identify and describe the dental and craniofacial alterations typical of six genetic and chromosomal syndromes examined. Materials and Methods- A dental visit was performed to 195 patients referred from Sant’Orsola Hospital of Bologna, University of Bologna, to Service of Special Need Dentistry, Dental Clinic, Department of Biomedical and Neuromotor Science, University of Bologna. The patients recruited were 137 females and 58 males, in an age range of 3-49 years (mean age of 13.8±7.4). The total sample consisted of subjects affected with Down Syndrome (n=133), Familiar Hypophosphatemic Ricket (n=10), Muscular Dystrophies (n=12), Noonan Syndrome (n=13), Turner Syndrome (n=17), Williams Syndrome(n=10). A questionnaire regarding detailed medical and dental history, oral health and dietary habits, was filled by parents/caregivers, or patients themselves when possible. The intra-oral and extra-oral examination valued the presence of facial asymmetries, oral habits, dental and skeletal malocclusions, dental formula, dental anomalies, Plaque Index (Silness&LÖe Index), caries prevalence (dmft/DMFT index), gingivitis and periodontal disease, and mucosal lesions. Radiographic examinations (Intraoral radiographies, Orthopanoramic, Skull teleradiography) were executed according to patient’s age and treatment planning. A review of literature about each syndrome and its dental and cranio-facial characteristics and about caries, hygiene status and malocclusion prevalence on syndromic and non-syndromic population was performed. Results - The data of all the patients were collected in the “Data Collection Tables” created for each syndrome. General anamnesis information, oral hygiene habits and dmft/DMFT, PI, malocclusion prevalence were calculated and compared to syndromic and non-syndromic population results found in literature. Discussions and conclusions - Guidelines of Special Care dentistry were indicated for each syndrome, in relation to each syndrome features and individual patient characteristics.

Photophysics of Carbon Nanotubes: from Dispersion to Supramolecular Systems

The aim of this PhD thesis is the investigation of the photophysical properties of materials that can be exploited in solar energy conversion. In this context, my research was mainly focused on carbon nanotube-based materials and ruthenium complexes. The first part of the thesis is devoted to carbon nanotubes (CNT), which have unique physical and chemical properties, whose rational control is of substantial interest to widen their application perspectives in many fields. Our goals were (i) to develop novel procedures for supramolecular dispersion, using amphiphilic block copolymers, (ii) to investigate the photophysics of CNT-based multicomponent hybrids and understand the nature of photoinduced interactions between CNT and selected molecular systems such as porphyrins, fullerenes and oligo (p-phynylenevinylenes). We established a new protocol for the dispersion of SWCNTs in aqueous media via non-covalent interactions and demonstrated that some CNT-based hybrids are suitable for testing in PV devices. The second part of the work is focussed on the study of homoleptic and heteroleptic Ru(II) complexes with bipyridine and extended phenanthroline ligands. Our studies demonstrated that these compounds are potentially useful as light harvesting systems for solar energy conversion. Both CNT materials and Ru(II) complexes have turned out to be remarkable examples of photoactive systems. The morphological and photophysical characterization of CNT-based multicomponent systems allowed a satisfactory rationalization of the photoinduced interactions between the individual units, despite several hurdles related to the intrinsic properties of CNTs that prevent, for instance, the utilization of laser spectroscopic techniques. Overall, this work may prompt the design and development of new functional materials for photovoltaic devices.

Cognitive and behavioural assessment of parkinsonian syndromes at onset: a longitudinal study

Background: cognitive impairment is one of the non motor features widely descripted in parkinsonian syndrome, it has been related to the motor characteristics of the parkinsonian syndrome, associated with neuropsychiatric dysfunction and the characteristic sleep and autonomic features. It has been shown to be highly prevalent at all disease stages and to contribute significantly to disability. Objectives: aim of this study is to evaluate longitudinally the cognitive and behavioral characteristics of patients with a parkinsonian syndrome at onset; to describe the cognitive and behavioral characteristics of each parkinsonian syndrome; to define in PD patients at onset the presence of MCI or Parkinson disease dementia; to correlate the cognitive and behavioral characteristics with the features of the parkinsonian syndrome and with the associated sleep and autonomic features. Results: we recruited 55 patients, 22 did not present cognitive impairment both at T0 and at T1. 18 patients presented a progression of cognitive impairment. Progressive cognitively impaired patients were older and presented the worst motor phenotype. Progression of cognitive impairment was not associated to sleep and autonomic features. Conclusion: the evaluation of cognitive impairment could not be useful as a predictor of a correct diagnosis but each non motor domain will help to clarify and characterize the motor syndrome. The diagnosis of parkinsonian disorders lies in building a clinical profile in conjunction with other clinical characteristics such as mode of presentation, disease progression, response to medications, sleep and autonomic features.

The velocity dispersion profile of the globular cluster 47Tucanae

Gli ammassi globulari rappresentano i laboratori ideali nei quali studiare la dinamica di sistemi ad N-corpi ed i suoi effetti sull’evoluzione stellare. Infatti, gli ammassi globulari sono gli unici sistemi astrofisici che, entro il tempo scala dell’età dell’Universo, sperimentano quasi tutti i processi di dinamica stellare noti. Questo lavoro di tesi si inserisce in un progetto a lungo termine volto a fornire una dettagliata caratterizzazione delle proprietà dinamiche degli ammassi globulari galattici. In questa ricerca, strumenti di fondamentale importanza sono il profilo di dispersione di velocità del sistema e la sua curva di rotazione. Per determinare le componenti radiali di questi profili cinematici in ammassi globulari galattici è necessario misurare la velocità lungo la linea di vista di un ampio campione di stelle membre, a differenti distanze dal centro. Seguendo un approccio multi-strumentale, è possibile campionare l’intera estensione radiale dell’ammasso utilizzando spettrografi multi-oggetto ad alta risoluzione spettrale nelle regioni intermedie/esterne, e spettrografi IFU con ottiche adattive per le regioni centrali (pochi secondi d’arco dal centro). Questo lavoro di tesi è volto a determinare il profilo di dispersione di velocità dell’ammasso globulare 47 Tucanae, campionando un’estensione radiale compresa tra circa 20'' e 13' dal centro. Per questo scopo sono state misurate le velocità radiali di circa un migliaio di stelle nella direzione di 47 Tucanae, utilizzando spettri ad alta risoluzione ottenuti con lo spettrografo multi-oggetto FLAMES montato al Very Large Telescope dell’ESO. Le velocità radiali sono state misurate utilizzando la tecnica di cross-correlazione tra gli spettri osservati e appropriati spettri teorici, e sono state ottenute accuratezze inferiori a 0.5km/s. Il campione così ottenuto (complementare a quello raccolto con strumenti IFU nelle regioni centrali) è fondamentale per costruire il profilo di dispersione di velocità dell’ammasso e la sua eventuale curva di rotazione. Questi dati, combinati col profilo di densità dell’ammasso precedentemente determinato, permetteranno di vincolare opportunamente modelli teorici come quelli di King (1966) o di Wilson (1975), e di arrivare così alla prima solida determinazione dei parametri strutturali e dinamici (raggi di core e di metà massa, tempo di rilassamento, parametro collisionale, etc.) e della massa totale e distribuzione di massa del sistema.

Acute coronary syndromes in young patients: Presentation, treatment and outcome

Background: Acute coronary syndromes (ACS) in very young patients have been poorly described. We therefore evaluate ACS in patients aged 35 years and younger. Methods: In this prospective cohort study, 76 hospitals treating ACS in Switzerland enrolled 28,778 patients with ACS between January 1, 1997, and October 1, 2008. ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). Results: 195 patients (0.7%) were 35 years old or younger. Compared to patients N35 years, these patients were more likely to present with chest pain (91.6% vs. 83.7%; P=0.003) and less likely to have heart failure (Killip class II to IV in 5.2% vs. 23.0%; Pb0.001). STEMI was more prevalent in younger than in older patients (73.1% vs. 58.3%; Pb0.001). Smoking, family history of CAD, and/or dyslipidemia were important cardiovascular risk factors in young patients (prevalence 77.2%, 55.0%, and 44.0%). The prevalence of overweight among young patients with ACS was high (57.8%). Cocaine abuse was associated with ACS in some young patients. Compared to older patients, young patients were more likely to receive early percutaneous coronary interventions and had better outcome with fewer major adverse cardiac events. Conclusions: Young patients with ACS differed from older patients in that the younger often presented with STEMI, received early aggressive treatment, and had favourable outcomes. Primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in adolescence.

Cellular actors, Toll-like receptors, and local cytokine profile in acute coronary syndromes

Inflammation plays a key role in acute coronary syndromes (ACS). Toll-like receptors (TLR) on leucocytes mediate inflammation and immune responses. We characterized leucocytes and TLR expression within coronary thrombi and compared cytokine levels from the site of coronary occlusion with aortic blood (AB) in ACS patients.

Different disparities of gender and race among the thrombotic thrombocytopenic purpura and hemolytic-uremic syndromes

Thrombotic thrombocytopenic purpura (TTP) and hemolytic-uremic syndrome (HUS) represent multiple disorders with diverse etiologies. We compared the gender and race of 335 patients enrolled in the Oklahoma TTP-HUS Registry across 21 years for their first episode of TTP or HUS to appropriate control groups. The relative frequency of women and white race among patients with TTP-HUS-associated with a bloody diarrhea prodrome and the relative frequency of women with quinine-associated TTP-HUS were significantly greater than their control populations. The relative frequency of women and black race among patients with idiopathic TTP and TTP-associated with severe ADAMTS13 deficiency was significantly greater than their control populations. The relative frequency of black race among patients who had systemic lupus erythematosus (SLE) preceding TTP was significantly greater than among a population of patients with SLE, and the relative frequency of black race among patients with other autoimmune disorders preceding TTP was significantly greater than their control population. No significant gender or race disparities were present among patients with hematopoietic stem cell transplantation-associated thrombotic microangiopathy, TTP associated with pregnancy, or TTP associated with drugs other than quinine. The validity of these observations is supported by the enrollment of all consecutive patients across 21 years from a defined geographic region, without selection or referral bias. These observations of different gender and race disparities among the TTP-HUS syndromes suggest the presence of different risk factors and may serve as starting points for novel investigations of pathogenesis.

Relating the physicochemical characteristics and dispersion of multiwalled carbon nanotubes in different suspension media to their oxidative reactivity in vitro and inflammation in vivo

Reactive oxygen species (ROS) production is important in the toxicity of pathogenic particles such as fibres. We examined the oxidative potential of straight (50 microm and 10 microm) and tangled carbon nanotubes in a cell free assay, in vitro and in vivo using different dispersants. The cell free oxidative potential of tangled nanotubes was higher than for the straight fibres. In cultured macrophages tangled tubes exhibited significantly more ROS at 30 min, while straight tubes increased ROS at 4 h. ROS was significantly higher in bronchoalveolar lavage cells of animals instilled with tangled and 10 mum straight fibres, whereas the number of neutrophils increased only in animals treated with the long tubes. Addition of dispersants in the suspension media lead to enhanced ROS detection by entangled tubes in the cell-free system. Tangled fibres generated more ROS in a cell-free system and in cultured cells, while straight fibres generated a slower but more prolonged effect in animals.

[A Swiss multicentric project to improve the prevention of cardiovascular event recurrence after acute coronary syndromes]

Recurrence of cardiovascular events and mortality remain high after acute coronary syndromes. A Swiss multicentric study, "Inflammation and acute coronary syndromes (ACS)--Novel strategies for prevention and clinical managements", is currently underway with the support of the Swiss National Science Foundation. The study includes a clinical research subproject of which the aim is to assess the impact of the ELIPS program (multi-dimEnsionaL prevention Program after acute coronary Syndrome) on the recurrence of cardiovascular events after an ACS. The basic research sub-projects aim to investigate novel cardiovascular risk biomarkers and genetic determinants of recurrence and to study the role of stem cells after an ACS. Another sub-project will evaluate intracoronary imaging techniques and the efficacy of different types of stents.

Effects of cardiology review of the electrocardiogram in patients with suspected acute coronary syndromes

Misclassification of the electrocardiogram (ECG) contributes to treatment errors in patients with acute coronary syndrome. We hypothesized that cardiology ECG review could reduce these errors.

Presentation and outcome of patients with acute coronary syndromes in eastern Nepal

The burden of ischemic heart disease (IHD) in developing countries is on the rise, due to urbanisation, industrialisation and the low availability of evidence based therapies and interventions.