Multicenter observational study on the reliability of the HEART score

Nicola Parenti,Giuseppe Lippi,Maria Letizia Bacchi Reggiani,Antonio Luciani,Mario Cavazza,Antonello Pietrangelo,Alberto Vegetti,Lucio Brugioni,Laura Bonfanti,Gianfranco Cervellin 대한응급의학회 2019 Clinical and Experimental Emergency Medicine Vol.6 No.3

Objective To rapidly and safely identify the risk of developing acute coronary syndrome in patients with chest pain who present to the emergency department, the clinical use of the History, Electrocardiogram, Age, Risk Factors, and Troponin (HEART) scoring has recently been proposed. This study aimed to assess the inter-rater reliability of the HEART score calculated by a large number of Italian emergency physicians. Methods The study was conducted in three academic emergency departments using clinical scenarios obtained from medical records of patients with chest pain. Twenty physicians, who took the HEART score course, independently assigned a score to different clinical scenarios, which were randomly administered to the participants, and data were collected and recorded in a spreadsheet by an independent investigator who was blinded to the study’s aim. Results After applying the exclusion criteria, 53 scenarios were finally included in the analysis. The general inter-rater reliability was good (kappa statistics [κ], 0.63; 95% confidence interval, 0.57 to 0.70), and a good inter-rater agreement for the high- and low-risk classes (HEART score, 7 to 10 and 0 to 3, respectively; κ, 0.60 to 0.73) was observed, whereas a moderate agreement was found for the intermediate-risk class (HEART score, 4 to 6; κ, 0.51). Among the different items of the HEART score, history and electrocardiogram had the worse agreement (κ, 0.37 and 0.42, respectively). Conclusion The HEART score had good inter-rater reliability, particularly among the high- and low-risk classes. The modest agreement for history suggests that major improvements are needed for objectively assessing this component.

Prevalence of incidental maxillary sinus findings in Italian orthodontic patients: a retrospective cone-beam computed tomography study

Gracco, Antonio,Parenti, Serena Incerti,Ioele, Christian,Bonetti, Giulio Alessandri,Stellini, Edoardo The Korean Association Of Orthodontists 2012 대한치과교정학회지 Vol.42 No.6

Objectives: To determine the prevalence of incidental maxillary sinus findings in a large sample of orthodontic patients by cone-beam computed tomography (CBCT) with a wide field of view and assess the relationships of such abnormalities with age and gender. Methods: Five hundred thirteen CBCT scans obtained for orthodontic diagnosis and treatment planning in a Northern Italian population (N = 513; 292 female and 221 male subjects; 1,026 maxillary sinuses) were studied. The frequencies of pseudocysts and mucosal thickening of the maxillary sinus were recorded. Logistic regression analysis was used to determine the influence of age and gender on these abnormalities. Results: Pseudocysts were detected in 52 patients (10.1%) and 59 sinuses (5.75%). Mucosal thickening was observed in 206 patients (40.1%) and 258 sinuses (25.1%). Gender and age were significantly associated with pseudocysts (p = 0.027) and mucosal thickening (p < 0.001), respectively. Conclusions: Half of the orthodontic patients had incidental maxillary sinus findings. Men were more likely to show pseudocysts, and older patients (aged 41 - 60 years) were more likely to show mucosal thickening.

Prevalence of incidental maxillary sinus findings in Italian orthodontic patients

Antonio Gracco,Serena Incerti Parenti,Christian Ioele,Giulio Alessandri Bonetti,Edoardo Stellini 대한치과교정학회 2012 대한치과교정학회지 Vol.42 No.6

Objectives: To determine the prevalence of incidental maxillary sinus findings in a large sample of orthodontic patients by cone-beam computed tomography (CBCT) with a wide field of view and assess the relationships of such abnormalities with age and gender. Methods: Five hundred thirteen CBCT scans obtained for orthodontic diagnosis and treatment planning in a Northern Italian population (N = 513; 292 female and 221 male subjects; 1,026 maxillary sinuses) were studied. The frequencies of pseudocysts and mucosal thickening of the maxillary sinus were recorded. Logistic regression analysis was used to determine the influence of age and gender on these abnormalities. Results: Pseudocysts were detected in 52 patients (10.1%) and 59 sinuses (5.75%). Mucosal thickening was observed in 206 patients (40.1%) and 258 sinuses (25.1%). Gender and age were significantly associated with pseudocysts (p = 0.027) and mucosal thickening (p < 0.001), respectively. Conclusions: Half of the orthodontic patients had incidental maxillary sinus findings. Men were more likely to show pseudocysts, and older patients (aged 41 - 60 years) were more likely to show mucosal thickening.

Interdisciplinary rehabilitation of a root-fractured maxillary central incisor

Giulio Alessandri Bonetti,Serena Incerti Parenti,Maurizio Ciocci,Luigi Checchi 대한치과교정학회 2014 대한치과교정학회지 Vol.44 No.4

Single-tooth implantation has become a common treatment solution for replacement of a root-fractured maxillary incisor in adults, but the long-term esthetic results can be unfavorable due to progressive marginal bone loss, resulting in gingival recession. In this case report, a maxillary central incisor with a root fracture in its apical one-third was orthodontically extruded and extracted in a 21-year-old female. Implant surgery was performed after a 3-month healing period, and the final crown was placed about 12 months after extraction. After 12 years, favorable osseous and gingival architectures were visible with adequate bone height and thickness at the buccal cortical plate, and no gingival recession was seen around the implant-supported crown. Although modern dentistry has been shifting toward simplified, clinical procedures and shorter treatment times, both general dentists and orthodontists should be aware of the possible long-term esthetic advantages of orthodontic extrusion of hopelessly fractured teeth for highly esthetically demanding areas and should educate and motivate patients regarding the choice of this treatment solution, if necessary.

Effects of ultrasonic instrumentation with different scaler-tip angulations on the shear bond strength and bond failure mode of metallic orthodontic brackets

Giulio Alessandri Bonetti,Serena Incerti Parenti,Daniela Rita Ippolito,Maria Rosaria Gatto,Luigi Checchi 대한치과교정학회 2014 대한치과교정학회지 Vol.44 No.1

Objective: To evaluate the effects of ultrasonic instrumentation with different scaler-tip angulations on the shear bond strength (SBS) and bond failure mode of metallic orthodontic brackets. Methods: Adhesive pre-coated metallic brackets were bonded to 72 extracted human premolars embedded in autopolymerizing acrylic resin. The teeth were randomly divided into 3 groups (n = 24 each) to undergo no treatment (control group) or ultrasonic instrumentation with a scaler-tip angulation of 45˚ (45˚-angulation group) or 0˚ (0˚-angulation group). SBS was tested in a universal testing machine, and adhesive remnant index (ARI) scores were recorded. The Kruskal-Wallis test and Mann-Whitney U-test were used for statistical analysis. Results: The control group had a significantly higher mean SBS value than the treated groups, which showed no significant differences in their mean SBS values. The ARI scores were not significantly different among the groups. Conclusions: Ultrasonic instrumentation around the bracket base reduces the SBS of metallic orthodontic brackets, emphasizing the need for caution during professional oral hygiene procedures in orthodontic patients. The scaler-tip angulation does not influence the SBS reduction and bond failure mode of such brackets.

Unusual Cross-Linked Polystyrene by Copper-Catalyzed ARGET ATRP Using a Bifunctional Initiator and No Cross-Linking Agent

Niccolò Braidi,Mirko Buffagni,Valentina Buzzoni,Franco Ghelfi,Francesca Parenti,Maria Letizia Focarete,Chiara Gualandi,Elena Bedogni,Luisa Bonifaci,Gianfranco Cavalca,Angelo Ferrando,Aldo Longo,Ida Mo 한국고분자학회 2021 Macromolecular Research Vol.29 No.4

An anomalous polystyrene gel was obtained during the copper-catalyzed “activators regenerated by electron transfer” “atom transfer radical polymerization” (ARGET ATRP) of styrene at 60-70 °C, using ascorbic acid/Na2CO3 as the reducing system and EtOAc/EtOH as the solvent mixture. The result is remarkable since no branching nor cross-linking reagents were added to the reaction mixture and their formation in situ was excluded. The anomalous PS branching, at the origin of the phenomenon, requires a generic bifunctional initiator and is mechanistically bound to termination reactions between bifunctional macroinitiators. As a matter of fact, the branching/cross-linking phenomenon loses intensity, or even disappears, under reaction conditions that cause the built-up of CuII or increase the chain polymerization rate. The temperature is also a critical variable since no branching was observed for temperatures higher than 90 °C. We believe that the route toward gelation starts with a controlled chain polymerization of styrene from the bifunctional initiator, soon integrated by a step-growth polymerization due to radical coupling of the terminal units. The progressive decrease in the number of chains and free radicals in the reaction mixture should make more and more probable the intramolecular coupling between the C−Cl ends of the remaining long and entangled chains, producing a polycatenane network.

Copper-Catalysed “Activators Regenerated by Electron Transfer” “Atom Transfer Radical Polymerisation” of Styrene from a Bifunctional Initiator in Ethyl Acetate/Ethanol, Using Ascorbic Acid/Sodium Carbonate as Reducing System

Niccolò Braidi,Mirko Buffagni,Franco Ghelfi,Manuel Imperato,Alberto Menabue,Francesca Parenti,Armando Gennaro,Abdirisak A. Isse,Elena Bedogni,Luisa Bonifaci,Gianfranco Cavalca,Angelo Ferrando,Aldo Lon 한국고분자학회 2020 Macromolecular Research Vol.28 No.8

A new copper(II) chloride/tris(2-piridylmethyl)amine (1/1) catalysed “Activators Regenerated by Electron Transfer” “Atom Transfer Radical Polymerisation” (ARGET ATRP) process for the polymerisation of styrene is described. The salient features of the method are the simultaneous use of ascorbic acid (reducing agent) and Na2CO3 (basic agent), the employment of a bifunctional initiator (ethyl 2,2-dichloropropionate) and the utilisation of a green solvent mixture composed of ethyl acetate and ethanol (AcOEt/EtOH). Na2CO3 plays a central role since not only preserves the ligand from protonation, but it can also activate the reducing agent. The quantity of monomer in the reaction mixture, the AcOEt/EtOH ratio and the load of ascorbic acid/carbonate are important factors for achieving a regular transformation. Working at 100 °C and with a metal load of only 0.025 mol%, an almost perfectly controlled telechelic polystyrene is produced, provided that conversion is kept below 50%. If conversion is higher, the control is gradually lost due superimposition of a step-growth process to the main chain polymerisation process. Two interesting phenomena, encountered during this study, are activation of the redox complex by using only Na2CO3 and gelation of polystyrene at 60 °C.

Cephalometric predictors of treatment outcome with mandibular advancement devices in adult patients with obstructive sleep apnea : a systematic review

Giulio Alessandri-Bonetti,Daniela Rita Ippolito,Maria Lavinia Bartolucci,Vincenzo D’Anto,Serena Incerti-Parenti 대한치과교정학회 2015 대한치과교정학회지 Vol.45 No.6

Objective: The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods: The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions: Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed.