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Most patients with idiopathic REM sleep behavior disorder (iRBD) will develop an overt α-synucleinopathy over time, with a rate of phenoconversion of 73.5% after 12 years from diagnosis. Several markers of phenoconversion were identified; however, most studies investigated biomarkers separately, with retrospective study designs, in small cohorts or without standardized data collection methods. The risk FActoRs PREdictive of phenoconversion in idiopathic REM sleep behavior disorder: the Italian STudy (FARPRESTO) is a multicentric longitudinal retrospective and prospective study with a cohort of incident (prospective recruitment) and prevalent (retrospective recruitment) iRBD patients, whose primary aim is to stratify the risk of phenoconversion, through the systematic collection by means of electronic case report forms of different biomarkers. Secondary aims are to (1) describe the sociodemographic and clinical characteristics of patients with iRBD; (2) collect longitudinal data about the development of α-synucleinopathies; (3) monitor the impact of iRBD on quality of life and sleep quality; (4) assess the correlation between phenoconversion, cognitive performance, and loss of normal muscle atony during REM sleep; (5) identify RBD phenotypes through evaluating clinical, biological, neurophysiological, neuropsychological, and imaging biomarkers; and (6) validate vPSG criteria for RBD diagnosis. The FARPRESTO study will collect a large and harmonized dataset, assessing the role of different biomarkers providing a unique opportunity for a holistic, multidimensional, and personalized approach to iRBD, with several possible application and impact at different levels, from basic to clinical research, and from prevention to management. The FARPRESTO has been registered at clinicaltrials.gov (NCT05262543).

C9orf72 mutation (C9+) is a common genetic cause of frontotemporal dementia and amyotrophic lateral sclerosis. C9+ clinical phenotype is heterogeneous and epilepsy has been recently described in few cases. We report a 47-year-old patient who developed reflex reading epilepsy (RRE) at the age of 19. After the first years with exclusive reflex seizures, afterwards the patients developed drug-resistant, unprovoked seizures and progressive cognitive deterioration. In the last years, a progressive motor impairment with spastic tetraparesis also occurred. During the hospitalization, the patient underwent an extensive workup identifying C9+ expansion and a family history suggestive for an autosomal dominant inheritance. This report, together with the few cases already described, raises the possibility that epileptic manifestations are part of the clinical phenotype of C9ORF72 mutation and reflect hyperexcitability of cortical networks involved in neurodegeneration.

We summarize here the progress in identifying the neuronal network as well as the function of paradoxical sleep and the gaps of knowledge that should be filled in priority. The core system generating paradoxical sleep localized in the brainstem is now well identified, and the next step is to clarify the role of the forebrain in particular that of the hypothalamus including the melanin-concentrating hormone neurons and of the basolateral amygdala. We discuss these two options, and also the discovery that cortical activation during paradoxical sleep is restricted to a few limbic cortices activated by the lateral supramammillary nucleus and the claustrum. Such activation nicely supports the findings recently obtained showing that neuronal reactivation occurs during paradoxical sleep in these structures, and induces both memory consolidation of important memory and forgetting of less relevant ones. The question that still remains to be answered is whether paradoxical sleep is playing more crucial roles in processing emotional and procedural than other types of memories. One attractive hypothesis is that paradoxical sleep is responsible for erasing negative emotional memories, and that this function is not properly functioning in depressed patients. On the other hand, the presence of a muscle atonia during paradoxical sleep is in favour of a role in procedural memory as new types of motor behaviours can be tried without harm during the state. In a way, it also fits with the proposed role of paradoxical sleep in setting up the sensorimotor system during development.

Fluoride is recommended for its cariostatic effect, but excessive fluoride intake may have health risks. Increased prevalence of dental fluorosis in areas with low fluoride content in drinking water has been attributed to the inappropriate excessive intake of fluoride supplements (tablets and drops) and toothpaste ingestion. The aim of the present study was to estimate the fluoride intake and the risk of fluorosis in children (6 months–6 years) in the Castelli Romani area (province of Rome, Italy), which is volcanic, therefore with a higher concentration of fluorine. Measurements of the fluoride content in drinking water, mineral waters, vegetables and commercial toothpaste for children were performed. The fluoride concentrations of all samples were determined using a Fluoride Ion Selective Electrode (GLP 22, Crison, Esp). Data were analyzed by descriptive statistics. Differences between samples were determined by Student’s t-test. The fluoride content in tap water samples collected from public sources averaged from 0.35 to 1.11 ppm. The Pavona area showed the highest content of fluoride with respect to the others (p ≤ 0.05). The fluoride content in mineral water samples averaged from 0.07 to 1.50 ppm. The fluoride content of some vegetables showed increased mean values when compared to control vegetables (p ≤ 0.05). Within the limitations of the present study, considerations should be made when prescribing fluoride toothpaste for infants (6 months–4 years) in the areas with high fluoride content, because involuntary ingestion is consistent.

Background Cognitive dysfunctions are very frequent in people living with multiple sclerosis (MS). Several studies have previously indicated grey matter (GM) atrophy as useful predictor of patients’ cognitive impairment. However, considerable uncertainty exists about the possible impact of deep grey matter volumes on cognition. This study aimed to evaluate the relationship of the subcortical (sc) GM volumes with the presence and severity of global and selective cognitive impairment in MS. Methods A group of MS patients with relapsing remitting course were enrolled. Patients underwent a neuropsychological evaluation by using the Brief Repeatable Battery of Neuropsychological Tests (BRBN) and the Delis–Kaplan Executive Function System Sorting Test (D-KEFST); z scores were estimated and items with z score below 2 standard deviation were considered failed. Thus, brain MRIs images were acquired and measurements of whole brain (WB), white matter (WM), and cortical grey matter (GM) were obtained by SIENAX. After FIRST tool segmentation, volumes of subcortical GM structures were also estimated. Results The sample included 50 MS patients, of which 16/50 (32%) subjects were cognitively impaired. Multiple regression analyses found a significant association of severity of cognitive impairment, defined as number of failed neuropsychological tests, with lower volumes of cortex (p=0.003), thalamus (p=0.009), caudate (p=0.011), putamen (p=0.020), pallidus (p=0.012) and hippocampus (p=0.045), independently from other MS features. In addition, an association between accumbens volume and D-KEFS ST FSC and D-KEFS ST FSD z scores was observed (p Conclusions Our results indicated that volumes of several scGM structures, and in particular of thalamus, contribute to determine cognitive dysfunctions in MS, mainly influencing the executive functioning. Further investigations in larger MS cohorts with cognitive impairment are necessary to better understand the structural brain damage underlying this “invisible disability”.

Introduction This study compared the efficacy of BioPure MTAD (Dentsply Tulsa, Tulsa, OK), 17% EDTA, and 42% citric acid in endodontic smear layer removal and degree of erosion in the apical third of endodontic canals. Methods Ninety-six extracted single-rooted human teeth were randomized into four groups ( n = 24) and instrumented using System GT nickel-titanium rotary instruments (Dentsply Tulsa, Tulsa, OK). Each canal was irrigated with one of the following solutions: BioPure MTAD, 17% EDTA, 42% citric acid, or 5.25% NaOCl (control). Next, all specimens were irrigated with 5.25% NaOCl. Results Evaluation by scanning electron microscopy showed no significant differences among test irrigants in removing the smear layer. However, the efficacy of BioPure MTAD and 17% EDTA in removing the smear layer was significantly greater than 5.25% NaOCl (control). The erosive effects of irrigating solutions could not be evaluated. Conclusions In conclusion, the protocols used in this study were not sufficient to completely remove the smear layer in the apical third of prepared root canals.

The purpose of this study was to evaluate morphological and biomechanical characteristics of a commercial mini-implant.Orthodontic low head mini implants, in the two available sizes of 1.5 and 2 mm, have been used. The electronic scanning microscope evaluation has been tested on 3 groups each one composed of 4 samples, observed in numerous enlargements and in the three dimensions of the space. The groups were composed of new mini implants, undamaged mini implants observed after their clinical use and mini-implants broken at the moment of their insertion or removal after their therapeutical use.The microscope analysis of unused mini implants has shown how the diameter reduction of the neck represents the area of greater weakness; such parameter is very important in determining screw resistance to fracture. In fact the fracture observed in vivo always happened to this degree. Some micro carvings and cracks were shown on the surface, these irregularities could facilitate or promote the enlargement of the cracking itself.From the results obtained it is clear that the steel is adequate for permanence in the oral cavity, and moreover the material itself is adapted to bear the pressure put on it during therapy. However, it remains advisable to make certain changes to better the surface and geometry of the miniscrews.

The need to be able to use a material with esthetic characteristics of ceramic and mechanical properties of the metallic brackets has led clinical and industrial research towards the realization of zirconium brackets. These brackets seem to respond to both the requirements of new esthetic concepts and of interesting biomechanical qualities: hardness, resistance to abrasion, resistance to compression, reduced coefficient of friction during mechanical sliding, stability in a humid temperature and to the aggression of oral fluids.Twenty samples of zirconium brackets have been observed at SEM realized using the metal injection molding (MIM) technology: 10 new ones used as base samples and 10 used samples with the purpose of assessing the morphologic aspect and the structural variations after clinical use.The comparison the samples showed some structural changes regarding the surface of the body of the brackets, while slot and wings maintain an interesting stability of construction, a moderate degree of abrasion even after the application of considerable clinical strength.The conclusion is drawn that the positive clinical response in the use of these brackets and the limited scientific literature on the use of zirconium in orthodontics is worthy of further research.

Topographic mapping of brain electrical activity has become a powerful tool in neurological diagnosis. Maps are obtained from a reduced number of actual measurements by means of mathematical interpolation. Most of these systems use linear combination of the values measured and, in spite of its importance, the choice of the exponent "n" in the weighting function is made ad hoc. In this paper we present a critical analysis of such method and propose an objective criterion for the estimation of that exponent. As well, we propose another criterion for determining the number of leads used in the interpolation of each point.

THE TREND of imported malaria cases in Italy from 1960 to 1988 is discussed. Comparative analysis of malaria incidence in the last three years is also presented. Since 1985, a rapid increase was recorded with 191 cases in a 1986, 287 in 1987 and 350 in 1988. In 1986-1988 Plasmodium falciparum was responsible for 74% cases of the total number, followed by P. vivax (21%), P. malariae (2.2%) and P. ovale (1%). 86% of the imported cases was acquired in African countries, 8% in Asia and 3% in South America. As far as travellers categories are concerned, workers represented 46% of the total population, tourists 37%, seamen and aircrew 2% and strangers coming from endemic malaria areas and travelling to Italy 16%. In 1986, 1987 and 1988 three, four and two deaths respectively, due to malaria, were reported.

The article reports on the case of a young patient on OC (oral contraception) for 3 months who suddenly developed benign endocranic hypertension. Such cases have been frequently reported in the published literature, especially, but not always, in connection with obese patients. Suspension of OC treatment usually terminates the problem. The cause of the association OC-headache is not yet well known.

The trend of imported malaria cases in Italy from 1960 to 1988 is discussed. Comparative analysis of its incidence in the last three years is also presented. Since 1985, a rapid increase has been recorded with 191 cases in 1986, 287 in 1987 and 350 in 1988. In 1986-88 Plasmodium falciparum has been responsible for 74% of the total number, followed by P. vivax (21%), P. malariae (2%) and P. ovale (1%). 86% of the imported cases have been acquired in African countries, 8% in Asia and 3% in South America. As far as travelers categories are concerned workers represent 45.6% of the total population, tourists 36.6%, seamen and aircrew 2.1% and strangers coming from endemic malaria areas and traveling to Italy 15.7%. In 1986, 1987, and 1988 one, two and two deaths, respectively, due to malaria, are reported.