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Background: Women with aesthetic prostheses must be included in the target population of mammography screening programmes. Breast implants are radiopaque and partially obscure the breast tissue. This can be avoided with the use of the Eklund technique, which causes an increased radiation exposure. In this study, augmented women undergoing a dedicated protocol within a population-based screening programme were compared according to selected indicators with the standard screening population. Essential dosimetric parameters and their time trend were also assessed., Materials and Methods: The study was conducted in a screening centre in Milan in the years 2009-2016. The screening protocol for women with breast implants included a double-read mammography with the Eklund views, ultrasound and clinical breast examination., Results: A total of 28,794 women were enrolled, including 588 (2%) women with breast implants and 28,206 (98%) undergoing the standard screening protocol. The invasive assessment rate was 9.0‰ for women with breast implants vs. 15‰ in the standard cohort. The surgical referral rate was 2.2% vs. 0.9%. The detection rate was similar in the two groups (4.0 and 4.5‰, respectively). There were significant differences in the average glandular dose according to the mammography equipment. The use of the Eklund views increased over time., Conclusions: Screening of augmented women according to a specific protocol in the contexts of population-based programmes is feasible. Observed differences in screening indicators relative to the standard screening population require further research. The increasing use of Eklund views probably results from quality assurance measures associated with screening programmes.

Background: communicating breast cancer screening (BCS) limits and overdiagnosis implies providing complete and balanced information to allow informed decision-making., Objectives: to describe women's perceptions, preconceptions, and information preferences regarding the breast cancer screening (BCS) programme paper and web information materials of the Agency for Health Protection of the Metropolitan Area of Milan (Lombardy Region, Northern Italy)., Design: qualitative, descriptive study., Setting and Participants: participants' voluntary recruitment took place in the registration departments of three hospitals. Participants were purposively recruited based on sociodemographic characteristics of the target population of the programme (44 women aged 40-74 years, living in the Metropolitan Area of Milan). In each material type subgroup, different health literacy levels and age classes were included, until thematic saturation was reached., Main Outcome Measures: thematic analysis of qualitative data collected during think-aloud interviews., Results: the thematic analysis identified 5 main themes: 1. validation of the information reported in the materials, according to the interviewees' personal experiences;2. information preferences of particular subgroups of women, which led to a tailored approach for the web materials;3. negative emotions elicited while receiving information regarding BCS limits, which guided the rewriting of certain definitions; 4. disproportioned risk perception, with greater weight attributed to the risk of false negative results than the risk of overdiagnosis; 5. organizational preferences regarding the type and frequency of the provided tests and the age limits of the programme., Conclusions: in the present sample of women living in the Metropolitan Area of Milan, knowledge and comprehension of overdiagnosis are scarce. The main reasons for distrust in the BCS programme rely on the preexisting beliefs regarding the most appropriate tests and age limits. These beliefs were established from previously received information, inconsistent with that officially provided by the programme.

Background: A multidisciplinary working group applied the Healthcare Failure Mode and Effects Analysis (HFMEA) approach to the flow of kits and specimens for the first-level test of a colorectal cancer screening programme using immunochemical faecal occult blood tests., Methods: HFMEA comprised four steps: (1) identification and mapping of the process steps (subprocesses); (2) analysis of failure modes and calculation of the risk priority numbers (RPNs); (3) identification of corrective actions; and (4) follow-up and evaluation of corrective actions., Results: The team identified 9 main failure modes, 12 effects and 34 associated causes. RPN scores ranged from 2 to 96. Failure modes within the first five positions in the ranking list ordered by RPN concerned: 'degraded haemoglobin in the specimen', 'mixed-up kits' and 'anonymous specimen'. All of these could lead to false-negative results and/or subjects with positive tests not being recalled for assessment. The team planned corrective actions for those failure modes. As a result, the follow-up of corrective actions showed a significant decrease in the proportion of anonymous kits from 11.6 to 4.8 per 1000 (relative reduction of 59%). The HFMEA exercise led to a reduction in: missed positive tests; missed cancer and high-risk adenomas; complaints about the communication of test results to a person who never did the test; and false-negative results due either to haemoglobin degradation or an expired sampling tube., Conclusions: HFMEA is a useful tool for reducing errors in colorectal cancer screening programmes using faecal occult blood tests and is characterised by a straightforward interpretation of results and ease of communication to healthcare managers and decision makers., Competing Interests: Competing interests: None declared.

Background: Children often receive inferior alveolar nerve blocks (IANBs) when their third molars are just beginning to develop. The location of the third-molar follicle is close to where the needle penetrates during an IANB. The authors examined the possible association between IANBs and missing third molars., Methods: The authors examined 439 potential sites of third-molar development for evidence of third-molar follicles on panoramic radiographs of randomly selected children 7 years and older. The authors conducted a statistical comparison of the incidence of missing third-molar follicles in a control group of children who had no history of receiving IANBs with children in a test group who had a definitive history of receiving IANBs by means of generalized estimating equations., Results: The authors found a statistically significant greater incidence of missing third-molar follicles in mandibular quadrants that had a definitive history of receiving IANBs compared with mandibular quadrants that had no history of receiving IANB., Conclusion: IANBs administered to young children when the third-molar tooth bud is immature may stop third-molar development. Owing to the significant clinical implications, further research is needed to verify these results., Practical Implications: Dentists inadvertently may be stopping the development of third molars when administering IANBs to children.

Background: The Chikungunya virus (CHIKV) is transmitted by Aedes mosquitoes and recently caused a massive epidemic on La Réunion Island, in the Indian Ocean. Between July and September 2007 it caused the first autochthonous epidemic outbreak in Europe, in the Region of Emilia-Romagna in the north-east of Italy., Materials and Methods: After the first reports of an unusually high number of patients with a febrile illness of unknown origin in two contiguous villages, an outbreak investigation was carried out to identify the primary source of infection, the modes of transmission and the dynamics of the epidemic. An active surveillance system was also implemented. Laboratory diagnosis was performed through serology and polymerase chain reaction (PCR) analysis. Blood donation was discontinued in the areas involved from September to October 2007 and specific precautionary blood safety and self-sufficiency measures were adopted by the regional health and blood authorities and the National Blood Centre. An estimate method to early assess the risk of viraemic blood donations by asymptomatic donors was developed, as a tool for "pragmatic" risk assessment and management, aiming at providing a reliable order of magnitude of the mean risk of CHIKV transmission through blood transfusion., Results: Two hundred and seventeen cases of CHIKV infection were identified between 4th July and 28th September. The disease was fairly mild in most of the cases. The precautionary measures adopted in the blood system caused a considerable reduction of the collection of blood components and of the delivery of plasma to the pharmaceutical industry for contract manufacturing. The estimated risk of CHIKV transmission through blood transfusion peaked in the third week of August., Conclusion: ACHIKV epidemic poses considerable problems for public health authorities, who not only need good routine programmes of vector control and epidemiological surveillance but also local and national emergency plans to sustain the blood supply, so as to promptly deal with the potentially severe effects of an epidemic outbreak, especially when affected areas locally require a significant blood inventory and at the same time represent a critical resource for other areas depending on external supplies of blood components.

Introduction: Wisdom teeth continue to plague man with a high rate of frequency. It may be possible to prevent their development in children at an early age with a non- or minimally invasive technique, even before the tooth begins to form, by treating the soft tissue overlying the site of their development. A previous study that treated the intra-oral soft tissues of newborn rats with a 20 watt diode laser stopped third molar development up to 80% of the time with minimum observable side effects. This brief report describes a similar use of the diode laser in a limited number of young beagle pups. It is the first reported attempt at preventing third molar development in an animal model close in size to man., Materials and Methods: Four 6-7 week old beagle pups were treated on one side of their mandibles with either a 20 or a 100 watt, 800 nm diode laser at a time third molar tooth buds are just beginning to form under the oral mucosa. Six months following treatment, the pups were examined intra-orally and radiographically for evidence of third molar formation., Results: The two intra-oral sites that received the 20 watt diode laser treatment showed normal third molar development. The two intra-oral sites that received the 100 watt diode laser treatment did not develop third molars., Conclusions: The diode laser may be capable of selectively stopping third molar development and further studies are warranted., (2007 Wiley-Liss, Inc)

Background: Third molars are teeth with questionable value. People who never develop third molars avoid confronting the disease and pain these teeth often cause. Since third molars do not begin to develop until children are approximately five years of age, a window of opportunity exists to therapeutically prevent this tooth's development. The dentition of neonate rats possess developmental stages of molars similar to that of five-year-old children. This pilot study tests the hypothesis that third molars can be selectively prevented from developing., Methods: Thirty-three neonate rats received a momentary pulse of electrosurgical energy to one of their maxillary tuberosities. The tuberosities on the contralateral sides received no treatment. Intraoral and radiographic examinations of sacrificed animals occurred when they were between 47 and 52 days old. Several tuberosity areas from sacrificed animals underwent histologic examination., Results: Ten rats showed no intraoral or radiographic evidence of third molar development, and six developed smaller-than-normal third molars. Development of the maxilla also was affected frequently. One treated tuberosity area that was missing a third molar showed no histologic evidence of tooth-forming tissues, cyst formation or other significant abnormal tissue changes., Conclusions: Maxillary third molars can be selectively prevented from developing in rat pups at or near the time of tooth bud initiation; however, electrosurgical energy is too powerful and uncontrollable to reliably confine its damage to only the tooth-forming tissues., Clinical Implications: Third molars may be able to be selectively prevented from developing in growing children near the time of tooth bud initiation if less-differentiated precursor tooth-forming tissues can be selectively targeted.

FG is created by combining the two principal clotting factors found in plasma, fibrinogen and thrombin, whose natural function is to halt bleeding and seal tissues. We determined the safety, and efficacy of autologous FG by an automated device CryoSeal FS System. This procedure allows the blood transfusion center to produce a standardized product having similar characteristics of the pharmaceutical products available on the market and to produce a consistent amount of FG components from a single unit of autologous blood. The study involved a retrospective controlled evaluation of urologic patients compared with a control group operated of radical perineal prostatectomy. Blood loss difference is not significant. The hospital stay of the study group is shorter then the control group. The control group received more unit of homologous blood compared to the study group. This acquisition is suggestive for hypothetical blood saving.

Background and Objectives: Third molars (wisdom teeth) in humans have limited functional value and cause a high frequency of morbidity. A window of opportunity exists to stop their development. The purpose of this study is to evaluate whether a long pulse diode laser can selectively prevent third molar development in a rat animal model., Study Design/materials and Methods: The study calculated theoretical diode laser parameters and irradiated 2- to 4-day-old rat pups in the posterior aspects of the oral cavity near the time of tooth bud initiation. Rats were sacrificed at 35-50 days and examined intraorally and radiographically for third molar development. Control and treated sides were compared histologically., Results: Nearly half of the maxillary third molars and 80% of the mandibular third molars were selectively prevented from developing using a 20 W diode laser with infrequent, minor adverse effects on maxillary jaw growth., Conclusions: This study confirms the hypothesis that controlled, non-invasive laser treatment delivered on the surface of the oral mucosa near the site of tooth bud formation can selectively achieve third molar agenesis. It also offers hope that further innovative studies may bring about a safe, non-invasive laser treatment to selectively prevent third molar development in humans., ((c) 2004 Wiley-Liss, Inc.)

Background: Third molars are teeth that have little functional value and a relatively high rate of associated pain and disease. Their value as part of the dentition of modern people is dubious., Types of Studies Reviewed: The authors review the evolution, development, morbidity and treatment of third molars. They assess the value of third molars in the 21st century and describe the risks these teeth pose when they develop in the dentition., Conclusions: There is a mandate for the dental profession to improve health outcomes and quality of life. The prevention of third molar-related morbidity should be included in dental research efforts. The authors suggest that novel preventive methodologies be developed to alleviate the problems third molars pose. One potential methodology suggested is intentional therapeutic agenesis of this tooth., Clinical Implications: Prevention of third molar development early in life, even before tooth bud initiation, could dramatically improve health care outcomes for millions of people.

The four types of fractures most frequently encountered in posterior teeth--obliquely directed complete fractures, vertically directed complete fractures, obliquely directed incomplete fractures, and vertically directed incomplete fractures--have been described. A detailed treatment approach for each type has been presented.

Within 24 hours after dental treatment, discomfort was experienced by 78% of the patients questioned. Sensitivity to cold was the most frequent type of discomfort experienced (reported by 50% of the patients). Postoperative discomfort resulting from cold stimulus was most often mild (in 78%), occasionally moderate (in 22%), and never severe. The duration of postoperative discomfort resulting from cold stimulus was most often fleeting (reported by 94%) and seldom prolonged (reported by 6%). The second most frequent type of postoperative discomfort reported was associated with the administration of the local anesthetic. Sensitivity to sweets does not seem to be a source of postoperative discomfort following routine operative dental procedures.

The split-root syndrome is an often misdiagnosed painful condition. The major causes of the splits have been discussed. In addition, classical symptoms associated with this syndrome have been illustrated by two case reports to facilitate the syndrome's recognition.

Many of the signs and symptoms of muscle pathosis and fatigue are better treated when the underlying cellular and biochemical mechanisms of muscle function are approached. The basic structural and functional components of muscle tissue and the biochemical cellular activity of muscle contraction have been described. The muscle physiology of the functional activities of chewing and swallowing have been compared to the muscle physiology of the parafunctional habits of clenching and bruxing.