Department of Medical Sciences

To assess whether craniofacial morphology and vertical growth patterns are associated with a preference for hard or soft alimentary boluses in a sample of orthodontic patients. This cross-sectional study included 121 orthodontic patients (69 females, 52 males; mean age = 12.3 ± 3.3 years). Before-treatment, lateral skull x-rays were collected and lateral cephalometric analysis performed, considering variables SpP^GoGn, SN^GoGn, SpP^CoOr, and AN^B. Before undergoing chewing pattern analysis, each patient was asked to chew a standardized soft bolus (chewing gum) and subsequently a standardized hard bolus (wine gum) in a flavor of their choice. Subsequently, each patient was asked to express a preference for one of the two boluses, and the answer was recorded. To assess the association between bolus hardness preference and cephalometric variables, multiple linear regression analyses were performed, controlling for sex and age. Soft bolus was preferred by 64% of subjects (n = 77) and hard bolus by 36% (n = 44). Increased SpP^GoGn angle was significantly associated with soft-bolus preference (P <.05) as well as being female but was independent of age. SN^GoGn increased with age (P <.05) but did not correlate with bolus preference or sex. No significant associations were observed for SpP^CoOr and AN^B. Soft bolus preference was significantly associated with increased intermaxillary divergence but not with cranial divergence, mandibular rotation, or sagittal skeletal relationship. These findings suggest that patients with intermaxillary hyperdivergent patterns may self-select softer boluses, due to a compensatory functional-structural feedback loop.

Aim: The aim of this study was to evaluate the distribution, seasonal variations, co-infection patterns and age group differences of viral and bacterial agents detected by syndromic panel method in patients with acute respiratory tract infection (ARTI).Material and Methods: In this retrospective cross-sectional study conducted in a single center between February 2023 and January 2024, nasopharyngeal swab samples of 453 patients with suspected ARTI were analyzed using QIAstat-Dx Respiratory Panel (Qiagen®). The panel detects 22 viral and atypical bacterial agents. Statistical analyses were performed with SPSS 26.0.Results: At least one agent was detected in 45.2% of patients and positivity was significantly higher in the pediatric group (62.7%) compared to adults (33.2%) (p

Early diagnosis of Congenital Hypothyroidism (CH) is critical to prevent irreversible neurodevelopmental damage. However, current TSH-based newborn screening using Dried Blood Spots (DBS) is limited by factors that lead to false-positive and false-negative results, necessitating the development of alternative methods. Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) as a high-throughput solution was investigated. This study presents a novel diagnostic approach utilizing DBS peptide barcoding, which was supported by comprehensive LC-MS/MS and network analysis. Peptide profiles showed a marked and reproducible difference between groups. MALDI-TOF MS identified a unique signature, including six dominant peptides specific to the CH-positive group. Subsequent analysis identified 37 candidate peptides, with network analysis linking 12 key proteins to established CH-related agents (e.g., thyroxine, TSHR). The MALDI-TOF MS peptidomic approach is validated as a robust, rapid, and cost-effective alternative for CH screening. This methodology represents a significant advance toward overcoming the limitations of current TSH assays and establishing a clinically translatable biomarker panel for improved personalized diagnosis of CH.

Psoriasis is a chronic immune-mediated skin disease with highly variable responses to systemic therapies. Emerging evidence highlights the microbiome as a potential modulator of drug efficacy and toxicity. Gut bacteria can enzymatically metabolize drugs, such as methotrexate, altering bioavailability and therapeutic outcomes, while microbial metabolites-including short-chain fatty acids, branched-chain amino acids, and tryptophan derivatives-shape host immunity and barrier integrity, influencing drug action. Baseline microbial signatures have been linked to treatment response, potentially predicting anti-TNF or IL-17 inhibitor efficacy. Systemic therapies themselves reshape microbial communities: IL-17 blockade induces broad shifts in gut and skin microbiota, whereas cyclosporine and anti-TNF agents exert subtler effects. Small molecules such as apremilast and fumarates may reduce fungal overgrowth and influence microbial composition, whereas data on JAK/TYK2 inhibitors remain limited. Notably, current evidence exhibits a literature bias toward the gut microbiota, while the roles of the oral and skin axes remain understudied. Adjunctive microbiome-directed interventions, including probiotics and fecal microbiota transplantation, have demonstrated potential to enhance treatment outcomes by promoting anti-inflammatory taxa and restoring barrier function. Despite these promising findings, current evidence is heterogeneous, often limited by small sample sizes, short follow-up, and variable methodology. Integrating pharmacomicrobiomics data with clinical, genetic, and multi-omics profiling could enable precision medicine approaches in psoriasis, allowing therapy selection tailored to individual microbial and metabolic signatures. Future research should focus on longitudinal, multicenter studies to identify actionable microbial biomarkers, clarify mechanistic interactions between drugs, microbes, and host immunity, and evaluate microbiome-targeted adjuncts in randomized trials. Understanding the bidirectional crosstalk between systemic therapies and the microbiome may transform psoriasis management, improving efficacy, reducing adverse events, and enabling durable, personalized responses.

SARS-CoV-2, the causative agent of COVID-19, remains a global concern due to gaps in understanding its pathogenesis. Peptidyl-arginine deiminases (PADs) are emerging as key regulators of viral replication and inflammation. PADs catalyze the conversion of arginine into citrulline, a modification linked to autoimmune diseases. Here, we show that PAD-mediated citrullination plays a crucial role in SARS-CoV-2 infection. Using human cell lines and in K18-hACE2 transgenic mice infected with different SARS-CoV-2 strains, we demonstrate that viral replication is associated with increased PAD4 expression. Mass spectrometry shows 170 distinct differentially citrullinated proteins in infected cells and tissues. Importantly, PAD4 inhibition significantly reduces viral replication and restores a citrullination profile comparable to that of uninfected mice. These findings suggest that SARS-CoV-2 exploits PAD-mediated citrullination to enhance replication and inflammation. Thus, targeting PAD4 may represent a viable strategy to curb viral spread and mitigate COVID-19-associated hyperinflammation.

Identifying chronic myeloid leukaemia (CML) patients at risk of therapeutic switch remains debated. We analysed the cumulative risk of treatment change in the CML Italian network prospective cohort based on first-line tyrosine kinase inhibitors and patient characteristics. Sub-hazard ratios (sHRs) were estimated using Fine and Gray multivariable models. Among 1662 patients, initial treatment consisted of imatinib for 840 (50.5%), nilotinib for 490 (29.5%) and dasatinib for 332 (20.0%). Subsequently, 492 patients (29.6%) required second-line therapy, with 232 (47.1%) switching due to resistance and 176 (35.8%) due to intolerance. At 2 years, the risk of resistance was 18.3% for imatinib, 8.4% for dasatinib (sHR = 0.32; 95% confidence interval 0.21-0.49) and 6.8% for nilotinib (0.29; 0.19-0.42). The risk of switching increased in intermediate (1.95; 1.40-2.72) and high Eutos long term survival (ELTS) risk (3.19; 2.10-4.83) but was reduced with older age (0.97 per year; p < 0.0001). Intolerance at 2 years was 8.5% for imatinib, 12.4% for dasatinib (2.55; 1.73-3.75) and 5.2% for nilotinib (1.04; 0.65-1.65). Switching to a third-line therapy at 3 years was 8% for imatinib, 5% for dasatinib and 4% for nilotinib. The results showed that the time to first treatment switch for resistance is shorter for younger patients, for imatinib and for intermediate/high ELTS risks. The risk of switching for intolerance is higher for patients initially treated with dasatinib.

This review examines the protocols and rationale for stopping antiarrhythmic drugs (AADs) before interventional electrophysiology (EP) procedures to establish a drug-free baseline, ensuring diagnostic accuracy and procedural success. The review provided a detailed analysis of procedure-specific AADs washout requirements for supraventricular tachycardia, atrial fibrillation, and ventricular tachycardia ablation, and a comprehensive, drug-by-drug guide to calculate washout periods, based on pharmacokinetic and pharmacodynamic principles. This guide details the half-life, metabolism, and elimination pathways for all major AAD classes, and gives specific, actionable recommendations for adjusting wash-out times based on patient-specific factors, including age, renal function, and hepatic impairment. The aim is to provide clinicians with evidence-based guidance for standardizing AADs washout, thereby improving the safety and success of interventional EP procedures.