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Objective: The purpose of this study was to compare surgical and nonsurgical approaches to the treatment of BRONJ and the possible usefulness of Nd:YAG and Er: YAG lasers. Methods: One hundred and twenty-eight patients (33 males, 95 females; 52 with diagnosis of multiple myeloma, 53 with diagnosis of bone metastasis, and 23 with diagnosis of osteoporosis) affected by BRONJ were evaluated at the Unit of Oral Pathology and Medicine and Laser-Assisted Surgery of the University of Parma, Italy, between January 2004 and July 2009. Overall number of BRONJ sites was 151, and number of treated sites was 101. In order to assess the efficacy of different treatments, sites were subclassified as follows: Group 1 (G1): 12 sites treated with medical therapy; Group 2 (G2): 27 sites treated with medical therapy associated with low level laser therapy (LLLT); Group 3 (G3): 17 sites treated with a combination of medical and surgical therapy; Group 4 (G4): 45 sites treated with a combination of medical therapy, surgical (including laserassisted) therapy, and LLLT. Outcome of treatment was assessed using the staging system proposed by Ruggiero et al. Transition from a higher stage to a lower one for at least 6 months was considered as clinical improvement and suggestive of a successful treatment. Results: Clinical improvement was achieved in 3 out of 12 (25%) BRONJ sites in G1. Sites if G2 with an improvement were 18 out of 27 (66%). Nine out 17 BRONJ sites (53%) in G3 had a transition to a lower stage after treatment. For sites in G4, a clinical improvement was recorded in 40 out of 45 cases (89%). Conclusions: In our experience, the percentage of success obtained with a combined approach based on medical therapy, surgical (including laser-assisted) therapy, and LLLT (G4) is significantly higher than the percentage of improvement obtained in G1, G2, and G3. 91) Vescovi, P; Merigo, E; Meleti, M; Manfredi, M; Guidotti, R; Nammour, S (2012) Bisphosphonatesrelated osteonecrosis of the jaws: a concise review of the literature and a report of a single-centre experience with 151 patients JOURNAL OF ORAL PATHOLOGY & MEDICINE 41(3):214-221 IF=2.075 [Article] The osteonecrosis of the jaws (ONJ) is an adverse side effect of long-term bisphosphonate therapy (BPT) firstly described in 2003. The aetiology of BRONJ remains unknown, and the pathogenesis seems multifactorial and related to several local or general factors. Many expert panel developed preventive protocols to facilitate specialists involved in the multidisciplinary management of BRONJ patients. In this paper, we present a concise review of the literature, and we report the experience of the University of Parma with 151 patients that assumed BPT for both oncological (121 patients) and non-oncological (30 patients) diseases. One hundred and thirtynine BRONJ sites were treated with different approaches (surgical and non-surgical, laser-assisted and non-laserassisted): in terms of clinical improvement, a statistically significant difference was found between the group treated with the only medical therapy; in terms of complete healing, the introduction in the treatment protocols of both laser-assisted approach and surgical approach improves the therapeutical results. 92) Zampolini, M; Zaccaria, B; Tolli, V; Frustaci, A; Franceschini, M (2012) Rehabilitation of traumatic brain injury in Italy: A multi-centred study BRAIN INJURY 26(1):27-35 IF=1.75 [Article] Objectives: The aims of this study were to analyse TBI rehabilitation in Italy, identifying the main factors conditioning motor and functional recovery and destination upon discharge of traumatic severe acquired brain injury (sABI) patients who had undergone intensive rehabilitative treatment. Design: An observational prospective study of 863 consecutive patients admitted to 52 Rehabilitation Centres from January 2001 to December 2003. Results: The main cause of trauma
was road accidents (79.8%), the mean length of stay was 87.31 +/- 77.26 days and 40.4% access to rehabilitation facilities after a month. Pressure sore rates fell from 26.1% to 6.6% during the rehabilitation programme. After discharge 615 patients returned home, whilst 212 were admitted to other health facilities. Discussion: This study highlights some major criticisms of rehabilitation of TBI. The delay of admission and evitable complications such as pressure sores are correlated to a worse outcome. While LOS causes a problem of cost-effectiveness, the rate of home discharge is prevalent and very high compared with other studies. 93) Zanon, E; Iorio, A; Rocino, A; Artoni, A; Santoro, R; Tagliaferri, A; Coppola, A; Castaman, G; Mannucci, PM (2012) Intracranial haemorrhage in the Italian population of haemophilia patients with and without inhibitors HAEMOPHILIA 18(1):39-45 IF=2.364 [Article] 94) Zucali, PA; Simonelli, M; Michetti, G; Tiseo, M; Ceresoli, GL; Collova, E; Follador, A; Lo Dico, M; Moretti, A; De Vincenzo, F; Lorenzi, E; Perrino, M; Giordano, L; Farina, G; Santoro, A; Garassino, M (2012) Second-line chemotherapy in malignant pleural mesothelioma: Results of a retrospective multicenter survey LUNG CANCER 75(3):360-367 IF=3.356 [Article]
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