Prolongation of the QT interval in the first week of life is strongly associated with SIDS. Neonatal electrocardiographic screening may permit the early identification of a substantial percentage of infants at risk for SIDS, and the institution of preventive measures may therefore be possible.

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A prospective electrocardiographic study was designed to establish baseline values for electrocardiographic measurements, with specific reference to the QT interval during infancy, and to test the "QT hypothesis" for the sudden infant death syndrome (SIDS). In this ongoing study, ECGs are recorded on the fourth day of life and in the second, fourth and sixth months. The state of health at 1 year is ascertained by a phone call. So far, 4205 newborns have been enrolled. The mean QTc (QT interval corrected for heart rate) was 397 +/- 18 msec (+/- SD) at the fourth day, 409 +/- 15 msec (p less than 0.0001) at the second month, and 406 +/- 15 msec at the fourth month; by the sixth month, it returned to 400 +/- 14 msec. In 88 newborns, the QTc increased by over 40 msec at the second month. Among the 2000 infants checked at 1 year, there have been three sudden and unexpected deaths. The QTc of one of the victims at the fourth day was 563 msec, which exceeded the mean by more than 9 standard deviations, while the QTc of the other SIDS victims exceeded the mean by more than 2 and 3 standard deviations. These results are consistent with the "QT hypothesis," but more data are necessary before any conclusion on the potential relationship between QT interval prolongation and SIDS can be drawn. This study provides definitive waking normal values for QT interval in infancy and indicates that the QT interval lengthens physiologically and temporarily during the first months of life. In some infants, this lengthening may transiently impair cardiac electrical stability.

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The long-term effects of orthodontic appliances in the oral environment and the subsequent leaching of metals are relatively unknown. A method for determining the effects of various types of soldering and welding, both of which in turn could lead to leaching of metal ions, on the growth of osteoblasts, fibroblasts, and oral keratinocytes in vitro, is proposed. The effects of cell behaviour of metal wires on osteoblast differentiation, expressed by alkaline phosphatase (ALP) activity; on fibroblast proliferation, assayed by the 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulphophenil)-2H-tetrazolium-phenazine ethosulphate method; and on keratinocyte viability and migration on the wires, observed by scanning electron microscopy (SEM), were tested. Two types of commercially available wires normally used for orthodontic appliances, with a similar chemical composition (iron, carbon, silicon, chromium, molybdenum, phosphorus, sulphur, vanadium, and nitrogen) but differing in nickel and manganese content, were examined, as well as the joints obtained by electrical resistance welding, traditional soldering, and laser welding. Nickel and chromium, known as possible toxic metals, were also examined using pure nickel- and chromium-plated titanium wires. Segments of each wire, cut into different lengths, were added to each well in which the cells were grown to confluence. The high nickel and chromium content of orthodontic wires damaged both osteoblasts and fibroblasts, but did not affect keratinocytes. Chromium strongly affected fibroblast growth. The joint produced by electrical resistance welding was well tolerated by both osteoblasts and fibroblasts, whereas traditional soldering caused a significant (P < 0.05) decrease in both osteoblast ALP activity and fibroblast viability, and prevented the growth of keratinocytes in vitro. Laser welding was the only joining process well tolerated by all tested cells.

BackgroundThe purpose of this controlled study was to investigate indirect effects on mandibular arch dimensions, 1 year after rapid palatal expansion (RPE) therapy.MethodsThirty-three patients in mixed dentition (mean age 8.8 years) showing unilateral posterior crossbite and maxillary deficiency were treated with a RPE (Haas type) cemented on the first permanent molars. Treatment protocol consisted of two turns per day until slight overcorrection of the molar transverse relationship occurred. The Haas expander was kept on the teeth as a passive retainer for an average of 6 months. Study models were taken prior (T1) and 15 months on average (T2) after expansion. A control group of 15 untreated subjects with maxillary deficiency (mean age 8.3 years) was also recorded with a 12-month interval. Stone casts were digitized with a 3D scanner (3Shape, DK).ResultsIn the treated group, both mandibular intermolar distance (+1.9 mm) and mandibular molar angulation (+9°) increased. Mandibular incisor angulation showed an increase of 1.9°. There was little effect on intercanine distance and canine angulation. Controls showed a reduction in transverse arch dimension and a decrease in molar and canine angulation values.ConclusionsRPE protocol has indirect widening effects on the mandibular incisors and first molars.

Loose ligaments are often a predisposing factor of temporomandibular joint (TMJ) disorders. This causal factor was analyzed in 701 subjects presenting at the TMJ and Posture Center of Siena University with TMJ pain or dysfunction. Along with the conventional jaw examination, a Carter and Wilkinson test as modified by Beighton was also done. We found a correlation among the parameters of age, gender, TMJ disorder, joint pain, muscle pain, and loose ligaments.

Our results broaden the spectrum of diabetes phenotypes resulting from KCNJ11 mutations. They indicate testing for KCNJ11 mutations should be considered not only for neonatal diabetes but also for other forms of dominantly inherited diabetes with later onset, especially where these are associated with a low body mass index and low birth weight.