Medical Sciences (Pharmacology, Clinical Pathology, General medicine, Infectious Diseases, Maxillo-facial Surgery, Patho

Targets
At the end of the course, the student will acquire the fundamental knowledge of pharmacology useful for framing some pharmacological-therapies focusing on the dental and oral cavity. In addition, the student will be alert to some emergency situations that he may face during his professional activity.
INTRODUCTION TO PHARMACOLOGY
Drug therapy, risks and benefits
Pharmaceutical preparations and formulations and their influence on the drug's action
The research and development of a new drug: pre-clinical and clinical trials
Role of healthcare professionals in clinical trials
Pharmacokinetics
Dose / response relationship.
Plasma concentration / pharmacological effect relationship
Therapeutic interval and toxicity
Minimum effective concentration (CME) and maximum tolerated concentration (CMT)
Latency, intensity and duration of the pharmacological effect
Routes of administration of drugs and selection criteria
Influence of the route of administration on latency, intensity and duration of the effect
Maintenance of stable plasma levels: intravenous infusion, repeated administration, therapeutic regimen, loading and maintenance dose
ABSORPTION OF DRUGS
Mechanisms of transfer of drugs through cell membranes: passive diffusion and facilitated diffusion, active transport and passive transport, phagocytosis and pinocytosis Factors that influence absorption.
DISTRIBUTION OF DRUGS IN THE BODY
Real and apparent volume of distribution Factors affecting distribution and redistribution.
BIOTRANSFORMATION
Meaning and consequences of biotransformation reactions: Phase I and II reactions
Factors that influence biotransformation processes: exogenous and endogenous causes
Enzyme induction and inhibition
ELIMINATION
Main elimination routes: biliary and renal
PHARMACOKINETIC PARAMETERS
Bioavailability, plasma half-life, volume of distribution and clearance of drugs
ADVERSE DRUG REACTIONS
Classification and causes of adverse reactions
DRUG RESPONSE VARIABILITY
Factors that determine interindividual variability: genetic makeup, sex, age, physiological and pathological conditions
Drug interactions and their consequences.
Intolerance, idiosyncrasy and hypersensitivity
PHARMACODYNAMIC
The "targets" of drugs: main classes and their characteristics
Agonist and antagonist drugs. Efficacy, potency and clinical significance
NON STEROID ANTI-INFLAMMATORY DRUGS (NSAIDs)
Mechanism of action Pharmacological action: antipyretic effect, analgesic effect, anti-inflammatory effect
Therapeutic use. Adverse effects
STEROID ANTI-INFLAMMATORY DRUGS
Synthesis and regulation of glucocorticoid release Pharmacological effects and mechanism of action
Side effects and contraindications Clinical use
ANTI-HISTAMINE DRUGS and ANTI-ALLERGIC DRUGS
GENERAL ANESTHETICS
General inhalation and intravenous anesthetics: pharmacological effects and undesirable effects
LOCAL ANESTHETICS
Mechanism of action, pharmacological effect and undesirable effects
ANTIBACTERIAL CHEMOTHERAPY OF INFECTIOUS DISEASES
Antibiotic- therapy
Bacteria and their biochemical reactions as potential pharmacological targets
Mechanisms underlying antibiotic resistance
PHARMACOLOGY OF BONE TISSUE
Bisphosphonates, vitamin D3, calcitonin and new agents: mechanism of action, pharmacological effect and undesirable effects

Anatomo-Pathology module
I. Methodological bases used in anatomo-pathological diagnostics:
· Definition of pathological anatomy;
· Main activities of the pathologist: autopsy, macroscopic examination, histopathological examination, cytopathological examination, histochemical examination, immunohistochemical examination, molecular pathology examination;
· Compilation of the request for histopathological and cytopathological examination;
· Protection of patient privacy;
· Method of collection of the material to be submitted to the anatomical-pathological examination;
· Handling of the material for the histopathological diagnosis: fixation and processing of the samples; preparation and staining of histological slides;
· Immunohistochemistry techniques in pathological anatomy;
· Molecular biology techniques in pathological anatomy;
· Diagnostic cytopathology: methods of collection and processing of cytological material; cytopathology principles;
· Light microscope and observation of histopathological slides;
· Transmission and scanning electron microscope.

II. Principles of pathological diagnostics:
· Interpretation of the anatomical-pathological findings;
· Disorders of cell proliferation and differentiation (in particular, hypertrophy, hyperplasia, metaplasia, neoplasia);
· Classification of neoplasms (histotype, TNM grade and stage);
· Pathological anatomy of the oral cavity (in particular, pre-cancerous, benign neoplasms, malignant neoplasms, odontogenic tumors);
· Pathological anatomy of the salivary glands;
· Pathological anatomy of the tonsils;
· Elements of pathological anatomy of the cardiovascular, nervous, respiratory, digestive, genitourinary and integumentary systems.

Clinical pathology module
TARGETS
At the end of the course the student will acquire the fundamental knowledge of Clinical Pathology useful for the diagnostic framework of some pathologies with particular reference to the dental field and the oral cavity.
SUBJECTS
- Blood count: evaluation of white blood cells, red blood cells and diagnostic applications
- Tumor markers: description of the main markers and clinical applications
- Autoimmune diseases: description, diagnosis, with particular reference to autoimmune diseases involving the oral cavity

Module of Infective Diseases
- Introduction to infectious diseases
- Sepsis and septic shock
* clinical pathogenesis and diagnostics
- Endocarditis:
* clinical pathogenesis and diagnostics
- HIV and hepatitis
* clinical pathogenesis and diagnostics
- Systemic infectious diseases involving the oral cavity

Internal Medicine module
Clinical methodology
Acute coronary syndromes and atherosclerosis
Heart failure
Arterial hypertension
Diabetes mellitus
Respiratory failure
Acute lung diseases
Chronic lung diseases
Oral manifestations of autoimmune and systemic rheumatological diseases

- blood count: assessment of white blood cells and red blood cells and their diagnostic value
- diagnostic evaluation of tumor markers
- diagnostic evaluation of autoimmune diseases

I. Methodological bases used in anatomo-pathological diagnostics:
· Definition of pathological anatomy;
· Main activities of the pathologist: autopsy, macroscopic examination, histopathological examination, cytopathological examination, histochemical examination, immunohistochemical examination, molecular pathology examination;
· Compilation of the request for histopathological and cytopathological examination;
· Protection of patient privacy;
· Method of collection of the material to be submitted to the anatomical-pathological examination;
· Handling of the material for the histopathological diagnosis: fixation and processing of the samples; preparation and staining of histological slides;
· Immunohistochemistry techniques in pathological anatomy;
· Molecular biology techniques in pathological anatomy;
· Diagnostic cytopathology: methods of collection and processing of cytological material; cytopathology principles;
· Light microscope and observation of histopathological slides;
· Transmission and scanning electron microscope.
II. Principles of pathological diagnostics:
· Interpretation of the anatomical-pathological findings;
· Disorders of cell proliferation and differentiation (in particular, hypertrophy, hyperplasia, metaplasia, neoplasia);
· Classification of neoplasms (histotype, TNM grade and stage);
· Pathological anatomy of the oral cavity (in particular, pre-cancerous, benign neoplasms, malignant neoplasms, odontogenic tumors);
· Pathological anatomy of the salivary glands;
· Pathological anatomy of the tonsils;
· Elements of pathological anatomy of the cardiovascular, nervous, respiratory, digestive, genitourinary and integumentary systems.

Atherosclerosis, metabolic disease, diabetes mellitus, arterial hypertension, ischemic heart disease, heart failure.
Respiratory diseases and tuberculosis.

- Introduction to Infection Diseases
- Microorganisms and main agents of infectious diseases
- Symbiosis and Parasitic Guest Relationships
- The microbial flora
- Infectious diseases
- Virulence factors
- Method of transmission of infectious diseases
- Ways of appearance of an infectious disease in the population
- The guest's defenses
- The concept of Immunity
- The innate defenses (Natural Immunity)
- The acquired defenses (Adaptive Immunity)
- Lymphocytes and lymphatic organs
- The stages of adaptive response
- Clonal selection
- Antibodies
- The presentation of the antigen
- The MHC system
- The humoral answer
- The cell-mediated response
- The immunopathogenesis of infectious diseases
- Elements of diagnostics of infectious diseases
- Diagnosis of infectious diseases
- Introduction to serological techniques
- Meaning of the search for antibodies or antigens
- Serological techniques most frequently used in the diagnostic laboratory (agglutination, ELISA, immunofluorescence, Western blot)
- Molecular biology techniques for the diagnosis of infectious diseases
- The polymerase chain reaction (PCR) technique for the detection of microbial nucleic acids
- Hepatitic virus infections
- Hepatitis C and B
- Definition of infectious hepatitis and main viral agents
- HCV and HBV viruses
- Natural history of C and B virus infections
- Method of transmission
- Diffusion in Italy and in the world
- Professional exhibition
- Prevention
- Retrovirus infections
- HIV and AIDS infection
- The virus
- Pathogenesis of AIDS
- Method of transmission
- Diffusion in the world and in Italy
- Professional risk and prevention of exposure
- Sexually Transmitted Infections (MTS)

1 Cranio facial malformations
· Lip and palate clefts
· Facial clefts
· Craniostenosis and craniofaciostenosis (general principles, plagiocephaly, trigonocephaly, scaphocephaly, brachycephaly, S. of Appert, S. of Crouzon etc.)
· Latero-facial microsomies

2 Cranio-maxillofacial traumatology: general principles, pathogenesis, diagnostic aspects and treatment notes
· Management of the traumatized patient and emergencies in facial traumatology
· Soft tissue traumatology (wound healing, lesions of the glandular ducts etc.)
· Traumatology of the facial skeleton (mandibular fractures, maxillary fractures, nose fractures, zygomatic fractures, orbital fractures, craniofacial fractures, complex fractures)

3 Growth anomalies of the maxilla and the mandible
· Etiopathogenesis of maxillary and mandibuar deformities
· Physical examination in orthognathic surgery (facial examination, occlusal examination, teleradiographic and cephalometric examination)
· Treatment planning and role of pre and post surgical orthodontic therapy
· Classification and treatment of maxilary and mandibular deformities
· Dento-facial asymmetries

4 Surgical pathology of the temporomandibular joint. Diagnostic aspects and elements of therapy
5 Temporomandibular disorders.
· Arthrosis and arthritis
· Ankylosis
- condylar fractures
- malformations
· Tumors

6 Oro-maxillofacial cystic lesions: diagnostic and treatment aspects
· Definition and classification of cystic lesions
· Bone cysts (odontogenic, non-odontogenic and pseudocyst)
· Soft tissue cysts (of the thyroglossal duct, dermoids, brachials etc.)

7 Benign oro-maxillofacial tumors:
· diagnostic aspects and treatment modalities
· Classification of benign tumors
· Odontogenic and non-odontogenic benign bone tumors (clinical, radiographic and microscopic pictures)
· Benign soft tissue tumors (clinical and instrumental pictures)

8 Malignant oro-maxillofacial tumors
· Carcinoma of the oral cavity (epidemiology, risk factors, biology, clinical features , staging, treatment and prognosis)
· Nose-ethmoid-maxillary tumors and main sarcomas of the extreme cephalic
· Skin tumors (classification, risk factors, biology, clinical features, staging, treatment)

9 Maxillofacial reconstructive surgery
· General principles (surgical problems, classification and biology of grafts, flaps and microvascular flaps)
· Reconstructive modalities of the facial skeleton (jaw, upper jaw, etc)
· Reconstructive modalities of soft tissues (skin, lips, oral floor etc.)
CAD CAM customized reconstruction of the facial skeleton

10 Inflammatory pathologies of oro-maxillofacial hard and soft tissues
· microbiology, clinical features and treatment principles
· Abscesses and odontogenic phlegmons
· Osteitis and osteomyelitis
· sinusitis
· Necrotizing fasciitis

11 Surgery of the trigeminal and facial nerves
· Classification of nerve injuries
· Injury of the trigeminal nerve and of the facial nerve: diagnostic features and therapy modalities

The stress:
· definition,
· clinical and instrumental parameters
· Practical measures
The water balance:
· Dehydration
· Hyperhydration
· The reinstatement
Dysphagia:
· Main causes
· Clinical remedies
· Feeding methods
Thyroid pathology:
· Hypothyroidism
· Hyperthyroidism
· Hyperparathyroidism
· Hypoparathyroidism
Breast pathologies:
· Benign breast tumors
· Malignant breast neoplasms
· Surgical techniques
· Reconstructive plastic surgery