Understanding congenital vertical talus

Congenital vertical talus (CVT) is a rare foot deformity that presents with a rigid flat foot at birth. CVT can present as an isolated abnormality in the newborn, however in at least 50% of cases in association with other conditions. Full neuro-axial imaging is essential to detect any associated neurologic problems. Radiographs of the foot, including forced plantar and dorsiflexion laterals, are diagnostic. Gold standard modern treatment uses the Dobbs method of serial manipulation and casting with minimally-invasive stabilization of the talonavicular joint and Achilles tendon tenotomy.     

The Effect of Corneal Higher Order Aberrations on Postoperative Residual Astigmatism after Toric IOL Implantation

Background: To demonstrate the effect of preoperative higher order aberrations (HOAs) on postoperative residual astigmatism in toric intraocular lens (IOL) implantation.

Methods: A retrospective, controlled, comparative study that involved patients who underwent toric IOL implantation. Patients were divided into two groups according to the difference between the estimated residual astigmatism and actual postoperative astigmatism [difference ≤0.5 diopters (D), Group A; difference >0.5 D, Group B]. Corneal astigmatisms with axis, and various aberration values were compared between the two groups.

Results: Total RMS and HOA RMS values in Group B were significantly higher than those in Group A (p < .001, = 0.003). The vertical coma value, and its absolute value, in Group B were significantly higher than those in Group A (p < .001, = 0.002). The total RMS and absolute value of the vertical coma showed a positive linear correlation with the degree of residual postoperative astigmatism (R-square = 0.139, 0.131; p = .027, 0.036).

Conclusions: If the residual astigmatism after insertion of the toric IOL was greater than expected, corneal aberrations, shown by total RMS and HOA RMS values before surgery, especially of the vertical coma, tended to be high.     

如何根据特异性IgM和IgG评价新型冠状病毒宫内垂直传播

新型冠状病毒能否通过宫内垂直传播感染胎儿是关注的焦点,而如何正确评价新型冠状病毒是否存在宫内垂直传播,更是问题的关键所在。病毒学和血清学证据对诊断病毒宫内垂直传播都有价值。单纯将血清学结果用于确定新型冠状病毒宫内传播时,应至少对新生儿随访3~6个月,动态观察IgM和IgG滴度变化,同时随访其母亲,与母亲特异性抗体的滴度进行比较。     

Characterization of heat resistant hydraulic sealer for warm vertical obturation

ObjectiveWarm vertical compaction of gutta-percha is a technique that is used by most specialists for root canal obturation. The sealers currently available exhibit irriversible chemical changes when heated. New biologically active sealers that do not sustain irreversible changes when heated are an attractive alternative to be used with warm vertical compaction obturation technique. The aim of this study was to measure the heat generated by warm vertical compactors inside the root canal, characterize a newly developed root canal sealer at different temperatures and verify its suitability at the actual temperature window used clinically.MethodsThe typical temperatures generated by two heat carriers in a root canal were assessed by thermocouples. Two premixed root canal sealers TotalFill BC and HiFlow BC (FKG, Switzerland) were allowed to set and they were characterized by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and X-ray diffraction analysis (XRD) immediately after setting and by XRD after 28 days in physiological solution. The ion leaching in solution was assessed by inductively coupled plasma (ICP). The organic component was extracted in acetone and assessed by Fourier transform infrared spectroscopy (FT-IR) for both the unset sealer and sealer subjected to different temperatures. The heat profiles of both sealers were investigated by FT-IR and thermographic analysis.ResultsNone of the devices tested achieved the temperatures set on the dial. The highest temperatures were coronal followed by apical for both devices. The sealers were identical except for the vehicle. The inorganic components included tricalcium silicate, dicalcium silicate and zirconium oxide. No calcium hydroxide was produced by any of the sealers after immersion in physiological solution but calcium was released in solution. The chemistry of both sealers was modified when heated but both recovered when cooled.SignificanceThe heat carriers were unreliable and the heat generated inside the canal was not the same as the temperature set on the dial. Since both sealers had identical chemistry save for minimal modifications to the organic component and were both resistant to heat, TotalFill BC sealer is recommended for use with warm vertical compaction technique as it is cheaper and as effective as the HiFlow.