Stability of the implant/abutment joint in a single-tooth external-hexagon implant system: clinical and mechanical review

Rigorous efforts have recently been made to reduce the recurrence of implant/abutment joint failure in single‐tooth implant restorations. However, the current knowledge about the stability of implant/abutment joints in an external hexagon implant system is incomplete. We reviewed clinical data regarding single‐tooth implant treatment with Brånemark implants, specifically the CeraOne abutment system (Nobel Biocare AB, Göteborg, Sweden). In vitro studies on joint stability were systematically assessed. Bending overload and the presence of misfit at the implant/abutment joint interface are the critical mechanical conditions that can make the joint unstable. Appropriate joint fitness and proper alignment of the implant should be assessed, and occlusal adjustment by narrowing the restoration width and flattening cuspal inclination should be applied to avoid bending moments caused by the lateral component of occlusal forces. Sufficient clinical reports of longer duration that evaluate and verify longer‐term success of the newly manufactured joint components were unavailable.     

Management of acute meningococcal septicaemia in Al-Nasser Paediatric Hospital: a retrospective cohort study

Background

Acute meningococcal septicaemia is a fulminant disease, and mortality and long-term morbidity can be very high if not treated appropriately. We aimed to evaluate case fatality rate of all children admitted with acute meningococcal septicaemia.

Nutritional assessment in patients with liver cirrhosis

Malnutrition is a liver cirrhosis complication affecting more than 20%-50% of patients. Although the term can refer to either nutrient deficiency or excess, it usually relates to undernutrition in cirrhosis settings. Frailty is defined as limited physical function due to muscle weakness, whereas sarcopenia is defined as muscle mass loss and an advanced malnutrition stage. The pathogenesis of malnutrition in liver cirrhosis is multifactorial, including decreased oral intake, maldigestion/malabsorption, physical inactivity, hyperammonemia, hypermetabolism, altered macronutrient metabolism and gut microbiome dysbiosis. Patients with chronic liver disease with a Body Mass Index of < 18.5 kg/m² and/or decompensated cirrhosis or Child-Pugh class C are at the highest risk of malnutrition. For patients at risk of malnutrition, a detailed nutritional assessment is required, typically including a history and physical examination, laboratory testing, global assessment tools and body composition testing. The latter can be done using anthropometry, cross-sectional imaging including computed tomography or magnetic resonance, bioelectrical impedance analysis and dual-energy X-ray absorptiometry. A multidisciplinary team should screen for and treat malnutrition in patients with cirrhosis. Malnutrition and sarcopenia are associated with an increased risk of complications and a poor prognosis in patients with liver cirrhosis; thus, it is critical to diagnose these conditions early and initiate the appropriate nutritional therapy. In this review, we describe the prevalence and pathogenesis of malnutrition in liver cirrhosis patients and discuss the best diagnostic approach to nutritional assessment for them.     

Anatomical closure of trocar site by using tip hole needle and redirecting suture hook

Background  

The incidence of trocar site incisional hernia following laparoscopic surgery is reported to be relatively high. The main reasons are trocar diameter and design, pre-existing fascial defects, and some operation- and patient-related factors. The goal of this article is to present a new procedure for anatomical closure of the trocar site to prevent its herniation.     

Antipyrine, indocyanine green, and lorazepam determined in plasma by high-pressure liquid chromatography

This HPLC method for measuring antipyrine, lorazepam, and indocyanine green in 0.5 mL of plasma can be used in studies of liver function in which these "model" compounds are used. After a fast, simple, one-step extraction procedure with acetonitrile, an isocratic HPLC system is used, with a single detection wavelength (214 nm) and a single internal standard (1-acetamidopyrene). The mobile phase is a 47/53 (by vol) mixture of acetonitrile and 50 mmol/L phosphate buffer, pH 6. The three compounds are separated on an LC-18 reversed-phase column. The low cost of the HPLC method makes feasible the routine clinical measurement of all three compounds.     

Central nervous system tumors in the first year of life: a clinical and pathologic experience from a single cancer center

Purpose

This study aims to review our experience with central nervous system (CNS) tumors occurring during the first year of life and to report differing features found in our series.

Methods

This is a retrospective study of infants with CNS tumors diagnosed at our institution from 2006 to 2011.

Results

A total of 19 cases were identified, with a median age of 232 days and predominance of male gender. Males were younger than females at the time of diagnosis (p value?=?0.039). There were 13 low-grade tumors, glial tumors being the most common (11/13, p value?=?0.003) and six high-grade tumors, atypical teratoid rhabdoid tumor being the most common (4/6). Low-grade tumors predominated in the supratentorial region, while high-grade tumors were seen in the infratentorial area (p value?=?0.035). Males had a predilection to have more supratentorial tumors (p value?=?0.058). Four patients underwent gross total resection, and eight received chemotherapy; none received radiotherapy. Two patients had spinal cord tumors; both were of pilomyxoid astrocytoma histology. Rare tumors included hemangiopericytoma (n?=?1) and atypical choroid plexus tumor (n?=?1), both occurring in the supratentorial area and affecting the youngest patients in this group; they were diagnosed prenatally and at 107 days, respectively. The median progression-free and overall survivals were 269 and 667 days, respectively. Among all tested parameters, only the grade of the tumor affected the outcome.

Conclusions

Diagnosis and management of infant's CNS tumors remain challenging. Pathologists should be aware of the diversity of histological types. Assigning appropriate tumor grade is fundamental in predicting the outcome.     

Teicoplanin measurement in patients with renal failure: comparison of fluorescence polarization immunoassay, microbiological assay, and high-performance liquid chromatographic assay.

Characterization of antibiotic pharmacokinetics in patients with renal insufficiency may be complicated by interfering substances within the assay. We compared three different assays for teicoplanin in serum and dialysate of 10 hemodialysis and six continuous ambulatory peritoneal dialysis (CAPD) patients. The microbiological assay (micro) had a within-run and between-run coefficient of variation (% CV) of less than 7.5% for concentrations ranging from 0.2 to 96 micrograms/ml. The high-performance liquid chromatographic assay (HPLC) within- and between-run %CV was less than 8% for concentrations ranging from 1 to 80 micrograms/ml. The fluorescence polarization immunoassay (FPIA) within- and between-run %CV was less than 7% for concentrations ranging from 5 to 100 micrograms/ml. In serum of hemodialysis patients FPIA results were slightly higher than HPLC results: FPIA = 1.11 HPLC + 2.37 (r = 0.975, n = 202), and FPIA concentrations in serum were also slightly higher than those measured by micro (FPIA = 1.21 micro - 1.57, r = 0.972, n = 161). The HPLC and micro serum results were also comparable in hemodialysis patients: micro = 0.92 HPLC + 2.89, r = 0.953, n = 160. However, in CAPD patients micro results were lower than HPLC results in serum (micro = 0.82 HPLC + 0.49, r = 0.981, n = 262). In peritoneal dialysate, HPLC values were approximately 60% of the micro values. Thus, FPIA may be the optimal technique for therapeutic monitoring of teicoplanin in the clinical setting due to its simplicity, specificity, and good correlation to HPLC and micro.     

Synthesis and biological evaluation of N-salicyloyl-N-benzyl thiourea and 2,2-dimethyl-4-oxo-6-methoxy benzo-1,3-dioxin

The synthesis of N-salicyloyl-N-benzyl-thiourea and 2,2-dimethyl-4-oxo-6-methoxy-benzo-1,3-dioxin are described. They were studied for their antiviral, antiproliferative and antimicrobial activities in vitro. N-salicyloyl-N-benzyl-thiourea exhibited significant activity against Gram-positive bacteria and against influenza viruses types A/Philippine/H3N2, A/Chilli/H1N1 and B/Paraha, as well as against K562 cell proliferation. By contrast, no such activity was demonstrated by 2,2-dimethyl-4-oxo-6-methoxy-benzo-1,3-dioxin.