Prosthodontic Considerations in the Implant‐Supported All‐Ceramic Restoration of Congenitally Missing Maxillary Lateral Incisor: A Clinical Report

The congenitally missing maxillary lateral incisor is the most common agenesis in the anterior region. There are several treatment options for this anomaly, which causes severe deficiencies: orthodontic space closure, tooth‐supported restoration, or single‐tooth implant. Each of these solutions has a high degree of success if used in the correct situation. An implant‐supported restoration with an interdisciplinary approach provides a predictable outcome. This article describes the treatment of a patient with agenesis of the maxillary left lateral incisor. After orthodontic space management, it was decided to restore the tooth with an all‐ceramic crown cemented on a zirconia custom abutment, which fractured after only 6 weeks of service. Fractographic analysis revealed that the failure was due to over‐reduction of the buccal wall to correct the labial emergence of the implant. Zirconia abutments should be designed with even wall thicknesses of at least 0.8 mm to avoid areas that may compromise functional success.     

Prevalence and impact of insomnia in children and adolescents with body dysmorphic disorder undergoing multimodal specialist treatment

European Child & Adolescent Psychiatry - Pediatric body dysmorphic disorder (BDD) is challenging to treat. This study aimed to establish the prevalence of insomnia in youth with BDD and explore...     

Clinical differentiation of inflammatory bowel disease (IBD) in Latin America and the Caribbean

The aim of the present study was to describe the epidemiological and clinical characteristics of inflammatory bowel disease (IBD), including medical and surgical treatments, in several countries in Latin America and the Caribbean.IBD is recognized as a global health problem because its incidence and prevalence have increased significantly over the last few years.This multicenter retrospective cohort study included 4714 patients with IBD diagnosed from 9 countries in Latin America and the Caribbean: Colombia, Cuba, Dominican Republic, Ecuador, Mexico, Peru, Puerto Rico, Uruguay, and Venezuela.Crohn disease (CD) was more frequent in Puerto Rico (71.9%), the Dominican Republic (61.0%), and Peru (53.1%). Ulcerative colitis was more frequent in Colombia (78.6%), Venezuela (78.2%), Mexico (75.5%), Cuba (69.9%), Ecuador (64.1%), and Uruguay (60.9%). The following clinical characteristics were more frequent in the Caribbean: penetrating behavior in CD, steroid dependence, steroid resistance, intolerance to thiopurines, extraintestinal manifestations, surgeries, hospitalizations due to IBD, and family history of IBD. The factors associated with the use of biological therapy were pancolitis in ulcerative colitis, penetrating behavior in CD, steroid resistance and dependence, presence of extraintestinal manifestations, and the need for surgery.This study from Latin America and the Caribbean demonstrated the different epidemiological and clinical characteristics of IBD.     

Evaluación de la contractilidad del ventrículo izquierdo en pacientes con estenosis aórtica grave,flujo bajo,gradiente bajo y fracción de expulsión preservada

Introduction:

In patients with severe aortic stenosis, low-gradient, low-flow and preserved ejection fraction (≥ 50%) (LG/LFp) the decrease in stroke volume index (Svi) could be due to diminished contractility. The aim of this study was to analyze if low Svi in patients with LG/LFp is related to a decrease in contractility.

Methods:

Thirty patients with LF/LGp and 63 normal subjects were studied with Doppler echocardiography. The level of contractility (LC) was assessed by mean of midwall shortening fraction (mSF) – end-systolic stress (ESS) relationship. Relative wall thickness (RWT) and aortic valve area (AVA) were calculated.

Results:

LC was diminished in 40% of LF/LGp patients. By bivariate analysis LC correlated with RWT and mSF. Svi correlated with AVA but not with LC. In multiple linear regression RWT and mSF were predictors independents of LC. About Svi, AVA was the only predictor independent variable.

Conclusion:

Decreased contractility was present in 40% of LF/LGp patients despite preserved ejection fraction. LC had correlation with mSF and EPR. Low Svi appears to be related to aortic stenosis severity rather than low contractility.Key words: Aortic stenosis, Contractility, Echocardiography, Ventricular function     

Safe use of systemic bevacizumab for respiratory recurrent papillomatosis in two children

Recurrent respiratory papillomatosis can be a devastating condition for a child, with severe consequences. Currently, there is no proven successful medical treatment. We describe the use of systemic bevacizumab to treat two children affected by aggressive recurrent respiratory papillomatosis. Respiratory symptoms and quality of life improved dramatically in both patients, without observing any toxicity. The only complication was mild proteinuria. Systemic bevacizumab is a promising adjuvant treatment in aggressive recurrent respiratory papillomatosis in children. It is effective and well tolerated. Further studies are needed to establish the optimal dosing frequency and duration of therapy. Laryngoscope, 129:1001–1004, 2019     

Computed Tomography in the Diagnosis of Sacroiliitis

Computed tomography (CT) and conventional radiography of the sacroiliac joint were compared in 43 patients. CT appeared to be far more sensitive and equally specific in the recognition of sacroiliitis. In a number of patients with sacroiliitis diagnosed by both techniques, CT demonstrated abnormalities that were not demonstrated by conventional radiographs. Of those patients with clinical evidence of sacroiliitis and HLA—B27 positivity, 50% had negative or equivocal radiographs compared to 19% who had negative computed tomographic images for sacroiliiti.