Anomalous coronary artery causing transmural ischaemia and ventricular tachycardia in a high school athlete

A previously asymptomatic 15-year-old boy was treated at our institution after an episode of chest pain, palpitation, and syncope while playing in a high school soccer game. The patient's resting electrocardiogram was normal. A transthoracic echocardiogram showed an anomalous left main coronary artery originating from the right sinus of Valsalva. Contrast-enhanced multidetector computed tomography demonstrated clearly that the anomalous vessel coursed between the aorta and the pulmonary trunk (interarterial subtype). Treadmill testing registered several nonsustained polymorphic ventricular tachycardias and transmural myocardial ischaemia in the early recovery phase (ST-elevation up to 5mm in CM5 and V2 leads). The patient underwent bypass grafting. One year later, he remains asymptomatic, and new treadmill tests have been normal. In this patient, severe transmural myocardial ischaemia was detected, possibly due to collapse or vasospasm of the anomalous vessel, triggering life-threatening ventricular arrhythmias.     

Silicone index: an alternative approach for tooth fragment reattachment

Tooth fragment reattachment is a simple, conservative, fast, and affordable treatment option for fractured teeth when the fragment is available. However, this technique can present some difficulties, among which is the possibility of the fragment being positioned and bonded inadequately. To avoid this situation, it is necessary to establish a reference for the adequate positioning of the fragment using a silicone index. CLINICAL SIGNIFICANCE: This article presents an alternative approach for better handling of tooth fragments resulting from trauma by using a silicone index as a guide to proper positioning and bonding.     

Glass carbomer and compomer for ART restorations: 3-year results of a randomized clinical trial

Clinical Oral Investigations - To evaluate the survival of atraumatic restorative treatment (ART) restorations using high viscosity glass ionomer cement (GIC), compomer (COM), and glass carbomer...