Cryotherapy in reducing pain,trismus, and facial swelling after third-molar surgery: Systematic review and meta-analysis of randomized clinical trials

Background

The aim of this systematic review and meta-analysis was to evaluate the efficacy of cryotherapy in reducing pain, trismus, and facial swelling in patients undergoing third-molar surgery.

Two-Dimensional FEA of Dowels of Different Compositions and External Surface Configurations

Purpose: The degree of stress generated in the endodontically treated and restored tooth can be influenced by the composition and configuration of the dowels used for the restoration. Using two‐dimensional (2D) finite element analysis (FEA), this study tested the hypothesis that the characterization of the stress distribution can be influenced by which evaluation method is employed: protrusion loading and 4‐point flexural strength test or varying the type of material (carbon and glass fiber) or the external configuration of the dowel (smooth and serrated). Materials and Methods: For simulation of the protrusion load test, models were generated with Mechanical‐AutoCAD V6 software from an image of an anatomical plate, one maxillary central incisor, and two dowels and exported to Ansys 9.0. The bone region model was fixed, and a tangential load of 1 N with a 135° inclination to the tooth longitudinal axis was applied at the level of the palatal surface of the crown. In the simulation of a 4‐point flexural strength test, a 1 N perpendicular load was applied in two points to the dowel. The dental materials and structures were considered elastic, isotropic, homogeneous, and linear, with the exception of the dowel, which was assumed to exhibit orthotropic behavior. Mechanical properties were defined based on a review of the literature, and the model was meshed with an eight node tetrahedral element. Results: The stress results from both tests were analyzed according to von Mises criteria and principal stresses (Sx). Data from the 4‐point flexural strength test simulation showed that, for the serrated dowels, a higher stress concentration was found; however, no difference in the occlusal load for material or dowel configuration was found. Conclusions: These results suggest that although the external configuration of the dowel influences direct loading, when the dowel is integrated to the tooth and setting material, the influence on biomechanical behavior disappears.     

Conservative treatment of lumbar spondylolysis in young soccer players

Purpose  

The purpose of this study was to report the functional outcomes of young active soccer players with lumbar spondylolysis undergoing conservative treatment.     

Real‐time motion correction for high‐resolution larynx imaging

Motion—both rigid‐body and nonrigid—is the main limitation to in vivo, high‐resolution larynx imaging. In this work, a new real‐time motion compensation algorithm is introduced. Navigator data are processed in real time to compute the displacement information, and projections are corrected using phase modulation in k‐space. Upon automatic feedback, the system immediately reacquires the data most heavily corrupted by nonrigid motion, i.e., the data whose corresponding projections could not be properly corrected. This algorithm overcomes the shortcomings of the so‐called diminishing variance algorithm by combining it with navigator‐based rigid‐body motion correction. Because rigid‐body motion correction is performed first, continual bulk motion no longer impedes nor prevents the convergence of the algorithm. Phantom experiments show that the algorithm properly corrects for translations and reacquires data corrupted by nonrigid motion. Larynx imaging was performed on healthy volunteers, and substantial reduction of motion artifacts caused by bulk shift, swallowing, and coughing was achieved. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Estadificación mediante tomografía computarizada del carcinoma de páncreas

Pancreatic carcinoma is becoming more common in our environment; the mortality rate for this tumor has barely changed over the last 20 years.Early diagnosis and accurate staging are crucial to ensure an appropriate therapeutic approach, which should aim to improve survival in patients in whom complete resection is possible and to minimize surgical morbidity and mortality in those with a high risk of residual disease after the intervention.Various imaging techniques are used for tumor staging: multidetector computed tomography (CT), magnetic resonance imaging, positron emission tomography (PET)-CT, endoscopic ultrasound, and diagnostic laparoscopy. Currently, multidetector CT is the technique of choice for the study of pancreatic tumors; thus, this article aims to review the state of the art in staging adenocarcinoma of the pancreas, focusing mainly on the applications and limitations of this technique.     

Glucosamine sulfate effect on the degenerated patellar cartilage: preliminary findings by pharmacokinetic magnetic resonance modeling

Normal and degenerated cartilages have different magnetic resonance (MR) capillary permeability (K^trans) and interstitial interchangeable volume (v_e). Our hypothesis was that glucosamine sulfate treatment modifies these neovascularity abnormalities in osteoarthritis. Sixteen patients with patella degeneration, randomly distributed into glucosamine or control groups, underwent two 1.5-Tesla dynamic contrast-enhanced MR imaging studies (treatment initiation and after 6 months). The pain visual analog scale (VAS) and American Knee Society (AKS) score were used. A two-compartment pharmacokinetic model was used. Percentages of variations (postreatment-pretreatment/pretreatment) were compared (t-test for independent data). In the glucosamine group, pain and functional outcomes statistically improved (VAS: 7.3 ± 1.1 to 3.6 ± 1.3, p < 0.001; AKS: 18.6 ± 6.9 to 42.9 ± 2.7, p < 0.01). Glucosamine significantly increased K^trans at 6 months (−54.4 ± 21.2% vs 126.7 ± 56.9%, p < 0.001, control vs glucosamine). In conclusion, glucosamine sulfate decreases pain while improving functional outcome in patients with cartilage degeneration. Glucosamine sulfate increases K^trans, allowing its proposal as a surrogate imaging biomarker after 6 months of treatment.     

Postmortem genetic testing should be recommended in sudden cardiac death cases due to thoracic aortic dissection

Background

Acute thoracic aortic dissections and ruptures, the main life-threatening complications of the corresponding aneurysms, are an important cause of sudden cardiac death. Despite the usefulness of the molecular diagnosis of these conditions in the clinical setting, the corresponding forensic field remains largely unexplored. The main goal of this study was to explore and validate a new massive parallel sequencing candidate gene​ assay as a diagnostic tool for acute thoracic aortic dissection autopsy cases.

Materials and methods

Massive parallel sequencing of 22 thoracic aortic disease candidate genes performed in 17 cases of thoracic aortic dissection using AmpliSeq and Ion Proton technologies. Genetic variants were filtered by location, type, and frequency at the Exome Aggregation Consortium and an internal database and further classified based on the American College of Medical Genetics and Genomics (ACMG) recommendations published in 2015. All prioritized results were confirmed by traditional sequencing.

Results

From the total of 10 potentially pathogenic genetic variants identified in 7 out of the 17 initial samples, 2 of them were further classified as pathogenic, 2 as likely pathogenic, 1 as possibly benign, and the remaining 5 as variants of uncertain significance, reaching a molecular autopsy yield of 23%, approximately.

Conclusions

This massive parallel sequencing candidate gene approach proved useful for the molecular autopsy of aortic dissection sudden cardiac death cases and should therefore be progressively incorporated into the forensic field, being especially beneficial for the anticipated diagnosis and risk stratification of any other family member at risk of developing the same condition.

     

Association of sedentary time and physical activity with pain,fatigue, and impact of fibromyalgia: the al‐Ándalus study

We examined the association of objectively measured sedentary time (ST) and physical activity (PA) levels with pain, fatigue, and the impact of the disease in women with fibromyalgia. Four hundred and nineteen (mean age ± SD = 51.7 ± 7.6 years old) women with fibromyalgia participated. ST and PA levels (light, moderate, and moderate‐to‐vigorous [MVPA]) were measured with triaxial accelerometry. We assessed experimental pain with algometry and clinical pain, fatigue, and impact of fibromyalgia with a number of questionnaires. The association of ST and light PA with most of the pain‐ and fatigue‐related outcomes and impact of fibromyalgia (all, P ≤ 0.019) was independent of moderate and vigorous PA. Furthermore, the association of vigorous PA with general and physical fatigue was independent of ST and light and moderate PA (all, P < 0.001). In conclusion, lower levels of ST or higher levels of light PA are associated with lower pain, fatigue, and the overall impact of the disease independent of moderate and vigorous PA in women with fibromyalgia. Interestingly, higher vigorous PA is independently associated with lower general and physical fatigue. These results are significant for future ST and PA intervention studies in this population.     

Influence of metabolic syndrome on post-stroke outcome,angiogenesis and vascular function in old rats determined by dynamic contrast enhanced MRI

Stroke affects primarily aged and co-morbid people, aspects not properly considered to date. Since angiogenesis/vasculogenesis are key processes for stroke recovery, we purposed to determine how different co-morbidities affect the outcome and angiogenesis/vasculogenesis, using a rodent model of metabolic syndrome, and by dynamic enhanced-contrast imaging (DCE-MRI) to assess its non-invasive potential to determine these processes. Twenty/twenty-two month-old corpulent (JCR:LA-Cp/Cp), a model of metabolic syndrome and lean rats were used. After inducing the experimental ischemia by transient MCAO, angiogenesis was analyzed by histology, vasculogenesis by determination of endothelial progenitor cells in peripheral blood by flow cytometry and evaluating their pro-angiogenic properties in culture and the vascular function by DCE-MRI at 3, 7 and 28 days after tMCAO. Our results show an increased infarct volume, BBB damage and an impaired outcome in corpulent rats compared with their lean counterparts. Corpulent rats also displayed worse post-stroke angiogenesis/vasculogenesis, outcome that translated in an impaired vascular function determined by DCE-MRI. These data confirm that outcome and angiogenesis/vasculogenesis induced by stroke in old rats are negatively affected by the co-morbidities present in the corpulent genotype and also that DCE-MRI might be a technique useful for the non-invasive evaluation of vascular function and angiogenesis processes.     

Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: Parte 1

IntroductionThe main challenge of Parkinson's disease in women of childbearing age is managing symptoms and drugs during pregnancy and breastfeeding. The increase in the age at which women are having children makes it likely that these pregnancies will become more common in future.ObjectivesThis study aims to define the clinical characteristics of women of childbearing age with Parkinson's disease and the factors affecting their lives, and to establish a series of guidelines for managing pregnancy in these patients.ResultsThis consensus document was developed through an exhaustive literature search and a discussion of the available evidence by a group of movement disorder experts from the Spanish Society of Neurology.ConclusionsParkinson's disease affects all aspects of sexual and reproductive health in women of childbearing age. Pregnancy should be well planned to minimise teratogenic risk. A multidisciplinary approach should be adopted in the management of these patients in order to take all relevant considerations into account.