Acute transverse myelitis following SARS-CoV-2 vaccination: a case report and review of literature

Journal of Neurology - To report a unique case and literature review of post COVID-19 vaccination associated transverse myelitis and with abnormal MRI findings. Coronavirus disease have been...     

Maxillary distraction using a trans-sinusal distractor: technical note

In this pilot study, the principle of distraction osteogenesis was used to advance the midface of a boxer dog. A modified high Le Fort I-type osteotomy was performed. Following a latency period of 5 days the maxilla was distracted 14 mm in 14 consecutive days at a rate of 1 mm per day. Ten weeks after the completion of the distraction, multiple biopsies were taken across the distraction gap. Histological observation showed bone deposition in the osteotomy sites. Soft and hard tissue formation resulted in complete healing across the distraction gap. The maxillary sinus was used to accommodate the distraction device. Superimposition of the standardized lateral cephalograms taken at the end of distraction and 14 months after the removal of the distractors showed no sign of relapse in the achieved sagittal advancement of the maxilla. This small, intraoral trans-sinusal placed distractor has a completely new conceptual design, and may be helpful in distraction of maxilla in children and adults with midfacial hypoplasia.     

Cephalometric evaluation of maxillary advancement with an internal distractor in an adult boxer dog

Objective – The aim of the study was to evaluate cephalometrically the effects of distraction of the maxilla over a 1‐year period by means of an internal distractor applied in a boxer dog. Design – Internal distractors were placed bilaterally in the internal cavity of the maxillary sinus of a 2‐year‐old boxer dog after a Le Fort I osteotomy. Distraction was started 5 days after surgery and activations were continued for 14 days at a rate of 1 mm/day. Standardized lateral cephalograms were taken with an external source of 90 kV, 60 mS immediately pre‐surgery, at day 1 after the start of the distraction (dp) and at day 5 dp, day 7 dp, day 10 dp, day 14 dp (end of distraction), at 14 days of consolidation period (cp), at 28 days cp and at 56 days cp (removal of the distractors). One year after the removal of the distractor, a final lateral cephalogram was taken. Cephalometric analysis was performed and superimpositions were used for the evaluation of the sagittal position of the maxilla. Results – The linear measurements, as well as the superimposition showed evidence for a significantly advanced position of the maxilla, which was stable 1 year after removal of the distractor. Conclusion – The application of the internal maxillary distractor in a boxer dog resulted in a sagittal advancement of the midface that was still present after 1 year.     

Skeletal and dento-alveolar stability after surgical-orthodontic treatment of anterior open bite: a retrospective study.

The aim of this investigation was to assess skeletal and dento-alveolar stability after surgical-orthodontic correction of skeletal anterior open bite treated by maxillary intrusion (group A) versus extrusion (group B). The cephalometric records of 49 adult anterior open bite patients (group A: n = 38, group B: n = 11), treated by the same maxillofacial surgeon, were examined at different timepoints, i.e. at the start of the orthodontic treatment (T1), before surgery (T2), immediately after surgery (T3), early post-operatively (+/- 20 weeks, T4) and one year post-operatively (T5). A bimaxillary operation was performed in 31 of the patients in group A and in six in group B. Rigid internal fixation was standard. If maxillary expansion was necessary, surgically assisted rapid palatal expansion (SRPE) was performed at least 9 months before the Le Fort I osteotomy. Forty-five patients received combined surgical and orthodontic treatment. The surgical open bite reduction (A, mean 3.9 mm; B, mean 7.7 mm) and the increase of overbite (A, mean 2.4 mm; B, mean 2.7 mm), remained stable one year post-operatively. SNA (T2-T3), showed a high tendency for relapse. The clockwise rotation of the palatal plane (1.7 degrees; T2-T3), relapsed completely within the first post-operative year. Anterior facial height reduction (A, mean -5.5 mm; B, mean -0.8 mm) occurred at the time of surgery. It can be concluded that open bite patients, treated by posterior Le Fort I impaction as well as with anterior extrusion, with or without an additional bilateral sagittal split osteotomy (BSSO), one year post-surgery, exhibit relatively good clinical dental and skeletal stability.     

Using a Theory-Guided Learning Collaborative Model to Improve Implementation of EBPs in a State Children’s Mental Health System: A Pilot Study

Learning collaboratives (LCs) are used widely to promote implementation of evidence-based practices. However, there has been limited research on the effectiveness of LCs and models vary widely in their structure, focus and components. The goal of the present study was to develop and field test a theory-based LC model to augment a state-led, evidence-based training program for clinicians providing mental health services to children. Analysis of implementation outcomes contrasted LC sites to matched comparison sites that participated in the clinical training program alone. Results suggested that clinicians from sites participating in the LC were more highly engaged in the state-led clinical training program and were more likely to complete program requirements.     

Stress on health-related quality of life in older adults: the protective nature of mindfulness

Objectives: The current study examined whether the link between stress and health-related quality of life was buffered by protective factors, namely mindfulness, in a sample of middle-aged and older adults.

Methods: In this cross-sectional study, 134 healthy, community-dwelling adults (ages 50–85 years) were recruited from Dallas, TX. The participants were screened for depressive symptoms and severity (using the Patient Health Questionnaire [PHQ-9]). All participants completed measures of self-reported health status (i.e. SF36v2: mental and physical health composites), life stress (using the Elders Life Stress Inventory [ELSI]), and trait mindfulness (i.e. Mindful Attention Awareness Scale).

Results: Hierarchical regressions (covarying for age, gender, and education) showed that life stress was inversely related to physical and mental health. Mindfulness was positively related to mental health. The negative effect of life stress on mental health was weakened for those individuals with higher levels of trait mindfulness.

Conclusions: The results suggest that mindfulness is a powerful, adaptive strategy that may protect middle-aged and older adults from the well-known harmful effects of stress on mental health.