Vertical Transmission of SARS-CoV-2 in Second Trimester Associated with Severe Neonatal Pathology

The effects of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in women on the gestation course and the health of the fetus, particularly in the first and second trimesters, remain very poorly explored. This report describes a case in which the normal development of pregnancy was complicated immediately after the patient had experienced Coronavirus disease 2019 (COVID-19) at the 21st week of gestation. Specific conditions included critical blood flow in the fetal umbilical artery, fetal growth restriction (1st percentile), right ventricular hypertrophy, hydropericardium, echo-characteristics of hypoxic-ischemic brain injury (leukomalacia in periventricular area) and intraventricular hemorrhage at the 25th week of gestation. Premature male neonate delivered at the 26th week of gestation died after 1 day 18 h due to asystole. The results of independent polymerase chain reaction (PCR), mass spectrometry and immunohistochemistry analyses of placenta tissue, umbilical cord blood and child blood jointly indicated vertical transmission of SARS–CoV-2 from mother to the fetus, which we conclude to be the major cause for the development of maternal vascular malperfusion in the studied case.     

乙肝病毒携带产妇感染状态与新生儿发生宫内感染的相关性分析

目的 探讨孕妇乙肝感染状态与新生儿宫内感染的关系.方法 将115例乙肝表面抗原(hepatitis B surface antigen,HBsAg)阳性的孕妇分为A组(乙肝HBsAg,HBeAg,HBcAb阳性组)、B组(乙肝HBsAg,HBeAb,HBcAb阳性组)、C组(HBsAg,HBcAb阳性组)、D组(HBsAg,HBeAg阳性组).对上述部分孕妇进行乙肝两对半及PCR-HBV-DNA值的检测,对其所生的新生儿在出生后24h内进行乙肝两对半的检测.结果 乙肝大三阳(HBsAg,HBeAg,HBcAb阳性)孕妇与乙肝小三阳(HBsAg,HBeAb,HBcAb阳性)孕妇比较,新生儿发生宫内感染差异无统计学意义(P=0.256),乙肝孕妇体内HBV-DNA值＞105基因拷贝/ml时发生新生儿宫内感染高于体内HBV-DNA值＜105基因拷贝/ml(P=0.001).结论 乙肝大三阳孕妇或体内HBV-DNA载量高是新生儿宫内感染的危险因素,应及时给予阻断,产后及时采取联合免疫措施,减少乙肝患儿的发生.     

热牙胶系统2种根管充填方法的临床效果比较

目的 比较热牙胶充填系统2种根管充填方法的临床效果。方法 选择2013年5月至2016年5月在安徽医科大学第二附属医院口腔科因牙髓病、根尖周病需行根管治疗的患者83例,共83颗患牙,按随机数字表法分为两组,试验组42例患者,42颗患牙（119个根管）,对照组41例患者,41颗患牙（111个根管）。试验组患者采用热牙胶连续波加压充填+冷牙胶侧方加压法进行根管充填,对照组患者采用单纯热牙胶连续波加压充填法。比较2组患者充填方法在临床操作中容易出现的失误率（携热器带出牙胶尖、根管内气泡）、根充恰填率以及1年后临床成功率。结果 试验组患者携热器向上拔出时牙胶尖带出根管数6根,对照组43根,差异有统计学意义（P<0.05）。根管内气泡实验组5根,对照组11根,差异无统计学意义（P>0.05）。试验组根管恰填113根,对照组根管恰填74根,差异有统计学意义（P<0.05）。根管治疗术后1年复查,试验组患者临床成功率为95.24%,对照组为85.37%,两组差异无统计学意义（P>0.05）。结论 2种根管充填方法均能达到良好的临床效果,热牙胶连续波加压充填联合冷牙胶侧方加压法较单纯热牙胶连续波加压法充填根管操作失误少、根尖封闭效果更好。     

Evaluación inicial del programa de prevención de la transmisión materno-infantil de la infección por el virus de la inmunodeficiencia humana en Guinea Ecuatorial

Background

The prevalence of human immunodeficiency virus (HIV)-infected pregnant women in Equatorial Guinea (EG) has been reported as 7.3%. In 2008 an updated version of the PMTCT protocol was accepted according to the current WHO guidelines. The aim of this study was to describe the characteristics and outcome of children exposed to HIV after the introduction of the protocol.

Methods

A retrospective review was conducted on the clinical characteristics of the infants born to HIV-infected mothers in the Hospital Regional de Bata and Primary Health Care Centre Maria Rafols in Bata (EG) between June 2008 and November 2011. The diagnosis of HIV infection in children was based on rapid serology tests.

Results

A total of 103 children were included, of which 47 were males. Fifty three patients (51%) completed the follow-up (51%). Fourteen children (26%) were diagnosed with HIV infection (11 presumptive diagnosis, 3 due to persistence of antibodies at 18 months). Six children (12%) died before a definitive diagnosis. Just over than half (52%) of mothers received antiretroviral therapy (ART) during pregnancy. The transmission rate in children whose mothers received ART was 16% (3/19), compared with 43% (10/23) in children whose mothers did not receive it. Only one child was infected (8%) when the mother received ART, and child received postnatal prophylaxis.

Conclusions

The PMTCT protocol compliance was still very low. Antiretroviral therapy in pregnant women decreased the rate of vertical transmission, but the rate still remains very high. Many children were lost to follow-up. Strategies to prevent loss to follow-up and methods for earlier virological diagnostic are needed.     

Minimally Invasive Treatment of an Adult with Severe Pseudo Class III Malocclusion

Pseudo class III malocclusion is reverse anterior occlusion or anterior cross‐bite with first molars and canines in a class I relationship. It is very important to diagnose the pseudo class III from true skeletal class III. The combination of anterior displacement of the mandible, tooth wear, and loss of occlusal vertical dimension (OVD) in adults may result anterior cross‐bite. The key factor in diagnosis of this malocclusion is an interdisciplinary approach with an orthodontist. Cephalometric images are essential for diagnosis of pseudo class III mal‐occlusion. Most relevant publications on correcting this condition have recommended either full‐coverage restorations or extraction and placement of implants to correct this malocclusion. Advances of material and technology may help dental practitioners to restore tooth wear and OVD with a conservative approach without removing more tooth structures. This clinical report shows the treatment of pseudo class III with minimally invasive treatment using partial coverage restorations fabricated with lithium disilicate.     

In Vivo Detection of Subtle Vertical Root Fracture in Endodontically Treated Teeth by Cone-beam Computed Tomography

IntroductionThe purpose of this study was to evaluate the diagnostic accuracy of cone-beam computed tomographic (CBCT) imaging in the detection of subtle vertical root fractures (VRFs) in endodontically treated teeth in vivo and to discuss direct and indirect evidence for the diagnosis of subtle VRFs.MethodsTwenty-nine endodontically treated teeth with suspected VRFs from 29 patients were examined using CBCT imaging. CBCT images were scored based on evaluation of the fracture line and vertical buccopalatal (lingual) bone loss. VRF was diagnosed only when a definite fracture line was detected on CBCT images, and findings of periodontal exploration or surgical extraction were considered the gold standard. The diagnostic sensitivity, specificity, and accuracy were assessed.ResultsOf the 29 teeth, 27 were positive and 2 were negative for VRF according to the gold standard. Sensitivity, specificity, and accuracy were 33.3%, 100%, and 37.9%, respectively, based on the direct finding of a fracture line on CBCT images. However, vertical buccopalatal (lingual) bone loss was found in 25 of 27 teeth with VRFs.ConclusionsAlthough the accuracy of CBCT imaging for the diagnosis of subtle VRFs in endodontically treated teeth in vivo was poor, vertical buccopalatal (lingual) bone loss is an important indirect sign for the diagnosis of VRFs, which can be found on CBCT images.     

三壁骨缺损对牙周膜应力影响的三维有限元分析

目的 研究三壁骨缺损对正常咬合力下牙周膜应力的影响。方法 基于锥形束CT（CBCT）的DICOM格式数据,分别建立下颌全牙列牙齿、牙周膜和牙槽骨的有限元模型。采用修改骨缺损区域单元弹性模量的方法分别模拟位于近中和远中的不同深度（占根长1/3、2/3和3/3）的邻面三壁骨缺损。对骨缺损的牙齿施加与牙体长轴呈45°的正常咬合力,分析牙周膜等效应力。结果 牙槽骨无缺损时,14颗牙齿的牙周膜等效应力平均值为5.71 MPa。牙槽骨缺损深度占根长1/3、2/3和3/3时,牙周膜等效应力平均值分别为6.61、7.14、7.42 MPa。随着三壁骨缺损深度的增加,牙周膜应力明显增大,吸收的前期应力增量大于后期。位于近中的不同深度（占根长1/3、2/3和3/3）的邻面三壁骨缺损牙周膜等效应力平均值分别为6.62、7.19、7.51 MPa,位于远中的不同深度（占根长1/3、2/3和3/3）的邻面三壁骨缺损牙周膜等效应力平均值分别为6.60、7.10、7.33 MPa。三壁骨缺损位于牙齿近中或远中,对其牙周膜的应力影响无显著差异。在相同缺损深度下,各类牙齿牙周膜等效应力大小关系为前磨牙>磨牙>切牙>尖牙。结论 即使较浅的三壁骨缺损,仍然会造成牙周膜应力的明显增加,因此对于早期的三壁骨缺损患牙,在临床上要引起充分的重视,尽早治疗干预。