Rehabilitation of a patient with mini-implants after avulsion of the upper incisors: A 13-year follow up

Treatment following avulsion of a tooth in the growing patient requires a complex multidisciplinary therapeutic approach for the clinical team. The literature offers different therapeutic solutions following the avulsion of one or more teeth, but unfortunately all of them have negative repercussions on the patients' life quality, they involve long treatment plans, they are not always feasible, and they have limits. Alternatively, a new treatment concept that uses mini-implants can be considered and is presented with its rationale, clinical steps and 13 years of follow up of one case

Traumatic Dental Injuries: Clinical Case Presentation and a 10-Year Epidemiological Investigation in an Italian Dental Emergency Service

Traumatic dental injuries (TDIs) are very common in the world population, and international literature reports several studies which helped in the definition of international guidelines. The aim of this study is to present two clinical cases of TDI and to investigate epidemiological and etiological aspects of TDIs in patients treated in Modena, Italy, between January 2010 and December 2020. The presented case reports are two explicative clinical cases of successful TDI management with a long-Term follow-up. The epidemiological analysis was performed on patients who visited the Dental Emergency Service of the Dentistry and Oral-Maxillo-Facial Surgery Unit of Modena (Italy) over a period of 10 years. Data relating to age, gender, type of trauma, and place of accident were collected. Five-hundred-sixty-five TDIs that occurred to patients from 1 to 68 years old were reported, with a total of 860 injured teeth. The peak age at which TDIs are most represented varies between 2 and 3 years old, and they occurred frequently from 1 up to 7 years old. 57.5% were male, while 42.5% were female. The most common trauma resulted to be the uncomplicated crown fracture (20%), immediately followed by lateral luxation (19%), intrusive luxation (18%), avulsion (17%), and complicated crown fracture (15%). TDIs occurred at home in 44% of cases. The need for more prevention training must be highlighted, due to the fact that many TDIs occur at home and in a preschool age

Insulinoma presenting as idiopathic hypersomnia

We report the case of a 32-year-old woman with a history of increased sleep need and difficulty waking up; the diagnosis of idiopathic hypersomnia was hypothesized. During ambulatory polysomnography (PSG), the patient presented an episode characterized by loss of consciousness and jerking of the four limbs. A video-PSG monitoring was performed and the patient showed unresponsiveness and drowsiness at 7 a.m. During the episode, EEG showed theta-delta diffuse activity, and blood glucose level was 32 mg dl(-1). The diagnosis of insulinoma was then assumed; CT scan showed a hypodense mass into the pancreatic tail, and a partial pancreasectomy was performed. The described symptoms disappeared, and 5 years later the findings of a complete clinical and neurophysiological examination were negative. The clinical picture of insulinoma presenting with paroxysmal disorders has been previously described; however, whereas hypersomnia is uncommon, in the current case it represents the main symptom. Clinicians should keep in mind that neuroglycopenia should be considered in the differential diagnosis of patients with hypersomnia, particularly if the clinical scenario does not conform to standard criteria

Complex nanostructures in diamond

Meteoritic diamonds and synthesized diamond-related materials contain a wide variety of complex nanostructures. This Comment highlights and classifies this structural complexity by a systematic hierarchical approach, and discusses the perspectives on nanostructure and properties engineering of diamond-related materials

Improvements to the Copernicus Trajectory Design and Optimization System for Complex Space Trajectories

The purpose of this assessment was to develop updates and new features for the NASA Copernicus Spacecraft Trajectory Design and Optimization analysis tool (version 5.0) for application to NASA programs and projects. These updates will significantly improve the ability to design and optimize complex trajectories over multiple trajectory phases; will allow the use of unique vehicle-specific guidance, control, and trajectory strategies and constraints; and the creation of an almost unlimited number of unique user-defined capabilities. The primary stakeholders for this assessment are the trajectory design and optimization analysts and engineers, and the chief engineers and project managers for existing programs, projects, and/or tasks that involve impulsive, finite burn, and/or continuous thrust trajectories (e.g., Sun, planet, comet, asteroid, halo orbit, Lagrange point, and distant retrograde orbit). The breadth of application spans the preliminary engineering and mission design concepts and optimization, to the development of candidate reference missions and integrated mission design for vehicle system design and operation, to the design and development of flight trajectories and associated propulsive maneuvers for real-time operations

1991-05-04

Abstract OBJECTIVES: To analyse the virological and clinical efficacy of cidofovir combined with highly active antiretroviral therapy (HAART) in AIDS-related progressive multifocal leukoencephalopathy (PML). DESIGN: Multicentre observational study of consecutive HIV-positive patients with histologically or virologically-proven PML. Group A, 26 patients treated with HAART; group B, 14 patients treated with HAART plus cidofovir 5 mg/kg intravenously per week for the first 2 weeks and alternate weeks thereafter. JC virus DNA was quantified in cerebrospinal fluid (CSF) by PCR. RESULTS: Baseline virological, immunological and clinical characteristics were homogeneous between the groups. In one case cidofovir was discontinued because of severe proteinuria. There was no significant difference in HIV RNA responses and changes in the number of CD4 cells between group A and B. After 2 months of therapy, five out of 12 (42%) patients from group A and seven out of eight (87%) from group B reached undetectable JC virus DNA in the CSF (Chi-square P = 0.04); moreover, 24% of group A and 57% of group B patients showed neurological improvement or stability (P = 0.038). One-year cumulative probability of survival was 0.67 with cidofovir and 0.31 without (log-rank test, P = 0.01). Variables independently associated with longer survival were the use of cidofovir, HAART prior to the onset of PML, a baseline JC virus DNA load in CSF or = 60. CONCLUSIONS: In AIDS-related PML, cidofovir added to HAART is associated with a more effective control of JCV replication, with improved neurological outcome and survival compared with HAART alone

Raman elastic geobarometry for anisotropic mineral inclusions

Elastic geobarometry for host-inclusion systems can provide new constraints to assess the pressure and temperature conditions attained during metamorphism. Current experimental approaches and theory are developed only for crystals immersed in a hydrostatic stress field, whereas inclusions experience deviatoric stress. We have developed a method to determine the strains in quartz inclusions from Raman spectroscopy using the concept of the phonon-mode Gr\ufcneisen tensor. We used ab initio Hartree-Fock/Density Functional Theory to calculate the wavenumbers of the Raman-active modes as a function of different strain conditions. Least-squares fits of the phonon-wavenumber shifts against strains have been used to obtain the components of the mode Gr\ufcneisen tensor of quartz (\u2060\u3b3m1 and \u3b3m3\u2060) that can be used to calculate the strains in inclusions directly from the measured Raman shifts. The concept is demonstrated with the example of a natural quartz inclusion in eclogitic garnet from Mir kimberlite and has been validated against direct X-ray diffraction measurement of the strains in the same inclusio

Suicide risk in medically ill inpatients referred to consultation-liaison psychiatric services: A multicenter study

Background: The aim of this multicenter study was to investigate the suicide risk in medically ill patients admitted to six Italian hospitals for whom a consultation-liaison intervention was requested. Methods: Participants completed socio-demographic and clinical report forms and the Brief Illness Perception Questionnaire. Suicidality was assessed using the P4 screener that investigates the presence of Past suicide attempts, Plans to commit a suicide, Probability of completing suicide, and Preventive factors. Participants were categorized as being at no, low or high suicide risk. Univariate and multivariable associations of categorical and continuous variables with suicide risk were investigated using multinomial logistic regression. Results: Of the 641 inpatients, with mean age 60 years (SD = 16.9) and 49.2 % male, 13.2 % were at high suicidal risk (HR), 7.6 % low risk (LR) and 79.2 % no risk. Contacts with psychiatrists in the previous six months were associated with LR and HR (OR = 2.159 and 2.634, respectively), ongoing benzodiazepine use was associated with a threefold likelihood of LR (OR = 3.005), and the experienced intensity of illness symptoms was associated with LR and HR (OR = 1.257 and OR = 1.248, respectively). CL psychiatrists prescribed appropriate psychotropic drugs and activated liaison interventions and psychological support for the level of suicidal risk. Limitations: The use of self-report measures bears the risk of recall bias. Conclusions: Our findings based on psychiatric consultations in the general hospital underscore the need to include suicide risk in the routine assessment of inpatients referred to CL psychiatric services and to plan an appropriate management of suicidal risk after discharge