Takayasus's Arteritis in Pregnancy. Case Report and Literature Review

SummaryBackground and objectivesTakayasus's Arteritis (TA) is a chronic, inflammatory, progressive, idiopathic disease that causes narrowing, occlusion, and aneurysms of systemic and pulmonary arteries affecting especially the aorta and its branches. During pregnancy, one should pay special attention to these patients. The objective of this report was to present the peripartum anesthetic care of a patient with TA and a review of the literature.Case reportThis is a 31-year old gravida who underwent exchange of the aortic arch and placement of a metallic aortic valve for TA four years ago. She had no complications during pregnancy, and she was admitted at 34 weeks of pregnancy for anticoagulation management. Elective cesarean section was performed at 39 weeks with continuous epidural anesthesia. Fractionated doses of local anesthetic were administered to guarantee slow installation of the blockade. The patient remained hemodynamically stable and was transferred to the ICU in the postoperative period.ConclusionsSeveral complications can affect gravidas with TA. Careful patient evaluation, treatment of TA complications, and anestheticsurgical planning are fundamental. Maintenance of perfusion is the main concern in these patients, and neuraxial blocks may be used without harming the mother and fetus. In patients with compensated TA complications, monitoring does not differ from that routinely used in cesarean sections. Continuous epidural anesthesia with slow installation maintains hemodynamic stability and allows monitoring cerebral perfusion through the level of consciousness. To avoid postoperative hypoperfusion or hypertensive complications patients should be monitored in an intensive or semi-intensive care unit for 24 hours

Fracture Of Distal Humerus: Mipo Technique With Visualization Of The Radial Nerve.

To evaluate the outcomes in patients treated for humerus distal third fractures with MIPO technique and visualization of the radial nerve by an accessory approach, in those without radial palsy before surgery. The patients were treated with MIPO technique. The visualization and isolation of the radial nerve was done by an approach between the brachialis and the brachiorradialis, with an oblique incision, in the lateral side of the arm. MEPS was used to evaluate the elbow function. Seven patients were evaluated with a mean age of 29.8 years old. The average follow up was 29.85 months. The radial neuropraxis after surgery occurred in three patients. The sensorial recovery occurred after 3.16 months on average and also of the motor function, after 5.33 months on average, in all patients. We achieved fracture consolidation in all patients (M=4.22 months). The averages for flexion-extension and prono-supination were 112.85° and 145°, respectively. The MEPS average score was 86.42. There was no case of infection. This approach allowed excluding a radial nerve interposition on site of the fracture and/or under the plate, showing a high level of consolidation of the fracture and a good evolution of the range of movement of the elbow. Level of Evidence IV, Case Series.22300-

Clinical comparison of marginal fit of ceramic inlays between digital and conventional impressions

PURPOSE. The aim of this stuldy was to compare the clinical marginal fit of CAD-CAM inlays obtained from intraoral digital impression or addition silicone impression techniques. MATERIALS AND METHODS. The study included 31 inlays for prosthodontics purposes of 31 patients: 15 based on intraoral digital impressions (DI group); and 16 based on a conventional impression technique (CI group). Inlays included occlusal and a non-occlusal surface. Inlays were milled in ceramic. The inlay-teeth interface was replicated by placing each inlay in its corresponding uncemented clinical preparation and taking interface impressions with silicone material from occlusal and free surfaces. Interface analysis was made using white light confocal microscopy (WLCM) (scanning area: 694 × 510 μm2) from the impression samples. The gap size and the inlay overextension were measured from the microscopy topographies. For analytical purposes (i.e., 95-%-confidence intervals calculations and P -value calculations), the procedure REGRESS in SUDAAN was used to account for clustering (i.e., multiple measurements). For p-value calculation, the log transformation of the dependent variables was used to normalize the distributions. RESULTS. Marginal fit values for occlusal and free surfaces were affected by the type of impression. There were no differences between surfaces (occlusal vs. free). Gap obtained for DI group was 164 ± 84 μm and that for CI group was 209 ± 104 μm, and there were statistical differences between them (p = .041). Mean overextension values were 60 ± 59 μm for DI group and 67 ± 73 μm for CI group, and there were no differences between then (p = .553). CONCLUSION. Digital impression achieved inlays with higher clinical marginal fit and performed better than the conventional silicone materials. [J Adv Prosthodont 2024;16:57-65]IOIA. SL, Granada, SpainProject PID2020.116082GB.I00 (MCIN/AEI/10.13039/501100011033)Research group CTS-974 (Junta de Andalucía, Spain

Perfil Epidemiológico de mães de pacientes com transtorno do Espectro Autista da Associação de Pais de Autistas do Município de São João Del Rei / Epidemiological profile of mothers of patients with autistic spectrum disorder of the Association of Parents of Autism of the Municipality of São João Del Rei

O autismo hoje é definido como TEA (Transtorno do Espectro Autista) e é conhecido como um estado ou uma condição em que o indivíduo parece estar recluso a si próprio. Pouco se conhece sobre a patogenia do autismo e, com isso, os sintomas ainda são pouco claros. Alguns fatores de riscos podem estar envolvidos como: aspiração de mecônio, lesão ou traumatismo no nascimento, malformação congênita, anemia no lactente e incompatibilidade ABO ou Rh também estão entre os fatores relacionados. Além disso, sabe-se que há um componente genético envolvido para que o transtorno se manifeste. O aumento da prevalência do autismo está possivelmente relacionado às mudanças na conscientização, critérios diagnósticos mais apurados, maior acesso a instrumentos de diagnóstico ou triagem. Este trabalho teve por objetivo analisar a frequência das etiologias para a predição do TEA na ASPAS (Associação de Pais de Autistas de São João del Rei-MG), indicando os fatores de riscos que podem estar associados ao TEA. Foi realizado um estudo envolvendo 16 pacientes de ambos os sexos assistidos pela ASPAS. Os dados coletados foram:sexo, idade materna no parto, idade gestacional no parto, uso de medicação no decorrer da gestação, traumas obstétricos ou complicações periparto, incompatibilidade do sistema ABO(Rh), diabetes mellitus gestacional, doença autoimune na história familiar, infecções no período gestacional, exposição a poluentes atmosféricos, carência de vitamina D no período gestacional, tabagismo no período gestacional, . A análise foi realizada através das distribuições de frequências e porcentagem. Foi possível delinear o perfil epidemiológico dos pacientes, observando os fatores de risco e as características demográficas.Estes resultados poderão auxiliar nas condutas de assistência aos pacientes com TEA de São João del Rei - MG

On Fiedler's characterization of tridiagonal matrices over arbitrary fields

M. Fiedler proved in [1] that the set of real n-by-n symmetric matrices A such that rank(A + D) ≥ n - 1 for every real diagonal matrix D is the set of matrices PT PT where P is a permutation matrix and T an irreducible tridiagonal matrix. We show that this result remains valid for arbitrary fields with some exceptions for 5-by-5 matrices over Z3CMU