Digital planning and guided surgery in dental implants: a case report

Background: Dental implants are constantly evolving, with several new technologies. Nowadays, it is the most sought after treatment option for individuals who are candidates for oral rehabilitation, improving esthetics and recovering masticatory capacity. Always in search of minimally invasive procedures, dentistry has sought ways to decrease surgical time, decrease morbidity and greater safety of the surgical procedure. Based on these searches digital planning and guided surgery are being widely used, with the possibility of greater predictability and precision in the planning of dental implants, giving greater chances of successful surgery along with the technique performed correctly

Bone substitutes in Le Fort I osteotomy to promote bone union and skeletal stability

Background: Maxillary advancement by Le Fort I osteotomy has become the standard procedure to restore function and facial aesthetics, correct skeletal and occlusal discrepancies and treat obstructive sleep apnea in patients with facial deformities. Incomplete ossification between the bone segments at the jaw osteotomy site has proven to be a major problem in these cases. There are several studies in the literature that address orthognathic surgery, but only a limited number that discuss the use of graft materials in maxillary osteotomy. Bone grafts were introduced in recent decades in order to promote and improve bone union and prevent the formation of gaps

Effects of Endocannabinoid System Modulation on Cognitive and Emotional Behavior

Cannabis has long been known to produce cognitive and emotional effects. Research has shown that cannabinoid drugs produce these effects by driving the brain’s endogenous cannabinoid system and that this system plays a modulatory role in many cognitive and emotional processes. This review focuses on the effects of endocannabinoid system modulation in animal models of cognition (learning and memory) and emotion (anxiety and depression). We review studies in which natural or synthetic cannabinoid agonists were administered to directly stimulate cannabinoid receptors or, conversely, where cannabinoid antagonists were administered to inhibit the activity of cannabinoid receptors. In addition, studies are reviewed that involved genetic disruption of cannabinoid receptors or genetic or pharmacological manipulation of the endocannabinoid-degrading enzyme, fatty acid amide hydrolase (FAAH). Endocannabinoids affect the function of many neurotransmitter systems, some of which play opposing roles. The diversity of cannabinoid roles and the complexity of task-dependent activation of neuronal circuits may lead to the effects of endocannabinoid system modulation being strongly dependent on environmental conditions. Recent findings are reviewed that raise the possibility that endocannabinoid signaling may change the impact of environmental influences on emotional and cognitive behavior rather than selectively affecting any specific behavior

Is that a relict rock glacier?

The distribution of rock glaciers is often used to investigate the occurrence of permafrost inmountain areas and to understand their climate and paleoclimate evolution. This requires the creation of regional and global inventories capable of discriminating active and relict landforms in order to forecast the presence or absence of ice in the ground. In this paper, geomorphological, geophysical and microclimatic surveys are performed on a rock glacier of the Carnic Alps (Eastern European Alps). In the classification currently used for implementing regional inventories of permafrost evidence in the Alps, this rock glacier would be defined as relict. However the geophysical, climatological and geomorphological results indicate that internal ice is widespread in large portions of the rock glacier. These are generally interpreted as ice in pore spaces and local ice lenses, probably without layers of massive ice. Moreover the occurrence of ice during the maximum thawing season at depths b15 m, assumed here as the depth of zero annual amplitude, suggests that the ice occurring within the rock glacier is related to current cryotic conditions due to density driven air flow (i.e. the chimney effect). This research demonstrates that the current altitudinal limit of alpine permafrost can be locally several hundreds of meters lower than forecasted byempiricalmodeling based only on the rock glacier distribution and classification. Therefore, rock glacier classifications based only on remote sensing and geomorphological evidence as the main sources for extracting regional climate and paleoclimate signals should be treated with caution

Somatostatin and dopamine receptors as targets for medical treatment of Cushing's Syndrome

Somatostatin (SS) and dopamine (DA) receptors are widely expressed in neuroendocrine tumours that cause Cushing's Syndrome (CS). Increasing knowledge of specific subtype expression within these tumours and the ability to target these receptor subtypes with high-affinity compounds, has driven the search for new SS- or DA-based medical therapies for the various forms of CS. In Cushing's disease, corticotroph adenomas mainly express dopamine receptor subtype 2 (D2) and somatostatin receptor subtype 5 (sst5), whereas sst2is expressed at lower levels. Activation of these receptors can inhibit ACTH-release in primary cultured corticotroph adenomas and compounds that target either sst5(pasireotide, or SOM230) or D2(cabergoline) have shown significant efficacy in subsets of patients in recent clinical studies. Combination therapy, either by administration of both types of compounds separately or by treatment with novel somatostatin-dopamine chimeric molecules (e.g. BIM-23A760), appears to be a promising approach in this respect. In selected cases of Ectopic ACTH-producing Syndrome (EAS), the sst2-preferring compound octreotide is able to reduce cortisol levels effectively. A recent study showed that D2receptors are also significantly expressed in the majority of EAS and that cabergoline may decrease cortisol levels in subsets of these patients. In both normal adrenal tissue as well as in adrenal adenomas and carcinomas that cause CS, sst and DA receptor expression has been demonstrated. Although selected cases of adrenal CS may benefit from sst or DA-targeted treatment, its total contribution to the treatment of these patients is likely to be low as surgery is effective in most cases

Optimization of quasi-hemispherical CdZnTe detectors by means of first principles simulation

In this paper we present the development of quasi-hemispherical gamma-ray detectors based on CdZnTe. Among the possible single-polarity electrode configurations, such as coplanar, pixelated, or virtual Frisch-grid geometries, quasi-hemispherical detectors are the most cost-effective alternative with comparable raw energy resolution in the high and low energy range. The optimal configuration of the sensor in terms of dimension of the crystals and electrode specifications has been first determined by simulations, and successively validated with experimental measures. Spectra from different sources have been acquired to evaluate the detectors performances. Three types of detectors with different CZT volumes have been fabricated, namely 10 × 10 × 5 mm3, 15 × 15 × 10 mm3 and 20 × 20 × 10 mm3. In the case of 10 × 10 × 5 mm3 crystals, the optimum pixel size determined by our simulation tool was confirmed by experiments: the best spectroscopic resolution of 1.3% at 662 keV has been found for a 750 μm diameter pixel detector. The best energy resolution values obtained for the 15 × 15 × 10 mm3 and 20 × 20 × 10 mm3 detectors were respectively 1.7% and 2.7% at 662 keV

Cardiac surgery in a patient with retroperitoneal fibrosis and heart valvulopathy, both due to pergolide medication for Parkinson's disease

Retroperitoneal fibrosis is best described as a chronic inflammatory process which may be idiopathic, but can rarely be brought about by medications, such as pergolide, used for treating Parkinson's disease. Pergolide can produce a fibrotic process in heart valves, resulting in valve insufficiency in up to 25% of cases. Herein we describe the case of a 68-year-old man who received pergolide for 2 years for Parkinson's disease. The patient developed retroperitoneal fibrosis resulting in renal failure from ureteral obstruction necessitating ureteral stenting, as well as significant aortic and mitral valve insufficiency. He successfully underwent surgery for combined aortic valve, mitral valve and ascending aorta replacement because of severe valve insufficiency and dilated (d = 5.8 cm) ascending aorta. Retroperitoneal fibrosis improved with pergolide cessation and corticosteroid treatment. This is the second case reported in the literature, of a patient who had double valve and ascending aorta replacement surgery because he suffered from this rare but serious adverse effect of dopamine agonists used for managing Parkinson's disease

Medical treatment of prolactinomas.

Prolactinomas, the most prevalent type of neuroendocrine disease, account for approximately 40% of all pituitary adenomas. The most important clinical problems associated with prolactinomas are hypogonadism, infertility and hyposexuality. In patients with macroprolactinomas, mass effects, including visual field defects, headaches and neurological disturbances, can also occur. The objectives of therapy are normalization of prolactin levels, to restore eugonadism, and reduction of tumor mass, both of which can be achieved in the majority of patients by treatment with dopamine agonists. Given their association with minimal morbidity, these drugs currently represent the mainstay of treatment for prolactinomas. Novel data indicate that these agents can be successfully withdrawn in a subset of patients after normalization of prolactin levels and tumor disappearance, which suggests the possibility that medical therapy may not be required throughout life. Nevertheless, multimodal therapy that involves surgery, radiotherapy or both may be necessary in some cases, such as patients who are resistant to the effects of dopamine agonists or for those with atypical prolactinomas. This Review reports on efficacy and safety of pharmacotherapy in patients with prolactinomas