The α-synuclein PET tracer [18F] ACI-12589 distinguishes multiple system atrophy from other neurodegenerative diseases.

A positron emission tomography (PET) tracer detecting α-synuclein pathology will improve the diagnosis, and ultimately the treatment of α-synuclein-related diseases. Here we show that the PET ligand, [18F]ACI-12589, displays good in vitro affinity and specificity for pathological α-synuclein in tissues from patients with different α-synuclein-related disorders including Parkinson's disease (PD) and Multiple-System Atrophy (MSA) using autoradiography and radiobinding techniques. In the initial clinical evaluation we include 23 participants with α-synuclein related disorders, 11 with other neurodegenerative disorders and eight controls. In vivo [18F]ACI-12589 demonstrates clear binding in the cerebellar white matter and middle cerebellar peduncles of MSA patients, regions known to be highly affected by α-synuclein pathology, but shows limited binding in PD. The binding statistically separates MSA patients from healthy controls and subjects with other neurodegenerative disorders, including other synucleinopathies. Our results indicate that α-synuclein pathology in MSA can be identified using [18F]ACI-12589 PET imaging, potentially improving the diagnostic work-up of MSA and allowing for detection of drug target engagement in vivo of novel α-synuclein targeting therapies.

Experimental Mindfulness Intervention in an Emergency Department for Stress Management and Development of Positive Working Environment.

Mindfulness-based interventions have increasingly gained the interest of health professionals in the last decade, especially practices that are short, economical, easily accessible, and physically, cognitively, and psychologically compelling. Nurses of Emergency Departments are a special, dynamic, but at the same time vulnerable group of health professionals who work in shifts and face multiple challenges. Considering the recent literature and the fact that stress and a hostile work environment are the top ranked health professionals' challenges, there is a need for a further study of the use of mindfulness. This study aimed to investigate the effect of the application of mindfulness on nurses in the Emergency Department on several factors related to daily nursing practice and that directly affect these specific health professionals. This experimental study was performed on 14 participating nurses in the Emergency Department of a Public General Hospital in Athens, randomized into two groups: a control and an intervention group. The data collection tools were two digital smart devices, participatory observation, and semi-structured interviews. By practicing mindfulness meditation, the participating nurses in the intervention group showed improvement in their cognitive functions (attention, thinking, memory, concentration), professional interpersonal relationships, personal satisfaction and communication with patients and caregivers, sleep rate, negative emotions, and behaviors. The findings suggest that the application of mindfulness practices should be considered an easy, affordable, economical, accessible, and effective method that nurses can use to strengthen and empower themselves, enjoying its multiple benefits. The effectiveness of the application of mindfulness remains an important issue for future research in other health professionals as well.

Peripheral Osteoma of the Mandibular Condyle-Case Series.

The purpose of this article is to present four new cases of peripheral osteoma of the mandibular condyle and the literature review. A retrospective study of files from our Department of Oral and Maxillofacial Surgery over the last 6 years revealed four cases of peripheral osteomas located in the area of the mandibular condyle. Diagnostic procedure included clinical, radiographic, and histologic criteria. Gardner's syndrome was excluded from patient history and clinical evaluation. One patient had only an aesthetic disturbance, with facial swelling, and the other three patients presented disturbances of the mandibular function, including deviation during mouth opening along with malocclusion. Three of the patients were male and one was female; all were of middle age (45-65 years old). The proposed surgical treatment was accepted by half of the patients, while the remaining half declined the operation after a confirmation of the diagnosis. Peripheral osteomas of the maxillofacial region are uncommon, and some cases with multiple osteomas are related to Gardner's syndrome. An osteoma of the mandibular condyle is very rare and surgical treatment is challenging for the surgeon with regards to the approach selection and the related complications. In the two cases that accepted the proposed surgical treatment, no recurrence and no complication was observed.

Self-Assessment of Health Professionals' Cultural Competence: Knowledge, Skills, and Mental Health Concepts for Optimal Health Care.

Current research often refers to cultural competence to improve health care delivery. In addition, it focuses on the cultural uniqueness of each health service user for optimal personalized care. This study aimed to collect self-assessment data from health professionals regarding their cultural competence and to identify their development needs. A mixed methods design was adopted using the Cultural Competence Self-assessment Checklist of the Central Vancouver Island Multicultural Society. This was translated into Greek, validated, and then shared with health professionals in Cyprus. Subsequently, a semi-structured interview guide was designed and utilized. This was structured in exactly the same question categories as the questionnaire. Data collection took place between October 2021 and May 2022, and convenience sampling was used to recruit 499 health scientists in Cyprus. The sample comprised doctors, nurses, psychologists, midwives, social workers, and physiotherapists. Subsequently, 62 interviews were conducted with participants from the same specialties. The results showed that (compared to other health professionals) nurses and psychologists are more sensitive to issues of cultural competence. It would appear that the more socially oriented sciences had better-prepared healthcare staff to manage diversity in context. However, there is a gap between knowledge and skills when comparing doctors to nurses; they seem to be more skilled and willing to intervene actively in cases of racist behavior or problem-solving. In conclusion, participants identified the importance of their cultural competence; they also realized the importance of optimal planning of personalized health care. There is a significant need for continuous and specialized cultural competence training for all health professions.

Knowledge and Attitudes Regarding Organ Transplantation Among Cyprus Residents.

BACKGROUND: Organ transplantation was one of the greatest achievements of medical science during the 20th century. Knowledge, education, and culture all play prominent roles in transplantation because of the complexity of the process from donation to transplantation. PURPOSE: The aim of this research was to determine and analyze the knowledge and attitudes about organ donation and transplantation among the general population in Limassol, Cyprus. METHODS: A quantitative research approach was followed, and a questionnaire consisting of closed-ended questions was completed by adults from the general population in Limassol. RESULTS: One thousand two hundred adults out of the 1,346 adults who were contacted responded to the survey (response rate: 89%) and were included as participants. Of the participants, 93.4% (p < .05) considered organ donation to be lifesaving, 57% expressed interest (and 39.8% expressed disinterest) in becoming organ donors, 80.6% (p < .05) expressed awareness of there being a waiting list for people in need of organ transplantation, 50.4% agreed that brain death must be confirmed before organ removal for transplantation, and 47% recalled having been informed about organ donation through the media, with 31.5% stating that they had never been informed about organ donation. CONCLUSIONS: The participants demonstrated limited awareness regarding the organ donation system in Cyprus. Furthermore, a significant percentage stated that they lacked a source for obtaining related information. The Cypriot society should be informed and encouraged to participate in organ donation to increase the rate of organ transplantation.

The use of mineralized bone allograft as a single grafting material in maxillary sinus lifting with severely atrophied alveolar ridge (1-3 mm) and immediately inserted dental implants. A 3- up to 8-year retrospective study.

OBJECTIVE: The primary aim of our study was to evaluate the efficacy of mineralized bone allograft alone in sinus floor augmentation with simultaneous implant placement in cases with severe atrophy of the residual maxillary bone (bone height < 4 mm). METHODS: Thirty-five dental implants were placed in 29 patients who underwent sinus augmentation via traditional lateral window technique from 2008 to 2013. Patients with residual alveolar height between 1 and 3 mm at the site of implantation were included in the study. The height of residual bone was initially estimated by plain panoramic X-ray and reevaluated intraoperatively by precise micrometric measurement at the site of implantation. Implants of 13 mm height and 3.5 or 4.3 mm in diameter were inserted simultaneously. Mineralized bone allograft was used alone to augment the sinus floor. RESULTS: No wound dehiscence was recorded. In one case there was a postoperative site infection which subsided with antibiotics without implant failure. One implant migrated during the postoperative period to the maxillary sinus and was removed. One implant failed. The remaining 33 implants were successfully loaded. Follow-up ranged from 3 to 8 years. CONCLUSIONS: Maxillary sinus lift in severely absorbed alveolar ridges with simultaneous implant placement could be safely performed using mineralized allograft alone, rendering the procedure less invasive and less time-consuming.

Inflammatory myofibroblastic tumour of the maxillary sinus and the oral cavity.

BACKGROUND: Inflammatory myofibroblastic tumours (IMT) are benign lesions that mimic malignant neoplastic processes due to their infiltrating and destructive nature. They can be found anywhere in the body, although they are most commonly located in the lung. IMTs of the head and neck region are rare entities. CASE REPORT: We report a case of a maxillary IMT with an enlarged intraoral component which was adequately treated with surgical excision without long-lasting additional corticosteroid treatment. DISCUSSION: Inflammatory myofibroblastic tumours can be easily misdiagnosed as malignant neoplastic processes due to their destructive nature. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures.

Thalamic volume measurement in normal fetuses using three-dimensional sonography.

PURPOSE: Brain thalami are important for a wide range of sensorimotor and neuropsychiatric functions. This study was carried out to calculate normative values for thalami volume during fetal life. METHODS: Fetal thalami volumes were measured using 3D ultrasound in 122 normal, singleton fetuses at 20(+0) -34(+6) weeks' gestation. Virtual Organ Computer-aided AnaLysis (VOCAL) was used to obtain a sequence of six sections of each thalamus, starting from the transthalamic view of the brain at an axial plane. Thalamic contour was drawn manually. Volume contrast imaging was used to enhance image quality when needed. The volume of the thalamus distal to the transducer was also measured by a second operator in 30 randomly selected cases, blind to the measurements of the first, to calculate interobserver agreement. RESULTS: Thalamic volume increased with gestational age, following a quadratic equation (R(2) = 0.83). There was no significant difference in volume between the right and left thalamus. The mean volume of each thalamus increased from 0.45 ml at 20(+0) weeks, to 1.39 ml at 28(+0) weeks, to 2.17 ml at 34(+0) weeks. The 95% limits of interobserver agreement for thalamic volume were -14.3% to +17.2%. CONCLUSIONS: The increase in thalamic volume with gestation can be described adequately by a quadratic equation. The moderate interobserver repeatability is attributed to the similar echogenicity between the thalamus and its surrounding structures.

Salivary gland trauma: a review of diagnosis and treatment.

Salivary gland trauma is uncommon. Parotid gland and duct injuries are far more common than injuries to submandibular and sublingual glands due to anatomic position. Several methods of treating salivary duct injuries and their complications have been advocated. Optimal treatment outcomes can be achieved with early diagnosis, adequate evaluation, and proper management. This article presents current diagnostic and treatment protocols of salivary gland trauma. The anatomy of the salivary glands is briefly described and clinical cases are also presented to illustrate the treatment options described.

Basal cell carcinoma arising in association with a maxillary keratocyst in a patient with Gorlin-Goltz syndrome. Report of a case.

INTRODUCTION: Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant inherited disorder which is characterized by the presence of multiple basal cell carcinomas, maxillary keratocysts, and musculoskeletal anomalies. CASE REPORT: We present a case of a patient suffering from Gorlin-Goltz syndrome who developed an intraosseous basal cell carcinoma associated with a recurrent maxillary keratocyst. To our knowledge, this is the first case of malignant transformation of a keratocyst into a basal cell carcinoma described in the literature. CONCLUSION: This case highlights the importance of careful histologic examination of keratocysts excised in patients suffering from Gorlin-Goltz syndrome.

Displacement of three dental implants into the maxillary sinus in two patients. Report of two cases.

INTRODUCTION: Reconstruction of the posterior edentulous maxilla with dental implants has become a popular practice worldwide. However, the poor bone quality and quantity in this area is sometimes related with complications. Dental implant displacement into the maxillary sinus is a rare complication. CASE REPORT: In the present paper, we present two patients with three implants displaced into the maxillary sinus. The implants were removed soon after their displacement, using the classic intraoral approach, through the anterior wall of the maxillary sinus. The operation was performed under local anesthesia for both of the patients. The postoperative course was uneventful for both of the patients without any wound dehiscence. Recovery remained uneventful, without any signs of postoperative sinusitis. DISCUSSION: Implant displacement into the maxillary sinus is of rare occurrence and usually related to inadequate bone quality and quantity. Dental implants into the maxillary sinus usually act as foreign bodies and should be removed, to avoid the development of sinus complications. Removal of dental implants from the maxillary sinus can be performed either with functional endoscopic sinus surgery, or with intraoral operation through the anterior maxillary wall especially in fresh cases and in the presence of oroantral communication.

Infratemporal fossa metastasis from carcinoma of the uterine cervix.

INTRODUCTION: Carcinoma of the uterine cervix is the fourth commonest malignant tumor in women. The disease spreads into the surrounding tissues by direct infiltration whereas spread by hematogenous dissemination is relatively unusual, and most commonly involves the lung, bone, and liver. The involvement of oral and maxillofacial region is extremely rare in gynecological cancer. CASE REPORT: In this paper, we present an unusual case of a metastatic squamous cell carcinoma originating in the infratemporal fossa of a 37-year-old woman who had underwent a subtotal hysterectomy, for squamous cell carcinoma of the cervix, 22 months earlier. A whole-body CT scan revealed a mass of enlarged lymph nodes in the mediastinum as well. The patient, who had presented for evaluation of a rapidly increasing trismus associated with deep intermittent facial pain and temporal swelling had initially been treated for a TMJ dysfunction and later for an infratemporal fossa abscess for long before a definite diagnosis was made. A high index of suspicion is possible to make an early diagnosis, which when coupled with an aggressive management can improve survival and quality of life.

Textiloma of the frontal bone twenty years after craniotomy for Apert syndrome.

INTRODUCTION: The presence of intracranial foreign body granulomas is an unusual condition. They can be caused by foreign substances which are either inadvertently or deliberately left in the surgical field. Some foreign materials (textilomas, gossypibomas, gauzomas, muslinomas) along with the resulting foreign body reaction, in the surrounding tissue, can cause infection or abscess formation in an early stage whereas others remain clinically silent for many years. PATIENT: We present the case of a foreign body granuloma (textiloma) caused by a gauze which had been placed, during a corrective craniotomy, in a patient with Apert syndrome at the age of five. At presentation the clinical and radiological findings were suggestive of an infection. RESULTS: Surgical exploration of the region demonstrated the presence of gauze, in a frontal bone defect, surrounded by large masses of reactive granular tissue which were extended to the underlying dura mater. The symptoms resolved completely after the foreign body's retrieval. CONCLUSION: Foreign body granulomas, although rare, must always be taken under consideration in the differential diagnosis of craniofacial masses or procedures; especially in cases where a previous craniofacial operation has taken place.

Effect of in vitro aging on the stiffness of bioabsorbable fixation plates.

The purpose of this study was to investigate the effect of in vitro aging on the stiffness of bioabsorbable fixation plates. Twenty-four polylactic/polyglycolic acid plates (LactoSorb; Lorenz, Jacksonville, FL) were divided in 3 groups of 8 specimens each. Group A served as control, and groups B and C were immersed in 0.1 M lactic acid for 15 and 30 days, respectively. All specimens were subjected to a 3-point bending test, using a universal testing machine, and the stiffness of each specimen was estimated. When analyzed with one-way analysis of variance, no difference was observed for the control and in vitro-aged specimens with regard to stiffness. Long-term (30 d) in vitro aging of poly-L-lactic acid bioabsorbable fixation plates does not seem to significantly affect the stiffness of the material as derived from a 3-point bending test.

Development of a fast and selective method for the sensitive determination of anatoxin-a in lake waters using liquid chromatography-tandem mass spectrometry and phenylalanine-d5 as internal standard.

Anatoxin-a is a potent alkaloid neurotoxin produced by a number of cyanobacterial species and released in freshwaters during cyanobacterial blooms. Its high toxicity is responsible for several incidents of lethal intoxications of birds and mammals around the world; therefore anatoxin-a has to be regarded as a health risk and its concentration in lakes and water reservoirs should be monitored. Phenylalanine is a natural amino acid, also present in freshwaters, isobaric to anatoxin-a, with a very similar fragmentation pattern and LC retention. Since misidentification of phenylalanine as anatoxin-a has been reported in forensic investigations, special care must be taken in order to selectively determine traces of anatoxin-a in the presence of naturally occurring phenylalanine. A fast LC tandem MS method was developed by using a 1.8 microm 50 x 2.1 mm C18 column for the separation of anatoxin-a and phenylalanine, achieving a 3-min analysis time. Isotopically labelled phenylalanine-d(5) was employed as internal standard to compensate for electrospray ion suppression and sample preconcentration losses. Both compounds were preconcentrated 1,000-fold on a porous graphitic carbon solid-phase extraction (SPE) cartridge after adjustment of sample pH to 10.5. The method was validated by using lake water spiked at four different levels from 0.01 to 1 microg L(-1). Anatoxin-a recovery ranged from 73 to 97%, intra-day precision (RSD%) ranged from 4.2 to 5.9, while inter-day precision (RSD%) ranged from 4.2 to 9.1%. Limits of detection and quantification were 0.65 and 1.96 ng L(-1) respectively. The method was successfully applied for the detection of anatoxin-a in Greek lakes at concentrations ranging from less than 0.6 to 9.1 ng L(-1).

Effect of suppressor current intensity on the determination of glyphosate and aminomethylphosphonic acid by suppressed conductivity ion chromatography.

This paper presents the application of ion chromatography with electrolytic eluent generation and mobile phase suppression for the direct conductimetric detection of glyphosate and its degradation product aminomethylphosphonic acid (AMPA). The compounds were separated on a Dionex AS18 anion exchange column with a 12-40 mM KOH step gradient from 9 to 9.5 min. The effect of the suppressor current intensity on the electrostatic interaction of these amphoteric compounds with the suppressor cation exchange membranes was evaluated. A suppressor current gradient technique was proposed for the limitation of peak broadening and baseline noise, in order to improve method sensitivity and detectability. It was observed that residual sample carbonates co-eluted with AMPA when a large injection loop was installed for the low level determination of both compounds in natural waters. For this reason, glyphosate was isocratically eluted using 33 mM KOH in order to decrease analysis time within 10 min and a column clean up step using 100 mM KOH was used to ensure retention time reproducibility. The developed method was applied to the analysis of drinking and natural water and it was further successfully applied to orange samples with slight modifications. Instrumental LOD for glyphosate was 0.24 microg/L, while method LOD was 0.54 microg/L for spring waters and 0.01 mg/kg for oranges using a 1000 microL direct loop injection of the sample. Intra-day and inter-day precision (as %RSD) for water samples was 4.6% and 12% at a spiking level of 2 microg/L, and the recovery ranged from 64% to 88% depending on sample conductivity. For orange samples, the inter-day precision was 1.4% at a spiking level of 4.4 mg/kg, while overall recovery was 103%. The developed method is direct, fast, sensitive and relatively inexpensive, and could be used as an ideal fast screening tool for the monitoring of glyphosate residues in water and fruit samples.

Foreign body in the maxillary sinus: report of an unusual case.

The accidental displacement of foreign bodies into the maxillary sinus is not an unusual complication in dental clinical practice. However, dental materials, and, in particular, dental impression materials, introduced into the sinus several weeks to months after a maxillary tooth extraction or dentoalveolar surgery through either a small, long-standing oroantral fistula or an insufficiently healed extraction wound is uncommon. In the case reported, 3 months after a maxillary molar extraction, the material used for maxillary impression was pushed into the antrum through a small, almost invisible, oroantral fistula that was unseen by the specialists the patient had been visiting, worsening the patient's existing sinusitis.

Ameloblastic fibroma of the mandible associated with root resorption and unerupted teeth: a case report.

Ameloblastic fibroma (AF) is an uncommon benign odontogenic mixed tumor. A case of an AF associated with unerupted and missing teeth is presented. A 13-year-old girl was referred for evaluation of a painless swelling of her right mandible. The most remarkable finding was the resorption of the proximal root of the permanent first molar. The lesion was completely enucleated. Follow-up showed satisfactory bony healing, and the resorbed root was completely surrounded by a continuous layer of intact lamina dura. In most cases, the patient presents to the clinician complaining of an unerupted tooth at the posterior area of the mandible. The most remarkable finding in our case, however, was the coexisting root resorption. This finding could indicate a more aggressive form of AF. AF has a very good prognosis. Malignant transformation is extremely rare.