Juvenile idiopathic arthritis and the temporomandibular joint: a case-control study of magnetic resonance imaging findings in relation to clinical and psychosocial factors.

AIM: In juvenile idiopathic arthritis (JIA), the temporomandibular joint (TMJ) is a particularly challenging joint to assess both clinically and with imaging. The aim of this article is to investigate TMJ magnetic resonance imaging (MRI) findings in relation to clinical and psychosocial factors in patients with JIA and healthy individuals related to TMJ arthritis in JIA. MATERIALS: In total, 45 patients (6-16 years) with JIA and 16 healthy age- and sex-matched controls were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered questionnaires about psychosocial factors (pain intensity, pain-related disability, depression, stress, catastrophising, pain locations, and jaw function) and underwent bilateral MRI of the TMJ. CONCLUSION: This study indicates a substantial overlap of TMJ MRI findings in both the inflammatory domain and the damage domain between JIA patients and healthy individuals. In JIA patients, the inflammatory MRI sign of bone marrow oedema seems to influence orofacial pain intensity.

Anterior approach of abdominal field block at linea semilunaris: A surgically assisted novel technique for postoperative analgesia in cesarean section.

CONTEXT: Post Caesarean pain is described as moderate to severe. Although advances in the new analgesics techniques, no current standard exists for optimizing and managing. Taking into consideration of acute post Caesarean pain, this novel technique of surgically assisted anterior abdominal field block at linea semilunaris have proved considerable analgesic potential along with multimodal analgesia. AIMS: Although advances have been made in the understanding of the pathophysiology and in the development of new analgesics, patients still suffer from moderate-to-severe post-Cesarean pain. Taking into consideration the consequences of pain, this anterior approach to abdominal field block technique was performed to minimize acute pain experienced during post-Cesarean section. SETTINGS AND DESIGN: Prospective observational study design. MATERIALS AND METHODS: In the present study, a total of 120 parturients undergoing cesarean section (CS), after closure of uterine incision were included. We intraoperatively, under all asepsis, performed surgically assisted abdominal field block at linea semilunaris, by bilaterally injecting 20 mL 0.25% bupivacaine on each side, in addition to standard analgesic 100 mg diclofenac suppository. Each patient was assessed at 0, 4, 8, 12, and 24 h after surgery, by an independent observer for pain using NRS 0-10 and the time of the first demand for analgesic diclofenac paracetamol and its side effects. STATISTICAL ANALYSIS USED: The entire data is statistically analyzed using Statistical Package for Social Sciences (SPSS ver. 21.0, IBM Corporation, USA) for MS Windows. The categorical variables were compared using Wilcoxon's signed-rank test. RESULTS: Of the total 120 patients, it is worth noting that none of the patients had severe or worst pain. The percentage of patients who did not require analgesia were (96.7%) at 4 h, (81.7%) at 8 h, (77.5%) at 12 h, and (90.8%) at 24 h. The mean analgesic consumption of paracetamol diclofenac on 4, 8, 12, 16, and 24 h after CS was significantly less. No patient required opioid supplementation. Patient satisfaction was high and was early ambulated. CONCLUSIONS: There is considerable potential for anterior approach abdominal field block, (linea semilunaris block) to comprise an effective component of a multimodal regimen for post-Cesarean section analgesia and is easy to perform within limited resources.

Les différences liées au genre dans les accidents vasculaires cérébraux

L'impact dévastateur des accidents vasculaires cérébraux sur la qualité de vie des sujets a motivé à conduire cette étude. Le but est d'identifie lesdifférences entre les genres dans la perspective d'optimiser la prise en charge surtout sur facteurs se révélant péjoratives individuellement pour chaque groupe MéthodesIl s'agit d'une étude prospective analytique d'une durée de neuf (9) mois allant de juillet 2019 à mars 2020 aux urgences médicales de l'Hôpital National de Niamey. Etait éligible, tout patient consentant ayant développé un AVC avec une lésion objectivée au scanner cérébral.Résultats : L'étude avait inclus au total 100 sujets dont 59 ayant présenté un infarctus cérébral et les 41 autres un AVC hémorragique. Le sex-ratio était de 1. Au niveau de l'âge il n'y a pas eu de différence entre les genres (p=0,547). Les non-instruits ont été retrouvés plus chez les femmes (p=0,001). Des pressions artérielles systoliques (p=0,014) et diastoliques p=0,014) et diastoliques (p=0,02) au stade 3 de l'OMS ont concernées plus les hommes que les femmes. Les femmes ont été les plus intéressées par l'infarctus cérébral et inversement les hommes par l'AVC hémorragique (p=0,025). Le genre n'a pas eu de lien statistique avec le décès (p˃0,05).Conclusion : L'étude a seulement objectivé une rela-tion entre le genre, le niveau d'instruction, la pression artérielle et le type d'accident vasculaire

Effective dose of cone beam CT (CBCT) of the facial skeleton: a systematic review.

OBJECTIVE: To estimate effective dose of cone beam CT (CBCT) of the facial skeleton with focus on measurement methods and scanning protocols. METHODS: A systematic review, which adhered to the preferred reporting items for systematic reviews (PRISMA) Statement, of the literature up to April 2014 was conducted. Data sources included MEDLINE®, The Cochrane Library and Web of Science. A model was developed to underpin data extraction from 38 included studies. RESULTS: Technical specifications of the CBCT units were insufficiently described. Heterogeneity in measurement methods and scanning protocols between studies made comparisons of effective doses of different CBCT units and scanning protocols difficult. Few studies related doses to image quality. Reported effective dose varied across studies, ranging between 9.7 and 197.0 µSv for field of views (FOVs) with height ≤5 cm, between 3.9 and 674.0 µSv for FOVs of heights 5.1-10.0 cm and between 8.8 and 1073.0 µSv for FOVs >10 cm. There was an inconsistency regarding reported effective dose of studies of the same CBCT unit with the same FOV dimensions. CONCLUSION: The review reveals a need for studies on radiation dosages related to image quality. Reporting quality of future studies has to be improved to facilitate comparison of effective doses obtained from examinations with different CBCT units and scanning protocols. A model with minimum data set on important parameters based on this observation is proposed. ADVANCES IN KNOWLEDGE: Data important when estimating effective dose were insufficiently reported in most studies. A model with minimum data based on this observation is proposed. Few studies related effective dose to image quality.

The effect of heat stress on the antibacterial resistance and plasmid profile in Escherichia coli isolates.

In order to study the effect of heat stress on the antibacterial resistance and plasmid profile in Escherichia coli, thirty E. coli were isolated from sheep liver. Antibiotic susceptibility test were done by antibiotic disc diffusion method using filter paper disc on two 24 h cultures of each isolate which grown at 37 and 43 degrees C simultaneously in BHI Broth (Merck VM460193 531). The isolates which grown at 43 degrees C were under heat stress during their growth. Ten commonly used antibiotics, viz., ampicillin, erythromycin, neomycin, trimethoprim-sulfamethoxazol, lincospectine, tetracycline, gentamycin, flumequine, vancomycin and Tiamulin (Padtan Teb). The resistance level of all E. coli isolates against 10 antibacterial drugs compared statistically in 37 and 43 degrees C using MINITAB Version 14 program. Plasmid DNAs were extracted from each of the E. coli isolates which were grown at 37 and 43 degrees C overnight using alkali lysis method. In this study *lambdaDNA (EcoR1+Hind III digested) was used as marker DNA. According to the results of this study, the resistance rate of E. coli isolates have decreased against trimethoprim-sulfamethazol, lincospectine, tiamaulin, tetracyclin and gentamycin at 43 degrees C but only the difference between the resistance rate against gentamycin in 37 degrees C (83.3%) and 43 degrees C (60%) was significant Characterization of Plasmid DNAs by agarose gel electrophoresis showed that each of the thirty drug resistant E. coli harbored a single plasmid. There was no difference among the plasmid profiles of the thirty isolates in 37 and 43 degrees C. As the plasmid profile did not change in 43 degrees C (heat stress) so the resistance differences against antibacterial drugs were not significant except for gentamycine that its resistance may is chromosomal. According to the results of this study, In conclusion it can be said that heat stress could not be effective on antibacterial resistance and plasmid profile if the duration of the stress is short. The long duration of the heat stress plus other stress factors such as starvation will effect the plasmid replication and finally plasmid copy number of bacteria. Mechanism of this phenomenon remains unknown, though one might speculate that some bacterial addiction modules that are activated upon amino acid starvation, like mazEF could be involved.

Reporte de 100 casos, experiencia de tratamiento quirúrgico en el Hospital Español de México y el Hospital San Eloy: Vizcaya España / Dupuytren's diasease: report of a 100 cases: experience of surgical treatment

En el periodo de enero de 1995 a octubre de 1997, se captaron 62 pacientes que presentaban enfermedad de Dupuytren (ED), con un total de 100 casos, utilizándose la clasificación de TUBIANA, de acuerdo a la gravedad de la enfermedad, distribuyéndose 10 casos en el grado I, 38 casos en el grado II, 42 casos en el grado III y 10 casos grado IV, todos los casos sin antecedente quirúrgico, la edad de presentación osciló, entre los 55 y 65 años de edad. El antecedente más importante que se encontró fue el heredofamiliar de 1a. y 2a. generación, una vez decidido el tratamiento quirúrgico se realizaron incisiones digitopalmares con técnica de BRUNER con liberación de nódulos y estructuras involucradas; se dejó drenaje durante 48 horas en todos los pacientes y se colocó férula antibraquipalmar con retiro de puntos a los 12 días, dentro de las complicaciones encontradas fueron hematomas en 18 casos, los cuales fueron drenados con necrosis de bordes de la herida en los casos más avanzados de la enfermedad. Un caso con infección superficial el cual cedió con antibiótico y un caso en el cual se tuvo que amputar el 5º dedo a los 6 meses de postoperatorio

Human T-lymphotropic virus type I infection in the Solomon Islands.

To ascertain the prevalence of human T-lymphotropic virus type I (HTLV-I) infection and the occurrence of diseases caused by HTLV-I in the Solomon Islands, we tested 1141 sera from 851 patients (317 females and 534 males), who were hospitalized at the Central Hospital in Honiara between February 1984 and November 1988, for antibodies to HTLV-I using an enzyme-linked immunosorbent assay (ELISA). Sera from 69 of 81 ELISA-positive patients and from 56 ELISA-negative patients were then tested by Western analysis. As verified by strict Western immunoblot criteria, the overall HTLV-I seroprevalence was 2.2% (19/851). Age- and gender-specific prevalence data indicated an age-related acquisition of infection with no sexual predominance. No diagnosis category was over-represented among the seropositive patients. HTLV-I-specific antibodies were found in serum and cerebrospinal fluid samples from one of six patients with spastic paraparesis. As in other Melanesian populations, the majority of ELISA-positive sera could not be confirmed by Western analysis. Reactivity to three or more gag-encoded proteins was found in 85% (45/53) of ELISA-positive, Western blot-indeterminate sera, and 30% (16/53) reacted to p19 and an env gene product but lacked reactivity to p24. Whether or not the high frequency of indeterminate HTLV-I Western immunoblots in the Solomon Islands is indicative of incomplete specific reactivity to HTLV-I or the existence of antigenically related retroviruses is being investigated.