Caries temprana de la infancia: rehabilitación estética, funcional e integral en paciente preescolar. Caso clínico / Early childhood caries: esthetic, functional and comprehensive rehabilitation in preschool patient. A clinical case

La American Academy of Pediatric Dentistry (2020) define a la caries temprana de la infancia (CTI) como una forma severa de caries de etiología multifactorial que compromete la dentición primaria de niños pre-escolares. Afecta principalmente a los incisivos primarios superiores seguidos de los primeros molares primarios, pudiendo promover el desarrollo de hábitos parafuncionales, reducción de la eficacia masticatoria, pérdida de la dimensión vertical, alteraciones en la fonación y defectos estéticos que causan repercusiones emocionales e impacto psicosocial. La insuficiente cantidad y calidad de estructura coronaria remanente, luego de la eliminación del tejido cariado, puede comprometer la adhesión de los materiales de restauración. El objetivo de este trabajo es presentar la atención y el seguimiento a dos años de un paciente preescolar que presenta CTI, que concurrió para su atención a la Cátedra de Odontología Integral Niños de la Facultad de Odontología de la Universidad de Buenos Aires (AU)

Fast growing pseudotumour in a hairdresser after metal-on-metal hip resurfacing: a case report.

A 44-year-old female hairdresser who underwent metal-on-metal hip resurfacing (MOMHR) for hip osteoarthritis developed a benign pelvic pseudotumour. Elevated levels of chromium and cobalt ions were detected in the blood. Patch testing after pseudotumor formation, showed positive skin reactions to cobalt and nickel. Marked hypereosinophilia was noted, as well as the presence of eosinophils in the pseudotumor mass. A revision to a ceramic-on-ceramic implant was performed. Radiographs showed no implant loosening or bone resorption. We hypothesized that a steep cup positioning as well as hypersensitivity response to the metal nanoparticles and ion release may have induced pseudotumour development. Currently there is no evidence that negative patch testing reduces the probability to develop an adverse reaction to metal debris therefore we suggest to carefully investigate patient medical history regarding occupation exposure and daily contact with jewellery, beauty and cleaning products before implanting MOMHR. The main challenge is to identify a sensitive patient candidate to MOMHR never suspected to be.

The importance of rehabilitation after lower limb fractures in elderly osteoporotic patients.

Improving rehabilitation strategies after lower limb fractures among elderly patients is an urgent public health challenge due to the increasing proportion of older population and therefore the raised number of falls and fractures. Due to their strategic positioning, physiatrists should aim not only to improve functional outcomes after acute fracture treatment but also to address the underlying osteoporotic condition in order to prevent the devastating socioeconomic consequences of osteoporotic fractures.

A comparison of hemiarthroplasty with a novel polycarbonate-urethane acetabular component for displaced intracapsular fractures of the femoral neck: a randomised controlled trial in elderly patients.

We undertook a randomised controlled trial to compare bipolar hemiarthroplasty (HA) with a novel total hip replacement (THR) comprising a polycarbonate-urethane (PCU) acetabular component coupled with a large-diameter metal femoral head for the treatment of displaced fractures of the femoral neck in elderly patients. Functional outcome, assessed with the Harris hip score (HHS) at three months and then annually after surgery, was the primary endpoint. Rates of revision and complication were secondary endpoints. Based on a power analysis, 96 consecutive patients aged > 70 years were randomised to receive either HA (49) or a PCU-THR (47). The mean follow-up was 30.1 months (23 to 50) and 28.6 months (22 to 52) for the HA and the PCU group, respectively. The HHS showed no statistically significant difference between the groups at every follow-up. Higher pain was recorded in the PCU group at one and two years' follow-up (p = 0.006 and p = 0.019, respectively). In the HA group no revision was performed. In the PCU-THR group six patients underwent revision and one patient is currently awaiting re-operation. The three-year survival rate of the PCU-THR group was 0.841 (95% confidence interval 0.680 to 0.926). Based on our findings we do not recommend the use of the PCU acetabular component as part of the treatment of patients with fractures of the femoral neck.

Suspension of water droplets on individual pillars.

We report results of extensive experimental and numerical studies on the suspension of water drops deposited on cylindrical pillars having circular and square cross sections and different wettabilities. In the case of circular pillars, the drop contact line is pinned to the whole edge contour until the drop collapses due to the action of gravity. In contrast, on square pillars, the drops are suspended on the four corners and spilling along the vertical walls is observed. We have also studied the ability of the two geometries to sustain drops and found that if we compare pillars with the same characteristic size, the square is more efficient in pinning large volumes, while if we normalize the volumes to pillar areas, the opposite is true.

A two-year prospective and retrospective multi-center study of the TriboFit® Hip System.

The first 50 cases using a polycarbonate-urethane acetabular component in the TriboFit® Hip System for human hip reconstruction were reviewed. The average follow-up for cases not revised or deceased prior to 24 months was 28.0 months. The clinical results were similar to those reported in the literature for the same indications and follow-up. Therefore, with 2 to 4 years follow-up, it can be concluded that the TriboFit® Hip System is as safe and effective for use as a hip replacement system in femoral neck fracture patients as traditional hemiarthroplasty systems, and in osteoarthritis patients as a total hip system made of traditional bearing materials.

[Neuroleptanalgesia in patients undergoing percutaneous, ultrasound-directed radiofrequency for primary or secondary, single or multiple hepatic neoplasms]. / Neuroleptoanalgesia in pazienti sottoposti a radiofrequenza percutanea ecoguidata per neoplasie epatiche primitive o secondarie, singole o multiple.

BACKGROUND: The use of percutaneous ultrasound-directed radiofrequency is a recent technique in non-surgical therapy of some neoplastic liver lesions. Purpose of this study is to demonstrate that the use of a narcosis-free analgesia allows to perform this procedure, which is generally painful and badly by the patient. METHODS: We treated 51 patients for a total of 126 procedures; the first 17 patients underwent a mono- or multipolar technique with uncooled electrodes, while the remaining 34 patients have been treated with double perfusion lumen electrodes with the chance of tipcooling. We used diidrobenzoperydol and fentanyl with a mean dose for each session of 209 micrograms for the first 17 patients and 109 micrograms for the other 34. RESULTS: Using VAS, we obtained a painless procedure in 42 patients and mild-pain sensations in 9 patients, while one hour after the procedure painless or light-pain sensation were observed in 49 patients and mild-pain in 2 patients, which required the use of FANS i.v. At discharge, all patients were pain-free or with very light pain sensation. We reduced the intra-hospital observation of patients from 5 to 3 hours, once the technique has been modified. 4 patients complained about nausea and 1 of these emesis. We did not observe any cardiovascular, respiratory and/or neurological complications. CONCLUSIONS: The use of neuroleptanalgesia allowed us to perform the described procedure with a good feeling by the patients.

[Sleep disorders in patients in recovery. Preliminary results in 20 patients]. / I disturbi del sonno nei pazienti in rianimazione. Risultati preliminari su 20 pazienti studiati.

Various aspects of the critically ill patient sharing pain, physical distress, anxiety, environmental components, predispose him to develop some sleep disorders (SD). We studied 20 conscious patients, age 16-80 (mean 48.15 SD of mean +/- 25), undergoing ICU mean 14.3 days (SD of mean +/- 7.5), to evaluate SD rate and their possible leading causes. Through Spearman Rank test SD was related to Apache II score, admission state anxiety, satisfactory sedation, days of ICU stay and age respectively. Conclusive results showed SD rate in all our patients. Excepted a statistical trend to significativity of SD versus satisfactory sedation: RS 0.311 (threshold value for 20 patients: 0.377), no relation was found between SD and data recorded. These preliminary results emphasize the importance of looking for SD in ICU patients though many factors may play a role to develop them.

[Rhabdomyolysis in meningoencephalitis caused by echovirus]. / Rabdomiolisi in corso di meningoencefalite da echo virus.

We report one case of atraumatic rhabdomyolysis associated with Echo group viral encephalitis, not complicated by acute renal failure. Clinical and bio-humoral outlines are described, characterized by favourable evolution despite high muscular enzymatic peaks. We emphasize that the positive course is probably due to the early institution of prophylactic measures, and that, anyway, the subject still remains exposed to major rhabdomyolysis risk in the presence of stress factors, including general anesthesia.

Air filtration and prevention of aspergillary pneumopathies. Preliminary comparative study of two mobile units for bacteriological air purification with recycling.

Two mobile units for air filtration with recycling designed to reduce the aerobiocontamination of hospital rooms were tested. Their efficacity was evaluated by measurement of particle retention and by quantitative determination of the reduction of aerobiocontamination in rooms occupied by patients. Results show a significant improvement in the aerobiocontamination of test rooms as compared to control rooms. It is thus reasonable to suppose that these systems may provide a practical solution to the problems posed by hospitalization in ordinary rooms of patients subjected to aplasive chemotherapy. A randomized clinical trial is in progress.