Redundancy of the Visual Identification of Lingula in the Bilateral Sagittal Split Ramal Osteotomy Procedure of the Mandible.

Introduction: The bilateral sagittal split ramus osteotomy (BSSRO) is the technique in vogue which is used for correction of a range of mandibular corpus deformity involving the dentoalveolar segment. The surgical technique has been subjected to a variety of modifications ever since its inception in the 1950s. One of the operative objectives which has been advocated sacrosanct has been the visual identification of lingula during the exposure of the medial aspect of the ramus. Materials and Method: BSSRO was successfully carried out in 45 cases operated over a period of eight years for correction of different kinds of skeletal mandibular deformity. The medial subperiosteal dissection did not involve a visual identification of the lingula. Conclusion: In our experience, the visual identification of the lingula is not essential to carry out a safe BSSRO procedure.

Midface fracture pattern in a tertiary care hospital - A prospective study.

Introduction: The midface with multiple bones and cavities is vulnerable to fractures more commonly. Midface is one of the most frequently injured areas of the body, accounting for 23%-97% of all facial fractures. The classic LeFort type of fractures are uncommon nowadays and a more common picture is more severe forms primarily due to the high-speed vehicles that are a major cause of these fractures. It, therefore, has become imperative to determine the commonly occurring patterns of fractures in this area in the present time for a better insight into diagnosis and treatment plans. The aim of this article was to determine fracture patterns in midface trauma to ease the treatment planning in such a scenario. Materials and Methods: This prospective study included 114 patients who reported to a tertiary hospital during a 4-year period and were diagnosed with suspected midface fractures. The etiology and pattern of fractures of midface were assessed based on history, clinical examination, and imaging data. The diagnosis of a fracture was based on the clinical history, signs and symptoms, manual examination, and correct interpretation of radiographs and computed tomography. Midface fractures were recorded as LeFort I, II, III, dentoalveolar, palatal, zygomatic complex fracture, nasal bones, naso-orbital-ethmoidal complex, and orbital and zygomatic arch fractures. Etiological factors were classified as road traffic accidents (RTAs), fall, assault, and sports injuries. Results: During the 4-year period, a total of 114 patients were included. Patients' ages ranged from 17 to 68 years, with 102 males and 12 females. The most common fracture in this study was found to be zygomatic complex fractures (52%), and RTA was identified as the main cause of fracture in this study (79.2%). Conclusion: The midface fractures are more common in males due to the propensity of males to use two-wheelers more than females. The prominence of the zygoma makes it more vulnerable to fractures than rest of the bones in the midface. Increased speed of vehicles and lack of discipline in following traffic rules have resulted in RTA, being the biggest etiological factor in midface injuries.

Neurofilaments in neurologic disorders and beyond.

Many neurologic diseases can initially present as a diagnostic challenge and even when a diagnosis is made, monitoring of disease activity, progression and response to therapy may be limited with existing clinical and paraclinical assessments. As such, the identification of disease specific biomarkers provides a promising avenue by which diseases can be effectively diagnosed, monitored and used as a prognostic indicator for long-term outcomes. Neurofilaments are an integral component of the neuronal cytoskeleton, where assessment of neurofilaments in the blood, cerebrospinal fluid (CSF) and diseased tissue has been shown to have value in providing diagnostic clarity, monitoring disease activity, tracking progression and treatment efficacy, as well as lending prognostic insight into long-term outcomes. As such, this review attempts to provide a glimpse into the structure and function of neurofilaments, their role in various neurologic and non-neurologic disorders, including uncommon conditions with recent knowledge of neurofilament-related pathology, as well as their applicability in future clinical practice.

Ophthalmic Complications Associated with Zygomatic Complex Fractures: A Randomised Descriptive Clinical Study.

Background and Objectives: Trauma to the maxillofacial region is usually associated with varying degrees of disruption of the soft and hard tissues in the region and injuries to the neighbouring structures such as eyes, brain, nasal apparatus and paranasal sinuses. Injuries to the middle third of the face commonly destroys the integrity of the orbital skeleton, and are frequently complicated by injury to the eye, ranging between 2.7 and 67% as reported in the literature. These injuries may result in loss of vision or compromised ocular function. When these injuries are severe, they may be detected with ease by any medical or maxillofacial surgeon but many injuries appear minimal and may be missed by the non-ophthalmologist. Methods: A total of thirty patients were selected who were diagnosed with a zygomatic complex fracture, irrespective of sex predilection and in the age group of 18-70 years. All patients underwent a thorough ophthalmic examination by an Oral and Maxillofacial Surgeon and an Ophthalmologist preoperatively and on postoperative day 2, and 7 and all findings were documented separately by the surgeon and the ophthalmologist and the findings were later compared. Results: The statistical analysis was performed using SPSS VERSION 21.0, Shapiro-Wilk test which was used to assess the normality. Descriptive analysis was done for age and gender distribution of study subjects, which are expressed as number and frequency. Cochran's q test was used to determine if there are differences in various study factors among OMFS and ophthalmologists at three time intervals which are expressed as number and frequency. Kappa agreement was used to assess the measurement of agreement between OMFS and ophthalmologists for each factor at each time interval and these are expressed as number and frequency, and p ≤ 0.05 is considered as statistically significant. Upon examination by an OMFS periorbital oedema (p = 0.000), periorbital ecchymosis (p = 0.002), chemosis (p = 0.02) and exophthalmos (p = 0.03) were considered clinically significant. Upon examination by an ophthalmologist subconjunctival haemorrhage (p = 0.05), periorbital oedema (p = 0.05), periorbital ecchymosis (p = 0.00), ptosis (p = 0.006), enopthalmos (p = 0.05) and diplopia (p = 0.05) were considered to be clinically significant. Upon correlation of the findings of the surgeon and the ophthalmologist it was seen that certain parameters like corneal injury, Phthisis bulbing, examination of posterior segment can be better done by the ophthalmologist. Interpretation and Conclusion: In conclusion, it was determined that there is a significant correlation between ophthalmic injuries caused by zygomatic complex fractures. There are a wide array of injuries affecting the eye due to trauma to the middle third of the face, and the superficial injury can be well evaluated and documented by a surgeon; however due to the extensive nature of the injuries in trauma and the importance of the eye, an ophthalmic examination cannot be ruled out. The need for evaluation of such injures deem it pertinent for observation by an ophthalmologist.

Infiltrating lipomatosis, an etiology for TMJ ankylosis?

Infiltrating lipomatosis is a rare benign condition causing diffuse fatty infiltration into the surrounding soft tissue and in rare cases causes hyperplasia of the adjacent bone. We report a case with clinical and radiological evidence of a 34-year-old female patient who reported a swelling in the left middle third of the face with exophytic temporomandibular joint (TMJ) ankylosis of the left side resulting in restricted mouth opening and facial asymmetry since 21 years. The number of cases reported in the literature is rare. Surgery is the treatment of choice.

Role of the Maxillofacial Surgeon in Identifying the Correlation Between Facial Bone Fractures and Traumatic Brain Injury - A Prospective Study.

Introduction: Maxillofacial trauma accounts for a high percentage of patients reporting to the emergency medicine department and being admitted in the hospital. The purpose of this study was to form a direct association between maxillofacial fractures and traumatic brain injury (TBI). Methods: Ninety patients with maxillofacial fractures that reported to/were referred to the Department of Oral and Maxillofacial Surgery were observed for features indicative of TBI based on clinical presentation and radiological interpretations. Parameters such as loss of consciousness, vomiting, dizziness, headache, seizures and the requirement for intubation, cerebrospinal fluid rhinorrhoea and otorrhoea were also assessed. Appropriate radiographs for the diagnosis of the fracture were taken followed by a computed tomography (CT) scan when indicated in accordance to the Canadian CT Head Rule. These scans were then assessed for contusion, extradural haemorrhage, subdural haemorrhage, subarachnoid haemorrhage, pneumocephalus and cranial bone fracture. Results: A total of 90 patients were evaluated, of which 91.1% were males and 8.9% were females. Association between the occurrence of head injury and different maxillofacial bone fractures using the Chi-square test showed a statistical significance of <0.001 in patients with naso-orbito-ethmoid as well as frontal bone fractures. There was a clear association between fractures present in the upper as well as the middle third of the face and traumatic head injury (P ≤ 0.001). Discussion: Patients with the frontal bone and zygomatic bone fractures have a high prevalence of TBI. Patients with the upper and middle third of the face injury are more prone to traumatic head injury and importance should be given to patients with the same and prevent poor prognosis.

Correlation of Panoramic Radiological and Intra-Operative Findings of Impacted Mandibular 3rd Molar in Relation to Inferior Alveolar Canal: A Prospective Study.

AIM: The objective of this study was to correlate the preoperative radiological findings and intraoperative surgical findings during removal of impacted mandibular 3rd molar with respect to the inferior alveolar canal. MATERIALS AND METHOD: The prospective study design included 100 patients between the age group of 20 years and 50 years who visited the Department of Oral and Maxillofacial Surgery at Vydehi Institute of Dental Sciences and Research Centre, Whitefield, Bengaluru. A preoperative panoramic radiograph was taken and the parameters were assessed and a normal surgical protocol was followed to extract the impacted mandibular 3rd molar with intra-operative assessment as well. RESULTS: Out of the 100 patients with definitive radiological signs showing close relation of the third molar to the mandibular canal who underwent surgical removal, only 12 patients presented with definitive clinical findings of the association. CONCLUSION: A true close relationship between the third molars and mandibular canal increases the risk of inferior alveolar nerve injury, and accurate evaluation of the relationship is essential to avoid the risk of surgery. The accuracy of the plain radiographs to diagnose an intimate relationship between the neurovascular bundle and the third molar root has its limitations, since only 12 of the 100 patients with positive radiological signs showed clinical evidence of involvement. Surgeons should be aware of the limitations of the radiographic markers of panoramic radiography and should consider more detailed imaging in more specific cases in which one or more radiographic marker is present.

Melanotic neuroectodermal tumor of infancy of maxilla: Report of a case with review of literature.

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, fast-growing, pigmented neoplasm of neural crest origin. Despite of its rapid and locally infiltrative growth, it is still considered benign with high recurrence rate and malignant potential, so early diagnosis is extremely important to limit its local expansion. Recurrences can be expected primarily because of incomplete excision, tumor dissemination, or due to its multicentric nature. We report a case of MNTI originating in the maxilla of a 7-month-old male infant, which was managed with complete surgical excision of the tumor, with no signs of recurrence after a 1-year follow-up period. In addition, a complete literature review has been reported, in an attempt to understand the origin, histopathologic and immunohistochemistry features with surgical modalities and advantages of radiotherapy and chemotherapy in cases where complete surgical extirpation is questionable.

Assessment of Postoperative Bleeding after Dental Extractions in Patients Who Are On Antiplatelet Therapy: A Prospective Study.

INTRODUCTION: Patients with ischemic heart disease are placed on antiplatelet therapy (APT). This study allows a definite protocol to be set which will allow us the make the right judgment when it comes to extractions in patients on APT. MATERIALS AND METHODS: For this study, 100 patients were taken up for dental extraction after obtaining a thorough case history. Bleeding time was assessed preoperatively for all the patients and patients with normal bleeding time were taken up for surgery under local anesthesia. Local haemostatic measures were employed after the extraction. Patients were monitored for first 30 minutes at the clinic and a telephonic review of all the patients was done at 24 h-48 h interval after the procedure. If there was an active ooze from the surgical site at any point, haemostatic measures with local haemostatic agents were carried out. RESULTS: In patients with mono antiplatelet therapy, bleeding was noted in 16 patients after the 1 h time interval and was absent after 24h-48 h time intervals. The q = 32 and the P < 0.001, making it statistically significant. Regarding patients on dual APT, bleeding was noted in ten patients after 1 h, and in one patient after 24 h with no patients presenting with bleeding at the 48 h time interval. The q = 16.545 and P < 0.001, making it statistically significant. DISCUSSION: The benefits of continuing APT for patients who require dental extraction outweighs the risks of postoperative bleeding. CONCLUSION: Antiplatelets are used for the prevention of myocardial infarction, ischemic stroke, and vascular death among patients who are at high risk of these events. Antiplatelets have minimal impact on the amount and duration of bleeding following routine dental extractions.

Molecular Mirror Technology Facilitates High-Throughput, Accurate SARS-CoV-2 Testing.

Tests to diagnose acute SARS-CoV-2 infection are at the center of controlling the COVID-19 pandemic. Rapid tests benefit from providing quick results but suffer from lower sensitivity, while PCR tests usually take longer to provide more reliable results and can be difficult to scale to meet population needs. We evaluated the diagnostic efficacy of a Molecular Mirror assay (MMA) using nucleic acid extraction and a nucleic acid extraction-free method to determine its ability to identify SARS-CoV-2 in nasal specimens from individuals suspected of having SARS-CoV-2. We compared the MMA using nucleic acid extraction to the emergency use authorization (EUA)-approved TaqPath reverse transcriptase PCR (RT-PCR) assay to determine its performance characteristics. From 412 total specimens (including 115 previous positives and 297 previous negatives), we found that the positive percent agreement (PPA) was 99.1% (confidence interval [CI], 97.4% to 100.0%) and the negative percent agreement (NPA) was 99.3% (95% CI, 98.4% to 100.0%) for SARS-CoV-2 detection. Using the extraction-free method, we analyzed 109 specimens (51 previous positives and 58 previous negatives) and found that the PPA for the more rapid version of the assay was 87.8% (95% CI, 78.5% to 96.9%) and the NPA was 100.0% (95% CI, 100.0%) for virus detection. The extraction method has performance comparable to what is observed in many PCR-based assays. The extraction-free method has lower PPA but has the advantage of being more rapid and having a higher throughput. Our data offer a proof of concept that nuclear magnetic resonance (NMR) detection can be used in SARS-CoV-2 diagnostic testing and may allow for alternative supply chains to increase testing options. IMPORTANCE Accurate diagnostics for SARS-CoV-2 infections have been critical for responding to the COVID-19 pandemic. Both high-sensitivity/specificity PCR-based tests and lower-sensitivity/specificity rapid antigen assays have been the subject of worldwide supply chain limitations as individual facilities and countries have struggled to meet their population testing needs. We evaluated the diagnostic efficacy of a Molecular Mirror assay (MMA), which uses nuclear magnetic resonance to detect the presence of SARS-CoV-2 nucleic acids both with and without full nucleic acid extractions. We found that compared to a U.S. emergency use authorization (EUA) approved assay (TaqPath) that uses reverse transcriptase PCR (RT-PCR), the MMA had high PPA and NPA with full nucleic acid extractions, and acceptable positive percent agreement (PPA) and negative percent agreement (NPA) with an extraction-free protocol. In a landscape marred by supply chain shortages across the world, altered SARS-CoV-2 detection methods such as the MMA can add to testing supplies while providing quality SARS-CoV-2 testing results.

Conservative Management of Odontogenic Keratocyst in a Tertiary Hospital.

INTRODUCTION: Odontogenic keratocysts (OKCs) are benign intraosseous odontogenic lesions that have a locally aggressive behavior and exhibit a high recurrence rate after the treatment. The most appropriate surgical approaches for the successful treatment of OKCs remain controversial. AIM: The aim of this study was to evaluate the conservative management of OKCs by enucleation along with peripheral ostectomy and chemical cauterization in terms of recurrence rates after the surgical procedure. MATERIALS AND METHODS: A retrospective study on 36 cases of OKCs treated at the Oral and Maxillofacial Surgery Department of a tertiary hospital from 2010 to 2017 was done. The demographic, clinical, radiographic, and histologic data were collected for each patient. All cases were surgically treated by enucleation followed by peripheral ostectomy and chemical cauterization using Carnoy's solution. The teeth that were involved in the lesion were extracted. The diagnosis was confirmed with excisional biopsy and histopathology reports. RESULTS: Most of the OKCs were found in the mandible, except three which were present in the maxilla. A significantly higher incidence was seen in males in the age group of 21-30 years. Most of the cases (30 out of 36 cases) were accessed intraorally. Patients were followed up for up to 5 years. Recurrence of the operated OKCs was observed in five cases which were managed by enucleation with peripheral ostectomy and chemical cauterization again with good results. CONCLUSION: The results suggest that proper enucleation followed by peripheral ostectomy and chemical cauterization using Carnoy's solution may be the best and optimal approach for the management of OKC.

A Retrospective Study of Condylar Fracture Management in a Tertiary Care Hospital-A 10-Year Experience.

INTRODUCTION: Since the advent of rigid fixation, there has been a paradigm shift in the management of condylar fractures from closed treatment options to open reduction and rigid internal fixation. MATERIALS AND METHOD: Sixty-eight cases of condylar fractures reporting to Vydehi Institute of Dental Sciences, Bangalore, between 2009 and 2018 were reviewed in terms of age, sex, type of fracture, position of the mandibular third molar and the treatment rendered. RESULTS: The majority of the patients were males (60). There was an involvement of the right side in 34, left in 21 and bilateral involvement in 13 cases. Forty-three of the fractures were subcondylar, and 25 were intracapsular. Significantly in most cases, the mandibular third molar was either fully erupted (42) or missing (12). Sixty-one cases were subjected to surgical management including 49 cases of rigid internal fixation, and 12 of the intracapsular fractures had the condylar stump/segment removed. Only seven cases were not treated surgically. Most of the cases (44) were in the age group of 21-40, 12 were in the age group of 41-60, 9 were in the age group of 1-20, and 3 patients were above 60. CONCLUSION: Condylar fractures more often do not require surgical intervention, and their incidence is more likely to occur when the third molar is either fully erupted or missing.

GLP-1 receptor agonists for Parkinson's disease.

BACKGROUND: Parkinson's disease (PD) is a progressive disorder characterised by both motor and non-motor problems. Glucagon-like peptide-1 (GLP-1) receptor agonists, licensed for treatment of type 2 diabetes, work by stimulating GLP-1 receptors in the pancreas, which triggers the release of insulin. GLP-1 receptors have been found in the brain. Insulin signalling in the brain plays a key role in neuronal metabolism and repair and in synaptic efficacy, but insulin signalling is desensitised in the brain of people with PD. Researchers are exploring the neuroprotective effects of GLP-1 receptor agonists in neurodegenerative disorders such as PD. OBJECTIVES: To evaluate the effectiveness and safety of GLP-1 receptor agonists for Parkinson's disease. SEARCH METHODS: We searched the Cochrane Movement Disorders Group trials register; the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library; and Ovid MEDLINE and Embase. We also searched clinical trials registries, and we handsearched conference abstracts. The most recent search was run on 25 June 2020. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of adults with PD that compared GLP-1 receptor agonists with conventional PD treatment, placebo, or no treatment. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion, extracted data, and assessed risk of bias. We rated the quality of evidence using GRADE. We resolved discrepancies between the two data extractors by consultation with a third review author. MAIN RESULTS: Through our searches, we retrieved 99 unique records, of which two met our inclusion criteria. One double-blind study of exenatide versus placebo randomised 62 participants, who self-administered exenatide or placebo for 48 weeks and were followed up at 60 weeks after a 12-week washout. One single-blind study of exenatide versus no additional treatment randomised 45 participants; participants in the intervention group self-administered exenatide for 12 months, and all participants were followed up at 14 months and 24 months following absence of exenatide for 2 months and 12 months, respectively. These trials had low risk of bias, except risk of performance bias was high for Aviles-Olmos 2013. Exenatide versus placebo Primary outcomes We found low-certainty evidence suggesting that exenatide improves motor impairment as assessed by the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III in the off-medication state (mean difference (MD) -3.10, 95% confidence interval (CI) -6.11 to -0.09). The difference in scores was slightly greater when scores were adjusted for baseline severity of the condition (as reported by study authors) (MD -3.5, 95% CI -6.7 to -0.3), exceeding the minimum clinically important difference (MCID). We found low-certainty evidence suggesting that exenatide has little or no effect on health-related quality of life (HRQoL) as assessed by the Parkinson's Disease Questionnaire (PDQ)-39 Summary Index (SI) (MD -1.80, 95% CI -6.95 to 3.35), the EuroQol scale measuring health status in five dimensions (EQ5D) (MD 0.07, 95% CI -0.03 to 0.16), or the EQ5D visual analogue scale (VAS) (MD 5.00, 95% CI -3.42 to 13.42). Eight serious adverse events (SAEs) were recorded, but all were considered unrelated to the intervention. Low-certainty evidence suggests that exenatide has little or no effect on weight loss (risk ratio (RR) 1.25, 95% CI 0.89 to 1.76). Exenatide versus no treatment Primary outcomes at 14 months We found very low-certainty evidence suggesting that exenatide improves motor impairment as assessed by MDS-UPDRS Part III off medication (MD -4.50, 95% CI -8.64 to -0.36), exceeding the MCID. We are uncertain whether exenatide improves HRQoL as assessed by the PDQ-39 SI (MD 3.50, 95% CI -2.75 to 9.75; very low-quality evidence). We found very low-certainty evidence suggesting that exenatide has little or no effect on the number of SAEs (RR 1.60, 95% 0.40 to 6.32). We found very low-certainty evidence suggesting that exenatide may lead to weight loss (MD -2.40 kg, 95% CI -4.56 to -0.24). Primary outcomes at 24 months We found evidence as reported by study authors to suggest that exenatide improves motor impairment as measured by MDS-UPDRS Part III off medication (MD 5.6 points, 95% CI 2.2 to 9.0). Exenatide may not improve HRQoL as assessed by the PDQ-39 SI (P = 0.682) and may not result in weight loss (MD 0.1 kg, 95% CI 3.0 to 2.8). AUTHORS' CONCLUSIONS: Low- or very low-certainty evidence suggests that exenatide may improve motor impairment for people with PD. The difference in motor impairment observed between groups may persist for some time following cessation of exenatide. This raises the possibility that exenatide may have a disease-modifying effect. SAEs were unlikely to be related to treatment. The effectiveness of exenatide for improving HRQoL, non-motor outcomes, ADLs, and psychological outcomes is unclear. Ongoing studies are assessing other GLP-1 receptor agonists.

Synovial Chondromatosis of the Temporomandibular Joint.

Synovial chondromatosis is a rare condition characterized by the presence of loose cartilaginous bodies, due to the abnormal proliferation of synovial membrane. However, its manifestation in the temporomandibular joint is a rare finding, occurring predominantly in females. This case report describes the clinical features, diagnosis and management of a case of synovial chondromatosis.

Comparison of Ultrasonography with Conventional Radiography in Diagnosis of Zygomatic Complex Fractures.

INTRODUCTION: The diagnosis of zygomatic complex fractures is important in planning the treatment since the complex gives form to the projection, width and height of the midface. AIM: This study was carried out to assess the diagnostic sensitivity and utility of high-resolution ultrasonography in comparison with conventional radiography in the diagnosis of the zygomatic complex fractures. MATERIALS AND METHOD: Twenty-five cases of clinically diagnosed zygomatic complex fractures were subjected to conventional radiographs and USG study. RESULTS: The accuracy in terms of specificity and sensitivity of USG was comparable to conventional radiographs in the detection of the fractures of the zygomatic complex. CONCLUSION: This study points to the suitability of USG as an alternative to the use of plain radiographs in the diagnosis of zygomatic complex fractures. USG is safe, inexpensive and an accurate adjunct to conventional radiography in diagnosis of zygomatic complex fractures.

Ameloblastoma Management: "Horses for Courses" Protocol.

PURPOSE: The purpose of the article is to review 45 cases of ameloblastoma treated in a tertiary care centre depending on the extent of the pathology, in terms of recurrence and morbidity of the patients. MATERIALS AND METHOD: This was a retrospective study of patients who underwent treatment for ameloblastoma between 2009 and 2018 at Vydehi Institute of Dental Sciences, Bangalore. During the first phase of 4 years, the focus of the treatment was on avoiding any recurrence, and therefore, resection followed by reconstruction with reconstruction plates was the only modality used in ten patients. However, from 2014, it was decided to treat each patient based on the extent of the lesion and decide on either conservative management in the form of enucleation followed by peripheral ostectomy and chemical cauterisation or resection with safe margins and reconstruction with reconstruction plates. RESULTS: The study sample consisted of 45 patients, and the ages ranged from 12 to 65 years with an average of 36. There were 30 males and 15 females. In the first phase of treatment protocol adopted, ten patients underwent resection. In the later period, 18 patients were treated by conservative methods and 16 patients were treated by radical management. There were only three recurrences over a period of 3-year follow-up in the group treated conservatively. CONCLUSION: Considering the benign nature of the tumour and the morbidity after resection, patients, most of whom are in the younger age group, can still be subjected to conservative treatment provided they are followed up for a long period thus assuring them of a better quality of life.

Nuclear magnetic resonance biosensor for rapid detection of Vibrio parahaemolyticus.

BACKGROUND: Vibrio parahaemolyticus is a Gram-negative bacterium widely distributed in marine environments and a well-recognized invertebrate pathogen frequently isolated from seafood. V. parahaemolyticus may also spread into humans, via contaminated, raw, or undercooked seafood, causing gastroenteritis and diarrhea. METHODS: A Nuclear Magnetic Resonance (NMR)-based detection system was used to detect pathogenic levels of this microorganism (105 CFU/ml) with Molecular Mirroring using iron nanoparticles coated with target-specific biomarkers capable of binding to DNA of the target microorganism. The NMR system generates a signal (in milliseconds) by measuring NMR spin-spin relaxation time T2, which correlates with the amount of microorganism DNA. RESULTS: Compared with conventional microbiology techniques such as real-time PCR (qPCR), the NMR biosensor showed similar limits of detection (LOD) at different concentrations (105-108 CFU/ml) using two DNA extraction methods. In addition, the NMR biosensor system can detect a wide range of microorganism DNAs in different matrices within a short period of time. CONCLUSION: NMR biosensor represents a potential tool for diagnostic and quality control to ensure microbial pathogens such as V. parahaemolyticus are not the cause of infection. The "hybrid" technology (NMR and nanoparticle application) opens a new platform for detecting other microbial pathogens that have impacted human health, animal health and food safety.

Posterior Fossa Lesion Load and Pathological Laughing and Crying in Multiple Sclerosis.

BACKGROUND: Pathological laughing and crying (PLC) encompasses episodes of involuntary laughing, crying, or both that are contextually incongruous with the individual's subjective mood. Despite a 10% to 46% prevalence in people with multiple sclerosis (MS) and reduced quality of life, localization of neuroanatomical lesions associated with PLC remains poorly delineated. METHODS: The relationship between posterior fossa lesions and PLC in people with MS was examined using a retrospective medical record review of people with MS (2012-2016) who had completed the Center for Neurologic Study-Liability Scale (CNS-LS) and had undergone 1.5-T magnetic resonance imaging within 6 months of each other. RESULTS: Medical record review identified 80 potential cases, with 77 included. Brainstem and cerebellar lesions were counted, measured, and compared between people with MS who had positive results on the CNS-LS (scores ≥17, n = 22) with those who had negative results on the CNS-LS (scores ≤16, n = 55). Initial χ2 analysis showed no significant difference in lesion numbers in people with MS without (CNS-LS score ≤16) versus with (CNS-LS score ≥17) PLC. When analyzing only people with MS without evidence of depression, a significant inverse relationship was identified such that fewer posterior fossa lesions on automated magnetic resonance imaging was associated with the presence of PLC. CONCLUSIONS: Posterior fossa lesion load is not indicative of which individuals could develop PLC. Further investigations to delineate the primary source of PLC symptoms would aid in diagnosis and treatment of this condition.