Accuracy of IOS in Full-Arch Dentate Patients Compared to CBCT Cast-Scanning. An In-Vivo Study.

Twenty fully-dentate patients were enrolled in the study.Full-arch maxillary and mandibular PVS impressions were acquired using stock metal trays and the dual mix technique. A full-arch maxillary and mandibular intraoral scanner (IOS) was also obtained using the Trios IOS. The impressions were cast and subsequently scanned using a Planmeca Promax cone beam computed tomography (CBCT) scanner. The casts were also scanned in a Desktop Scanner for reference(7series Dental Wings). DICOM files from the CBCT device were converted into stl files. The.stl files from the CBCT and IOS devices were compared for accuracy against the reference files from the Desktop Scanner using a 3D surface measurement software. Statistical analysis was carried out using SPSS software. Trios had a smaller error (median = 39µm) than CBCT (median = 62µm),a statistically significant difference between the 2 modalities (z=-4.6, p⟨0.005).Concerning the IOS, the anterior teeth presented with a smaller error (42±16µm) as opposed to the posterior teeth (47±16µm), a significant difference (t(39)=-2.4, p=0,019). There were no significant differences in IOS mean accuracy between maxilla and mandible or between left and right quadrants. Fullarch digitization using the Trios IOS is significantly more accurate compared to CBCT scanning of the relevant plaster models. Anterior teeth Trios IOS is statistically more accurate compared to posterior teeth IOS.

Treatment of gram-negative bacterial meningitis in term neonates with third generation cephalosporins plus amikacin.

The aim of this retrospective study was to evaluate the clinical efficacy in terms of mortality and long-term morbidity of third generation cephalosporins and amikacin in combination for the treatment of gram-negative bacterial meningitis in a homogeneous group of neonates. A 15-year experience (1983-1997) with 72 term neonates without central nervous system anomalies and with gram-negative organisms grown in their cerebrospinal fluid treated with the above combination of antibiotics is presented. All isolated organisms were sensitive to cefotaxime or ceftazidime and to amikacin but 80% were resistant to ampicillin. The predominant infecting organism was Escherichia coli (68.0%) which was sensitive to both cefotaxime and amikacin in all cases but resistant to ampicillin in 48% of cases. Survival at discharge was 97.2% but ultimate survival was reduced to 94.4%, as 2 patients died a few months following discharge of conditions unrelated to meningitis. Ventriculitis was diagnosed in 10 neonates (13.8%). Among survivors, 1 neonate (1.3%) developed hydrocephalus needing shunting and 1 neonate (1.3%) with Proteus mirabilis developed a brain abscess with relapse of meningitis which was successfully treated with a 6-week course of chloramphenicol. At follow-up at an age greater than 6 months, 91.1% of the surviving infants were normal, while 92.3% of survivors at an age greater than 6 years were normal and attended normal school. These results, despite any reservations due to the nature of the study (retrospective, uncontrolled study), strongly support the use of third generation cephalosporins and amikacin in combination for the treatment of neonatal gram-negative bacterial meningitis.

Effect of body tilting on physiological functions in stable very low birthweight neonates.

In babies of very low birth weight (less than 1500 g) we studied the effect of head up tilting on oxygenation, respiratory rate, heart rate and blood pressure (n = 23), on gastric emptying (n = 10), and on weight gain (n = 6). Head up tilting to 45 degrees achieved the best oxygenation at the angles studied, and decreased the respiratory and heart rates; there was no significant change in blood pressure. Residue in the stomach was also significantly less at 45 degrees, and the neonates' weight gain was higher. We conclude that nursing stable very low birthweight infants with a higher head up tilt than is conventional may have some advantages.

Complex chromosome rearrangement in a retarded girl with malformations.

An apparently balanced unusual chromosome rearrangement involving chromosomes 2, 3, 4, 5 and 10 is reported in a 13 months old girl with multiple malformations and mental retardation.