Minimal Quantization Model in Pilot-Wave Hydrodynamics.

Investigating how classical systems may manifest dynamics analogous to those of quantum systems is a broad subject of fundamental interest. Walking droplets, which self-propel through a resonant interaction with their own wave field, provide a unique macroscopic realization of wave-particle duality that exhibits behaviors previously thought exclusive to quantum particles. Despite significant efforts, elucidating the precise origin and form of the wave-mediated forces responsible for the walker's quantumlike behavior remained elusive. Here, we demonstrate that, owing to wave interference, the force responsible for orbital quantization originates from waves excited near stationary points on the walker's past trajectory. Moreover, we derive a minimal model with the essential ingredients to capture quantized orbital dynamics, including quasiperiodic and chaotic orbits. Notably, this minimal model provides an explicit distinction between local forces, which account for the walker's preferred speed and wave-induced added mass, and spatiotemporal nonlocal forces responsible for quantization. The quantization mechanism revealed here is generic, and will thus play a role in other hydrodynamic quantum analogs.

Improved lipid-lowering treatment and reduction in cardiovascular disease burden in homozygous familial hypercholesterolemia: The SAFEHEART follow-up study.

AIM: We aimed to describe clinical and genetic characteristics, lipid-lowering treatment and atherosclerotic cardiovascular disease (ASCVD) outcomes over a long-term follow-up in homozygous familial hypercholesterolemia (HoFH). METHODS: SAFEHEART (Spanish Familial Hypercholesterolaemia Cohort Study) is a long-term study in molecularly diagnosed FH. Data analyzed in HoFH were prospectively obtained from 2004 until 2022. ASCVD events, lipid profile and lipid-lowering treatment were determined. RESULTS: Thirty-nine HoFH patients were analyzed. The mean age was 42 ± 20 years and nineteen (49%) were women. Median follow-up was 11 years (IQR 6,18). Median age at genetic diagnosis was 24 years (IQR 8,42). At enrolment, 33% had ASCVD and 18% had aortic valve disease. Patients with new ASCVD events and aortic valve disease at follow-up were six (15%), and one (3%), respectively. Median untreated LDL-C levels were 555 mg/dL (IQ 413,800), and median LDL-C levels at last follow-up was 122 mg/dL (IQR 91,172). Most patients (92%) were on high intensity statins and ezetimibe, 28% with PCSK9i, 26% with lomitapide, and 23% with lipoprotein-apheresis. Fourteen patients (36%) attained an LDL-C level below 100 mg/dL, and 10% attained an LDL-C below 70 mg/dL in secondary prevention. Patients with null/null variants were youngers, had higher untreated LDL-C and had the first ASCVD event earlier. Free-event survival is longer in patients with defective variant compared with those patients with at least one null variant (p=0.02). CONCLUSIONS: HoFH is a severe life threating disease with a high genetic and phenotypic variability. The improvement in lipid-lowering treatment and LDL-C levels have contributed to reduce ASCVD events.

Sinusitis originada por patologías o tratamientos dentales: revisión de la literatura / Sinusitis caused by dental treatment or pathology: a literature review

Introducción: la sinusitis odontogénica (SO) es una condición infradiagnosticada de la esfera otorrinolaringológica a pesar de su frecuencia que se estima entre 10 y el 40% de la rinosinusitis crónica. La SO representa hasta 75% de los casos de sinusitis maxilar unilateral y sigue pasando desapercibida en las guías más actuales de rinosinusitis, ocasionando una falta de consenso sobre los criterios diagnósticos y las pautas terapéuticas a observar. La dificultad en identificar el foco odontogénico en otorrinolaringología (ORL), y la de estimar la magnitud de la sinusitis en consultas de odontología, conduce frecuentemente a la persistencia de los síntomas y al fracaso de las terapias conducidas, impactando considerablemente en la calidad de vida de los pacientes. Por lo tanto, se elaboró esta revisión de la literatura para entender los desafíos que esta condición supone, a la luz de los estudios recientes en el tema. Métodos: se ha realizado una búsqueda exhaustiva de la literatura en Pubmed, Scopus y Google Scholar con términos relativos a las secciones y subsecciones de esta revisión. Resultados y conclusiones: el diagnóstico y el manejo de la SO plantean, por tanto, un desafío importante debido a la falta de protocolos estandarizados de diagnóstico y de procedimientos terapéuticos multidisciplinares consensuados. Se recomienda un enfoque interdisciplinar personalizado para lograr la resolución de la sintomatología y se precisan estudios bien diseñados, con estratificación según los causantes dentales y iatrogénicos, para generar una evidencia que respalde los futuros protocolos. (AU)

Introduction: Despite it being responsible for 10-40% of chronic rhinosinusitis cases, odontogenic sinusitis (OS) is an underdiagnosed otorhinolaryngological condition. OS represents up to 75% of cases of unilateral maxillary sinusitis and is still overlooked in most current rhinosinusitis guidelines. This leads to a lack of consensus on the diagnostic criteria and therapeutic guidelines to be observed. The difficulty in identifying the odontogenic focus in ENT consultations as well as estimating the magnitude of sinusitis in dental consultations frequently leads to the persistence of symptoms and the failure of the therapies undertaken, considerably impacting the quality of life of patients. This literature review was implemented to understand the challenges that this condition poses, in the light of recent studies on the subject. Methods: An exhaustive search of the literature in PubMed, Scopus and Google Scholar with terms related to the sections and subsections of this review. Results and conclusions: The diagnosis and management of OS therefore poses a significant challenge due to the lack of standardised diagnostic protocols and consensual multidisciplinary therapeutic procedures. A personalised interdisciplinary approach is recommended to achieve resolution of symptoms along with well-designed studies, stratified according to dental and iatrogenic causes, to provide evidence to support future protocols. (AU)

Sinusitis originada por patologías o tratamientos dentales: revisión de la literatura / Sinusitis caused by dental treatment or pathology: a literature review

Introducción: la sinusitis odontogénica (SO) es una condición infradiagnosticada de la esfera otorrinolaringológica a pesar de su frecuencia que se estima entre 10 y el 40% de la rinosinusitis crónica. La SO representa hasta 75% de los casos de sinusitis maxilar unilateral y sigue pasando desapercibida en las guías más actuales de rinosinusitis, ocasionando una falta de consenso sobre los criterios diagnósticos y las pautas terapéuticas a observar. La dificultad en identificar el foco odontogénico en otorrinolaringología (ORL), y la de estimar la magnitud de la sinusitis en consultas de odontología, conduce frecuentemente a la persistencia de los síntomas y al fracaso de las terapias conducidas, impactando considerablemente en la calidad de vida de los pacientes. Por lo tanto, se elaboró esta revisión de la literatura para entender los desafíos que esta condición supone, a la luz de los estudios recientes en el tema. Métodos: se ha realizado una búsqueda exhaustiva de la literatura en Pubmed, Scopus y Google Scholar con términos relativos a las secciones y subsecciones de esta revisión. Resultados y conclusiones: el diagnóstico y el manejo de la SO plantean, por tanto, un desafío importante debido a la falta de protocolos estandarizados de diagnóstico y de procedimientos terapéuticos multidisciplinares consensuados. Se recomienda un enfoque interdisciplinar personalizado para lograr la resolución de la sintomatología y se precisan estudios bien diseñados, con estratificación según los causantes dentales y iatrogénicos, para generar una evidencia que respalde los futuros protocolos. (AU)

Introduction: Despite it being responsible for 10-40% of chronic rhinosinusitis cases, odontogenic sinusitis (OS) is an underdiagnosed otorhinolaryngological condition. OS represents up to 75% of cases of unilateral maxillary sinusitis and is still overlooked in most current rhinosinusitis guidelines. This leads to a lack of consensus on the diagnostic criteria and therapeutic guidelines to be observed. The difficulty in identifying the odontogenic focus in ENT consultations as well as estimating the magnitude of sinusitis in dental consultations frequently leads to the persistence of symptoms and the failure of the therapies undertaken, considerably impacting the quality of life of patients. This literature review was implemented to understand the challenges that this condition poses, in the light of recent studies on the subject. Methods: An exhaustive search of the literature in PubMed, Scopus and Google Scholar with terms related to the sections and subsections of this review. Results and conclusions: The diagnosis and management of OS therefore poses a significant challenge due to the lack of standardised diagnostic protocols and consensual multidisciplinary therapeutic procedures. A personalised interdisciplinary approach is recommended to achieve resolution of symptoms along with well-designed studies, stratified according to dental and iatrogenic causes, to provide evidence to support future protocols. (AU)

Piperacillin-Tazobactam as an Adjuvant in the Mechanical Treatment of Patients with Periodontitis: A Randomized Clinical Study.

In this study, the aim was to evaluate the effects of the adjuvant piperacillin-tazobactam solution in the mechanical treatment of periodontitis. A single-blind split-mouth randomized study, it included 24 participants. All of them presented periodontitis stage III according to the 2018 World Workshop classification and the presence of at least one of the following periodontal pathogens: Aggregatibacter actinomycetemcomitans; Porphyromona gingivalis; Treponema denticola; Tannerella forsythia; Prevotella intermedia. The study established two groups: a control group (SRP: scaling and root planing) and a test group (SRP plus local piperacillin-tazobactam). The final recruitment included 11 women (45.8%) and 13 men (54.2%). The age range was between 25 and 72 years, and the mean age was 57 ± 10.20 years. Clinical controls were performed at 2 weeks, 3 months, and 6 months, repeating the SRP and applying the piperacillin-tazobactam solution again at the 3-month appointment. The clinical attachment level decreased by a mean of 2.13 ± 0.17 mm from the baseline to 6 months in the test group versus 1.63 ± 0.18 mm in the control group. The mean probing pocket depth decreased from 1.32 ± 0.09 mm in the test group, versus from 0.96 ± 0.14 mm on the control side. The plaque index in the test group decreased by 0.46 ± 0.04, while it decreased by an average of 0.31 ± 0.04 in the control group. In conclusion, the local use of piperacillin-tazobactam as complementary therapy produces better clinical results in patients with periodontitis. However, these results are not maintained over time, and so a more persistent local application is necessary.

Dental Transmigration: An Observational Retrospective Study OF52 Mandibular Canines.

The aim of this study was to analyze the prevalence of transmigrated canines in a Spanish population by evaluating their clinical and radiological characteristics. The descriptive observational study obtained 6840 orthopantomographs from all patients seeking dental care in the years 2017-21 via the Patient Reception Service and Dentistry Service at the Faculty of Dentistry at the Complutense University of Madrid and the Central Hospital of the Red Cross of Madrid (Spain). In total, 52 patients presented transmigrated canines, establishing a prevalence of 0.76%. This sample comprised 28 women and 24 men. Whenever a transmigrated canine was identified, a CBCT scan was obtained and used to evaluate the clinical and radiological variables associated with canine transmigration. The predominant side of the transmigration was the left (57.69%) compared to the right side (42.30%). The position of the canine, in order of frequency, according to the Mupparapu classification, corresponded to type IV (42.30%), type II (36.53%), type I (15.38%), and type V (5.76%), with no type III transmigrations found. Clinical manifestations were only recorded in 17.30% of cases, and 11.53% of the radiological findings showed the presence of tooth cysts that were confirmed by histopathological studies. Other impactions, in addition to the transmigrated canine, were found in five patients (9.61%), with the majority being the presence of third molars.

Utilización de dentina autógena para relleno del gap en el implante inmediato postextracción: a propósito de un caso clínico con seis meses de seguimiento / Autogenous dentin graft in the immediate post-extractive implant gap: six-month follow up of a clinical report

Introducción: las extracciones dentarias producen una reabsorción horizontal y vertical de la cresta alveolar, que se puede minimizar con algunas técnicas quirúrgicas, como la colocación de implantes inmediatos post-extracción, asociados al empleo de biomateriales. Caso clínico: se presenta el caso clínico de una mujer de 48 años, que acudió a consulta presentando dolor intenso en la zona del incisivo lateral superior izquierdo, asociado a una profundidad de sondaje de 12 mm. Se realizó la exodoncia del 2.2, y la colocación de un implante inmediato post-extracción, utilizando la dentina de la raíz extraída, para rellenar el gap entre el implante y la cortical vestibular, mostrando buenos resultados clínicos y radiográficos a los 6 meses tras la intervención. Discusión: aunque en la actualidad se utilizan multitud de biomateriales para reducir la reabsorción ósea en los implantes inmediatos post-extracción, ninguno de ellos parece tener mejores resultados que el resto, suponiendo en este sentido la dentina autógena una alternativa útil al tratarse de un material autólogo, con buenas tasas de aceptación por parte de los pacientes, y teniendo unas propiedades adecuadas de osteoconducción y osteoinducción.Conclusiones: la dentina autógena presenta buenos resultados clínicos y radiográficos para rellenar el gap en implantes inmediatos post-extracción (AU)

Introduction: Tooth extraction produces an horizontal and vertical resorption of the alveolar ridge, which can be reduced by many surgical techniques, such as immediate post-extractive implants, in combination with bone substitutes. Clinical case: A clinical case of a 48-year-old woman is presented, who went to dental clinic referring pain in her upper lateral incisor, associated to high probing depth. An immediate post extractive implant was placed, employing autogenous dentin from the root extracted, to fill the gap between the implant and the buccal plate, showing good clinical and radiographic evolution 6 months after surgery. Discussion: Although nowadays there are different bone substitutes to reduce bone resorption when immediate implants are placed, they have similar results, becoming autogenous dentin an useful alternative, which is an autologous material, with good patient acceptation rates and osteoconductive and osteoinductive properties.Conclusion: Autogenous dentin shows promising clinical and radiographical results when it is used to fill the gap in the post-extractive immediate implant (AU)

Analysis of the Radiological Changes of the Sinus Membrane Using Cone Beam Computed Tomography and Its Relationship with Dental Treatments. A Retrospective Study.

The aim of this study was to identify the most relevant dental factors and iatrogenic causes in the development of pathological changes to the sinus membrane and to analyse their possible influence on the development of odontogenic sinusitis. A descriptive, observational study was designed, with 276 patients who had been evaluated via cone beam computed tomography, analysing possible sinus thickening factors, such as apical infections, endodontic treatments, periodontitis, radicular cysts and impacted teeth, as well as iatrogenic factors caused by implant treatments or the development of oroantral communications produced during tooth extraction manoeuvres. Among the dental factors, periodontitis (47.1%), apical pathology (23.5%) and endodontic treatments (23.1%) were the predominant causes of sinus membrane thickening that most frequently produced an occupancy between 2 and 10 mm. Regarding the implant treatments, the placement of implants through the floor of the maxillary sinus was the main cause (9.8%), followed by sinus elevation techniques (6.2%). Dental extraction was the first cause of oroantral communication (5.0%), being the procedure that caused the greatest thickening of the sinus membrane. This study highlights the importance of dental treatments and iatrogenic factors in sinus pathology, and the need for diagnostic interrelations between the different specialists who address this pathology.

Manejo clínico odontológico de un paciente con mucopolisacaridosis tipo III. (Síndrome de Sanfilippo) / Dental clinical management of a patient with type III mucopolysaccharidosis (Sanfilippo syndrome)

El síndrome de Sanfilippo (mucopolisacaridosis tipo III) es un trastorno lisosomal causado por un defecto en el catabolismo del sulfato de heparano. La mucopolisacaridosis tipo III es el tipo más común de todas las mucopolisacaridosis. La base patógena de la enfermedad consiste en el almacenamiento de sustrato no degradado en el sistema nervioso central. El deterioro cognitivo progresivo que resulta en demencia y anomalías de comportamiento son las principales características clínicas del síndrome de Sanfilippo. La mucopolisacaridosis tipo III puede diagnosticarse erróneamente como otras formas de retraso del desarrollo, trastorno por déficit de atención/hiperactividad y trastornos del espectro autista, debido a la falta de síntomas somáticos y a la presencia de formas leves y atípicas de la enfermedad. Los pacientes con síndrome de Sanfilippo pueden tener niveles de glicosaminoglicanos en la orina comparativamente bajos, lo que da como resultado un ensayo urinario falso negativo. El diagnóstico definitivo se realiza mediante un ensayo enzimático en leucocitos y fibroblastos cultivados. Actualmente no existe un tratamiento eficaz de la mucopolisacaridosis tipo III, aunque las investigaciones en curso sobre el gen, la reducción de sustratos y las terapias de reemplazo de enzimas intratecales esperan obtener un método curativo para alterar el daño devastador del sistema nervioso central en un futuro próximo. El tratamiento odontológico de los pacientes con MPS-III requiere colaboración multidisciplinar, siendo de vital importancia el mantenimiento y controles periódicos, sobre todo en fases tempranas de la enfermedad. En estados avanzados se requerirá el uso de la anestesia general o la sedación profunda para dichos tratamientos, lo que supondrá un enorme reto para el profesional. (AU)

Sanfilippo syndrome (mucopolysaccharidosis type III) is a lysosomal disorder caused by a defect in the catabolism of heparan sulfate. Mucopolysaccharidosis type III is the most common type of mucopolysaccharidosis. The pathogenic basis of the disease consists of the storage of non-degraded substrate in the central nervous system. The progressive cognitive deterioration that results in dementia and behavioral abnormalities are the main clinical features of Sanfilippo syndrome. Mucopolysaccharidosis type III can be misdiagnosed as other forms of developmental delay, attention deficit/hyperactivity disorder and autistic spectrum disorders due to the lack of somatic symptoms, the presence of mild and atypical forms of the disease. Patients with Sanfilippo syndrome may have comparatively low glycosaminoglycan levels in the urine, resulting in a falsenegative urinary test. The definitive diagnosis is made by an enzymatic assay in cultured leukocytes and fibroblasts. There is currently no effective treatment for mucopolysaccharidosis type III, although ongoing research on the gene, substrate reduction and intrathecal enzyme replacement therapies hope to obtain a curative method to alter the devastating damage of the central nervous system in the future next. The dental treatment of patients with MPS-III requires multidisciplinary collaboration, being of vital importance the maintenance and periodic controls especially in early phases of the disease. In advanced stages, the use of general anesthesia or deep sedation will be required for dental procedures, which will be a huge challenge for the professional. (AU)

Emergent order in hydrodynamic spin lattices.

Macroscale analogues1-3 of microscopic spin systems offer direct insights into fundamental physical principles, thereby advancing our understanding of synchronization phenomena4 and informing the design of novel classes of chiral metamaterials5-7. Here we introduce hydrodynamic spin lattices (HSLs) of 'walking' droplets as a class of active spin systems with particle-wave coupling. HSLs reveal various non-equilibrium symmetry-breaking phenomena, including transitions from antiferromagnetic to ferromagnetic order that can be controlled by varying the lattice geometry and system rotation8. Theoretical predictions based on a generalized Kuramoto model4 derived from first principles rationalize our experimental observations, establishing HSLs as a versatile platform for exploring active phase oscillator dynamics. The tunability of HSLs suggests exciting directions for future research, from active spin-wave dynamics to hydrodynamic analogue computation and droplet-based topological insulators.

Abordaje mediante tres cavidades de un quiste dentígero de gran tamaño: a propósito de un caso / Approach with three cavities of a large dentigerous cyst: a case report

El quiste dentígero se considera un quiste odontogénico del desarrollo que está asociado a la corona de un diente no erupcionado. Suele ser asintomático y carecer de clínica asociada por lo que frecuentemente se trata de un hallazgo casual. Sin embargo puede haber situaciones en los que el quiste afecte a estructuras próximas y/o alcance gran tamaño. Se presenta un caso de un paciente de 65 años que acude derivado por su odontólogo general al constatar la presencia de una lesión radiotransparente de gran tamaño en el cuarto cuadrante. Se realizó un abordaje mediante tres cavidades de la lesión para su completa remoción, así como del cordal incluido asociado a la misma. Por último se colocó una mini placa como refuerzo

The dentigerous cyst is considered an odontogenic developmental cyst that is associated with the crown of a non-erupted tooth. It is usually asymptomatic and has no associated clinic, so it is usually a casual fi nding. However, it can affect nearby structures and / or reach large size. A case of a 65-year-old patient is presented who is referred by his general dentist to verify the presence of a large radiolucent lesion in the fourth quadrant. An approach was made using 3 cavities of the lesion for its complete removal, as well as the included wisdom tooth associated with it. Finally, a mini fi xing plate was placed as reinforcement

Consideraciones bucodentales en pacientes con Síndrome de Morquio / Dental considerations of the morquio síndrome

La mucopolisacaridosis tipo IV (MPS-IV) también conocida como enfermedad de Morquio en recuerdo del pediatra uruguayo Luis Morquio que la describió por primera vez, es una enfermedad congénita causada por la deficiencia de la enzima N-acetilgalactosamina 6 sulfatasa o de la enzima B-Galactosidasa. Estas anomalías enzimáticas tienen como consecuencia que se acumulen en diferentes tejidos del organismo cantidades elevadas de mucopolisacaridos. En la bibliografía se describe con detalle los defectos del esmalte que presentan los pacientes diagnosticados del síndrome de Morquio. Estos defectos son una característica aparentemente constante en la enfermedad y, por lo tanto, hace necesaria las visitas al odontólogo para su control evitándose problemas mayores. Dichos defectos consisten en un esmalte anormalmente delgado, que es áspero debido a los numerosos hoyos diminutos y a una superficie irregular. La delgadez del esmalte da como resultado una forma alterada y decoloración de los dientes que, añadido a los diastemas interdentales, provocan alteraciones en la oclusión. Aparte de estos defectos, el esmalte es histológicamente normal y tiene una du-reza y radiodensidad normales. El trata-miento odontológico de los pacientes con MPS-IV requiere colaboración multidisciplinar, debido a que las manifestaciones orales de la enfermedad pueden aparecer a cualquier edad, resultando en ocasiones tedioso para el paciente y complicado para el profesional. Especial mención merecen las terapias utilizadas como trata-miento sintomático de la enfermedad, así como el manejo de la vía aérea en el caso de intervenciones bajo anestesia general o sedación para tratar ciertas patologías del territorio bucomaxilodental

Mucopolysaccharidosis type IV (MPS-IV) also known as Morquio’s disease in memory of the Uruguayan pediatrician Luis Morquio who described it for the first time, is a congenital disease caused by the deficiency of the enzyme N-acetylgalactosamine 6 sulfatase or enzyme B -Galactosidase. These enzymatic anomalies result in high amounts of mucopolysaccharides accumulating in different tissues of the organism. The enamel defects presented by patients diagnosed with Morquio syndrome are described in detail in the bibliography. These defects are an apparently constant feature in the disease and, therefore, make visits to the dentist necessary for their control, avoiding major problems. These defects consist of an abnormally thin enamel that is rough due to numerous tiny holes and an irregular surface. The thinness of the enamel results in an altered form and discoloration of the teeth, which added to the interdental diastemas, cause alterations in the occlusion. Apart from these defects, the enamel is histologically normal and has a normal hardness and radiodensity.Dental treatment of patients with MPS-IV requires multidisciplinary collaboration, because the oral manifestations of the disease can appear at any age, being sometimes tedious for the patient and complicated for the professional. Special mention should be made of the therapies used as a symptomatic treatment of the disease, as well as the management of the airway in the case of interventions under general anesthesia or sedation to treat certain pathologies of the bucomaxillodental territory

A hydrodynamic analog of Friedel oscillations.

We present a macroscopic analog of an open quantum system, achieved with a classical pilot-wave system. Friedel oscillations are the angstrom-scale statistical signature of an impurity on a metal surface, concentric circular modulations in the probability density function of the surrounding electron sea. We consider a millimetric drop, propelled by its own wave field along the surface of a vibrating liquid bath, interacting with a submerged circular well. An ensemble of drop trajectories displays a statistical signature in the vicinity of the well that is strikingly similar to Friedel oscillations. The droplet trajectories reveal the dynamical roots of the emergent statistics. Our study elucidates a new mechanism for emergent quantum-like statistics in pilot-wave hydrodynamics and so suggests new directions for the nascent field of hydrodynamic quantum analogs.

Desplazamiento accidental del tercer molar al seno maxilar: protocolo de actuación / Accidental displacement of the third molar into the maxillary sinus: action protoco

Introducción: El desplazamiento accidental del tercer molar hacia el seno maxilar es una complicación de la cirugía bucal. La extracción de estos dientes generalmente es compleja debido a la escasa visibilidad, el espacio limitado y la ubicación espacial del diente, por lo que se requiere tener un cuidado meticuloso durante el tratamiento. Objetivo: El objetivo de este artículo ha sido el de establecer un protocolo de actuación basado tanto en el tratamiento quirúrgico como farmacológico, y el seguimiento que este tipo de complicaciones necesita según la literatura. Caso clínico: Se presenta el caso clínico de un varón de 17 años de edad, sin antecedentes médicos de interés, que fue remitido por su odontólogo para proceder a la valoración y extracción quirúrgica del tercer molar superior izquierdo que había sido desplazado al interior del seno maxilar tras el intento de exodoncia, y que producía sintomatología compatible con sinusitis aguda. La exploración radiológica descartó la afectación del resto de senos paranasales y confirmó la obstrucción casi completa del seno maxilar izquierdo. La extracción del cordal se realizó mediante ostectomía de la pared anterior del seno, pautándose tratamiento farmacológico postoperatorio y controles periódicos durante el primer año. Discusión: La terapéutica recomendada para esta complicación incluye la recuperación inmediata del diente, o la extracción posterior mientras la fibrosis se desarrolla en torno al diente desplazado, según sea necesario, tomando en cuenta la infección, el rango limitado del movimiento de la mandíbula, o malestar psicológico del paciente. El tratamiento médico y farmacológico que debe prescribirse según la literatura revisada, para facilitar el drenaje sinusal y el control de la infección. Conclusión: Para evitar este tipo de complicaciones, conviene realizar un estudio radiológico completo en los casos de cercanía del tercer molar superior en las inmediaciones del seno maxilar, y valorar la disposición e inclinación del mismo

Introduction: Accidental displacement of the third molar into the maxillary sinus is one of the complications of oral surgery. These extractions are usually complex due to some factors such as low visibility, limited space and the location of the tooth; so special care on these treatments is required. Objective: To establish an action protocol based on a surgical as well as a pharmacological treatment, and the monitoring that this kind of complications need according to the literature. Clinical case: A 17-year old man, with a noncontributory medical history, was referred to our clinic by a colleague to evaluate and perform a surgical extraction of his upper left third molar, which had been displaced into the maxillary sinus after a failed extraction, and was generating symptoms of acute sinusitis. The radiographic examination dismissed the affectation of the rest of the paranasal sinuses and confirmed the almost totally blockage of the left maxillary sinus. The extraction of this third molar took place by means of an anterior-wall ostectomy of the sinus; afterwards a pharmacological treatment was prescribed and regular control visits along the first year were planned. Discusion:The suggested treatment for this kind of complications involves the immediate recuperation of the tooth or its later extraction meanwhile the fibrosis forms around the displaced tooth, as needed. We have to take into account the infection, the limited mandibular range of movement as well as the patient's psychological discomfort. The medical and pharmacological treatment should be prescribed following the reviewed literature, in order to obtain the sinusal drainage and the infection control. Conclusion: It is convenient to carry out an exhaustive radiological examination in case of close relation between the maxillary third molar and the maxillary sinus as well as evaluate its position and inclination to avoid this kind of complications

Walking droplets in a circular corral: Quantisation and chaos.

A millimetric liquid droplet may walk across the surface of a vibrating liquid bath through a resonant interaction with its self-generated wavefield. Such walking droplets, or "walkers," have attracted considerable recent interest because they exhibit certain features previously believed to be exclusive to the microscopic, quantum realm. In particular, the intricate motion of a walker confined to a closed geometry is known to give rise to a coherent wave-like statistical behavior similar to that of electrons confined to quantum corrals. Here, we examine experimentally the dynamics of a walker inside a circular corral. We first illustrate the emergence of a variety of stable dynamical states for relatively low vibrational accelerations, which lead to a double quantisation in angular momentum and orbital radius. We then characterise the system's transition to chaos for increasing vibrational acceleration and illustrate the resulting breakdown of the double quantisation. Finally, we discuss the similarities and differences between the dynamics and statistics of a walker inside a circular corral and that of a walker subject to a simple harmonic potential.

Molecular basis of the familial chylomicronemia syndrome in patients from the National Dyslipidemia Registry of the Spanish Atherosclerosis Society.

BACKGROUND: Familial chylomicronemia syndrome (FCS) is an extremely rare lipoprotein disorder caused by mutations in at least 5 genes of the lipoprotein lipase (LPL) complex. OBJECTIVE: This work shows the molecular analysis of patients diagnosed with FCS, who attended the Spanish Arteriosclerosis Society lipid units and were included in the National Dyslipidemia Registry. METHODS: Among the 238 patients registered with severe hypertriglyceridemia (fasting triglycerides >1000 mg/dL), 26 were diagnosed with FCS as they had confirmed postheparin plasma LPL activity deficiency and/or homozygosity for loss-of-function mutations in LPL, GPIHBP1, APOC2, LMF1, or Apolipoprotein A5 (APOA5). RESULTS: Among the 26 FCS cases, 23 had mutations in the homozygous state: 19 in LPL and 4 in the GPIHBP1 gene. The molecular analysis revealed 3 novel mutations: 2 in LPL, in 2 unrelated patients (c.312delA; p.Asp105Thrfs*66 and c.629A>G; p.His210Arg), and 1 in GPHIBP1 in a third patient (c.502delC; p.Leu168Serfs*83). These 3 patients had confirmed lack of LPL activity. Three additional patients with confirmed LPL activity deficiency were heterozygous carriers of mutations in the genes analyzed. Among these, we found 2 novel mutations in APOA5 (c.50-1G>A and c.326_327insC; p.Tyr110Leufs*158). CONCLUSION: We have identified 5 novel pathogenic mutations: 2 in LPL, 1 in GPIHBP1, and 2 in the APOA5 gene. The genetic defaults accounting for the LPL activity deficiency of 23 of them have been clearly identified and 3 patients, who harbored mutations in heterozygosity, were diagnosed based on LPL activity deficiency, which raises the question of the involvement of new genes in the manifestation of FCS.

Repercusiones odontológicas y manifestaciones orales de la arteritis de células gigantes / Dental repercussions and oral manifestations or gian cell arteritis

La arteritis de células gigantes es una vasculitis primaria caracterizada por un infiltrado granulomatoso que obstruye la pared vascular provocando procesos isquémicos. Tiene gran importancia en odontología por su clínica, ya que puede afectar a la cavidad oral cursando con dolor odontogénico, necrosis lingual, necrosis labial, claudicación mandibular, hipoestesia mentoniana, inflamación facial y trismus. El conocimiento básico de las manifestaciones clínicas de la enfermedad permitirá al odontólogo evitar complicaciones como la ceguera o el desarrollo de una crisis suprarrenal que acabe con la vida del paciente

Giant cell arteritis is a primary vasculitis characterized by a granulomatous infiltrate that obstructs the vascular wall causing ischemic processes. It is of great importance in dentistry because of its clinical manifestations, as it can affect the oral cavity producing odontogenic pain, tongue necrosis, lip necrosis, jaw claudication, hypoesthesia of the chin, facial swelling and trismus. Basic knowledge of the clinical manifestations of the disease will allow the dentist to avoid complications such as blindness or the development of an adrenal crisis that could kill the patient

Consideraciones en cirugía bucal de los pacientes con enfermedad e Crohn / Considerations in oral surgery of patients with Crohn's disease

La enfermedad de Crohn es una inflamación crónica transmural de etiología desconocida que puede afectar a cualquier parte del tracto digestivo, desde la cavidad oral hasta la región anal, aunque su localización más frecuente es el íleon. El tratamiento odontológico de los pacientes requiere colaboración multidisciplinar, debido a que las manifestaciones orales de la enfermedad pueden aparecer incluso antes de que los signos intestinales. Especial mención merecen las terapias biológicas de última generación así como la corticoterapia empleada y sus repercusiones frente a cicatrización e infecciones del territorio bucal. El propósito del presente artículo es revisar las manifestaciones orales que presentan los pacientes diagnosticados de enfermedad de Crohn, así como establecer unos protocolos de actuación en la práctica odontológica, mediante el adecuado conocimiento de los diversos tratamientos que estos pacientes necesitan

Crohn's disease (C.D) is a chronic transmural inflammation of unknown etiology that can affect any part of the digestive tract, from the oral cavity to the anus, although its most frequent location is the ileum. The dental treatment of patients with C.D requires multidisciplinary collaboration, because oral manifestations of the disease may appear even before the intestinal signs. Special mention should be made of the biological therapies of last generation as well as the corticotherapy used and their repercussions against healing and infections of the oral territory. The purpose of our article is to review the oral manifestations presented by patients diagnosed with C.D, as well as to establish protocols of action in dental practice, through adequate knowledge of the various treatments that these patients need

Consideraciones odontológicas en los pacientes con Púrpura Trombocitopénica Idiopática / Dental considerations in patients with idiopathic thrombocytopenic purpura

Los trastornos de coagulación constituyen un gran inconveniente en la práctica odontológica diaria, especialmente en los cada vez más frecuentes tratamientos quirúrgicos implantológicos, por el riesgo de hemorragia. La púrpura trombocitopénica idiopática (PTI) o púrpura inmune primaria forma parte del grupo heterogéneo de enfermedades denominadas ‘raras’ y está caracterizada por una disminución temporal o persistente del recuento plaquetario. A un mayor número de sucesos hemorrágicos derivados de la PTI se añade el empleo de fármacos con una gran e importante repercusión odontológica como la ciclosporina, los anticuerpos monoclonales o los corticoides. El objetivo de este trabajo es facilitar al odontólogo las principales características de la enfermedad y las implicaciones farmacológicas relacionadas con su tratamiento a fin de dispensar una atención correcta e individualizada a cada paciente (AU)

Coagulation disorders are a major drawback in daily dental practice, more so in the increasingly frequent implant surgical treatments, because of the risk of bleeding. Idiopathic thrombocytopenic purpura (ITP) or primary immune purpura is part of the heterogeneous group of so-called ‘rare’ diseases and is characterized by a temporary or persistent decrease in platelet counts. A greater number of hemorrhagic events derived from ITP are added the use of drugs with a large and important dental impact, such as cyclosporine, monoclonal antibodies or corticosteroids. The objective of this work is to provide the dentist the main characteristics of the disease and the pharmacological implications related to its treatment in order to provide a correct and individualized care to each patient (AU)

Hemofilia y sus repercusiones en los tratamientos odontológicos de la cavidad bucal / Hemophilia and its repercussions on dental treatment of the oral cavity

La Hemofilia A y B es un trastorno congénito de la coagulación catalogada como enfermedad rara debido a su baja prevalencia. El déficit de factor VIII y IX, que caracteriza a esta patología, constituye un factor de riesgo de hemorragia en los tratamientos odontológicos, especialmente en los quirúrgicos, que es necesario prevenir y manejar por el odontólogo responsable del paciente. Sin embargo las medidas a adoptar frente a un paciente hemofílico suelen ser desconocidas por la mayoría de profesionales, lo que conlleva una atención odontológica deficiente y por ende un detrimento de la salud oral de estos pacientes. El objetivo de este trabajo es exponer de forma sintetizada y actualizada las medidas locales y generales a adoptar en el tratamiento odontológico de los pacientes hemofílicos, sin olvidar la imprescindible colaboración con el hematólogo del paciente (AU)

Hemophilia A and B is a congenital coagulation disorder classified as a rare disease due to its low prevalence. The factor VIII and IX deficiency, which characterizes this pathology, is a risk factor for excesive bleeding in dental treatments, especially in surgical procedures, which are necessary to prevent and manage by the dentist. However the measures to be taken in front of a hemophilic patient are usually unknown by most professionals, which implies poor dental care and therefore a detriment to the oral health of these patients. The aim of this paper is to present in a synthesized and updated way, local and general measures to be adopted in the dental treatment of hemophiliac patients, not forgetting the essential collaboration with the patient's hematologist (AU)