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05 for both) in all 28 participants. However, no significant difference was found between the precementation and the 12-week review (P=.085). The occlusal force reestablishment concerning sex, age, location, and arch of the prosthesis was found to be similar. Most of the participants (89.3%) achieved complete occlusal contact reestablishment and 10.7% partial occlusal reestablishment. The demographic and prosthesis factors were not significantly related to the occlusal reestablishment (P>.05).
Overall, occlusal force was reestablished after 12 weeks, and occlusal contact was completely reestablished in most participants after placement of RBFPDPs at an increased occlusal vertical dimension.
Overall, occlusal force was reestablished after 12 weeks, and occlusal contact was completely reestablished in most participants after placement of RBFPDPs at an increased occlusal vertical dimension.
When a cement-retained lithium disilicate crown needs to be removed, perforation is needed to reach the abutment screw. How this process affects its strength is unclear.
The purpose of this invitro study was to evaluate the fracture strength of milled lithium disilicate implant crowns with screw-access holes created before and after the firing stages.
Nine implant replicas with stock abutments were embedded in acrylic resin. Forty-five lithium disilicate (IPS e.max CAD) crowns were designed, milled, and divided into groups. The control group had no screw access, the blue state group had the screw access created in the intermediate phase of the ceramic, and the postfiring group had the screw access created after firing. The crowns were cemented with a self-adhesive resin cement, placed in an incubator for 24 hours and then thermocycled. The screw-access holes were sealed with composite resin. The crowns were loaded to failure with a universal testing machine using a 1-mm-diameter ball at a crosshead speength.
Various factors are responsible for sleep bruxism; however, whether the dopaminergic agonist group of drugs is effective in the treatment of sleep bruxism is unclear.
The purpose of this systematic review was to evaluate the effect of the dopaminergic agonist group of drugs in controlling sleep bruxism in comparison with no treatment or placebo-controlled treatment.
Two electronic databases, PubMed and Cochrane Central, were searched by using the keywords bruxism, sleep bruxism, dopamine, and dopamine agonist. After screening titles and abstracts, only those articles which met predefined inclusion criteria were selected for full-text assessment. Clinical trials using the dopaminergic agonist group of drugs as a treatment approach to sleep bruxism were included.
The literature search yielded a total of 64 articles from the 2 electronic databases (PubMed, 53; Cochrane Central, 11). After removal of the duplicates (n=8), the initial screening of titles and abstracts was performed by 2 independent reviewers, removing 46 articles. A total of 10 articles were selected for full-text reading, and 4 studies were included for qualitative analysis.
Levodopa (L-DOPA) and Bromocriptine showed decrease in root mean square value in electromyography per bruxism burst (P<.001) and 20% to 30% reduction of bruxism episodes during sleep in 2 different studies. However, treatment with bromocriptine led to conflicting result in another study in terms of frequency of bruxism episodes and amplitude of muscle contractions in electromyography (EMG). Bruxism bursts and episodes were also not significantly improved with another dopaminergic agonist group of drugs, Pramipexole (P>.001). Based on the limited evidence and conflicting results, significant conclusions cannot be generated, and further studies are required.
.001). Based on the limited evidence and conflicting results, significant conclusions cannot be generated, and further studies are required.Heart transplantation (HTx) remains the optimal treatment for selected patients with end-stage advanced heart failure. However, survival is limited early by acute rejection and long term by cardiac allograft vasculopathy (CAV). Even though the diagnosis of rejection is based on histology, cardiac imaging provides a pivotal role for early detection and severity assessment of these hazards. The present review focuses on the use and reliability of different invasive and non-invasive imaging modalities to detect and monitor CAV and rejection after HTx. Coronary angiography remains the corner stone in routine CAV surveillance. However, angiograms are invasive and underestimates the CAV severity especially in the early phase. Intravascular ultrasound and optical coherence tomography are invasive methods for intracoronary imaging that detects early CAV lesions not evident by angiograms. Non-invasive imaging can be divided into myocardial perfusion imaging, anatomical/structural imaging and myocardial functional imaging. The different non-invasive imaging modalities all provide clinical and prognostic information and may have a gatekeeper role for invasive monitoring. Acute rejection and CAV are still significant clinical problems after HTx. No imaging modality provides complete information on graft function, coronary anatomy and myocardial perfusion. However, a combination of invasive and non-invasive modalities at different stages following HTx should be considered for optimal personalized surveillance and risk stratification.Post-transplant lymphoproliferative disorders (PTLD) are a spectrum of heterogeneous lymphoproliferative conditions that are serious and possibly fatal complications after solid organ or allogenic hematopoietic stem cell transplantation. Most PTLD are attributed to Epstein-Barr virus reactivation in B-cells in the setting of immunosuppression after transplantation. Early diagnosis, accurate staging, and timely treatment are of vital importance to reduce morbidity and mortality. Given the often nonspecific clinical presentation and disease heterogeneity of PTLD, tissue biopsy and histopathological analysis are essential to establish diagnosis and most importantly, determine the subtype of PTLD, which guides treatment options. Advanced imaging modalities such as 18F-FDG PET/CT have played an increasingly important role and have shown high sensitivity and specificity in detection, staging, and assessing treatment response in multiple clinical studies over the last two decades. However, larger multicenter prospective validation is still needed to further establish the clinical utility of PET imaging in the management of PTLD. Significantly, new hybrid imaging modalities such as PET/MR may help reduce radiation exposure, which is especially important in pediatric transplant patients.
Breast cancer can be classified into different molecular subtypes with important therapeutic and prognostic implications. Neoadjuvant chemotherapy (NAC) increases the possibility of performing conservative surgery and allows in vivo testing of the sensitivity of the tumor. Our aim was to evaluate the pathological response to NAC in relation to the molecular phenotype and the different definitions of the pathological response.
228 patients treated with NAC and subsequent surgery between 2012 and 2018 were selected from our breast cancer database. Molecular phenotypes were established based on the criteria of the St Gallen 2013 Conference. Pathological response was evaluated following Miller-Payne (breast) and Sataloff (axilla) classification systems.
The most frequent molecular phenotype was luminal B/HER2 negative (30.3%), followed by luminal B/HER2 positive (26.3%), triple negative (24.6%), HER2 positive (13.2%), and luminal A (5.7%). The rate of pathological complete response (pCR) was 35.5% in breast and 15.3% in axilla. The rate of pCR considering breast and axilla together was 26.8%. The molecular phenotype with the highest rate of pCR was HER2 positive (66.7%) followed by triple negative (30.4%), luminal B/HER2 positive (21.7%), luminal B/HER2 negative (14.5%), and luminal A (7.7%) (p < 0.001). The same results were found with the different definitions of pCR we evaluated.
Complete pathological response to NAC in breast cancer depends largely on the molecular phenotype of the tumor, regardless of the definition of pCR, with the highest response rates in the breast and axilla in the HER2 positive and triple negative phenotypes.
Complete pathological response to NAC in breast cancer depends largely on the molecular phenotype of the tumor, regardless of the definition of pCR, with the highest response rates in the breast and axilla in the HER2 positive and triple negative phenotypes.Inflammatory fibroid polyps (IFPs) are rare mesenchymal neoplasms affecting the gastrointestinal tract which are considered benign and noninvasive. We present a case of an invasive IFP in a 46-year-old woman who presented with signs of intestinal obstruction due to ileal intussusception. A segment of the small intestine was resected and subsequently intestinal continuity was restored. A polypoid lesion was found obstructing the lumen. Histopathology revealed a mesenchymal proliferation of spindle and stellate cells, without cytological atypia, arranged in a fibromyxoid stroma. The tumor cells were located in the submucosa but also infiltrated the muscularis propria and the subserosa and were CD34 positive. The molecular study by PCR showed mutation in exon 12 of the PDGFRA gene. IFP is considered a true neoplasm and can also be considered as a potentially invasive lesion.Spindle cell carcinoma of the nasal cavity is a rare variant of squamous cell carcinoma. We report a case of a 50 year-old male presenting with a polypoid mass in the left nasal cavity. 17-DMAG Histologically, the tumor was biphasic, composed of non-keratinizing squamous nests and a sarcomatoid stroma with positivity for CKAE1-AE3. Metastatic ipsilateral lymph nodes were present and the patient underwent radical neck dissection, followed by adjuvant radiotherapy and cisplatin. Two years after diagnosis the patient is free of disease.Primary myxoid pulmonary sarcoma is a rare entity with an endobronchial growth. Although it should be included in the differential diagnosis of other sarcomas, its prognosis is usually favorable. We present the case of a 51-year-old patient with a mesenchymal tumor in the right lung, diagnosed as a primary pulmonary myxoid sarcoma, positive for EMA, vimentine and with a Ki-67 less than 5%; FISH revealed a EWSR1-CREB1 translocation.This update of the consensus of the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica - SEOM) and the Spanish Society of Pathology (Sociedad Española de Anatomía Patológica - SEAP), reviews the advances in the analysis of biomarkers in advanced colorectal cancer (CRC) as well as susceptibility markers of hereditary CRC and molecular biomarkers of localized CRC. Recently published information on the essential determination of KRAS, NRAS and BRAF mutations and the possible benefits of determining the amplification of human epidermal growth factor receptor 2 (HER2), the expression of proteins in the DNA repair pathway and the study of NTRK fusions are also evaluated. From a pathological point of view, the importance of analysing the tumour budding and poorly differentiated clusters and its prognostic value in CRC is reviewed, as well as the impact of molecular lymph node analysis on lymph node staging in CRC. The incorporation of pan-genomic technologies, such as next-generation sequencing (NGS) and liquid biopsy in the clinical management of patients with CRC is also outlined.