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false-positive diagnoses.Orthodontists often have trouble treating patients who have temporomandibular joint disorders because occlusion changes depend on the position of unstable condyles. This characteristic means the patients do not have definite criteria with which to make an accurate orthodontic diagnosis, so clinicians are unable to establish a reliable treatment plan. This article reports on the treatment of a patient with skeletal Class II relationship and condylar resorption. A stabilization splint was used before any active orthodontic tooth movement to stabilize her condylar position. Although the patient exhibited dramatically increased open bite and a retruded mandibular position after splint therapy, her occlusion and facial esthetics were resolved by orthodontic camouflage treatment with appropriate orthodontic mechanics after extraction of 4 premolars.Class III malocclusion presents some complexity in terms of diagnosis and treatment and affects not only the jaws but the whole craniofacial complex. Besides, functional forward displacement of the mandible may be diagnosed in a patient presenting Class III malocclusion, as the 2 entities are not incompatible or mutually exclusive. This case report describes the multidisciplinary, nonsurgical, orthodontic treatment of an adult patient with a skeletal Class III malocclusion, anterior crossbite, and a palatally impacted canine, treated with fixed appliances and skeletal anchorage. To upright the mandibular molars, distalize the whole mandibular arch, and avoid excessive inclination of maxillary incisors to improve dentofacial esthetics, miniscrews were placed in the retromolar area. The treatment results were very satisfactory and remained stable after a reasonable retention period.

The most common method of total wrist arthrodesis is dorsal compression plating, which can require revision for soft tissue or tendon irritation. A locked intramedullary system was developed to reduce this complication. The goal of this study was to investigate the complication rate of total wrist arthrodesis using this system in our center.

A retrospective chart review of all patients undergoing intramedullary wrist arthrodesis from January 2016 to February 2018 was performed.

Nine wrist arthrodeses were performed with locked intramedullary wrist fusion in 5 women and 4 men. The indications for fusion included posttraumatic arthritis in 7 and inflammatory arthritis in 2. Two patients underwent primary arthrodesis and 7 had revision from prior partial wrist fusions. Local bone graft at the radiocarpal joint was used in all cases. The mean follow-up was 27 weeks. Radiocarpal fusion was achieved in 8 patients after the initial procedure and in the ninth patient after revision. PAI-039 There were 6 complications in 4 patients with revision reoperation required in 3. The complications were metacarpal locking screw migration in 3, metacarpal fracture in 1, radiocarpal nonunion in 1, and symptomatic middle finger carpometacarpal nonunion in 1. The revision surgeries include distal screw removal in 1, distal screw removal with replacement in 1, and bone grafting in the radiocarpal nonunion.

Use of the locked intramedullary wrist fusion system yields high fusion rates. However, based on the high complication rate, particularly from distal screw migration, and the high revision rate in this series, we recommend caution with the use of this system.

Therapeutic V.

Therapeutic V.Body mass index (BMI) trajectories that improve over the lifecourse result in better cardiometabolic profiles, but only a small proportion of children of an unhealthy weight show improving BMI trajectories. This study aimed to examine the childhood factors related to diverging BMI trajectories from childhood into adulthood using data from the Childhood Determinants of Adult Health study. A convergent parallel mixed methods design was used. Quantitative data (n = 2206) came from the first (2004-06) and second (2009-11) adult follow-ups of 8498 Australian children (7-15 years) assessed in 1985. Using BMI z-scores, group-based trajectory modelling identified five trajectory groups Persistently Low, Persistently Average, High Decreasing, Average Increasing and High Increasing. Qualitative data (n = 50) were collected from a sub-group (2016; 38-46 years). Semi-structured interviews with 6-12 participants from each BMI trajectory group focused on individual, social and environmental influences on weight, diet and pbserve a legacy effect of parents' lifestyle behaviours on divergent BMI trajectories. This work provides direction for further exploration of the factors driving divergent BMI trajectories.In rural areas of sub-Saharan Africa, one in eight households obtain drinking water from a piped system; the rest fetch water from improved and unimproved sources located at some distance from their homes. This task falls primarily to women and girls, creating time poverty and risks to safety and health. In this paper, we present a conceptual model that elaborates the mechanisms linking access to piped water with food security and long-term economic impacts. These hypotheses were tested in a quasi-experimental study of four villages in rural Zambia using a combination of household surveys, Global Positioning System transponders, and water meters to measure time spent fetching water, water consumption, and how water was being utilized for domestic and productive activities. Households receiving the piped water intervention spent a median of 3.8 h per week less fetching water, savings that accrued primarily to women and girls. Household water consumption increased 32%, which was used for both domestic and productive uses. Increases in the frequency of gardening and the size of garden plots in treatment households were observed. Households receiving piped water reported being happier, healthier, and having more time to participate in work inside or outside the home. We find that piped water supplies can promote the economic development and well-being of rural households, with particular benefits to women and girls, conditional upon pricing and management models that ensure sustainable service.