Anatomical Defects Research Articles

EFFECTS OF PHYSICAL THERAPY IN MUSCULAR STRENGTH AND BALANCE, PAIN RELIEF AND FUNCTIONAL CAPACITY IN PATIENTS WITH PATELLOFEMORAL PAIN SYNDROME

Based on the research carried out from specialized sources, we can conclude that femoral-patellar pain syndrome is a clinical entity that leads to the appearance of anterior knee pain, in patients without pathological changes present in the cartilage of the femoral-patellar joint. Studies in the specialized literature demonstrate that a physical therapist can adapt an individual treatment plan for each patient depending on the underlying pathology. Considering the importance of the knee joint in everyday life, both for carrying out daily activities and for carrying out professional activities, we can conclude that its recovery is extremely important. The production mechanisms of the femoro-patellar syndrome are multiple, and this requires the implementation of a recovery program as effective as possible, based on the most accurate and detailed assessment. Current imaging techniques can provide us with important data regarding the situation of the knee joint, which makes the diagnosis of patellofemoral syndrome easier. Orthopedic treatment can be considered adjuvant in combating the pain caused by femoral-patellar syndrome if it is associated with an individualized and well-structured physical therapy program. Surgical interventions are only indicated for patients in whom an anatomical defect of the bone structures or the pathological alignment of the patella maintains the destruction of the cartilage. After any type of surgical intervention, it is mandatory to establish specialized physiotherapy programs with specific objectives, in order to ensure a high post-operative success rate.

Abnormal causal connectivity of prefrontal-limbic circuit by structural deficits in drug-naive anxiety disorders

BackgroundStructural and functional deficits in the prefrontal-limbic circuit have been revealed in patients with anxiety disorders. However, the effect of structural abnormalities on causal connectivity within this circuit remains unclear. This study aimed to investigate causal connectivity in the prefrontal-limbic circuit associated with structural deficits in drug-naive patients with generalized anxiety disorder (GAD) and panic disorder (PD) and the changes after treatment. MethodsA total of 64 GAD patients, 54 PD patients and 61 healthy controls (HCs) completed the resting-state magnetic resonance imaging scans at baseline. Among them, 96 patients with anxiety disorders (52 in GAD group and 44 in PD group) completed a 4-week paroxetine treatment. Voxel-based morphometry and Granger causality analysis (GCA) were applied to analyze the data based on the human brainnetome atlas. ResultsPatients with GAD and PD showed decreased gray matter volume (GMV) in the bilateral A24cd subregions of cingulate gyrus. Whole-brain analysis revealed decreased GMV in the left cingulate gyrus in patients with PD. Hence, the left A24cd subregion was selected as a seed. Compared with HCs, unidirectional causal connectivity between the limbic-superior temporal gyrus (STG) temporal pole and the limbic-precentral/middle frontal gyrus was enhanced in patients with GAD and PD (from the left A24cd subregion of cingulate gyrus to the right STG temporal pole, and from the left A24cd subregion of cingulate gyrus to the right precentral/middle frontal gyrus). Compared with patients with PD, the limbic-precuneus unidirectional causal connectivity was enhanced in patients with GAD, and the cerebellum crus1 - limbic connectivity has a positive feedback effect. ConclusionsThe anatomical defects in the left A24cd subregion of cingulate gyrus may partially affect the prefrontal-limbic circuit, and the unidirectional causal effect from the left A24cd subregion to the right STG temporal pole may be an imaging change shared by anxiety disorders. The causal effect of the left A24cd subregion of cingulate gyrus to precuneus might be related to the neurobiology of GAD.

Analysis of the Robotic-Based In Situ Bioprinting Workflow for the Regeneration of Damaged Tissues through a Case Study.

This study aims to critically analyse the workflow of the in situ bioprinting procedure, presenting a simulated neurosurgical case study, based on a real traumatic event, for collecting quantitative data in support of this innovative approach. After a traumatic event involving the head, bone fragments may have to be removed and a replacement implant placed through a highly demanding surgical procedure in terms of surgeon dexterity. A promising alternative to the current surgical technique is the use of a robotic arm to deposit the biomaterials directly onto the damaged site of the patient following a planned curved surface, which can be designed pre-operatively. Here we achieved an accurate planning-patient registration through pre-operative fiducial markers positioned around the surgical area, reconstructed starting from computed tomography images. Exploiting the availability of multiple degrees of freedom for the regeneration of complex and also overhanging parts typical of anatomical defects, in this work the robotic platform IMAGObot was used to regenerate a cranial defect on a patient-specific phantom. The in situ bioprinting process was then successfully performed showing the great potential of this innovative technology in the field of cranial surgery. In particular, the accuracy of the deposition process was quantified, as well as the duration of the whole procedure was compared to a standard surgical practice. Further investigations include a biological characterisation over time of the printed construct as well as an in vitro and in vivo analysis of the proposed approach, to better analyse the biomaterial performances in terms of osteo-integration with the native tissue.

A REVIEW ARTICLE OF SHARIR RACHANAW.S.R. ANATOMY

Acharya Susruta provided several aspects associated with human anatomy at the side of application of dissection system. The historical Acharya of Indian device emphasizes structural employer of human frame. The Vedas of Indian device and Acharya described that how human body originated from Panchamahabhutas and relation among principles of Trigunas and physiology of human frame. similarly improvement of embryo and fitness of fetus correlated with satisfactory of Shukra wholesome progeny additionally supplied human body as an extension of the embryo. The classical texts supplied numerous ideas related to the human anatomy (Rachana Shaarira) and this newsletter elaborated identical. Human anatomy is one of the primary vital sciences of drugs. Anatomy is the branch of biology concerned with the examine of the shape of organism and their elements, The subject of anatomy is split into macroscopic and microscopic anatomy. Macroscopic anatomy is that the examination of an animal frame components the usage of unaided eyesight. Gross anatomy also consists of the department of superficial anatomy. Microscopic anatomy consists of using optical units in the test of the tissues of assorted structures, known as histology and within the have a have a look at of cells. The concept of congenital anomalies additionally presented in ayurveda which in particular takes vicinity due to the anatomical defects or physiological disturbances.Ayurveda provided several aspects associated with human anatomy at the side of utility of dissection manner and emphasizes structural commercial enterprise employer of human frame. it is believed that understanding about Rachana Shaarir enables medical physician to come to be high-quality in profession exercise. therefore, Ayurveda offers importance approximately the information of Rachana Sharir.

Role of vitamin E and zinc sulfate in infertile men

Infertility affects 15-30% of couples that are trying to conceive, about half of these cases, male partner is the sole contributing factor. Infertility remains a controversial problem worldwide, male infertility caused by different anatomical defect like obstruction of seminal tube and neurological abnormalities, resulting in abnormal spermatogenesis which weakens the function of sperm.Follow-up study done for 60 infertile men with age range between 30-45 years. Data collected was carried out during the period from April 2019 to August 2019 in Bajii city which include seminal fluid analysis, determination of testosterone, prolactin, and T3 and T4 before and after treatment with vitamin E(800 I.U/daily) and zinc sulfate(50mg/daily) which last for three months , all data were presented as mean and standard deviation. In this study we exclude any disease or abnormal condition that related to this group.There are 60 infertile men participated in this study, age range between 30-45 years. In these cases we measured the seminal fluid analysis, determination of testosterone, prolactin, and T3 and T4 before and after treatment with vitamin E(800 I.U/daily) and zinc sulfate(50mg/daily) which last for three monthsAbout the seminal fluid analysis, there is a significant increase in number of sperm in infertile men after the treatment, and also there is a significant increase in activity of sperm after treatment. Regarding the seminal fluid analysis, there is a significant increase in number of sperm in infertile men after the treatment compared with this before treatment and also there is a significant increase in activity of sperm after treatment compared with this before treatment. About the percentage of non-motile sperm, there is a significant decrease in this percentage after treatment compared with this before treatment, also there is decrease in percentage of abnormal sperm shape after treatment compared with this before treatment, while there is a significant increase in percentage of normal sperm shape after treatment compared with this before treatment About the concentration of prolactin, there is none significant difference between its level after treatment and before treatment. Regarding the concentration of testosterone, there is a significant elevation in its concentration after the treatment compared with its concentration before treatment and About the concentration of T3 and T4, there is none significant difference in its concentration after treatment and before treatment respectively.

Труднощі діагностики аномалії Кімерлі (власне клінічне спостереження)

Kimmerle’s anomaly is characterized by the presence of a bony arch of congenital or secondary origin in the structure of the first cervical vertebrae, which restricts the movement of the vertebral artery and causes its compression. This pathology belongs to craniovertebral malformations - congenital anatomical defects of the structure of the junction of the skull with the first cervical vertebra. Kimerly’s anomaly is diagnosed in approximately 12-30% of the population, causing vertebral artery syndrome, which is the cause of chronic ischemia in the posterior parts of the brain. Purpose - to describe the clinical case of Kimmerle’s anomaly in a teenager as an example of a long diagnostic search for this pathology. Clinical case. A 9-year-old girl complained of frequent headaches accompanied by vomiting. Similar conditions occurred every 3-4 weeks. Gastroenterological and neurological factors were not detected. The conditions were relieved by sleep, and drug therapy was not effective. During puberty, such attacks became less frequent and later disappeared. At the age of 16, the girl began to complain of neck pain, recurrent migraines, sharp «shooting» pain in the ear, accompanied by a buzzing sound, ringing, later joined by syncopal states, gait instability, and facial muscle weakness. An X-ray of the craniovertebral junction revealed Kimmerle’s anomaly. The patient’s condition improved with the use of the Shantz collar and constant physical therapy and neuroprotective therapy. Conclusions. Kimmerle’s anomaly can be asymptomatic and incidental, but in younger patients with a combination of neuro-otolaryngological symptoms and drop attacks, this pathology should be excluded. When taking anamnesis, attention should be paid to the chronology and conditions of symptom onset, as well as the patient’s medical history. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

The Outcome Of The Inverted Internal Limiting Membrane Flap Technique For The Repair Of Large Idiopathic Macular Holes.

Full-thickness macular hole is defined as an anatomical defect in the fovea that spans from the internal limiting membrane to the retinal pigment epithelium, assessed by spectral domain optical coherence tomography. The Objectives of the study are to determine the anatomical and visual outcome in patients undergoing pars plana vitrectomy along with inverted internal limiting flap closure in large idiopathic full-thickness macular holes (>400 μm). A prospective interventional study was conducted at a tertiary teaching eye hospital in Karachi, where patients of either gender and having macular holes greater than >400 μm were recruited. The study was conducted From January 9 to July 8, 2022, and all patients underwent pre-operative fundus examination and pars plana vitrectomy with inverted ILM flap closure. Data was entered and analyzed using SPSS 23. Follow-ups were conducted at 1 and 3 months. A total of 94 patients were enrolled with a mean age of 49.17±13.8 years. The mean duration of symptoms was 3.1±1.4 months. The mean pre-operative macular hole diameter was 854.31±08.36 μm and Stage 3 and 4 MH was present in 36.2% and 63.8% of patients, respectively. Anatomical closure was achieved in 93.6% of eyes (n=88/94). Pre-operative mean BCVA was LogMAR 0.90±0.24, which improved to LogMAR mean 0.70±0.27 at the final follow-up. As of the last follow-up, 92.6% of patients showed improved visual outcomes, with a mean three-line improvement in Snellen lines. After data stratification, no statistically significant result was obtained. The use of the inverted ILM flap technique resulted in improved anatomical and visual outcomes, in cases of large idiopathic macular holes.

Biomechanical Effects of a Novel Pedicle Screw W-Type Rod Fixation for Lumbar Spondylolysis: A Finite Element Analysis.

Lumbar spondylolysis involves anatomical defects of the pars interarticularis, which causes instability during motion. The instability can be addressed through instrumentation with posterolateral fusion (PLF). We developed a novel pedicle screw W-type rod fixation system and evaluated its biomechanical effects in comparison with PLF and Dynesys stabilization for lumbar spondylolysis via finite element (FE) analysis. A validated lumbar spine model was built using ANSYS 14.5 software. Five FE models were established simulating the intact L1-L5 lumbar spine (INT), bilateral pars defect (Bipars), bilateral pars defect with PLF (Bipars_PLF), Dynesys stabilization (Bipars_Dyn), and W-type rod fixation (Bipars_Wtyp). The range of motion (ROM) of the affected segment, the disc stress (DS), and the facet contact force (FCF) of the cranial segment were compared. In the Bipars model, ROM increased in extension and rotation. Compared with the INT model, Bipars_PLF and Bipars_Dyn exhibited remarkably lower ROMs for the affected segment and imposed greater DS and FCF in the cranial segment. Bipars_Wtyp preserved more ROM and generated lower stress at the cranial segment than Bipars_PLF or Bipars_Dyn. The injury model indicates that this novel pedicle screw W-type rod for spondylolysis fixation could return ROM, DS, and FCF to levels similar to preinjury.

Recurrent pneumococcal meningitis due to an acquired anatomical defect

A 66-year-old woman with type 2 diabetes, chronic sinusitis, chronic smoking, and a history of pneumococcal meningitis in 2019 presented to the hospital in October 2022 after being poorly responsive at home. On arrival, she was somnolent with a GCS of 5

Screening of asymptomatic bacteriuria in children with sickle cell disease

Abstract Background Asymptomatic bacteriuria (ASB) refers to two consecutive urine cultures growing more than 100 000 CFU/ml in a patient with no symptoms of urinary tract infection. In patients with sickle cell disease (SCD), the anatomical and physiological defects make ASB more prone to worsen the sickle nephropathy. Early detection and management of ASB in children with SCD may retard this progression. Aim To investigate the prevalence of ASB, its major determinants, and its effect on kidney functions in patients with SCD for early detection and treatment. Patients and methods The study was conducted at a children’s hospital during the period between June 2019 and February 2020. The study included 30 children previously diagnosed as having SCD. Midstream urine samples were collected twice from all patients and subjected to urinalysis and culture on chromogenic media. Only significant isolates were identified and subjected to antimicrobial susceptibility testing. Patients were divided into either ASB or sterile urine group. All patients with SCD were subjected to complete blood picture, reticulocytic count, markers of hemolysis, and serum creatinine. Results The prevalence of confirmed ASB was 16.7%. All children in ASB group had pyuria (100%). Staphylococcus saprophyticus (60%) was the commonest organism isolated, followed by Escherichia coli (20%) and Klebsiella pneumoniae (20%). Sulfamethoxazole+trimethoprim was the most sensitive antibiotic among all isolated microorganisms. The differences in kidney function results between the two groups were statistically insignificant. Conclusion ASB was of high prevalence in pediatric patients with SCD in Egypt at our hospital. Pyuria was the only major determinant. S. saprophyticus was the predominant organism. Serum creatinine was a nonsensitive marker to monitor kidney functions.

MP76-05 PERI-URETHRAL PROSTATIC CAVITY FORMATION FOLLOWING WATER VAPOR THERMAL THERAPY: AN UNRECOGNIZED COMPLICATION CAUSING PERSISTENT LUTS?

You have accessJournal of UrologyCME1 Apr 2023MP76-05 PERI-URETHRAL PROSTATIC CAVITY FORMATION FOLLOWING WATER VAPOR THERMAL THERAPY: AN UNRECOGNIZED COMPLICATION CAUSING PERSISTENT LUTS? Leo D. Dreyfuss, Kevin Alter, Adithya Balasubramanian, Barry Zisholtz, Kevin C. Zorn, Naeem Bhojani, Dean Elterman, and Bilal Chughtai Leo D. DreyfussLeo D. Dreyfuss More articles by this author , Kevin AlterKevin Alter More articles by this author , Adithya BalasubramanianAdithya Balasubramanian More articles by this author , Barry ZisholtzBarry Zisholtz More articles by this author , Kevin C. ZornKevin C. Zorn More articles by this author , Naeem BhojaniNaeem Bhojani More articles by this author , Dean EltermanDean Elterman More articles by this author , and Bilal ChughtaiBilal Chughtai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003350.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Water vapor thermal therapy (WVTT) causes tissue necrosis secondary to release of thermal energy within the collagen networks of the prostate transition zone. Some men experience worsening of LUTS following treatment. We report 3 patients with persistent LUTS following WVTT who were found to have anatomic abnormalities in the prostate, ultimately requiring repeat procedures. METHODS: WVTT (Rezum, NxThera, Inc, Maple Grove, MN) was offered to patients with bothersome LUTS and prostate volume less than 80 cc’s. WVTT was performed outpatient at a high-volume academic urology clinic. Patients were treated under local anesthesia with 1-3 sticks in bilateral lateral lobes. Patients underwent trial of void on post-procedure day 1 and were followed at regular intervals with post-operative surveys, post-void residual (PVR), and uroflowmetry. RESULTS: All 3 patients successfully underwent WVTT and passed trial of void with minimal post-void residual. Patient 1 experienced persistent bothersome LUTS despite medical therapy. Urodynamics revealed high pressure with low urinary flow. Cystoscopy revealed urethral cavities filled with debris causing obstruction (Figure 1A). Transurethral unroofing was performed leading to resolution of symptoms. Patient 2 experienced persistent LUTS, slow urinary stream, and elevated PVR’s to 100 mL following procedure. After 5 months of persistent symptoms, they began to experience watery ejaculate. CT Urogram revealed cystic dilation of prostatic urethra with urethral stones requiring cystoscopy and stone removal. Patient 3 experienced LUTS for 2.5 months following WVTT, at which time they developed watery ejaculate. Cystoscopy revealed prostatic urethral diverticulum (Figure 1B) and MRI showed 2.4×2.4×2.5 cm cystic cavity in prostatic transition zone contiguous with prostatic urethra (Figure 1C, D). Photoselective vaporization of the prostate was performed 14 months following index procedure with resolution of symptoms. At last follow up, all patients are voiding well with resolution of LUTS. CONCLUSIONS: WVTT may be associated with atypical tissue necrosis and cavity formation within prostatic transition zone. Patients with worsening or persistent LUTS following WVTT may benefit from further workup to exclude anatomic defects. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1092 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Leo D. Dreyfuss More articles by this author Kevin Alter More articles by this author Adithya Balasubramanian More articles by this author Barry Zisholtz More articles by this author Kevin C. Zorn More articles by this author Naeem Bhojani More articles by this author Dean Elterman More articles by this author Bilal Chughtai More articles by this author Expand All Advertisement PDF downloadLoading ...

Renal stone disease

Renal stone disease (urolithiasis, nephrolithiasis) covers many conditions causing kidney, ureteric or bladder stones. These include metabolic and inherited disorders, anatomical defects of the upper or lower urinary tract, and chronic urinary infection. However, most cases of renal stones are idiopathic. They present with loin or abdominal pain, and visible or non-visible haematuria; this is followed by the eventual passage of a stone and resolution, or the need for further investigation and intervention. Renal stones often recur, and it is important to identify the underlying cause, particularly because the risk can be related to diet and lifestyle, and is often associated with hypertension and/or diabetes mellitus. Although clinical management is largely surgical and can seem straightforward, the increasing prevalence of renal stone disease in developed countries is becoming a significant health and economic burden.

Relationship between the compressive strength, density and the width of the annual rings in a high-guality part of timber of Scots pine (Pinus sylvestris L.) wood

Investigation of round Scots pine wood WC01 class using X-ray computer tomography. Scots pine is the most widespread type of wood in Poland with wide industrial use. The typical starting material used for the production of layered floor elements are logs of WC01 class (class according to the Polish Standard PN-D-95008: 1992 and Order no 72 - GM-900-5 / 2013 of General Director of the State Forests in Poland). Using X-ray computed tomography, tests of fresh wood in the bark were carried out, confirming the full suitability of this technique for the precise assessment of wood density as well as its grain and distribution of anatomical defects (knots). The different level of humidity of sapwood and heartwood in fresh wood is visible in tomographic images and translates into a much higher recorded density of the wetter zone of sapwood. Calibration of the tomograph used made it possible to convert the Hounsfield density scale into actual densities expressed in kg/m3.

The tricuspid valve in hypoplastic left heart syndrome: Echocardiography provides insight into anatomy and function.

Tricuspid regurgitation (TR) is commonly seen in surgically palliated patients with hypoplastic left heart syndrome, and when significant, is associated with an increase in both morbidity and mortality. Tricuspid valve dysfunction appears to be the result of a combination of inherent structural malformations and the unique physiological circumstances resulting from right ventricular pressure and volume overload. Valve dysfunction evolves rapidly, and manifests early on in the surgical pathway. Whilst traditional echocardiographic imaging can identify anatomical defects and dysfunction resulting in varying degrees of regurgitation even at early stages, more sophisticated investigations such as 3D echocardiography, strain imaging and transesophageal 3DE might prove useful to better demonstrate the complex interactions between abnormal anatomy of the valve complex, ventricular function, mechanical synchrony, and TR. Recognition of specific mechanisms of TR can enhance patient-specific care by directing precise surgical interventions and by informing the best timing for intervention on the valve.

Diagnostic factors for recurrent pregnancy loss: an expanded workup

PurposeThere is limited information on the risk factors for recurrent pregnancy loss (RPL).MethodsIn this study, a patient-based approach was used to investigate the possible involvement and relative relevance of a large number of diagnostic factors in 843 women with RPL who underwent an extensive diagnostic workup including 44 diagnostic factors divided into 7 major categories.ResultsThe rates of abnormalities found were: (1) genital infections: 11.74%; (2) uterine anatomic defects: 23.72%; (3) endocrine disorders: 29.42%; (4) thrombophilias: 62%; (5) autoimmune abnormalities: 39.2%; (6) parental karyotype abnormalities 2.25%; (7) clinical factors: 87.78%. Six hundred and fifty-nine out of eight hundred and forty-three women (78.17%) had more than one abnormality. The mean number of pregnancy losses increased by increasing the number of the abnormalities found (r = 0.86949, P < 0.02). The factors associated with the highest mean number of pregnancy losses were cervical isthmic incompetence, anti-beta-2-glycoprotein-1 antibodies, unicornuate uterus, anti-prothrombin A antibodies, protein C deficiency, and lupus anticoagulant. The majority of the considered abnormalities had similar, non-significant prevalence between women with 2 versus ≥ 3 pregnancy losses with the exception of age ≥ 35 years and MTHFR A1298C heterozygote mutation. No difference was found between women with primary and secondary RPL stratified according to the number of abnormalities detected (Chi-square: 8.55, P = 0.07). In these women, the only factors found to be present with statistically different rates were age ≥ 35 years, cigarette smoking, and genital infection by Ureaplasma.ConclusionA patient-based diagnostic approach in women with RPL could be clinically useful and could represent a basis for future research.

Pituitary stalk interruption syndrome (PSIS) presenting in a Jordanian male patient with short stature and delayed puberty: a case report

BackgroundPituitary stalk interruption syndrome is a rare congenital pituitary anatomical defect manifested with wide and various clinical presentations. Short stature and delayed puberty are present in most cases and may be combined with extra pituitary malformations. Magnetic resonance imaging is considered the key factor for reaching the definite diagnosis as it reveals the different radiological presentations of this syndrome.Case presentationA 17-year-old male patient from Jordan was presented to the radiology department for pituitary MRI. The patient presents with multiple pituitary hormonal deficiency, short stature, and under-developed secondary sexual characteristics. The bone age of the patient was significantly less than the chronological age. MRI pituitary gland showed hypoplasia of the anterior pituitary, absence of the pituitary stalk and ectopic posterior pituitary gland located posterior to the optic chiasm. These findings were consistent with pituitary stalk interruption syndrome.ConclusionsConsidering uncommon incidence of pituitary stalk interruption syndrome, magnetic resonance imaging of the pituitary should be considered while examining a patient with pituitary deficiency for prompt diagnosis and treatment. Hormone replacement medication is the primary treatment for pituitary stalk interruption syndrome and should be started as soon as feasible. Thus, early diagnosis and monitoring of individuals are crucial.

Gastroesophageal reflux disease in children: What's new right now?

Gastroesophageal reflux (GER) in children is very common and refers to the involuntary passage of gastric contents into the esophagus. This is often physiological and managed conservatively. In contrast, GER disease (GERD) is a less common pathologic process causing troublesome symptoms, which may need medical management. Apart from abnormal transient relaxations of the lower esophageal sphincter, other factors that play a role in the pathogenesis of GERD include defects in esophageal mucosal defense, impaired esophageal and gastric motility and clearance, as well as anatomical defects of the lower esophageal reflux barrier such as hiatal hernia. The clinical manifestations of GERD in young children are varied and nonspecific prompting the necessity for careful diagnostic evaluation. Management should be targeted to the underlying aetiopathogenesis and to limit complications of GERD. The following review focuses on up-to-date information regarding of the pathogenesis, diagnostic evaluation and management of GERD in children.

Infections in DNA Repair Defects

DNA repair defects are heterogenous conditions characterized by a wide spectrum of clinical phenotypes. The common presentations of DNA repair defects include increased risk of cancer, accelerated aging, and defects in the development of various organs and systems. The immune system can be affected in a subset of these disorders leading to susceptibility to infections and autoimmunity. Infections in DNA repair defects may occur due to primary defects in T, B, or NK cells and other factors such as anatomic defects, neurologic disorders, or during chemotherapy. Consequently, the characteristics of the infections may vary from mild upper respiratory tract infections to severe, opportunistic, and even fatal infections with bacteria, viruses, or fungi. Here, infections in 15 rare and sporadic DNA repair defects that are associated with immunodeficiencies are discussed. Because of the rarity of some of these conditions, limited information is available regarding infectious complications.

Localized Depletion of Drosophila Upf1 and Upf2 in the Central Nervous System Leading to Anatomical Defects of the CNS of the Embryo and Larva

Localized Depletion of Drosophila Upf1 and Upf2 in the Central Nervous System Leading to Anatomical Defects of the CNS of the Embryo and Larva

Management of Curved Bone Defects in the Anterior Maxilla Using Bone Bending via a Kerfed Khoury Split Bone Block Technique.

The loss of teeth causes inevitable resorption of the alveolar bone. In the anterior arches, the curved anatomy further adds to the challenge of rehabilitation. These areas often require the shaping of membranes and multiple bone blocks through complex surgery to compensate for the curvature. The split bone block technique (SBBT) has been successfully used in complicated cases. However, the inability to create curves from the blocks means that larger quantities of bone or membranes are needed to compensate for this. Bone bending based on an ancient woodbending technique known as kerfing is proposed to shape rigid SBB plates to recreate the natural anatomy of anterior arches. Three patients presenting with bone destruction of the anterior maxilla underwent bone augmentation before implant placement using the SBBT combined with kerfing. The plates were successfully bent to the shape of each maxilla without any deleterious effects. All bone grafts healed uneventfully, and the bone curvature was successfully reconstructed. No complications were reported. Implant placement took place after 4 months and definitive restorations after 7 to 9 months. Clinical and radiographic assessments were performed at 1 year. Full customization of autogenous bone plates was possible through kerfing. This approach resulted in an ideal bone curve and shape in the facial and palatal aspects of the anterior maxilla. In addition, it enabled ideal implant placement with reduced bone harvesting volumes and decreased the need for soft tissue augmentation to recreate the curved shape. This technique promoted close-fitting autologous osseous plates that followed the anatomical curvature of the anterior maxilla, leading to optimal healing and excellent regeneration of the ridge width. This principle can be valuable when dealing with complex anatomical defects. Int J Periodontics Restorative Dent 2023;43:203-210. doi: 10.11607/prd.6469.