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A 41-year-old white European woman presented with a 4-week history of painless floaters in her left eye and best-corrected visual acuity (BCVA) of 6/6 and 6/30 in right and left eyes, respectively. She had no relevant medical history and was a non-smoker. She reported orogenital ulceration, erythema

Purpose To report a case of bilateral occlusive vasculitis associated with retinitis pigmentosa (RP). Method Case report. Case report A 34-year male presented with blurred vision in left eye (OS) for two weeks and right eye (OD) for one day. He had night blindness for five years. His best corrected visual acuity (BCVA) was OD 20/63 and OS 20/200. Ophthalmoscopy revealed bilateral RP with OD inflammatory central retinal vein occlusion (CRVO) and OS occlusive vasculitis with bilateral macular edema. Presumed intraocular tuberculosis (IOTB) was suspected based on clinical features, positive Mantoux and high-resolution computed tomography chest findings. Oral steroids and antitubercular therapy (ATT) were started. OD received six intravitreal ranibizumab injections. At his 7-month follow-up, BCVA improved, OD 20/40 and OS 20/80. Conclusion RP rarely can be associated with presumed IOTB. Oral steroids with ATT are helpful; however, in inflammatory CRVO, intravitreal ranibizumab can give good results.

Актуальність. Розлади моторики язика, що зустрічаються в практиці лікарів-неврологів, є наслідком великої кількості різноманітних патологій. Найпоширенішими захворюваннями, що можуть супроводжуватися розладами лінгвомоторики, є гострі порушення мозкового кровообігу та їх віддалені наслідки. Актуальним залишається питання участі лікаря-стоматолога у міжгалузевому підході до діагностики порушень моторики язика. Поширеним методом діагностики розладів функціонування м’язів є поверхнева електроміографія. Мета. Удосконалення методики електроміографічної діагностики патології лінгвомоторики у пацієнтів із віддаленими наслідками гострих порушень мозкового кровообігу в комбінації з оклюзійними дефектами. Матеріали та методи. Відповідно до поставленої мети нами було виконано поперечне дослідження «випадок — контроль». До клінічної групи дослідження увійшли 87 пацієнтів. Контрольну групу становили 40 осіб. Методика клінічного обстеження пацієнтів включала збір скарг і анамнезу життя та захворювання, неврологічне обстеження у стаціонарі під час надходження на планове лікування від наслідків перенесених цереброваскулярних хвороб. Стоматологічне обстеження включало зовнішній огляд і обстеження ротової порожнини щодо наявності дефектів зубних рядів і визначення інтенсивності каріозного процесу. Електроміографічне дослідження м’язів язика відбувалося за допомогою розробленого нами пристрою для поверхневої глобальної електроміографії. Результати. При дослідженні інтерференційної кривої у пацієнтів даної групи було виділено декілька типів патернів, характерних для неврологічних уражень центрального або периферичного мотонейрона. Для пірамідного патерну періоду спокою характерно збереження нормального вигляду ізолінії з візуально підвищеною амплітудою та поодинокими потенціалами фасцикуляцій. Період довільного максимального напруження характеризується збереженням вигляду нормальної веретеноподібної кривої з візуальним зменшенням максимальної амплітуди. Для ураження периферичного мотонейрона характерний розріджений характер кривої на фоні підвищення амплітуди довільного максимального напруження, що відповідає процесам реіннервації. При порівнянні показників пацієнтів клінічної групи з отриманими даними досліджуваних контрольної групи нами були отримані статистично вірогідні (p < 0,05) відмінності між кількісними показниками інтерференційної кривої за максимальною та середньою амплітудою періодів спокою та напруження, а також за середньою частотою періоду напруження. Висновки. Високі показники інтенсивності карієсу та його ускладнень у неврологічних пацієнтів свідчать про можливість залучення лікарів-стоматологів до діагностики та реабілітації даних хворих. Аналіз отриманих даних свідчить про можливість застосування запропонованої методики електроміографії для вдосконалення алгоритмів діагностики неврологічних захворювань.

Occlusion is a harmonious interaction of the dental system in dynamics, ending with the contact of teeth in conditions of their normal or disturbed ratio. This is a complex action involving teeth, masticatory muscles, TMJ. Occlusive disorders are a reflection of the external manifestations of pathological processes of the dental system. There is no doubt that in the search for etiological factors of occlusion disorders, the problem will manifest itself in one of the parts of the chewing system. The aim of the study was to optimize the early diagnosis of occlusive disorders in young patients without violating the integrity of the dentition. Materials and methods. The study included 36 patients without a violation of the integrity of the dentition aged 18 to 25 years (15 men, 21 women), who did not complain of pain in the dental system. A comprehensive dental examination was carried out and an individual "questionnaire and patient's health card" was filled out. Computer analysis with the T-Scan III occlusiography system of the company Tekscan (USA) was used to register the nature of the closing of the dentition, the study of diagnostic models in the PROTAR evo 7 KAVO articulator, as well as the study of the registration of the difference in the biopotentials of the masticatory and temporal muscles proper in patients in the phase of relative physiological rest and with maximum jaw compression using a four-channel electromyograph Synapsis NMF Neurotech (Russia). The results showed that the prevalence of occlusive disorders in the study group is 83.3%. The abnormal position of the teeth in the dentition in combination with malocclusion anomalies, non-physiological relief of the occlusal surfaces of the teeth formed due to various factors which cause the appearance of premature contacts. This prevents the harmonious sliding movements of the lower jaw and is accompanied by articulatory changes in the entire chewing system.

Occlusive disease of the iliac veins or major intrathoracic veins have traditionally been managed by conservative management or by major vascular reconstructive procedures. Over the past 15-20 years, these lesions have become amenable to management with venous stents. Lesions in the iliac venous system are typically due to thrombus secondary to deep vein thrombosis, and lesions in the superior vena cava are due to either malignant intrathoracic lesions, indwelling central venous catheters, pacemaker leads, or enlarged nodes due to granulomatous disease. The success rate for implantation is between 92% and 95% and associated implantation complications vary between 2% and 5%. Primary patency of iliac stents is 70-90% at three years. Venous stents have higher patency in the treatment of stenotic lesions compared to totally occlusive lesions. Primary patency of stents placed in the superior vena cava is also about 70-90% and generally lower in lesions due to malignancy likely related to life expectancy. Stents in the venous system are associated with few complications at the time of insertion and have excellent long-term patency.

To compare clinical profile and visual outcomes of occlusive versus non-occlusive retinal vasculitis (RV).A retrospective comparative study.284 patients were enrolled, including 124 patients with occlusive RV (ORV) and 160 patients with non-occlusive RV (NORV). Patients with ORV were older (p ≤ 10-3), predominantly male (p ≤10-3), with less bilateral involvement (31.5% vs 53,4%; p ≤ 10Occlusive and non-occlusive RV have distinctive clinical and etiological profile.

The article presents a clinical case of the simultaneous execution of endoscopic ventriculocisternostomy of the third ventricle floor (ETV), aqueductoplasty, fenestration of the supracerebellar cyst in occlusive hydrocephalus using a semi-rigid needle neuroendoscope. The authors describe a child who, at the age of 1 month, was admitted to Neurosurgical Department No. 1 of the Federal Center for Neurosurgery of the Ministry of Health of the Russian Federation in Tyumen with a diagnosis of congenital internal occlusive hydrocephalus, subcompensated course. MRI scan of the brain: triventricular occlusive asymmetric hydrocephalus is visualized, adhesions in the upper parts of the aqueduct, supracerebellar arachnoid cyst were visualised. ETV, aqueductoplasty, fenestration of the supracerebellar cyst were performed. There were no postoperative neurological, endocrine and infectious complications. The observation period after surgery is 7 years from today. Conclusion: preoperative MRI analysis of the structures of the third ventricular floor, interventricular and prepontine cisterns is important for understanding endoscopic, microsurgical anatomy and surgical planning. The use of modern improved endoscopic instruments, low-traumatic performance of all stages of the operation allow to restore cerebrospinal fluid circulation and achieve high efficiency in the treatment of occlusive hydrocephalus in the long-term period. This, in turn, relieves patients of the shunt-dependent state, constant correction of the dysfunctions of the shunt system and long-term, and often ineffective, treatment performed by neurologists and pediatricians.

Annotation. The case of successful treatment of a patient with critical lower extremity ischemia illuminates the possibilities of different approaches of the endovascular surgical method. The results of treatment of patients with occlusive-stenotic diseases of the lower extremities arteries as a result of obliterating atherosclerosis were analyzed. 243 patients underwent endovascular surgery. 14 (5.76%) patients were previously operated on. The multi-storey lesions were found in 35 (14.4%) cases. Most patients were ranged in age from 46 to 86 years. There were 175 men (72.0%) and 68 women (28.0%). The right lower extremity was affected more often – 148 (60.9%) patients than the left ones – 95 (39.1%). The thrombosis was diagnosed in 21 (10.6%) individuals as the most common complications in the early postoperative period. Limb amputation was performed in 12 patients. Mortality rate in the early postoperative period was 2.56% (4 patients died). It is established that the methods of choice in the reconstruction of stenotic-occlusive lesions of the arteries are: balloon angioplasty (and stenting), rotor-mechanical thromboaspiration, regional thrombolytic therapy. These methods are performed mainly under local anesthesia, they are minimally invasive and can be used in patients with severe comorbidities.

Cardiovascular disease remains one of the world's leading causes of death. Myocardial infarction (heart attack) is triggered by occlusion of coronary arteries by platelet-rich thrombi (clots). The development of new anti-platelet drugs to prevent myocardial infarction continues to be an active area of research and is dependent on accurately modelling the process of clot formation. Occlusive thrombi can be generated in vivo in a range of species, but these models are limited by variability and lack of relevance to human disease. Although in vitro models using human blood can overcome species-specific differences and improve translatability, many models do not generate occlusive thrombi. In those models that do achieve occlusion, time to occlusion is difficult to measure in an unbiased and objective manner. In this study we developed a simple and robust approach to determine occlusion time of a novel in vitro microfluidic assay. This highlighted the potential for occlusion to occur in thrombosis microfluidic devices through off-site coagulation, obscuring the effect of anti-platelet drugs. We therefore designed a novel occlusive thrombosis-on-a-chip microfluidic device that reliably generates occlusive thrombi at arterial shear rates by quenching downstream coagulation. We further validated our device and methods by using the approved anti-platelet drug, eptifibatide, recording a significant difference in the "time to occlude" in treated devices compared to control conditions. These results demonstrate that this device can be used to monitor the effect of antithrombotic drugs on time to occlude, and, for the first time, delivers this essential data in an unbiased and objective manner., Lab on a Chip, 21 (21), ISSN:1473-0197, ISSN:1473-0189

The paper presents a case of a patient with floating thrombosis in the right common carotid artery and occlusion of the carotid bifurcation of the right common carotid artery against the background of severe atherosclerosis of the common carotid artery with 70% stenosis. Thrombosis was identified using color duplex ultrasound scanning in an asymptomatic patient. During hospitalization, thrombosis was complicated by a cerebral infarction of the right middle cerebral artery, apparently of embolic origin.

Aim To establish an artery and venous sinus occlusion image score (AVOIS) which is compatible in both cerebral arteries and venous system diseases. Methods A total of 188 consecutive patients with the final diagnosis of anterior circulation infarct (ACI) and 56 consecutive patients with cerebral venous and sinus thrombosis (CVST) were retrospectively studied. The AVOIS was developed based on the severity of occlusive changes of main intracranial arteries and venous sinuses (present = 0, partial occlusion = 1, absent = 2), and divided into four groups (CVST group: 0, 1‐5, 6‐10, >10. ACI group: 0, 1‐5, 6‐10, >10) arbitrarily. A receiver operating characteristic (ROC) curve was applied to discover the sensitivity and specificity of AVOIS. The National Institutes of Health Stroke Scale (NIHSS), Clot Burden Score (CBS) were set as the reference. Logistic regression models were developed to adjust for baseline clinical variables and AVOIS. Length of hospital stay (LOS) was also evaluated using the Kaplan‐Meier estimator. Results For the CVST group, a positive correlation between AVOIS and NIHSS was discovered (Spearman's ρ = 0.54, p, A novel score system called the Artery and Venous Sinus Occlusion Image Score (AVOIS) was developed based on quantification analysis of the intracranial thrombus in both artery and venous sinus (Table 1). According to the CTA or MRA, anterior circulation and venous sinuses were allotted different scores (present = 0, partial occlusion = 1, absent = 2) by researchers. The total score on AVOIS in anterior circulation or venous sinus was accumulated to 14 points.

L’invagination iléo-colique sur tumeur caecale est une pathologie rare chez l’adulte. Les circonstances de découvertes sont très variées. Le diagnostic pré opératoire peut être difficile vu que le tableau clinique évolue le plus souvent selon un mode chronique. Nous rapportons un cas d’invagination iléo-caecale sur tumeur iléocæcale survenue chez une femme de 67 ans qui a été opérée en urgence pour un syndrome occlusif. Les signes cliniques et l’imagerie étaient en faveur d’une invagination intestinale aiguë. Cependant, le diagnostic étiologique a été posé en peropératoire et la laparotomie a révélé une invagination intestinale iléo-cæco-colique sur une tumeur du caecum et que la résection carcinologique avec anastomose immédiate était possible. L’évolution postopératoire a été favorable. Mots-clés : Invagination intestinale, caecum, Lipome.

Pulmonary artery thrombosis is reported in neonates with risk factors for hypercoagulability. No consensus exists regarding standard therapy for this condition. We present a neonate, with no risk factors for thrombosis, who was admitted after birth to the Pediatric Cardiac Intensive Care Unit with an occlusive left pulmonary artery thrombus. (Level of Difficulty: Intermediate.), Central Illustration

The article presents a study of the possibilities of the OccluSense device in obtaining information about the occlusal relationships of dental rows after treatment, including the making and installation of crowns which made of various structural materials-polymethylmethacrylate, E-max ceramics and zirconium dioxide. Comparative occlusal diagnostics was performed using OccluSense and T-Scan apparatus. The effectiveness of marking occlusal contacts on artificial crowns was evaluated by digital photometry. The results obtained showed that the data of comparative occlusal diagnostics obtained using the OccluSense and T-Scan apparatus are practically identical (they differ by a maximum of 3—4%).

BACKGROUND: Vaso-occlusive pain leads to high acute care utilization among patients with sickle cell disease (SCD). Data suggest that clinical pathways (CPWs) reduce variation in the management of vaso-occlusive pain and improve clinical outcomes. METHODS: We implemented and evaluated a CPW for vaso-occlusive pain at our institution using a before and after study design. The primary objective was to decrease acute care utilization among patients with SCD, which was assessed by the primary outcome measures of hospital length of stay (LOS), 30-day readmission rate, and total hospitalizations annually per patient. Secondary outcome measures were packed red blood cell transfusions, and acute chest syndrome incidence. Patient-controlled analgesia use and promethazine use were assessed to estimate CPW utilization. RESULTS: 344 admissions in 112 patients were analyzed, of which 193 admissions occurred pre-CPW and 151 admissions occurred post-CPW implementation. Post-CPW implementation, we observed a significant decrease in hospital admissions annually per patient, an increase in patient-controlled analgesia (PCA) use, and a decrease in intravenous (IV) promethazine use. We observed trends toward decreased 30-day readmission rate and increased ACS incidence, which were not statistically significant. No effect was found on hospital LOS. CONCLUSION: CPW implementation at our institution reduced variation in management and decreased hospital admissions for vaso-occlusive pain.

[Purpose] To examine the differences in rehabilitation progress after lower-extremity bypass surgery for peripheral arterial disease (PAD) depending on the occlusive lesions. [Participants and Methods] This was a retrospective study. We included 50 patients (61 limbs; 38 males and 12 females; mean age, 73 years) who underwent lower-extremity bypass surgery for Fontaine stage 2-3 PAD. The patients were assigned to the aortoiliac (A-I) group (n=23), femoropopliteal (F-P) group (n=18), and below-knee group (n=9). We evaluated the postoperative rehabilitation progress and length of hospital stay of these groups. [Results] The postoperative ankle-brachial pressure index (ABI) of the A-I group was significantly lower than that of the F-P group, although there were no differences before surgery. The progress of rehabilitation and the length of hospitalization showed no significant differences among the three groups. The postoperative date of independent walking was significantly later in the presence of complications than in the absence of complications. [Conclusion] The progress of rehabilitation after lower-extremity bypass surgery did not differ depending on the occlusive lesions, and patients may acquire independent walking ability in approximately 5 days in the absence of postoperative complications.

Background and purpose Despite advances in endovascular therapies, some patients experience vertebral artery stenosis or subclavian artery occlusion and may not benefit from less-invasive angioplasty/stenting. This study described 4 cases in which carotid-vertebral transposition (CVT) or carotid-subclavian transposition (CST) was adapted when endovascular treatment was unfeasible or unsuccessful. Presentation Case 1: A 65-year-old woman presented with severe stenosis of the right vertebral artery ostium, dysplastic left vertebral artery, and aneurysmal dilatation of proximal right subclavian artery and brachiocephalic trunk. Case 2: A 23-year-woman had severe stenosis at the first portion of left vertebral artery caused by Takayasu's arteritis. Because endovascular intervention was unfeasible, CVTs were performed in cases 1 and 2. Case 3: A 73-year-old man presented with total occlusion of the proximal right subclavian artery and severe stenosis of the right internal carotid artery. Case 4: A 58-year-old man experienced complete occlusion of the left subclavian artery and severe stenosis of the left common carotid artery. Duplex ultrasonography showed reverse flow in the vertebral artery in keeping with vertebral steal syndrome. Endovascular treatment was unsuccessful because the wire did not cross the occlusion of the subclavian artery. CSTs were performed with concurrent ipsilateral carotid endarterectomy in cases 3 and 4. Conclusion The present case series demonstrated that CST and CVT were effective treatment modalities for subclavian or vertebral artery lesions. Although endovascular stenting and angioplasty have been advocated as first-line management, CST and CVT should be considered as the remedy when endovascular intervention is unsuccessful or unfeasible.

Purpose:To report a case of hemorrhagic occlusive retinal vasculitis after cataract surgery.Methods:A 74-year-old woman presented with blurry vision and distorted vision, which started 2 days after an uncomplicated cataract surgery in the left eye. Intracameral vancomycin was injected during the cas

Aim: to study the long-term effectiveness of stimulation of the vein-occlusive mechanism by the addition of autologous stem cells and PRP therapy in the surgical removal of venous leak.Materials and Methods: comprehensive examination and treatment of 156 patients with vein-occlusive erectile dysfunction was carried out. Most of them – 112 (82.9%), – had left-sided or bilateral varicocele. In 86 patients of the first group with a proximal form of vein-occlusive erectile dysfunction, ligation of deep dorsal veins and veins of the penis and Marmara operation from a foam-pubic incision were performed. In 49 patients of the second group with a distal form of vein-occlusive erectile dysfunction, embolization of deep dorsal veins and veins of the Santorini plexus was performed through a conductor in the deep dorsal vein of the penis. To improve the venous occlusion mechanism, 1 million autologous endothelial stem cells and 2 millions autologous fibroblast stem cells were injected into each cavernous body, which were activated by vascular growth factor into the ligated veins (deep dorsal and large veins of the penis) in a retrograde direction during occlusive operations for 48 patients (groups 1b and 2b, respectively) and compared long-term results.Results: The effectiveness of surgical treatment according to subjective data (IIEF questionnaire) – after 2 months was almost equal, but after 18 months it was significantly higher in subgroups 1b and 2b (68,9% и 75,5) and according to objective data (no venous leakage with dopplerography of the penis), after 18 months in 73.4% and 91.4%, respectively.Conclusions: The use of autologous (endothelial and fibroblast) stem cells with the course of PRP therapy improves the veno-occlusive mechanism, increases the efficiency and long-term results of vein-occlusive surgeries for the treatment of VOED, creating an effective alternative to phalloprosthetics for men with this problem.

Aim:Coronavirus-19 (COVID-19) is caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Since the CoV-19 outbreak, public health has been affected in several areas, especially, mortality from malignancies has increased. Colorectal cancers (CRCs) is the third-most common cause of cancer-related deaths across the world. The present study aimed to investigate the time of CRC patients’ admission to hospital and its effects in the light of COVID-19 outbreak.Method:We examined the case of 62 patients who visited our hospital emergency department with intestinal obstruction due to CRC between 2019 and 2020. We categorised the patients admitted during the COVID-19 pandemic as group 1 and the others as group 2. We comparatively evaluated the demographic data, complaints and duration, tumour characteristics, blood values, complications, mortality rates and the length of hospital stay of the patients. We noted that the duration of admission to the hospital was prolonged after the patients developed obstructive symptoms.Results:As incidences of nausea/vomiting became more frequent, the duration of admission to the hospital after the complaints began and the resultant mortality rate were statistically higher among the group 1 patients. The haematocrit (htc) value was lower and the tumour size was larger in the deceased patients.Conclusion:COVID-19 pandemic delayed the diagnosis of patients with colorectal cancer. The time that elapsed after occlusion in CRC increased the rate of mortality and morbidity. It was observed that, especially, mortality was higher for elderly patients with low htc values. This increase in the mortality rates suggests the importance of the time of admission to the hospital in case of obstructive CRC. We thus believe that it is essential to propagate that the hospitals are safe from COVID to encourage the public to avail hospital services for serious cases in order to ensure timely diagnosis and treatment.

The purpose is using the occlusive hydrocolloid dressing (OHD) and gauze dressing (GD) to compare incidence of infection of wound and cost-effectiveness of dressing after hernia operation in children. Eighty children was undergo hernia surgery, wounds were dressing by OHD or GD. Hydrocolloid dressing was remain till suture was removed, and GD changed every day after operation. Calculations of cost dressing mean dressing alterations frequency and cost for each dressing in every treatment cluster. There are no variances amongst the two clusters concerning the incidence of wound infection. OHD was less costly and complex than GD, and GD necessary to be altered each day (p = 0.001). In conclusion, OHD is less costly to use, and less complex than GD because GD wanted to be altered more times during the period of healing.

There is little knowledge on the pathophysiology of pediatric stroke associated with radiation-induced occlusive cerebral vasculopathy (RIOCV). Herein, we present an extremely rare case of a child with multiple ischemic strokes in association with progressive RIOCV. The possibility of hemodynamic compromise and artery-to-artery embolism as a cause of the ischemic events is discussed.

Aim: To characterize vaso-occlusive crises (VOCs) and describe healthcare costs among commercially-insured, Medicaid-insured, and Medicare-insured patients with sickle cell disease (SCD). Materials and Methods: The IBM Truven Health MarketScan Commercial (2000-2018), Medicaid Analytic eXtract (2008–2014), and Medicare Research Identifiable Files (2012–2016) databases were used to identify patients with ≥2 SCD diagnoses. Study measures were evaluated during a 12-month follow-up period, stratified by annual number of VOCs (i.e., 0, 1, and ≥2). Results: Among 16,092 commercially-insured patients (mean age =36.7 years), 35.3% had 1+ VOCs. Mean annual total all-cause healthcare costs were $15,747, $27,194, and $64,555 for patients with 0, 1, and 2+ VOCs, respectively. Total all-cause healthcare costs were mainly driven by inpatient (0 VOC =31.0%, 1 VOC =53.1%, 2+ VOCs =65.4%) and SCD-related costs (0 VOC =56.4%, 1 VOC =78.4%, 2+ VOCs =93.9%). Among 18,287 Medicaid-insured patients (mean age =28.5 years, fee-for-service =50.2%), 63.9% had 1+ VOCs. Mean annual total all-cause healthcare costs were $16,750, $29,880, and $64,566 for patients with 0, 1, and 2+ VOCs, respectively. Inpatient costs (0 VOC =37.2%, 1 VOC =64.3%, 2+ VOCs =72.9%) and SCD-related costs (0 VOC =60.9%, 1 VOC =73.8%, 2+ VOCs =92.2%) accounted for a significant proportion of total all-cause healthcare costs. Among 15,431 Medicare-insured patients (mean age =48.2 years), 55.1% had 1+ VOCs. Mean annual total all-cause healthcare costs were $21,877, $29,250, and $58,308 for patients with 0, 1, and ≥2 VOCs, respectively. Total all-cause healthcare costs were mainly driven by inpatient (0 VOC =47.9%, 1 VOC =54.9%, 2+ VOCs =67.5%) and SCD-related costs (0 VOC =74.9%, 1 VOC =84.4%, 2+ VOCs =95.3%). Limitations: VOCs managed at home were not captured. Analyses were descriptive in an observational setting; thus, no causal relationships can be inferred. Conclusions: A high proportion of patients experienced VOCs across payers. Furthermore, inpatient and SCD-related costs accounted for a significant proportion of total all-cause healthcare costs, which increased with VOC frequency.

Subject. For the treatment of diseases of the temporomandibular joint, occlusal splints are used, in the manufacture of which different methods are used, which have their negative and positive properties. 3D printing technology allows the manufacture of occlusal splints with high precision fit to the dentition and with uniform occlusal contacts with respect to antagonist teeth. The goal is to study errors in the technology of manufacturing occlusal splints for the treatment of patients with diseases of the temporomandibular joint. Methodology. Thirty patients with distal displacement of the heads of the temporomandibular joint in the range of 1-1.5 mm were examined. Patients were diagnosed with Angle Grade 2. The methods used were tele-radiography, 3D computed tomography, and laboratory scanning of jaw models. Results. Errors were revealed in the manufacture of occlusal tires using digital scanning in the EXO-CAD program, various features of adaptation to occlusal tires obtained using 3D printing and cad-cam milling. Findings. 3D printing technology allows the manufacture of occlusal splints with high precision fit to the dentition with uniform occlusal contacts with respect to antagonist teeth. The technology for milling occlusal tires gives an advantage in their strength compared to 3D printing technology. However, the mouthguards made by technology are inferior to mouthguards made on a 3D printer in terms of elasticity of fit to the dentition, which can cause discomfort and pain during the use of milled mouthguards. Occlusal tires made by cold polymerization have lower accuracy of fit to the dentition and require correction when fitting and checking the occlusal relationship of the dentition.

Purpose: To analyze a case series of retinal vasculitis reported to the American Society of Retina Specialists (ASRS) following Food and Drug Administration approval of brolucizumab for treatment of neovascular age-related macular degeneration. Methods: The ASRS Research and Safety in Therapeutics Committee analyzed clinical and imaging characteristics from submitted reports of retinal vasculitis after brolucizumab. Results: Retinal vasculitis was reported in 26 eyes of 25 patients (22 [88%] female) after treatment with brolucizumab. Imaging studies were available for 24 of 26 eyes. Most cases (92%) were associated with intraocular inflammation, which presented at a mean of 25 days (range, 3-63 days) after the most recent brolucizumab injection. Mean visual acuity (VA) was 20/52 (range, 20/25-4/200) before the adverse event, 20/151 (range, 20/25-hand motion) at presentation of the adverse event, and 20/243 (range, 20/30-light perception) at last follow-up. Twelve eyes (46%) had a greater than 3-line decrease in VA at final follow-up, and 12 eyes (46%) had a final VA of 20/200 or worse. Analysis of retinal imaging identified vasculopathy that involved retinal arteries (91%), retinal veins (79%), and choroidal vessels (48%). Occlusive disease was apparent on imaging in 83% of eyes. Treatment approaches were varied. Conclusions: Retinal vasculitis has been identified in a series of eyes following brolucizumab. Although a few eyes in this series were asymptomatic or minimally symptomatic, some eyes had significant vision loss. A careful examination for signs of active inflammation prior to brolucizumab injection is recommended. Once vasculopathy is suspected, angiographic imaging may help define the spectrum of involvement. Optimal treatment strategies remain unknown.

Since skin on the lips has a lower water content in the stratum corneum (SC) and a higher transepidermal water loss (TEWL) value than skin on the cheek, the lips are usually very dry and rough areas. Therefore, a lip balm approach to increase occlusivity of the lips is generally used to reduce water loss. Although there have been reports of an improvement effect on lip roughness by specific care agents, differences in the effects due to the occlusivity of a formulation without a specific care agent have not been reported. The purpose of this study was to clarify the improvement effect on dryness and roughness of the lips by a highly occlusive formulation consisting of a combination of common oil and wax, not by a specific care agent.Twenty Japanese female subjects with normal skin (age range 20-39 years; mean 28.1) were enrolled in this study. A 4-week continuous use test was conducted using samples with low and high occlusivity. The degree of lip roughness and wrinkles was scored, the hollow index was assessed using ANTERA 3D images, and values of capacitance and TEWL were measured.The hollow index was significantly correlated with both the appearance roughness score and the wrinkle score. The sample with high occlusivity showed significant improvement in the appearance roughness score, wrinkle score, the hollow index and capacitance of the SC. In a comparison between the groups of samples with different occlusive properties, a significant improvement effect in rough appearance was seen in subjects using the highly occlusive formulation.The hollow index assessed by ANTERA 3D imaging allowed the objective evaluation of the improvement in appearance. In the case of continuous use of the highly occlusive formulation, an improvement of capacitance in the SC, which is most correlated with lip roughness, was obtained after 2 and 4 weeks. These results demonstrate for the first time that a highly occlusive formulation is effective in improving the roughness of the lips, and this effect is due to the difference in the occlusive property not by a specific care agent.La peau qui recouvre les lèvres ayant une plus faible teneur en eau dans la couche cornée (CC) et une valeur de perte d’eau transépidermique (PETE) plus élevée que la peau des joues, les lèvres sont généralement des zones très sèches et rugueuses. Par conséquent, l’utilisation d’un baume à lèvres pour augmenter l’occlusivité des lèvres est généralement l’approche adoptée pour réduire la perte d’eau. Même s’il y a eu des rapports d’un effet d’amélioration de la rugosité des lèvres grâce à des agents de soin spécifiques, aucune différence par rapport aux effets dus aux propriétés occlusives d’une formule ne contenant pas un agent de soin spécifique n’a été rapportée. Le but de cette étude était de clarifier l’effet d’amélioration de la sécheresse et de la rugosité des lèvres d’une formule hautement occlusive composée d’une association d’huile et de cire courantes, et non pas d’un agent de soin spécifique. MÉTHODES: Vingt sujets de sexe féminin japonais ayant une peau normale (tranche d’âge : 20 à 39 ans ; moyenne : 28,1) ont été inclus dans cette étude. Un test d’utilisation continue pendant 4 semaines a été mené en utilisant des échantillons ayant des propriétés occlusives faibles et élevées. Le degré de rugosité et de ridules des lèvres a été noté, l’indice de creux a été évalué à l’aide d’images 3D ANTERA, et les valeurs de capacitance et de PETE ont été mesurées. RÉSULTATS: L’indice de creux était significativement corrélé avec le score de l’aspect de rugosité et le score de ridules. L’échantillon comportant des propriétés occlusives élevées a démontré une amélioration significative du score de l’aspect de rugosité, du score de ridules, de l’indice de creux et de la capacitance de la CC. Dans une comparaison entre les groupes d’échantillons comportant différentes propriétés occlusives, une amélioration significative de l’effet sur l’aspect rugueux a été observée chez les sujets utilisant la formule aux propriétés occlusives élevées.L’indice de creux évalué par l’imagerie 3D ANTERA a permis d’effectuer une évaluation objective de l’amélioration de l’aspect. Dans le cas d’une utilisation continue de la formule aux propriétés occlusives élevées, une amélioration de la capacitance de la CC, qui était le plus corrélée avec la rugosité des lèvres, a été atteinte au bout de 2 et 4 semaines. Ces résultats montrent pour la première fois qu’une formule aux propriétés occlusives élevées est efficace dans l’amélioration de la rugosité des lèvres, et cet effet est dû à la différence dans les propriétés occlusives et non pas à un agent de soin spécifique.

As línguas do mundo apresentam peculiaridades que podem causar estranhamento por parte dos aprendizes em L2, que, ao serem expostos a um novo sistema, podem demonstrar ineficácia quanto ao conhecimento do padrão base da língua-alvo. Dentre os aspectos a serem observados nesse processo, encontram-se os padrões silábicos, que podem distinguir-se da língua materna do aprendiz. Assim sendo, este trabalho objetivou investigar como falantes aprendizes brasileiros de inglês configuram o padrão silábico CVC do inglês, sendo estes distribuídos em dois grupos: aprendizes que receberam instrução, e aprendizes que não receberam instrução explícita, quanto aos aspectos fonético-fonológicos de tal estrutura. A base teórica apresenta as ideias de Alves (2012), Barbosa e Madureira (2015), Collischonn (2014), Pedrosa (2012) e Selkirk (1982), dentre outros. Os resultados demonstram que os grupos apresentaram estratégias distintas para a produção da sílaba CVC. Mesmo no grupo em que houve produções esperadas (sílaba CVC), os aprendizes pareceram compensar a ausência vocálica alongando a oclusiva em coda, demonstrando processos variáveis interessantes. Tal pesquisa visa contribuir com o ensino do inglês (L2), bem como demonstrar que diversas pistas acústicas verificadas no desenvolvimento linguístico de L2 não devem ser negligenciadas, pois podem fornecer respostas interessantes no percurso desenvolvido pelo aprendiz.

Introduction. Atherosclerotic occlusive disease of the innominate artery (IA) represents a rare entity, comprising less than 2% of all extracranial causes of altered cerebral blood flow. This type of lesion is associated with adaptative hemodynamic changes increasing the risk of developing both cerebral and upper extremity ischaemia. Subclavian steal syndrome is a serious complication that may occur with occlusive lesions of the innominate artery and may represent an indication for revascularization. Case presentation. In the current paper we present the case of a patient who was admitted in our clinic for further investigations regarding episodes of dizziness and a difference of 30mmHg in the systolic blood pressure between his arms. On duplex ultrasonography scanning, an IA stenosis suspicion was raised, with associated retrograde flow through the right vertebral artery (VA) at light efforts of the right upper extremity. An angiographic evaluation confirmed the sub-occlusive lesion and reversed flow through the right VA. A decision was reached to undertake percutaneous transluminal angioplasty and stenting. There was no report of periprocedural complications, the intervention has been considered successful with no restenosis and no neurologic symptoms at 9 months follow-up. Discussion. Until recently, surgical treatment was the only option in the management of atherosclerotic disease of the IA, a procedure with high complication, morbidity and mortality rate. Therefore, endovascular treatment gained more ground and is considered today as the first line of treatment for this type of lesion. Conclusion. PTA and stenting of the IA still remains challenging mainly due to complex anatomy and the rarity of this pathology and we must keep in mind that the decision for the revascularization technique is personalized. This present case brings new evidence that percutaneous transluminal angioplasty is a safe and efficient method to manage an atherosclerotic lesion of the brachiocephalic artery.