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Objectives: The objective of this study was to investigate the relationship of the depression level with temporomandibular disorders (TMDs) in young conscripts as a population with chronic stresses. Material and Methods: A total number of 144 male conscripts with chronic stress and different levels of depression were assigned to four groups according to the Beck's Depression Inventory (BDI). The control group consisted of age‐matched male conscripts without chronic stress. The diagnosis of TMD was made according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Data were analyzed using Mann–Whitney and chi‐square tests. Results: The participants with severe depression were significantly more susceptible to have TMD (p =.001) followed by the moderate depression, borderline clinical depression, mild mood disturbance, and control groups. The TMD diagnoses were more prevalent within depression groups compared with the control population (p =.01). Conclusions: The level of depression is directly associated with the presence of TMD in young men with chronic stress. [ABSTRACT FROM AUTHOR]

* Context.--Clinical decision support (CDS) systems could assist less experienced pathologists with certain diagnostic tasks for which subspecialty training or extensive experience is typically needed. The effect of decision support on pathologist performance for such diagnostic tasks has not been examined. Objective.--To examine the impact of a CDS tool for the classification of ovarian carcinoma subtypes by pathology trainees in a pilot observer study using digital pathology. Design.--Histologic review on 90 whole slide images from 75 ovarian cancer patients was conducted by 6 pathology residents using: (1) unaided review of whole slide images, and (2) aided review, where in addition to whole slide images observers used a CDS tool that provided information about the presence of 8 histologic features important for subtype classification that were identified previously by an expert in gynecologic pathology. The reference standard of ovarian subtype consisted of majority consensus from a panel of 3 gynecologic pathology experts. Results.--Aided review improved pairwise concordance with the reference standard for 5 of 6 observers by 3.3% to 17.8% (for 2 observers, increase was statistically significant) and mean interobserver agreement by 9.2% (not statistically significant). Observers benefited the most when the CDS tool prompted them to look for missed histologic features that were definitive for a certain subtype. Observer performance varied widely across cases with unanimous and nonunanimous reference classification, supporting the need for balancing data sets in terms of case difficulty. Conclusions.--Findings showed the potential of CDS systems to close the knowledge gap between pathologists for complex diagnostic tasks. (Arch Pathol Lab Med. 2020;144:869-877; doi: 10.5858/arpa.2019-0390-OA), Advances in whole slide imaging (1) and the recent US Food and Drug Administration clearances of the first 2 whole slide imaging systems for primary diagnosis have accelerated efforts to [...]

Tehran University of Medical Sciences, Tehran, Iran ( mirahashemi@tums.ac.ir ) Background and Aims: Nowadays patients refer to orthodontist for issue such as dental crowding and other aesthetic problems. The aims of this study were to evaluate the relationship between some of mandibular anatomical landmarks and dental crowding in the patient with skeletal Cl II due to mandibular deficiency. Materials and Methods: 108 cases have been randomly selected out of patients with mandibular related Cl II problem associated with lower incisor crowding, out of orthodontic patient department of Tehran university of medical sciences. ANB, SNB, mandibular discrepancy, gonial angle, Sn-Go-Gn and IMPA was evaluated out of the data. Lateral cephalograms were used for this matter. The correlation between variables was evaluated by correlation test and after reviewing the data was analyzed using Normality test, the Pearson correlation coefficient was used for normally distributed variables. Results: Corpus-ramus length ratio had a significant relationship with dental crowding (P≤0.05) but there was no meaningful and significant relationship between other facial landmarks ( P = 0.26 ). Conclusion: there seems to be a slight relationship between facial landmarks and dental crowding in lower incisors. But further case control and clinical studies may be helpful in achieving more reliable data.

Background and Aims : The aim of this study was to evaluate the effect of chlorhexidin 2%, sodium hypochlorite 2.5% and hydrogen peroxide 3% as three effective and regular disinfectants on the microleakage of 7th generation bonding agents in vitro. Materials and Methods: 45 extracted molar teeth without carries were collected and disinfected. On buccal and lingual aspects of these teeth conventional class V cavity preparation were done (90 cavities), then randomly divided to 4 groups, three of them had 10 teeth (20 cavities) and one of them had 5 teeth (10 cavities) as control group. Cavities in each experimental group prepared with one of the disinfectants and then 7th generation bonding (Optibond all in one, kerr) was used as noted by manufacturer, then cavities filled with composite and polished. Bonding agent was used without our previous disinfectants manipulation in control group. Specimens were thermocycled with 1000 thermal cycles between 5 and 55 0 C each for 30 seconds and then immersed in the methylene blue 5%, then sectioned mesiodistally and investigated for microleakage under stereomicroscope (Olympus, Japan). Data were analyzed using Kruskal-Wallis and Wilcoxon mean rank tests. Results: Despite the lower mean rank values for the untreated group at both occlusal and gingival aspects, the Kruskal-Wallis procedure (α=0.05) showed that the treatment factor did not significantly affect the mean rank values neither in occlusal (P=0.12) nor in gingival (P=0.39) part of cavities. Conclusion: According to the results of this study, antimicrobial agents such as chlorhexidine 2%, sodium hypochloride 2.5% and hydrogen peroxide 3% can be used perior to 7th generation dentin bonding agent(Optibond all in one, kerr) without much concern.

Background: Roberts syndrome is a genetic disorder characterized by tetra-phocomelia with abnormalities of ESCO2. We report a male stillborn with tetra-phocomelia and no ESCO2 mutation. Case report: Pre- and post-natal imaging and autopsy findings included schizencephaly, phocomelia of four limbs, micrognathia, oligodactyly, and cardiopulmonary malformations. Microcephaly on pre-natal imaging was not confirmed by autopsy examination. Karyotype, prenatal chromosome microarray and ESCO2 gene testing were normal. Conclusion: Given the various skeletal anomalies found on autopsy and imaging evaluations, at least phenotypically, our case appeared to conform into Roberts syndrome spectrum. Since the infant did not have the mutation associated with this disorder, this infant could be labeled as the first report of a pseudo-Roberts syndrome because many of his phenotypic anomalies are characteristic of Roberts syndrome in absence of the ESCO2 gene mutation. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to identify which diagnostic parameters related to impacted maxillary canines can be reliably detected by the conventional orthodontic radiographic modalities and which factors need to be assessed by cone-beam computed tomography (CBCT). Design: In this cross-sectional study, 8 orthodontists evaluated 7 parameters related to the position and anatomy of the impacted canines by means of 2-dimensional (2D) records. After 1 month, the same process was repeated by means of CBCT by the same clinicians. Setting: Qazvin University of Medical Sciences. Patients and Participants: Thirty-two patients with alveolar cleft and impacted maxillary canines who had CBCT scans, lateral cephalograms, and orthopantomographs as pretreatment records. Main Outcome Measure: The diagnostic accuracy of 2D and 3-dimensional (3D) radiographic modalities was compared with each other and also with the gold standard by 3 radiologists. Results: The diagnostic accuracy of 2D and 3D imaging modalities was not significantly different regarding the mesiodistal inclination of the impacted tooth (P =.09), apex anatomy (P =.10), and mesiodistal position of the apex (P =.19). Cone-beam computed tomography had significantly higher diagnostic accuracy than conventional radiographic modalities regarding overlapping the adjacent tooth (P =.001), labio–palatal and apico–coronal position of the crown tip, and root resorption of the adjacent tooth (P =.01). Conclusion: The conventional orthodontic radiographic modalities were as accurate as CBCT for determination of impacted canine inclination, apex anatomy, and mesiodistal position of the apex. Cone-beam computed tomography showed higher diagnostic accuracy for other parameters. [ABSTRACT FROM AUTHOR]

Metastatic carcinoma to the skin occurs in only a minority of patients with a visceral or internal malignancy, with breast, lung, and colorectum accounting for the majority of cases. We present the case of a 66‐year‐old man with a recent violaceous nodule of the left scalp (1.2 × 1.0 × 0.2 cm) that was a metastatic pancreatic adenosquamous carcinoma, representing a seemingly rare event. Two months prior, after complaining of right hip pain, an image revealed a right femoral lesion. A biopsy of that lesion showed moderately differentiated adenocarcinoma. Subsequent imaging showed a mass in the pancreatic tail and also markedly elevated serum tumor markers, CA 19‐9 and carcinoembryonic antigen (5325 and 111.5 U/mL, respectively). Before the appearance of the scalp nodule, the patient received radiotherapy and was started on chemotherapy, which was continued after diagnosis and resection of the nodule. Subsequent metastases developed in the liver, lung and additional cutaneous lesions. He died 11 months after initial presentation with right hip pain. As this case shows, cutaneous metastases confer a poor prognosis, often with less than a year survival following their appearance. [ABSTRACT FROM AUTHOR]

Objective(s): to determine the effect of different doses of caffeine on orthodontic tooth movement (OTM) in rats. Materials and Methods: Forty male 250-300 g Sprague-Dawley rats were randomly divided into four groups of ten animals each and received 0 (control), 1 g/l, 2 g/l and 3 g/l caffeine in tap water for 3 days. Orthodontic appliances were ligated between the maxillary first molars and incisors on the 4th day of the study period. All rats were sacrificed after 2 weeks of treatment after which OTM was measured. Hematoxylin/eosin-stained sections of the molars were prepared and the mesial roots were examined for resorption-lacunae depth and osteoclast number. ANOVA was used for statistical analysis (P<0.05). Results: A significant decrease in OTM was observed only in the 2 g/l (P=0.043) and 3 g/l (P<0.01) caffeine-receiving rats compared to the control animals. Osteoclast counts and resorption-lacunae depths demonstrated significant differences between each of the caffeine groups and control rats (P<0.05). None of the variables showed significant differences between the caffeine groups (P>0.05). Conclusion: According to our findings, one of the effects of caffeine consumption during orthodontic treatment in rats was decreased root resorption. Additionally, concentrations of 2 g/l and 3 g/l inhibited OTM which seems to be due to its influence on osteoclast numbers. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To evaluate the quantitative biochemical response, recurrence rate, and rate of surgical complications for thyroid cancer revision surgery.Study Design: Retrospective review.Methods: This is a single institution analysis of a prospective database of 181 patients undergoing reoperation for local recurrent thyroid cancer by the same surgeon from 2004 to 2013 with intraoperative neural monitoring. Main outcome measures included pathologic findings, surgical complications, effect of reoperation on thyroglobulin (Tg) levels, and recurrence rate. We defined biochemical complete remission as postoperative stimulated Tg of 0.2 ng/mL or less.Results: Fourteen percent of the patients presented with permanent vocal cord palsy (VCP), and 20% of the patients presented with hypocalcemia prior to surgery. Among them, 70% of the patients underwent first revision surgery; whereas in 30% the surgery represented second or higher revision surgery, with 8% being a third or higher revision. None developed temporary or permanent VCP. Temporary hypocalcemia occurred in 9% of the patients, and permanent hypocalcemia occurred in 4.2%. The rate of cervical node recurrence was 5% at a median follow-up of 3.4 years. There were no disease-specific deaths. Mean preoperative basal Tg was 22.3 ng/mL and mean postoperative Tg was 5.7 ng/mL, a decline of 74% (P = 0.023, paired t test). Biochemical complete remission was achieved in 58% of all revision cases.Conclusion: Reoperative neural monitored surgery for recurrent thyroid cancer is a safe and effective procedure with limited morbidity in experienced hands, even in the setting of multiple prior revision surgeries and existing comorbidities such as VCP and hypocalcemia.Level Of Evidence: 4. [ABSTRACT FROM AUTHOR]