Still Scholarworks (A.T. Still University)
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A rare breast cancer in a patient with pierced nipples
No full textAbstract
Paget disease of the breast is a rare form of breast cancer that affects the nipple and areolar complex. Clinicians should have a high suspicion for this condition in patients who fail conservative treatment for benign-appearing dermatologic findings regardless of age or sex. This article describes a patient with whose presumed nipple infection was initially thought to be related to her nipple piercing
Legionella: An uncommon cause of community-acquired pneumonia
No full textAbstract
Legionnaires disease is an important, relatively uncommon, yet well known form of atypical community-acquired pneumonia (CAP). If not appropriately treated in the early stage of infection, it can be fatal. Several factors increase the risk of contracting Legionnaires disease, including age over 50 years, chronic cardiovascular disease, underlying respiratory disease, chronic renal disease, diabetes, smoking, any immunosuppressing condition, travel history, and certain types of employment. Legionnaires disease can present without the usual symptoms associated with pneumonia. The incidence of Legionnaires disease is increasing, and because of its morbidity and mortality, clinicians should consider it in the differential when treating patients with CAP. This article reviews the pathophysiology and treatment of Legionnaires disease and when to refer patients to tertiary centers for higher levels of care, including extracorporeal membrane oxygenation
The orbitalauricular chord of Alligator: The unusual functional linkage between the earflap and eyelid of Crocodylians
No full textOne of the distinctive features of the Crocodylia is the presence of a superficial meatal chamber the aperture of which is regulated by two earflaps. The movements of the upper earflap have been detailed by multiple workers, however, the mechanics of the lower earflap remain unresolved. The present study was undertaken to document the mechanics of the lower earflap in the American alligator, Alligator mississippiensis, and to explore the functional bases of coordinated movements between the lower earflap and lower eyelid in this species. This anatomical system was examined using a combination of fresh dissection, histology, and micro-CT analyses applied to post-embryonic specimens. The rostral margin of the lower earflap is tightly bound to a block of dense connective tissue herein termed the orbitalauricular chord. The orbitalauricular chord is anatomically distinct from both a ligament and a tendon. The dorsal surface of the orbitalauricular chord is attached to a slip of the levator palpebra, while the ventral surface is attached to a slip of the depressor palpebra. These attachments produce a simple mechanism for the elevation and depression of the lower earflap, and thus the opening and closing of the meatal aperture. The caudal surface of the orbitalauricular chord has connective tissue links to the rostral margin of the lower earflap. The morphology of the orbitalauricular chord appears to explain both the mechanics of the lower earflap and the functional coupling between the lower eyelid and lower earflap
The morphology of the suboccipital region in snakes, and the anatomical and functional diversity of the myodural bridge
No full textThe myodural bridge, that is, skeletal muscle fibers attaching to the cervical dura mater, has been described from a variety of mammals and other amniotes. To test an earlier assumption about the presence of the myodural bridge in snakes, a comparative study was designed using a group of Colubrine snakes. Serial histological sections revealed no evidence of the myodural bridge in any of the snakes examined. Further analyses, including histology, computed tomography (CT), and micro-CT imaging of other distantly related snakes, also turned up no evidence of a myodural bridge. The close apposition of adjacent neural arches in snakes may preclude muscle tendons from passing through the intervertebral joint to reach the spinal dura. It is hypothesized that the myodural bridge functions in the clearance of the cerebrospinal fluid (CSF) by creating episodic CSF pressure pulsations, and that snakes are capable of creating equivalent CSF pressure pulsations through vertebral displacement
A Comparison of Recommendations from a Computer-Based Decision System and Tobacco Treatment Specialists: Insights and Lessons Learned
No full textThis pilot study examines the similarities and differences between treatment recommendations offered by a decision system and trained tobacco treatment specialists. Using a sample of ten de-identified patient cases who used tobacco, we compared recommendations from the manual and preliminary review of cases by four tobacco specialists with the automated analysis of patient cases using both the first version of the rule-based system and the second version with improved and additional rules
The Role of Process-Directing Agents on Enamel Lesion Remineralization: Fluoride Boosters
No full textThe aim of this study was to investigate the effects of two process-directing agents (polyas-partic acid and osteopontin) used in a polymer-induced liquid-precursor (PILP) process on the remineralization of bacteria-induced enamel demineralization. Enamel demineralization lesions (depths of about 180–200 µm) were created and exposed to Streptococcus mutans, cultured with a 10% sucrose solution for 21 days, and remineralized using a PILP process (pH = 7.4, 14 days) with a calcium phosphate solution containing either polyaspartic acid or osteopontin in the presence or absence of fluoride (0.5 ppm). The specimens were examined under scanning electron microscopy. The fluoride was successfully incorporated into the PILP remineralization process for both polyas-partic acid and osteopontin. When the fluoride was added to the PILP remineralization solution, there was more uniform remineralization throughout the lesion than with either polyaspartic acid or osteopontin alone. However, in the absence of these process-directing agents, fluoride alone showed less remineralization with the formation of a predominantly surface-only layer. The PILP remineral-ization process relies on the ability of process-directing agents to stabilize calcium phosphate ions and holds promise for enamel lesion remineralization, and these agents, in the presence of fluoride, seem to play an important role as a booster or supplement in the continuation of remineralization by reducing the mineral gains at the surface layer
Future Drug Targets in Periodontal Personalised Medicine—A Narrative Review
No full textPeriodontal disease is an infection-driven inflammatory disease characterized by the destruction of tooth-supporting tissues. The establishment of chronic inflammation will result in progressive destruction of bone and soft tissue changes. Severe periodontitis can lead to tooth loss. The disease has complex pathogenesis with an interplay between genetic, environmental, and host factors and pathogens. Effective management consists of plaque control and non-surgical interventions, along with adjuvant strategies to control inflammation and disrupt the pathogenic subgingival biofilms. Recent studies have examined novel approaches for managing periodontal diseases such as modulating microbial signaling mechanisms, tissue engineering, and molecular targeting of host inflammatory substances. Mounting evidence suggests the need to integrate omics-based approaches with traditional therapy to address the disease. This article discusses the various evolving and future drug targets, including proteomics, gene therapeutics, vaccines, and nanotechnology in personalized periodontal medicine for the effective management of periodontal diseases
Effects of Mini-Implant-Assisted Rapid Palatal Expansion on Incisive Canal Morphology and Tooth–Canal Relationship
No full textThe objective of this study was to identify the change in incisive canal (IC) morphology and tooth–canal relationship after mini-implant-assisted rapid palatal expansion (MARPE). Pretreatment and posttreatment cone-beam computed tomography images of 30 subjects were retrospectively evaluated. The dimensional and volume changes of the IC after MARPE treatment were evaluated, and the tooth–canal relationship and positional relationship between the maxillary central incisors were additionally compared in the group where the root apex of the maxillary central incisors was higher than the IC oral opening. The mediolateral and labiopalatal widths of the IC were significantly increased in all three levels after MARPE treatment (p \u3c 0.01). The amount of increase was greater in the mediolateral direction than in the labiopalatal direction. The anteroposterior distance from the mesial point of the maxillary central incisors to the anterior margin of the IC was significantly decreased only in the oral opening level in the samples where the apices of the maxillary central incisors were located more superior to the oral opening of the IC (p \u3c 0.05). The mediolateral distance between the mesial points of the maxillary central incisors and the distance between the root apex of the maxillary central incisors significantly increased after MARPE (p \u3c 0.001). However, the distance between the crown tips of the maxillary central incisors did not significantly increase, even after MARPE treatment (p \u3e 0.05). The volume of the IC significantly increased after MARPE treatment (p \u3c 0.001), and the average increase in the total volume of the IC was about 65%. MARPE increased the width and volume of the IC and did not result in a clinically significant change in the root–canal relationship
Color stability of fully-and pre-crystalized chair-side CAD-CAM lithium disilicate restorations after required and additional sintering processes
No full textPURPOSE. The aim of this study was to investigate shade changes in fullyand pre-crystalized CAD-CAM lithium disilicate crowns after the required and additional firing processes. MATERIALS AND METHODS. One hundred and five crowns of shade A1 with high translucency were milled out of CAD-CAM lithium disilicate blocks and categorized as follows (n = 15): (1) restorations fabricated from Strau-mann n!ce with no additional sintering process; (2) restorations fabricated from Straumann n!ce with one additional sintering process; (3) restorations fabricated from Straumann n!ce with two additional sintering processes; (4) restorations fabricated from Amber Mill with one sintering process; (5) restorations fabricated from Amber Mill with two sintering processes; (6) restorations fabricated from IPS e.max CAD with one sintering process; (7) restorations fabricated from IPS e.max CAD with two sintering processes. All restorations were evaluated with a color imaging spectrophotometer. RESULTS. All restorations presented some color alteration from the original shade both after a single and after two firing processes. CONCLUSION. The required and additional sintering processes for restorations fabricated with chairside CAD-CAM lithium disilicate blocks cause an alteration of the original shade selected. Shade A1 high translucency restorations tend to change to a more yellowish B1 shade after a sintering process. [J Adv Prosthodont 2022;14:56-62