Diffuse large B-cell non-Hodgkin's lymphoma in a patient with autoimmune lymphoproliferative syndrome.

Mutations of Fas or Fas ligand genes result in the autoimmune lymphoproliferative syndrome (ALPS) in humans. We report here a diffuse large B-cell non-Hodgkin's lymphoma occurring in a man with ALPS. Fas-mediated lymphocyte apoptosis was defective in vitro, owing to a mutation within the death domain of the Fas molecule. High-dose methotrexate and doxorubicin-based chemotherapy led to complete remission of lymphoma.

Selection and ideal tridimensional implant position for soft tissue aesthetics.

While single-tooth replacement can be accomplished with predictability using implant therapy, this procedure is challenging in the anterior region where numerous criteria must be evaluated by the restorative team. The available height of bone, soft tissue volume, and three-dimensional position of the anticipated implant restoration are among the numerous concerns that must be addressed prior to the initiation of treatment. This article provides a comprehensive review for the selection and placement of implants in the aesthetic region and illustrates these principles with a case presentation.

[Failure of the treatment with antibiotics in severe Salmonella infections in children and use of quinolones]. / Echecs du traitement antibiotique des salmonelloses sévères de l'enfant et utilisation des quinolones.

BACKGROUND: Quinolone antibiotics are effective in the treatment of Salmonella infections in adults. Their use in children is limited by their side-effects. POPULATION AND METHODS: Forty-two patients (21 girls and 21 boys), aged 1 month to 12 years (mean 3.3 yrs) were admitted from September 1991 to June 1993 for severe Salmonella infections. Criteria of severity were persistent diarrhea and fever for more than 3 days. Thirty-one of these patients were less than 5 years of age. Blood culture was positive in 7 out of 35 patients: culture of the stools was positive in all patients. Five of the 42 patients had presented an acute episode of Salmonella infection a few weeks earlier and had remained asymptomatic carriers until the new acute and severe episode of diarrhea. All patients were given usual antibiotics, mainly ampicillin, amoxicillin, trimethoprime-sulfamethoxazole. Twenty-five of these patients were then given pefloxacin, 12 mg/kg/day, since the 5th day, for 7 days, because persistence of diarrhea and fever. RESULTS: Diarrhea and fever disappeared within less than 2 days in the group of patients given pefloxacin, even though in 6 patients the infecting Salmonella was in vitro resistant to beta-lactamins. Twenty % of patients remained asymptomatic carriers of Salmonella in the group treated by pefloxacin vs 47% in the group without it. There was no difference in species of Salmonella between both groups. None of the patients treated by pefloxacin developed side-effects during the six months following its administration. CONCLUSIONS: Short treatment by pefloxacin may be an alternative choice for treating severe Salmonella infections in children.

Use of pefloxacin after failure of initial antibiotic treatment in children with severe salmonellosis.

Sixteen children (7 males, 9 females) aged 0.1 to 9.5 years (mean 3.6 years) who were hospitalized for severe salmonella infection were treated with conventional antibiotics. In nine children disappearance of fever and bloody diarrhea was obtained 2 to 4 days after the beginning of antibiotic therapy. Although the antibiotic administered was active against the pathogen, after 4 to 8 days the seven other children experienced clinical failure of the initial therapy, with a temperature of over 39 degrees C, bloody diarrhea and positive stool culture in all cases. The seven Salmonella strains isolated (1 S. typhi, 1 S. paratyphi B, 2 S. enteritidis, 3 S. typhimurium) were all sensitive to ampicillin, cotrimoxazole and pefloxacin. These seven children were then given 12 mg/kg/day of pefloxacin orally for 7 days. Apyrexia and complete resolution of diarrhea were obtained within 1 to 3 days in all cases without side effects. Trials are needed to determine the safety and toxicity of quinolones in children, however short-term therapy with pefloxacin could be useful in children with severe invasive salmonellosis after failure of conventional antibiotic therapy.

Implant positioning for periodontal, functional, and aesthetic results.

Implant positioning requires the adherence to a very precise protocol in order to achieve the best periodontal, functional, and aesthetic results. In this article, the authors discuss the step-by-step procedure, including pre-implant study, transfer techniques, implant positioning, gingiva grafts, and post-implant hygiene.

Clinical results and guidelines on Steri-Oss endosseous implants.

A statistical study of the Steri-Oss implant system, concerning 673 implants placed in 280 patients in the course of a 5-year period, allows a therapeutic proposal to be made that will optimize the success rate of osseointegration. The study revealed indications specific to each type of implant, according to the depth and density of available bone. The use of titanium screws is recommended whenever bone quality is type I. In all other cases, where the density of bone decreases and approaches type IV, especially in the posterior maxilla, cylindrical hydroxyapatite-coated implants are recommended.