Ehlers-Danlos Syndrome in Prosthodontics, Periodontology, and Implant Dentistry: A Systematic Review of the Literature

Ehlers-Danlos Syndrome (EDS) is one of the most common congenital connective tissue disorders, affecting the synthesis and production of collagen cells. The medical implications for joints, muscles, soft tissue, and blood circulation have been documented in the literature. Many oral manifestations are displayed in EDS patients, including gingival recession, lack of attached gingiva, early severe periodontitis, and dental anomalies and dental caries. However, the literature is limited and oftentimes contradictory, and therefore provides no consensus for guidelines regarding prosthodontic, periodontal, and implant treatment of patients with EDS. Therefore, the aim of this systematic review was to analyze the pertinent literature regarding prosthodontics, periodontology, and implant dentistry in EDS patients.

Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine.

Background. The presence of ulcerative colitis (UC) with no bowel symptoms, as fever of unknown origin (FUO), is uncommon. Objective. To describe the case of an 80-year-old woman who presented with fever, with a history of UC under treatment with mesalazine. Case Presentation. She was admitted due to fever lasting for 12 days with no associated symptoms. Seven years earlier, she was diagnosed with UC. After an extended workup for FUO that failed to reach the diagnosis, she underwent a gallium-67 scintigraphy. This revealed a persistent diffuse concentration of gallium-67 in the ascending colon at 24-hour imaging that remained stable at 48- and 72-hour imaging without any topographic change after the use of laxatives. Considering the results and in the absence of another diagnosis, the patient was treated with 30 mg prednisone daily and mesalazine, as treatment of active UC. Subsequently, the patient's condition improved markedly and the fever retreated. One month later, she was reevaluated with a gallium-67 scintigraphy with total absence of gallium-67 concentration in the ascending colon. Conclusion. UC activity must be included in the differential diagnosis of FUO in patients with longstanding disease, since fever may present alone, with no other manifestations.

Persistent left superior vena cava leads to catheter malposition during PICC Port placement.

INTRODUCTION: We present a case of peripherally inserted central catheter (PICC) port placement where the catheter had been malpositioned to the persistent left superior vena cava. METHODS: Despite the obvious elevation of the P-wave signaling proximity of the catheter tip to the sinus node, the catheter was not in the desired location within the superior vena cava or the right atrium, because of the presence of a persistent left superior vena cava. Computed tomography was used in order to locate the catheter. RESULTS: The catheter was located in the persistent left superior vena cava. CONCLUSIONS: Malpositioning of the catheter in the persistent left superior vena cava occurs in 0.3%-0.5% of patients. The catheter was subsequently removed.