Updated European guidelines for clinical management of familial adenomatous polyposis (FAP), MUTYH-associated polyposis (MAP), gastric adenocarcinoma, proximal polyposis of the stomach (GAPPS) and other rare adenomatous polyposis syndromes: a joint EHTG-ESCP revision.

BACKGROUND: Hereditary adenomatous polyposis syndromes, including familial adenomatous polyposis and other rare adenomatous polyposis syndromes, increase the lifetime risk of colorectal and other cancers. METHODS: A team of 38 experts convened to update the 2008 European recommendations for the clinical management of patients with adenomatous polyposis syndromes. Additionally, other rare monogenic adenomatous polyposis syndromes were reviewed and added. Eighty-nine clinically relevant questions were answered after a systematic review of the existing literature with grading of the evidence according to Grading of Recommendations, Assessment, Development, and Evaluation methodology. Two levels of consensus were identified: consensus threshold (≥67% of voting guideline committee members voting either 'Strongly agree' or 'Agree' during the Delphi rounds) and high threshold (consensus ≥ 80%). RESULTS: One hundred and forty statements reached a high level of consensus concerning the management of hereditary adenomatous polyposis syndromes. CONCLUSION: These updated guidelines provide current, comprehensive, and evidence-based practical recommendations for the management of surveillance and treatment of familial adenomatous polyposis patients, encompassing additionally MUTYH-associated polyposis, gastric adenocarcinoma and proximal polyposis of the stomach and other recently identified polyposis syndromes based on pathogenic variants in other genes than APC or MUTYH. Due to the rarity of these diseases, patients should be managed at specialized centres.

The EUropean PErioperative MEdical networking (EUPEMEN) project: recommendations for perioperative care in colorectal surgery. a quality improvement study.

BACKGROUND: Despite consensus supporting enhanced recovery programs, their full implementation in such a context is difficult due to conventional practices within various groups of professionals. The goal of the EUropean PErioperative MEdical Networking (EUPEMEN) project was to bring together the expertise and experience of national clinical professionals who have previously helped deliver major change programs in their countries and to use them to spread enhanced recovery after surgery protocols (ERAS) in Europe. The specific aim of this study is to present and discuss the key points of the proposed recommendations for colorectal surgery. MATERIALS AND METHODS: Five partners from university hospitals in four European countries developed the project as partners. Following a non-systematic review of the literature, the European consensus panel generated a list of recommendations for perioperative care in colorectal surgery. A list of recommendations was formulated and distributed to collaborators at each center to allow modifications or additional statements. These recommendations were then discussed in three consecutive meetings to share uniform ERAS protocols to be disseminated. RESULT: The working group developed (1) the EUPEMEN online platform to offer, free of charge, evidence-based standardized perioperative care protocols, learning activities, and assistance to health professionals interested in enhancing the recovery of their patients; (2) the preparation of the EUPEMEN Multimodal Rehabilitation manuals; (3) the training of the trainers to teach future teachers; and (4) the dissemination of the results in five multiplier events, one for each partner, to promote and disseminate the protocols. CONCLUSION: The EUPEMEN project allowed the sharing of the expertise of many professionals from four different European countries with the objective of training the new generations in the dissemination of ERAS protocols in daily clinical practice through a new learning system. This project was proposed as an additional training tool for all the enhanced recovery program teams.

Patients' perception of using telehealth for consultation: insights after pandemic and development of an online calculator platform to predict acceptance of remote consultation: the TELEMED international study.

The COVID-19 pandemic has led to a change in healthcare models. The aim of this study was to evaluate patient acceptance of telehealth as an alternative to physical consultations, and to identify factors predicting higher satisfaction. This was an observational, cross-sectional, multi-center, international study. All consecutive patients for whom telehealth was used in consultations between April and July 2020 were considered for inclusion. The validated Telehealth Usability Questionnaire (TUQ) was used as a model to measure patient acceptance. Overall, 747 patients were observed, of whom 721 agreed to participate (96·5%). The TUQ showed that 86·9% of patients agreed that telehealth was useful; 85·2% supported the interface quality and 81·4% endorsed the interaction quality. Patients aged > 60 y were less likely to agree with the use of telehealth (p < 0·05). A web-based prediction tool was generated to calculate global satisfaction and to identify patients more likely to feel comfortable with telehealth. Telehealth is feasible and allows consultations that are satisfactory for patients. Technological advancements could ease safe implementation of telehealth into everyday practice. Adequate patient selection can be useful to ensure that the ideal strategy is used for each individual during and after the pandemic.

Association of mandibular canine impaction and anatomical factors: A multicentre retrospective panoramic study in Latin America.

INTRODUCTION: Mandibular canine impaction is infrequent in dental eruption anomalies and treatment is very challenging. The aim of this multicenter retrospective panoramic study in Latin America was to evaluate panoramic radiographic imaging characteristics of mandibular canine impaction (impaction area, mandibular base contact, transmigration, impaction height and sex) and their associations. MATERIAL AND METHODS: This cross-sectional study evaluated 212 digital panoramic radiographs from three radiological centres in Tingo Maria (Peru), Bogota and Tunja (Colombia). The study included children of both sexes with impacted mandibular canines. Mandibular alpha angle, contact with mandibular basal bone (MBB), impacted sector according to 10 sectors with an adaptation of the Ericson and Kurol method, presence of transmigration and the impacted height were measured and the relationship among these measures was analyzed. Fisher's exact test, Chi-square and binary logistic regression were used. (P<0.05). RESULTS: The mandibular canine impaction showed contact with the MBB (32.08%), dental transmigration (36.79%), mainly located at an apical (40.09%) and sub-apical (36.79%) level. Transmigration mainly occurred in sectors 6 (33.30%) and 10 (25.60%) (P<0.001). It was found that for each year of increase in age, the possibility of contact with the MBB decreased (ß=0.89, P=0.010), and as the alpha angle increased by one degree the probability of contact with the MBB decreased (ß=0.97, P=0.001) and the probability of transmigration increased (ß=1.05, P<0.001). CONCLUSIONS: One third of the impacted canines were in contact with the MBB, while another third presented dental transmigration and were mainly located apically and subapically of the incisor roots. These imaging features should be taken into account when planning orthodontic treatment.

Oral health-related quality of life, adaptation/discomfort during open bite treatment with spurs: complementary analysis from a randomized clinical trial.

This single-center trial aimed to longitudinally compare the oral health-related quality of life (OHRQOL), adaptation and discomfort during anterior open bite (AOB) treatment with lingual spurs and build-ups (SBU) versus spurs only (S) approaches. Children (7-11 years) with AOB were randomly allocated into two treatment groups (SBU or S). The Child Perception Questionnaire (CPQ8-10) was applied 1 and 12 months after installation of the appliances. Questionnaires evaluating functional adaptation and discomfort during the first month of treatment were also applied. A visual analog scale (VAS) was used in these questionnaires. Generalized mixed models were used for analyzing OHRQOL and discomfort data. Generalized linear models were used to assess adaptation outcomes (α = 0.05). The SBU group included 24 patients (7 males and 17 females; mean age 8.2 years) and the S group included 25 patients (11 males and 14 females; mean age 8.3 years). Regardless of the treatment type, overall OHRQOL scores at 12 months were 0.69 times those recorded at 1 month after the appliances installation (i.e., ~ 31% reduction; exp (ß) = 0.69; 95% CI: 0.55, 0.88). A significant interaction between treatment and time was detected for the 'functional limitations' domain. For this domain, a significant improvement from the first to the twelfth month was observed in the S group (P < 0.001). Patients in both treatment groups showed similar and easy adaptation to the appliances. Independent of the type of treatment, tongue-related discomfort decreased over time. One week and one month after the appliance's delivery, the discomfort scores were 0.19 (i.e., ~ 81% reduction; exp (ß) = 0.19; 95% CI: 0.13, 0.28; P < 0.001) and 0.02 (i.e., ~ 98% reduction; exp (ß) = 0.02; 95% CI: 0.01, 0.07; P < 0.001) times, respectively, those issued immediately after the installation of the appliances. Regardless of treatment type; overall OHRQOL improved from the first to the twelfth month of AOB treatment. The functional limitations score decreased in the S group. Children showed easy adaptation, and their discomfort decreased 1 week after the installation of the appliances.Trial registration: Clinicaltrials.gov; NCT03702881, date of registration: October 11, 2018.

The interference of digital radiographic image acquisition and processing protocols in the diagnosis of incipient enamel carious lesions.

Background: This study aims to evaluate the diagnosis of proximal carious lesions through different parameters of execution and visualization of the images. Material and Methods: Proximal carious lesions were artificially induced in human teeth three different times (10, 20, and 30 hours) by in vitro demineralization. The teeth were radiographed with the Dürr digital system using three exposure times (0.10, 0.16, and 0.20s) and three different resolutions in the scanning of the phosphor plates (20-, 25- and 40-line pairs). After acquiring the images, they were submitted to VistaScan Fine, Caries 1, and Caries 2 software filters. Three radiologists analyzed the images in JPEG format. Results: The Pearson's chi-square test showed an association between longer demineralization time and the presence of injury according to the professional's classification. There was no statistically significant association among the other parameters, exposure time, resolution, and use of filters and the presence of a lesion. All parameters showed a greater sensitivity than specificity. The exposure time of 0.2s showed better accuracy, the resolutions 25 and 40lp showed equal results and better than 20lp and the Fine filter obtained better values than the Caries 1 and 2 filters. Conclusions: Despite the variation of parameters, exposure time, resolution, and use of filters, there were no statistically significant differences. For better diagnostic accuracy, it is recommended to use 0.2s of exposure time and a Fine filter, and scan the phosphor plates with 25lp. Key words:Orbital fracture, Etiology, Orbital trauma, Road traffic accidents, Trauma.

Effectiveness and safety of azathioprine for inflammatory pouch disorders: results from the RESERVO study of GETECCU.

Background: The usefulness of thiopurines has been poorly explored in pouchitis and other pouch disorders. Objective: To evaluate the effectiveness and safety of azathioprine as maintenance therapy in inflammatory pouch disorders. Design: This was a retrospective and multicentre study. Methods: We included patients diagnosed with inflammatory pouch disorders treated with azathioprine in monotherapy. Effectiveness was evaluated at 1 year and in the long term based on normalization of stool frequency, absence of pain, faecal urgency or fistula discharge (clinical remission), or any improvement in these symptoms (clinical response). Endoscopic response was evaluated using the Pouchitis Disease Activity Index (PDAI). Results: In all, 63 patients were included [54% males; median age, 49 (28-77) years]. The therapy was used to treat pouchitis (n = 37) or Crohn's disease of the pouch (n = 26). The rate of clinical response, remission and non-response at 12 months were 52%, 30% and 18%, respectively. After a median follow-up of 23 months (interquartile range 11-55), 19 patients (30%) were in clinical remission, and 45 (66%) stopped therapy. Endoscopic changes were evaluated in 19 cases. PDAI score decreased from 3 (range 2-4) to 1 (range 0-3). In all, 21 patients (33%) presented adverse events and 16 (25%) needed to stop therapy. Conclusion: Azathioprine may be effective in the long term for the treatment of inflammatory pouch disorders and could be included as a therapeutic option.

Alveolar morphometry in young adults with and without agenesis of the upper lateral incisor: A retrospective study.

INTRODUCTION: We aimed to compare alveolar morphometry in young adults with agenesis of the upper lateral incisor versus the side without agenesis and versus matched controls. MATERIAL AND METHODS: In this observational retrospective study, cone beam computed tomography scans were obtained of 36 upper hemiarches from young adults aged 15 to 30 years. The hemiarches were distributed into three groups: group 1: 12 upper hemiarches presenting agenesis of the upper lateral incisor; group 2: 12 upper hemiarches from the opposite side without agenesis of the upper lateral incisor (control group 1); and group 3: 12 upper hemiarches without agenesis of the upper lateral incisor matched for age and sex with respect to the affected group (control group 2). A trained and calibrated investigator performed all the alveolar measurements at two different times, including sagittal, coronal and axial slices of each hemiarch. Paired Student's t-tests, Chi-square and repeated measures ANOVA with Bonferroni correction were used, (P<0.05). RESULTS: Apical mesial evaluation of group 1 (4.22±1.19mm) was significantly lower (P<0.001) than that of groups 2 (6.72±1.17mm) and 3 (7.58±1.67mm). Apical distal evaluation also showed differences (P<0.001) among the three groups, with the dimension being smaller in group 1 with agenesis (4.53±1.14mm), followed by group 2 without agenesis (6.23±1.55mm) and the healthy control group 3 (7.73±1.71mm). CONCLUSIONS: Lateral incisor agenesis significantly reduces the alveolar dimensions of the affected area. In cases of unilateral agenesis, the unaffected side also shows sequelae, with decreased dimensions compared to cases without agenesis. This condition should be taken into account when making therapeutic decisions regarding rehabilitation with implants or canine replacement.

Comparison of mesiodistal angulations of premolars and molars in anterior open bite subjects with different sagittal malocclusions: A retrospective study.

INTRODUCTION: Mesiodistal angulation of premolars and molars can be altered by forces of open bite malocclusion. The aim of this study was to compare the mesiodistal angulations of the posterior teeth in class I, II, and III individuals with anterior open bite (AOB) versus individuals with harmonious occlusion. METHODS: This comparative cross-sectional study used 299 lateral head radiographs of individuals with permanent dentition. There were 4 groups (harmonious occlusion [n=89], Class I open bite [OB] [n=75], Class II OB [n=66], and Class III OB [n=69]). Premolar (1UPM, 2UPM) and molar (1UM, 2UM) angulations were measured relative to the occlusal plane and the palatal or mandibular plane by a trained and calibrated evaluator. ANOVA and Scheffe tests were used for statistical analyses (P<0.05). RESULTS: The mesial angulation of the upper premolars showed greater angulation of between approximately 2° and 5° in the OB groups compared to the harmonious occlusion group (P<0.05). Only in the Class II OB group did the first and second upper molars show distal angulation in relation to the palatal plane (1UM 81.85°±5.42°; 2UM 75.32±7.4°) (P<0.05). The Class III OB group presented the greatest distal angulations of the lower premolars and molars (between 3° to 5° of difference, P<0.05) in relation to those of the harmonious occlusion group. CONCLUSIONS: The upper first premolars in all the AOB groups and the lower second premolars in the Class II OB group had greater mesioangulation. Additionally, the upper molars of the Class II OB group and the lower molars of the Class III OB group showed distoangulation compared with the molars in the group with harmonious occlusion.

Evaluación de Lesiones Periapicales Utilizando Tres Índices sobre Tomografía Computarizada Cone Beam

El uso de tomografía computarizada Cone Beam (CBCT) puede favorecer el diagnóstico temprano de periodontitis apical e influir en su pronóstico y tratamiento; sin embargo, no existe una estandarización entre los índices que determinan la presencia de lesiones periapicales en esta técnica radiológica. Es por tal motivo que, el objetivo de este estudio fue evaluar lesiones periapicales utilizando tres índices sobre CBCT. La población de estudio estuvo conformada por todas las CBCT realizadas en un centro radiológico peruano durante un año, se realizó un muestreo no probabilístico y se evaluaron 36 tomografías Cone Beam con los índices CBCT-PAI, COPI y CBCT-ERI; los datos recolectados fueron analizados estadísticamente y se determinó que el índice CBCT-PAI identificó 91,7 % lesiones periapicales; el índice COPI, 72,2 % y el índice CBCT-ERI, 88,9 %. Asimismo, se aplicó la prueba x2 de Pearson y se determinó un valor de p=0,05. Por lo tanto, se concluyó que el diagnóstico de lesiones periapicales sobre tomografía computarizada Cone Beam puede presentar resultados similares cuando se evalúa con cualquiera de los índices CBCT-PAI, COPI o CBCT-ERI.

The use of Cone Beam Computed Tomography (CBCT) can favor the early diagnosis of apical periodontitis and influence its prognosis and treatment; however, there is no standardization among the indexes that determine the presence of periapical lesions in this radiological technique. For this reason, the aim of this study was to evaluate periapical lesions using three indices on CBCT. The study population consisted of all the CBCT scans performed in a Peruvian radiological center for one year, a non-probabilistic sampling was performed and 36 Cone Beam tomography's were evaluated with the CBCT-PAI, COPI and CBCT-ERI indexes; the data collected were analyzed statistically and it was determined that the CBCT-PAI index identified 91.7 % periapical lesions; the COPI index, 72.2 % and the CBCT-ERI index, 88.9 %. Likewise, Pearson's x2 test was applied and a value of p=0.05 was determined. Therefore, it was concluded that the diagnosis of periapical lesions on Cone Beam computed tomography can present similar results when evaluated with any of the CBCT-PAI, COPI or CBCT-ERI indexes.

Home-based prehabilitation improves physical conditions measured by ergospirometry and 6MWT in colorectal cancer patients: a randomized controlled pilot study.

PURPOSE/BACKGROUND: Prehabilitation aims to improve physical condition in the preoperative period and, therefore, decrease the loss of cardiopulmonary capacity postoperatively, with the aim of reducing complications and promoting an early recovery. This study aims to evaluate the impact of home-based prehabilitation on the physical condition of patients treated surgically for colorectal cancer. METHODS: A prospective and randomized clinical study was conducted on 60 patients during two periods from October 2018 to February 2019 and from September 2019 to September 2020, in a single university hospital. Patients were randomized into two study groups (30 per group): prehabilitation vs. standard care. Changes in physical condition, measured at diagnosis, the day before surgery, and at 6-8 weeks after surgery using the cardiopulmonary exercise testing (CPET) and the 6-minute walk test (6MWT) were evaluated. RESULTS: Prehabilitation reduced postoperative complications (17.4% vs. 33.3%, p = 0.22) and hospital stay (5.74 vs. 6.67 days, p = 0.30). 6MWT showed a significant improvement in the prehabilitation group (+78.9 m). Six weeks after surgery, prehabilitation showed a significant improvement in the 6MWT (+68.9 m vs. -27.2 m, p = 0.01). Significant differences were also observed in the ergospirometry between the diagnosis and postoperative study (+0.79 METs vs. -0.84 METs, p = 0.001). A strong correlation was observed between CPET and 6MWT (0.767 (p < 0.001)). CONCLUSION: Home prehabilitation achieved lower overall postoperative complications than standard care and reached significant improvements in 6MWT and CET. A strong correlation was observed between CET and 6MWT, which allows validation of 6MWT as a valid and reliable measure of functional exercise capacity in colorectal patients when other, more specific and expensive tests are not available. TRIAL REGISTRATION: Registered in ClinicalTrials.gov in August 2018 with registration number https://clinicaltrials.gov/study/NCT03618329?cond=Prehabilitation%20cancer&term=arroyo&distance=50&rank=1  (NCT03618329). Initial results published in Supportive Care in Cancer: Effect of home-based prehabilitation in an enhanced recovery after surgery program for patients undergoing colorectal cancer surgery during the COVID-19 pandemic. DOI: https://doi.org/10.1007/s00520-021-06343-1 .

Conservative Treatment of Bilateral Impacted Mandibular Canines Traction.

The objectives of the treatment of impacted canines differ according to the characteristics of dental malocclusion. Traction of the tooth is a conservative and viable alternative, which allows for maintaining stability and occlusal function. The following case report describes the treatment of an 11.6-year-old female patient, who presented bilateral impaction of mandibular canines in contact with the midline, mixed dentition in the inter-transitional period, class I angle malocclusion, with light crowding teeth. The treatment comprised three phases. The first phase, verticalization of the mandibular canines in mixed dentition, was performed to pull the impacted bilateral mandibular canines towards the dental arch to achieve their verticalization, maintaining the molar relationship, and the position of the upper and lower incisors. In the second phase, osteogenic rest was planned to relieve post-traction stress while awaiting the replacement of the mixed dentition. Finally, the third phase in permanent dentition was to align and level canines within the arch after extraction of the deciduous canines. For the viability of the permanent mandibular canines in the dental arch, orthosurgical traction was implemented, with a traction system with closed nickel-titanium coil springs with a transitory rigid dental-mucous-supported anchorage device, which allowed control and protection of the adjacent teeth and movements with helical forces of a controlled three-dimensional range. The results of the treatment were adequate, achieving consolidated molar and canine relationships, overjet, overbite, and optimal facial balance.

The EUPEMEN (EUropean PErioperative MEdical Networking) Protocol for Bowel Obstruction: Recommendations for Perioperative Care.

Mechanical bowel obstruction is a common symptom for admission to emergency services, diagnosed annually in more than 300,000 patients in the States, from whom 51% will undergo emergency laparotomy. This condition is associated with serious morbidity and mortality, but it also causes a high financial burden due to long hospital stay. The EUPEMEN project aims to incorporate the expertise and clinical experience of national clinical specialists into development of perioperative rehabilitation protocols. Providing special recommendations for all aspects of patient perioperative care and the participation of diverse specialists, the EUPEMEN protocol for bowel obstruction, as presented in the current paper, aims to provide faster postoperative recovery and reduce length of hospital stay, postoperative morbidity and mortality rate.

Concordance of the facial biotype between Bjork-Jarabak cephalometrics and photographic analysis of the facial opening angle.

Background: Analysis of the facial biotype can provide useful information for orthodontic diagnosis and can determine the type of growth of a patient to guide orthodontic treatment. The objective of this study was to determine the concordance of the facial biotype according to Bjork-Jarabak cephalometric analysis and photographic analysis of the angle of facial opening in Peruvian individuals. Material and Methods: This retrospective study included 244 cephalometric radiographs and frontal photographs of the same patients obtained from a database. The facial biotype (mesofacial, brachyfacial, or dolichofacial) was determined with the Björk-Jarabak polygon (cephalometric) and the angle of facial opening (photographic). Two trained investigators performed all the measurements. The concordance of the facial diagnosis was determined using correlations of the interclass coefficient and the kappa test. p<0.05. Results: In cases with a mesofacial biotype, both analyses coincided in 60 individuals (68.2%), while in those diagnosed with a dolichofacial biotype, the analyses only coincided in 17 individuals (10.4%). There was no concordance between the two methods regarding the brachyfacial biotype since according to the angle of facial opening none of the individuals presented a brachyfacial biotype (kappa weighted test= 0.020, p=0.586). Conclusions: Cephalometric and photographic analyses should be complementary and one should not substitute the other. Attention should be focused on dolichofacial and brachyfacial biotypes, which showed less concordance between evaluations. So, more studies are needed to follow this line of research. Key words:Facial biotype, cephalometry, photography, facial type, radiography.

Three-dimensional decision support system for treatment of canine impaction.

INTRODUCTION: This study aimed to develop a 3-dimensional (3D) characterization of the severity of maxillary impacted canines and to test the clinical performance of this characterization as a treatment decision support tool. METHODS: Cone-beam computed tomography images obtained from 83 patients with 120 impacted maxillary canines were included. Quantitative information on the canine 3D position and qualitative assessment of root damage of adjacent teeth were evaluated. A severity index was constructed on the basis of the quantitative findings. Clinical applicability was tested by comparing clinical diagnosis and treatment planning for conventional records vs the 3D characterization via a 2-part survey. RESULTS: The average quantitative assessments of impacted maxillary canine position were 6.4 ± 3.6 mm from the midsagittal plane, 11.6 ± 3.1 mm in height relative to the occlusal plane, 31.5° ± 18° of roll, and 48.8° ± 14.3° of pitch. The severity index ranged from 0-13 with a mean score of 4.5 ± 2.2. Overlap with adjacent teeth was the greatest contributor (33%) to the index. Bicortically impacted canines caused the most severe root damage. Cone-beam computed tomography was preferred for assessing root damage and overall severity, whereas conventional imaging was sufficient for height and angulation assessment. The 3D report was very important or important for evaluating root damage, canine position, overall severity, and overlap. The 3D report changed most of the decisions relating to biomechanics, patient education, and treatment time estimate. The decision of exposure and traction vs extraction was changed 22% of the time after the presentation of the 3D report. CONCLUSIONS: The overlap with adjacent teeth frequently contributes the most to the severity index. The 3D report provided relevant clinical information regarding the canine position, damage to adjacent teeth, and the severity index, with a profound impact on the decisions of the clinicians regarding biomechanics, patient education, and treatment time estimate.

Evaluation of the follicular space volume of lower third molars with different impaction positions and angulations: A cone-beam computed tomography and histopathological study.

Objective: To quantify the volume of the follicular spaces of impacted lower third molars (ILTMs) with different impaction positions and angulations using cone-beam computed tomography (CBCT) and to determine its association with the histopathological findings. Study design: This study included 103 ILTMs of 33 men and 70 women aged 18-46 years (mean age, 29.18 years). The follicular space volumes were measured on CBCT by manual segmentation and correlated with the histopathological diagnosis of each ILTM having different impaction positions and angulations. Statistical Product and Service Solutions, version 24, was used for statistical analyses by applying the t-test and binary logistic regression and multiple linear regression tests (p < 0.05). Results: Overall, 83 (80.6%) dental follicles presented a non-pathological diagnosis (mean follicular volume, 0.10 cm3), whereas 20 (19.4%) presented a pathological diagnosis (mean follicular volume, 0.32 cm3; p = 0.001). Similarly, the impaction depth in Position C cases was associated with a pathological diagnosis (p = 0.010). Conclusion: The follicular volume of the ILTMs varied significantly in teeth with a histopathological diagnosis of a follicular cyst and was associated with the impaction depth, mainly in Position C cases, and its relationship with the mandibular ramus. A mean follicular volume of 0.32 cm3 was associated with a greater probability of a pathological diagnosis.

Postoperative chronic pain in arthroplasty papillon-lefèvre syndrome: 17-year dental follow-up: case report / Síndrome de papillon-lefèvre: seguimiento dental de 17 años: reporte de caso

Introduction: The present report describes the case of a 12-year-old patient with 17-year follow-up who was previously diagnosed with Papillon-Lefèvre Syndrome (PLS), which is a rare autosomal recessive irregularity in the cathepsin C gene (CTSC) characterized by palmoplantar hyperkeratosis and premature loss of primary and permanent teeth. Case Report: A specific mutation in the c.203 T > G gene inducing loss of function leading to PLS was detected, as was a mutation in the HLA-DRB1*11 allele, which is associated with this syndrome. There is no consanguinity of the parents, and the siblings are entirely healthy. Early identification of the main characteristics of this syndrome is imperative. Accurate diagnosis by genetic analysis allows differential diagnoses and timely comprehensive dental treatment. Conclusions: Additionally, it allows consultation with a dermatologist to maintain or improve the quality of life of patients with this condition due to progressive worsening and severity of the main physical manifestations. Keywords: Papillon-Lefevre Disease; Keratoderma, Palmo-plantar; Cathepsin C; Periodontitis; Skin Diseases, Genetic; Case reports

Introducción: El presente reporte describe el caso de un paciente de 12 años de edad con 17 años de seguimiento a quien previamente se le diagnosticó Síndrome de Papillon-Lefèvre (PLS), el cual es una rara irregularidad autosómica recesiva en el gen de la catepsina C (CTSC) caracterizada por hiperqueratosis palmoplantar y pérdida prematura de dientes primarios y permanentes. Reporte de Caso: Se detectó una mutación específica en el gen c.203 T > G que induce pérdida de función que conduce a PLS, así como una mutación en el alelo HLA-DRB1*11, que se asocia a este síndrome. No presenta consanguinidad de los padres, padres y hermanos totalmente sanos. La identificación temprana de las principales características de este síndrome es imperativa. El diagnóstico certero por análisis genético permite diagnósticos diferenciales y tratamientos odontológicos integrales oportunos. Conclusiones: Adicionalmente, permite la consulta con un dermatólogo para mantener o mejorar la calidad de vida de los pacientes con esta condición debido al progresivo empeoramiento y severidad de las principales manifestaciones físicas.

Association of breastfeeding duration with the development of non-nutritive habits, and transversal and vertical occlusal alterations in preschool children: A cross-sectional study.

BACKGROUND: Breastfeeding has multiple nutritional, immunological and psychological benefits, as well as a positive influence on the development of the stomatognathic system. OBJECTIVES: The present study attempted to determine the relationship between the duration of breastfeeding and the development of non-nutritive habits, and transversal and vertical occlusal alterations in preschool children. MATERIAL AND METHODS: This cross-sectional study involved 155 preschoolers aged 2-5 years from 3 public schools in Lima, Peru. The sample was divided into 2 groups with regard to the duration of breastfeeding: group A (n = 50) included infants that had been breastfed for up to 6 months; and group B (n = 105) included infants that had been breastfed for 6-12 months. Two trained and calibrated dentists evaluated each group, and clinically determined the presence or absence of transversal or vertical occlusal alterations. Likewise, the children's parents or caregivers were consulted to determine the development of non-nutritive habits. RESULTS: A significant association was found between breastfeeding duration and the development of the oral breathing habit; groups A and B showed a prevalence of 30.0% and 16.2%, respectively (p = 0.048). Likewise, breastfeeding duration affected the appearance of oral breathing (OR (odds ratio) = 0.84; 95% CI (confidence interval): 0.74-0.96; p = 0.011). Furthermore, the use of a bottle for more than 24 months significantly influenced the appearance of oral habits (OR = 3.55; 95% CI: 1.20-10.55; p = 0.022) and open bite (OR = 12.12; 95% CI: 1.16-126.31; p = 0.037). CONCLUSIONS: Breastfeeding duration of 6-12 months was shown to be a protective factor in preventing the appearance of oral breathing. Posterior crossbite (PCB), open bite and deep bite seemed not to be influenced by breastfeeding duration. However, the use of a bottle for more than 24 months significantly influenced the appearance of anterior open bite.

An international assessment of surgeon practices in abdominal wound closure and surgical site infection prevention by the European Society for Coloproctology.

AIM: The burden of abdominal wound failure can be profound. Recent clinical guidelines have highlighted the heterogeneity of laparotomy closure techniques. The aim of this study was to investigate current midline closure techniques and practices for prevention of surgical site infection (SSI). METHOD: An online survey was distributed in 2021 among the membership of the European Society of Coloproctology and its partner societies. Surgeons were asked to provide information on how they would close the abdominal wall in three specific clinical scenarios and on SSI prevention practices. RESULTS: A total of 561 consultants and trainee surgeons participated in the survey, mainly from Europe (n = 375, 66.8%). Of these, 60.6% identified themselves as colorectal surgeons and 39.4% as general surgeons. The majority used polydioxanone for fascial closure, with small bite techniques predominating in clean-contaminated cases (74.5%, n = 418). No significant differences were found between consultants and trainee surgeons. For SSI prevention, more surgeons preferred the use of mechanical bowel preparation (MBP) alone over MBP and oral antibiotics combined. Most surgeons preferred 2% alcoholic chlorhexidine (68.4%) or aqueous povidone-iodine (61.1%) for skin preparation. The majority did not use triclosan-coated sutures (73.3%) or preoperative warming of the wound site (78.5%), irrespective of level of training or European/non-European practice. CONCLUSION: Abdominal wound closure technique and SSI prevention strategies vary widely between surgeons. There is little evidence of a risk-stratified approach to wound closure materials or techniques, with most surgeons using the same strategy for all patient scenarios. Harmonization of practice and the limitation of outlying techniques might result in better outcomes for patients and provide a stable platform for the introduction and evaluation of further potential improvements.

Harnessing the Power of Technology to Improve Sexual and Reproductive Youth Health in Nicaragua: A Randomized Field Study.

Introduction: Nicaragua is among the poorest countries in Latin America and has one of the highest adolescent pregnancy rates in the region. One in four of pregnancies are adolescents and they are more likely to experience poverty and gender and economic inequality. Method: This pilot randomized field study assessed use, satisfaction, and impact of a brief e-learning short-term intervention to improve the sexual and reproductive health (SRH) knowledge, skills, motivations, and behaviors among 14-17-year-old Nicaraguan youth. Results: While access to technology and internet were significant barriers, App and email delivery channels were feasible means for communicating with youth who had access to the internet and mobile devices. Youth who used the app were most likely to complete the entire intervention. Youth were very satisfied with the intervention (98%) and significantly improved SRH knowledge, skills and motivations, and delayed age at the first sexual encounter. Conclusion: Results are promising and indicate potential for the scalability of this type of intervention.