Development of novel clinical examination scales for the measurement of disease severity in Creutzfeldt-Jakob disease

ObjectiveTo use a robust statistical methodology to develop and validate clinical rating scales quantifying longitudinal motor and cognitive dysfunction in sporadic Creutzfeldt-Jakob disease (sCJD) at the bedside.MethodsRasch analysis was used to iteratively construct interval scales measuring composite cognitive and motor dysfunction from pooled bedside neurocognitive examinations collected as part of the prospective National Prion Monitoring Cohort study, October 2008–December 2016.A longitudinal clinical examination dataset constructed from 528 patients with sCJD, comprising 1030 Motor Scale and 757 Cognitive Scale scores over 130 patient-years of study, was used to demonstrate scale utility.ResultsThe Rasch-derived Motor Scale consists of 8 items, including assessments reliant on pyramidal, extrapyramidal and cerebellar systems. The Cognitive Scale comprises 6 items, and includes measures of executive function, language, visual perception and memory. Both scales are unidimensional, perform independently of age or gender and have excellent inter-rater reliability. They can be completed in minutes at the bedside, as part of a normal neurocognitive examination. A composite Examination Scale can be derived by averaging both scores. Several scale uses, in measuring longitudinal change, prognosis and phenotypic heterogeneity are illustrated.ConclusionsThese two novel sCJD Motor and Cognitive Scales and the composite Examination Scale should prove useful to objectively measure phenotypic and clinical change in future clinical trials and for patient stratification. This statistical approach can help to overcome obstacles to assessing clinical change in rapidly progressive, multisystem conditions with limited longitudinal follow-up.

Relationship of Malocclusions with Disorders of the Temporomandibular Joint in Children of CALI—Colombia

Objective The aim of this study was to determine the relationship of malocclusion with the presence and severity of temporomandibular disorders (TMDs) in children. Materials and Methods A clinical examination was performed in 87 patients (from 4 to 14 years of age) who attended the dentistry clinics of Universidad del Valle. Results The 77 patients studied had malocclusions; 55 patients had TMD and 67.3% were female. The most frequent symptom of TMD was articular unilateral noise with 33.8%, followed by pain in at least one masticatory muscle with 26%. TMJ pain was observed in 24.7% of the patients. There was a statistically significant relationship between the presence and severity of TMD with type of dentition and transverse malocclusion, respectively. Conclusion The presence of TMD in children with malocclusion presented in a high frequency. TMD depends on the type of dentition and its severity is dependent on transverse malocclusion.

Interception of a Reverse Incisor Occlusion in Mixed Dentition

Introduction: This case report describes an orthodontic interception of a mixed dentition reverse incisor bite in a 12-year-old boy at the time of consultation. Case Report: After a careful clinical examination supported by routine radiological examinations, a skeletal class III diagnosis was made and an orthodontic interception was decided to restore the inverted incisor joint and the various orofacial functions disrupted by the malocclusion. After twenty months of interceptive treatment consisting of a joint jump and class III intermaxillary traction, we found satisfactory overhang and coverage allowing us to monitor the placement of the definitive canines with an improvement in the skin profile and smile. Conclusion: This simple gesture which made it possible to put the mandible back in a position restoring normal incisal coverage contributes to good orofacial muscle maturation closely linked to the various occlusal functions restored.

Spontaneous pre-axial polydactyly in Swiss mice

ABSTRACT: Spontaneous polydactyly has been described in several species, but only one report about it in Swiss mice. The aim of the current study was to report the spontaneous occurrence of pre-axial polydactyly in Swiss mice. Clinical examination showed one extra toe laterally to the first digit, in the plantar region, alopecia in the back, altered face growth anatomy and changed perineal region anatomy. Pre-axial polydactyly in the tibial side, fused metatarsals and Y-shaped free phalanges were evidenced in the radiographic images. Pre-axial polydactyly observed in the plantar region differed from that in reports on albino Swiss mice with post-axial polydactyly (Po/Po+) phenotype featured by one extra toe in the ulnar side of one, or both, front limbs, which is the dominant feature. The observed findings highlight the importance of both clinical examinations and close attention by professionals involved in rodents’ breeding on physical changes resulting from different causes, including the genetic ones, since they reveal mutations and, sometimes, new biomodels.

CORRELATION OF PANORAMIC RADIOGRAPHIC FINDINGS AND CLINICAL FINDINGS OF DENTAL PATIENTS AT MOI TEACHING AND REFERRAL HOSPITAL, KENYA

Purpose: The purpose of this study was to determine the correlation of panoramic radiographic findings and clinical findings among dental patients at Moi Teaching and Referral Hospital (MTRH), Kenya. Materials and Methods: This was a hospital based cross sectional study conducted at the Radiology and Imaging department and dental department at Moi Teaching and Referral Hospital from September, 2019 to June, 2020. A total of 93 consenting patients were enrolled using systematic random sampling. Standard chart review forms were administered, and clinical examination findings documented. Panoramic radiograph findings were then discussed with a consultant radiologists and findings recorded. Descriptive statistics were carried out. Categorical variables were summarized as frequencies and proportions, and reported in tables. Numerical variables were summarized as median and interquartile ranges. Cross tabulation was done to compare clinical examination and panoramic radiograph findings where total raw agreement was reported as proportions. Results: 93 patients whose ages ranged from 5-73 years with a mean of 29 years were included into the study. Radiographic features of dental caries were present in 54% of panoramic radiographs compared to clinical examination (50.5%) while 23.7% of radiographs revealed impacted teeth compared to clinical examination (19.4%). Radiographic features of periodontitis were observed in 14% compared to clinical examination (16.1%). Fractures (12.9%) were observed radiographically compared to (10.7%) clinically. Periapical lesions (8.6%) were observed radiographically compared to clinical examination (6.4%). Temporo-mandibular disorder (6.5%) were observed both on radiographs and clinical examination. Radiographic features of missing teeth (3.2%) were observed compared to clinical examination (1.1%) while only 1.1% of malpositioned teeth were observed radiographically compared to clinical examination (2.2%). Notably, mandibular lesions (3.2%) and nasal congestion (14%) were only discovered radiographically. The overall raw agreement between panoramic radiograph and clinical examination was 75.3% (70/93) with a p value of less than 0.001. Unique contribution to theory, practice and policy: The study recommends that all patients presenting with dental conditions should be done panoramic radiograph to improve diagnosis. Moi Teaching and Referral Hospital and the Ministry of Health to consider routine panoramic radiographs in the guidelines for the assessment of dental patients in all the hospitals offering, dental health services