Objective: To determine if measurements obtained from digital models from cone beam computed tomography (CBCT) images were comparable to the traditional method of digital study models by impressions. Materials and Methods: Digital models of 30 subjects were used. InVivoDental (Anatomage, San Jose, Calif) software was used to analyze CBCT scans taken by a Galileos cone beam scanner (Sirona, Charlotte, NC) with a field of view of 15 3 15 3 15 cm 3 and a voxel resolution of 0.125 mm. OrthoCAD (Cadent, Fairview, NJ) software was used to analyze impression scans of patients at different stages of orthodontic treatment. Impressions were taken using alginate and were mailed to OrthoCAD for digital conversion. The scans were then electronically returned in digital format for analysis. Results: The maxillary mean scores for the Little's Index were 9.65 mm for digital models and 8.87 mm for InVivoDental models, respectively. The mandibular mean scores for the Little's Index were 6.41 mm for digital models and 6.27 mm for InVivoDental models, respectively. The mean overjet measurements were 3.32 mm for digital models and 3.52 mm for InVivoDental models, respectively. The overbite measurements were 2.29 mm for digital models and 2.26 mm for InVivoDental models, respectively. The paired t-test showed no statistical significance between the differences in all measurements. Conclusions: CBCT digital models are as accurate as OrthoCAD digital models in making linear measurements for overjet, overbite, and crowding measurements (Angle Orthod. 2010;80:435-439.)
Frontotemporal dementia (FTD) is a debilitating disease that is well described in the “Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5)”, and typically presents with memory impairment, progressive decline in cortical functioning, and behavioral changes. Age of onset is generally in the late fifties, and usually the first presentation involves a change in behavior and emotional blunting. Treatment of FTD involves management of any neurobehavioral symptoms while trials of atypical antipsychotics are ongoing but suggest some efficacy. We present a case of a patient who first presented with severe paranoid personality traits and frank persecutory delusions. This atypical presentation of our patient first led to her incorrect diagnosis of a psychotic disorder and paranoid personality disorder. As a result of this diagnosis, she was treated unsuccessfully. A subsequent magnetic resonance imaging (MRI) then showed atrophy of frontal and temporal lobes bilaterally (left more prominent than right) which confirmed the diagnosis of FTD. The importance of this case involves the atypical presentation of paranoia and delusions, and our patient’s incorrect diagnosis based on her clinical presentation led to a trial of unsuccessful treatment. Only after performing an MRI, which showed atrophy, was the patient appropriately treated and deemed medically stable. This case report illustrates the importance of considering a rare presentation of frontotemporal lobe dementia with patients who are in the typical age range and present with paranoia and delusions.
Context:Emphysematous cystitis (EC) is a rare infection of the urinary tract that results in gas production in the bladder. It is more common in diabetic and female patients, and can be associated with more serious complications, including pyelonephritis.Case Report:We describe a case of recurrent bacterial cystitis caused by Escherichia coli (E. coli). An incidental finding in our patient of pneumaturia on computed tomography (CT) scan prompted further work-up. Differential diagnoses for pneumaturia include infection, trauma, and fistula, most commonly colovesicular. The patient history ruled out trauma and CT scanning ruled out a fistula; culture of the urine then showed a bacterial load greater than 100,000 E. coli/mL. The patient was then diagnosed with EC. She was treated with ceftriaxone and released in stable condition.Conclusion:The literature was scarce when it came to diagnoses of EC based on bacterial load. We present this case to increase health care providers' awareness of recurrent EC with a urine culture bacterial load greater than 100,000 E. coli/mL.
Ascites is more common in cirrhotic patients. Bladder or ureteral injury is possible in surgeries involving lower abdomen or pelvic area which can mimic ascites. Intraoperative bladder puncture or ureteral nicking during abdominal surgeries is a rare but potentially serious complication. It is important to recognize these complications as early as possible to minimize damage and prevent further treatment complications. We report a case of recurrent ascites in a 65-year-old female who underwent exploratory laparotomy for a ruptured diverticular abscess that paradoxically increased with furosemide treatment.
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