Severe early childhood caries (ECC), while strongly associated with Streptococcus mutans using selective detection (culture, PCR), has also been associated with a widely diverse microbiota using molecular cloning approaches. The aim of this study was to evaluate the microbiota of severe ECC using anaerobic culture. The microbial composition of dental plaque from 42 severe ECC children was compared with that of 40 caries-free children. Bacterial samples were cultured anaerobically on blood and acid (pH 5) agars. Isolates were purified, and partial sequences for the 16S rRNA gene were obtained from 5,608 isolates. Sequence-based analysis of the 16S rRNA isolate libraries from blood and acid agars of severe ECC and caries-free children had >90% population coverage, with greater diversity occurring in the blood isolate library. Isolate sequences were compared with taxon sequences in the Human Oral Microbiome Database (HOMD), and 198 HOMD taxa were identified, including 45 previously uncultivated taxa, 29 extended HOMD taxa, and 45 potential novel groups. The major species associated with severe ECC included Streptococcus mutans, Scardovia wiggsiae, Veillonella parvula, Streptococcus cristatus, and Actinomyces gerensceriae. S. wiggsiae was significantly associated with severe ECC children in the presence and absence of S. mutans detection. We conclude that anaerobic culture detected as wide a diversity of species in ECC as that observed using cloning approaches. Culture coupled with 16S rRNA identification identified over 74 isolates for human oral taxa without previously cultivated representatives. The major caries-associated species were S. mutans and S. wiggsiae, the latter of which is a candidate as a newly recognized caries pathogen.

Increasing internal scapular rotation and decreasing upward scapular rotation significantly increase glenohumeral contact pressure and the area of impingement of the rotator cuff tendon between the greater tuberosity and glenoid during simulated throwing motion.

Early excision and autografting are standard care for deeper burns. However, donor sites are a source of significant morbidity. To address this, the ReCell® Autologous Cell Harvesting Device (ReCell) was designed for use at the point-of-care to prepare a noncultured, autologous skin cell suspension (ASCS) capable of epidermal regeneration using minimal donor skin. A prospective study was conducted to evaluate the clinical performance of ReCell vs meshed split-thickness skin grafts (STSG, Control) for the treatment of deep partial-thickness burns. Effectiveness measures were assessed to 1 year for both ASCS and Control treatment sites and donor sites, including the incidence of healing, scarring, and pain. At 4 weeks, 98% of the ASCS-treated sites were healed compared with 100% of the Controls. Pain and assessments of scarring at the treatment sites were reported to be similar between groups. Significant differences were observed between ReCell and Control donor sites. The mean ReCell donor area was approximately 40 times smaller than that of the Control (P < .0001), and after 1 week, significantly more ReCell donor sites were healed than Controls (P = .04). Over the first 16 weeks, patients reported significantly less pain at the ReCell donor sites compared with Controls (P ≤ .05 at each time point). Long-term patients reported higher satisfaction with ReCell donor site outcomes compared with the Controls. This study provides evidence that the treatment of deep partial-thickness burns with ASCS results in comparable healing, with significantly reduced donor site size and pain and improved appearance relative to STSG.

If patients have left-sided localized abdominal pain without associated symptoms or laboratory abnormalities, clinicians should suspect the diagnosis of PEA and consider a CT scan.

Background: Several changes have been made to the revised 2017 international consensus guidelines for management of pancreatic intraductal papillary mucinous neoplasms (IPMNs). However, the diagnostic performance is yet to be verified. Purpose:To evaluate the revised guidelines for predicting malignant potential of pancreatic IPMNs and to compare diagnostic performance and intermodality agreement between contrast material-enhanced CT and MRI. Materials and Methods:In this retrospective study, two radiologists analyzed the preoperative contrast-enhanced CT and MRI of patients with surgically resected pancreatic IPMNs from January 2007 to December 2017. The diagnostic performance of CT and MRI were analyzed by using receiver operating curve analysis. Intermodality agreement was assessed by using weighted k and intraclass correlation coefficient values.Results: A total of 86 patients (mean age, 67.6 years 6 8.9 [standard deviation]; 47 men and 39 women) with pancreatic IPMNs (benign, 58; malignant, 28) were included. At both CT and MRI, enhancing mural nodule (P , .001), abrupt main pancreatic duct caliber change (P , .001), lymphadenopathy (P = .006), larger main pancreatic duct size (P = .003), and faster cyst growth rate (P = .04) were more common in malignant than benign IPMNs. Irrespective of the modality, enhancing mural nodule of 5 mm or greater had the highest odds ratio (25 at CT vs 29 at MRI). The diagnostic performance of CT (area under the receiver operating characteristic curve, 0.83 [95% confidence interval: 0.75, 0.92]) and MRI (area under the receiver operating characteristic curve, 0.86 [95% confidence interval: 0.77, 0.95]) for predicting malignant IPMNs were comparable (P = .43), with good intermodality agreement (k = 0.70). Conclusion:Among revised features, enhancing mural nodule of 5 mm or greater had the strongest association with malignant intraductal papillary mucinous neoplasm (IPMN), and diagnostic performance for prediction of malignant IPMNs were comparable between contrast-enhanced CT and MRI with good intermodality agreement.