Poor oral health in elite sport is a pressing issue, however little is known about the periodontal status of professional footballers. The aim of this study was to examine the prevalence of periodontitis in a group of professional footballers and its association with nutritional parameters and self-report non-traumatic injuries. Additionally, we assessed its association with anthropometric, dietary inflammatory load and self-reported muscular and/or articular injuries. Twenty-two professional footballers were evaluated at the beginning of the 2020–2021 season via full-mouth periodontal inspection, anthropometric measurements and the application of the dietary inflammatory index through a food intake measurement of 24 h dietary recall on two different days. Self-reporting non-traumatic muscular and articular injuries for the past 6 months were recorded from each athlete. Then we compared clinical measurements according to the periodontal status and we correlated age, periodontal and nutritional parameters. Overall, the prevalence of periodontitis was 40.9% and peri-implantitis was also observed. No significant differences were found regarding age or nutritional parameters according to the periodontal status. More non-traumatic muscular events in the past 6 months were found in the periodontitis group (55.6% vs. 38.4%), although the difference was non-significant. Both clinical attachment loss, periodontal pocket depth and the periodontal epithelial surface area revealed a significant moderate correlation with the percentage of fat mass, muscle mass, muscle mass index and total adipose folds. This group of professional footballers showed an alarming prevalence of periodontitis. Further studies shall examine whether periodontitis and periodontal treatment impact the performance of this group of athletes.

Warping of costal cartilage is well described; however, its strength and abundance still make it a desirable graft material, especially in complex reconstructive rhinoplasty. Despite multiple methods of cartilage harvest, carving, and preimplantation treatment being developed over the years, warp remains a challenging clinical problem. OBJECTIVE To assess whether the 30°oblique split method of preparing costal cartilage grafts produces less warping of the graft than the current standard of harvesting the central segment of a rib using the concentric carving method. DESIGN, SETTING, AND PARTICIPANTS This in vitro cadaveric study evaluated the warping of costal cartilage grafts using the oblique split method with an angle of 30°or the concentric carving method during a 3-month period beginning in December 2014. MAIN OUTCOMES AND MEASURES Millimeters of warp from baseline (at 1 hour) and at 1, 2, and 3 months, measured in the frontal and lateral planes. RESULTS Among 74 costal cartilage grafts (using the oblique split method with an angle of 30°in 41 and the concentric carving method in 33), the mean amount of warp in the frontal plane was between 1.12 mm (95% CI, 0.96-1.28 mm) and 1.57 mm (95% CI, 0.94-2.20 mm) for the oblique group and between 1.18 mm (95% CI, 0.98-1.38 mm) and 1.29 mm (95% CI, 0.86-1.72 mm) for the concentric group during the 3-month period. There was no statistically significant difference in the frontal plane between the 2 methods at 1 hour (P = .45; 0.10 mm, 95% CI, −0.38 to 0.17 mm), 1 month (P = .32; 0.13 mm, 95% CI, −0.13 to 0.40 mm), 2 months (P = .50; 0.28 mm, 95% CI, −0.55 to 1.11 mm), or 3 months (P = .15; 0.22 mm, 95% CI, −0.08 to 0.52 mm) using the t test, regression analysis, or panel data analysis. Similarly, no significant difference was found in the lateral plane at 1 hour (P = .89; 0.04 mm, 95% CI, −0.49 to 0.56 mm), 1 month (P = .82; 0.07 mm, 95% CI, −0.56 to 0.70 mm), 2 months (P = .29; 0.40 mm, 95% CI, −0.36 to 1.17 mm), or 3 months (P = .63; 0.22 mm, 95% CI, −0.70 to 1.13 mm) using the t test. Two grafts were excluded due to desiccation. CONCLUSIONS AND RELEVANCE The 30°oblique split and concentric carving methods of costal cartilage graft carving are equivalent in terms of the amount of warp. The oblique split method may be superior because of easier carving and the increased volume of material. LEVEL OF EVIDENCE NA.

Although vertical transmission of CHIKV has been reported, little is known about the role of placenta in the transmission of this virus and the effects of infection on the maternal-fetal interface. In this work we investigated five placentas from pregnant women who became infected during the gestational period. Four formalin-fixed paraffin-embedded samples of placenta (cases 1–4) were positive for CHIKV by RT-PCR. One (case 5) had no positive test of placenta, but had positive RT-PCR for CHIKV in the serum of the mother and the baby, confirming vertical transmission. The placentas were analyzed regarding histopathological and immunological aspects. The main histopathological changes were: deciduitis, villous edema, deposits, villous necrosis, dystrophic calcification, thrombosis and stem vessel obliteration. In infected placentas we noted increase of cells (CD8+ and CD163+) and pro- (IFN-γ and TNF-α) and anti-inflammatory (TGF-β and IL-10) cytokines compared to control placentas. Moreover, CHIKV antigen was detected in decidual cell, trophoblastic cells, stroma villi, Hofbauer cells, and endothelial cells. In conclusion, CHIKV infection seems to disrupt placental homeostasis leading to histopathological alterations in addition to increase in cellularity and cytokines overproduction, evidencing an altered and harmful environment to the pregnant woman and fetus.

Background. Duodenal gastrointestinal stromal tumours (GISTs) are an uncommon malignancy of the gastrointestinal (GI) tract. We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection. Case Presentation. A 61-year-old patient presented with acute life-threatening gastrointestinal bleeding. After oesophagogastroduodenoscopy failed to demonstrate the source of bleeding, a 5 cm ulcerating exophytic mass originating from the third part of the duodenum was identified at laparotomy. A successful limited wedge resection of the tumour mass was performed. Histopathology subsequently confirmed a duodenal GIST. The patient remained well at 12-month followup with no evidence of local recurrence or metastatic spread. Conclusion. Duodenal GISTs can present with life-threatening upper GI haemorrhage. In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection. This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.

SummaryNecrotising fasciitis is a rare condition that should be diagnosed early and managed aggressively in order to avoid death. We present a case of necrotising fasciitis of the thumb and discuss the assessment and management of this serious condition. A 44-year-old woman presented with a painful and erythematous right thumb and progressive swelling of her hand following a minor injury to the tip of her thumb 3 days previously. A diagnosis of necrotising fasciitis was made and the patient underwent urgent debridement of non-viable tissue. She required 1 week of supportive therapy in intensive treatment unit and was discharged from hospital after 3 weeks. Necrotising fasciitis is a rapidly progressing life-threatening infection, usually caused by streptococcal organisms. Immediate resuscitation, broadspectrum intravenous antibiotics and early surgical debridement are necessary in order to avoid significant morbidity and mortality. BACKGROUND

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In this series, the experience of individuals performing fine needle aspirations was the most important factor related to adequacy.

Twelve children (9 boys and 3 girls, ages 1 1/2-12 yrs.) with unicameral bone cysts were treated with triamcinolone acetonide (4 patients) or methylprednisolone acetate (8 patients) injected directly into the cyst cavity. Postinjection radiographic changes that indicate healing were noted in eight patients and included: reduced size of the cyst cavity, increased internal density, cortical thickening, and remodeling in the vicinity of the cyst. Additional injections were required in three patients because of delayed or partial healing. Recurrence of the cyst (1 case) was signaled by renewed rarefaction and bone expansion.