Objectives: Quantitative assessment of 3-dimensional progressive changes of the maxillary geometry in unilateral cleft lip palate (UCLP) with and without nasoalveolar molding (NAM). Methods: The study was designed as a prospective 2-arm randomized controlled clinical trial conducted in parallel. Forty infants with nonsyndromic UCLP were randomly assigned into a NAM-treated group (n = 20) and non–NAM treated group (n = 20). A total of 120 laser-scanned maxillary casts were collected and blindly analyzed via a modified algorithm at T0 (initial visit; baseline), T1 (after 3 wk; first interval), and T2 (after 6 wk; second interval). The main outcome measures were the amount and rate of cleft gap changes, the midline position, and the transverse, sagittal, and vertical growth through intervals. Results: More than 50% of the cleft gap (56.42%; P < 0.001) was reduced in the first 3 wk of alveolar molding (AM). The end point of the AM was obtained in 6 wk (86.25%; P < 0.001); then, the kinks of the greater segment were noticed. The AM effect decreased as far as posterior; the anterior arch width reduced slightly (1.23%; P < 0.001), while the middle and posterior arches increased slightly (P > 0.999 and P = 0.288, respectively). The posterior arch width was the least changing and was considered a baseline, while the anterior was the pivot of the segment rotation. Both groups showed different patterns of segment rotation and sagittal growth. The non–NAM treated group showed a slight increase in cleft gap length, arch width, and midline position. Conclusion: Based on this study, it was concluded that the NAM treatment is effective in minimizing cleft severity and realigning maxillary segments without the deterioration of the transverse and vertical arch growth. Near follow-up visits are recommended to monitor the rapid gap reduction within the first 3 wk. Further trials are recommended to compare the outcomes regarding the sagittal growth to reference values ( ClinicalTrials.gov NCT03029195). Knowledge Transfer Statement: The results of this study will help clinicians understand nasoalveolar molding biomechanics that may improve the treatment outcomes for patients with unilateral cleft lip and palate. The trial data can be a valuable guide to the qualitative and quantitative predictive virtual molding in computer aided design–simulated nasoalveolar molding therapy. The modified algorithm can be used by researchers to quantify the rate, the sequence, and the direction of the maxillary segments movement in unilateral cleft lip and palate.

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Background Osteoporosis is a major health problem of elders. Dual X-ray absorptiometry (DEXA) is the commonly used modality for diagnosis osteoporosis; serum markers have been suggested for predicting osteoporosis and discriminate osteoporotic from healthy subjects. We aimed to analyze the status of some bone turnover biochemical markers namely PINP, B-ALP, estrogen, and progesterone in the elderly osteoporotic and osteopenic women as probable markers for the discrimination between patients and healthy individual in diagnosing osteoporosis, and also, to detect the impact of osteoporosis on quality of life of patients using assessment of the quality of life for osteoporosis (ECOS-16). Post-menopausal 108 females were involved in the current study, divided into two groups (osteoporotic group (60 with BMD˂-2.5), osteopenic group (48 with BMD between − 1 and − 2.5)), and 60 healthy elderly females as control group were involved in the study. Serum levels of procollagen type I N-terminal propeptide (PINP), bone alkaline phosphatase (B-ALP), estrogen, and progesterone were measured by ELISA technique. Results PINP and B-ALP significantly differ between studied groups. Also, PINP and B-ALP levels had high sensitivity and specificity to discriminate osteoporotic patients from healthy individuals. PINP and B-ALP significantly correlated with bone mineral density (BMD) and with ECOS-16. Estrogen differs significantly between osteoporotic and osteopenic groups and significantly correlated with bone mineral density of femur (BMD-F) and bone mineral density of spine (BMD-S) in the osteopenic group. Progesterone differed significantly between patients and controls and significantly correlated with BMD-F in the osteoporotic group. Conclusion We can consider PINP and B-ALP as biomarkers for early detection then monitoring of osteoporosis. Measuring these serum markers can replace the assessment of BMD if not available. Also, it could replace the gap between BMD subsequently spaced assessment or could be of value in cases with severe spondylosis, DISH syndrome, old spondylarthritis, and/or previous spinal surgery. Sex hormones could not differentiate the normal from the osteoporotic/osteopenic patients, so they cannot be used as diagnostic or prognostic markers. Validation of this assumption needs large and longitudinal studies.

The G2019S mutation in the LRRK2 gene is quite common in Egyptian patients with sporadic PD. The mutation is associated with a higher degree of motor effect but does not seem to affect mentation or behavioral aspects of the disease.

INTRODUCTION: Cleft lip and palate (CLP) affects about 1.5 per 1000 live births (250,000 new cases per year) worldwide. They can be either unilateral or bilateral, complete or incomplete. The bilateral cleft lip and palate (BCLP) deformity typically arises with a protrusive premaxilla. The nasal deformity includes deficient columella, with flared lateral alar cartilages which usually require additional surgeries to improve the nasal symmetry. NasoAlveolar Moulding (NAM) technique, aims to align the alveolus, lip, and nose properly; reduce the severity of the nasal deformity, and lengthen the columella without surgery. OBJECTIVES: The study aims to quantify the effect of NAM therapy, fabricated by CAD/CAM additive manufacturing, in the improvement of nasolabial deformity in terms of bialar width, columellar length and width in infants with complete BCLP. MATERIALS AND METHODS: Ten infants with non-syndromic BCLP (age < 1 month) were selected. Impressions were obtained. The casts obtained from the impressions were scanned using a 3D laser scanner. Designing and 3D printing of the appliances were completed. The appliances were inserted and retained using surgical tapes. Nasal stents were incorporated 60 days after the start of the treatment. Nasal measurements were obtained before treatment and at the end of treatment (after four months). RESULTS: Data was collected and statistically analyzed. After NAM therapy, there was a statistically significant increase in columellar length and a statistically significant decrease in both columellar width and bialar width. CONCLUSIONS: CAD/CAM PNAM therapy has proved its effectiveness in BCLP by showing an improvement in the columellar and bialar presurgical presentation. CAD/CAM PNAM therapy should be considered a routine procedure in the treatment protocol for BCLP.