Calcinosis was common in both limited and diffuse systemic sclerosis; both longer disease duration and osteoporosis were independently associated with calcinosis. Prospective studies are needed to confirm our findings.
Tumor necrosis factor inhibitors (TNFi) have established efficacy in psoriasis and psoriatic arthritis; however, there are concerns regarding the risk of lymphoma with their use. Although current data suggest that this risk is not increased with TNFi treatment, there are no data on the risk of recurrence of previously treated lymphoma under TNFi therapy. Herein, we describe a 46-year-old man with recurrent non-Hodgkin lymphoma whose refractory psoriatic arthritis was effectively treated for 5.5 years with the TNFi etanercept, initiated just 7 months after achieving lymphoma remission, without recurrence of non-Hodgkin lymphoma. However, he subsequently died 6.5 years later of pancreatic adenocarcinoma.
Cracked tooth refers to an incomplete fracture of a tooth that may involve the pulp. Both vital and non vital teeth can develop cracks. The causative factors include previous restorative procedures, excess occlusal forces, developmental conditions that result in the formation of weakened tooth structure, trauma, etc. Most commonly involved teeth are the mandibular molars mainly due to the wedging effect of the maxillary mesio-palatal cusp onto the central fissure of the mandibular molar. The crack can involve the crown or the root of the tooth or both. It may be limited to the enamel, may involve dentin or can extend upto the pulp also. Diagnosis of this condition becomes challenging due to varied clinical features. Common symptoms involve pain on releasing the bite due to snapping of the segments or due to independent movement of the fractured segments. The patient has difficulty in identifying the offending tooth and may give a history of numerous dental procedures being performed which fail to relieve pain. This write up deals with the classification, epidemiology, diagnosis and management of cracked teeth, evaluation of crack, nature of symptoms, determining the prognosis and using current, short and long term strategies for successful management.
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