Introduction.Stroke is a significant underlying cause of epilepsy. Seizures due to ischemic stroke (IS) are generally categorized into early seizures (ESs) and late seizures (LSs). Seizures in thrombolysis situations may raise the possibility of other etiology than IS.Aim.We overtook a systematic review focusing on the pathogenesis, prevalence, risk factors, detection, management, and clinical outcome of ESs in IS and in stroke/thrombolysis situations. We also collected articles focusing on the association of recombinant tissue-type plasminogen activator (rt-PA) treatment and epileptic seizures.Results.We have identified 37 studies with 36,775 participants. ES rate was 3.8% overall in patients with IS with geographical differences. Cortical involvement, severe stroke, hemorrhagic transformation, age (<65 years), large lesion, and atrial fibrillation were the most important risk factors. Sixty-one percent of ESs were partial and 39% were general. Status epilepticus (SE) occurred in 16.3%. 73.6% had an onset within 24 h and 40% may present at the onset of stroke syndrome. Based on EEG findings seizure-like activity could be detected only in approximately 18% of ES patients. MRI diffusion-weighted imaging and multimodal brain imaging may help in the differentiation of ischemia vs. seizure. There are no specific recommendations with regard to the treatment of ES.Conclusion.ESs are rare complications of acute stroke with substantial burden. A significant proportion can be presented at the onset of stroke requiring an extensive diagnostic workup.

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Intraosseous heat produced by surgical tungsten carbide round drills remains under the threshold temperature of bone necrosis for up to 30 coronectomies; however, the use of increased axial pressure (∼ 25 N), especially with the combination of decreased irrigation (∼ 33%), can cause unacceptable temperatures during bone removal. Professionals should select drills and drilling parameters that generate an acceptable amount of heat during surgical tooth removal.

The overall success rate of mini-implants was found acceptable in this study, however, screw mobility in the buccal fold showed a high incidence, suggesting the thorough consideration of the immediate loading by buccal mini-implants.

Headache is a common problem with great effect both on the individual and on the society. Recent studies raised the possibility of increasing rate of specialty referrals, inappropiate treatment and advanced imaging for simple headache. The aim of our study was to analyze the characteritics of patients (including duration of symptoms, headache type, brain imaging, treatment) referred to our specialized headache clinic between 01/01/2014 and 01/01/2015 by their general practitioners and primary care neurologists due to chronic/treatment-resistant headache syndromes. 202 patients (mean age 53.6 ± 17.6 years) were evaluated in our clinic (102 females, mean age 50.14 ± 16.11 years and 100 males, mean age 57 ± 18.1 years). Migraine (84/202) and tension-type (76/202) were the most common syndromes. 202 plain brain CT, 60 contrast-enhanced CT and 128 MRI were carried out by their general practitioners or other healthcare professioners including neurologists before referral to our headache centre. Despite of extensive brain imaging appropiate treatment was started less than 1/3 of all patients and significant proportion received benzodiazepines or opioid therapy. Furthermore, more than 10% of referred patients presented with secondary headache including one meningitis. The management of headache is still a challenge for primary care physicians leading to medical overuse. Vast majority of our patients should not be referred to our specialized headache clinic as they had uncomplicated headache or other underlying conditions than pain.

Orofacial pain is the common name of a variety of disorders from inflammatory diseases to neuropathic pain syndromes. This condition is quite common, it may involve 7% of the whole population. Patients (and doctors) are not aware of the origin of their complaints, therefore initial management falls among the variety of healthcare professionals. The aim of our review was to summarize the current evidence of chronic orofacial pain including diagnosis, management and pitfalls. Orv Hetil. 2019; 160(27): 1047–1056.

Class II malocclusion is one of the most common dental anomalies and the use of intermaxillary elastomers is the standard method in its treatment. However, orthodontic elastics cannot exert continuous force over a period of time due to force degradation. Our goal was to mechanically characterize the different types of elastomers during static and cyclic loads, based on uniform methodology and examine the morphological changes after loading. Ten types of latex-containing and four latex-free intermaxillary elastics were examined from six different manufacturers. To determine the mechanical characteristics of the elastomers, tensile tests, cyclical tensile fatigue tests and 24 h relaxation tests were performed, and the elastics were also subjected to scanning electron microscopy (SEM) and Raman spectroscopy. Regardless of the manufacturer, the latex-containing elastomers did not show significant differences in the percentage of elongation at break during the tensile test. Only one type of latex-containing elastomer did not tear during the 24 h cyclical fatigue test. Fatigue was confirmed by electron microscopy images, and the pulling force reduced significantly. During the force relaxation test, only one latex-free ligature was torn; the force degradation was between 7.8% and 20.3% for latex ligatures and between 29.6% and 40.1% for latex-free elastomers. The results showed that dynamic loading was more damaging to ligatures than static loading, latex-containing elastomers were more resistant than latex-free elastics, and which observation could have clinical consequences or a potential effect on patient outcome.

Force provided by elastomers used in orthodontics can be affected by several factors present in the oral cavity. The aim of our study was to investigate the role of mouthwashes, toothbrushing, and smoking in the force decay of such elastomers. Tensile strength, changes in the force continuously exerted, and force decay of elastic chains (Ortho Organizer and Masel Short Power Chain) and elastic ligatures (Dentaurum and Masel) by two separate manufacturers were measured. Measurements were initially made on untreated elastics, followed by exposure to different environmental factors including cigarette smoke, toothbrushing (mechanical plaque control), and two different mouthwashes (chemical plaque control). Changes on the surface of the elastics were studied with scanning electron microscopy (SEM). Untreated Masel elastic ligature showed lower tensile strength than Dentaurum elastic ligature (2339 cN vs. 3660 cN), while significantly higher tensile strength was measured for Ortho Organizer elastic chains than Masel chains (2639 cN vs. 1324 cN). The decrease in the elastic force of Masel ligature was greater in response to all external factors compared to Dentaurum. Although brushing with toothpaste and toothbrush impacted the force of both Masel and Ortho organizer ligatures negatively, force degradation was more apparent in the case of the Ortho organizer. Surface changes were more visible when applying Curasept mouthrinse, however force decay was higher in the Corsodyl group. Mechanical and chemical plaque control can influence the tensile strength and force decay of orthodontic elastomers, which should be considered by selecting the elastomers or determining their changing interval for the practice.