Validity of Medical Insurance Guidelines for Orthognathic Surgery.

Purpose: The purpose of this study was to assess the validity of the medical insurance guidelines for orthognathic surgery used by the major American medical insurance companies.

Materials And Methods: This study assessed the validity of the medical insurance guidelines for orthognathic surgery used by Aetna, Anthem Blue Cross Blue Shield (BCBS), Cigna, Humana, and UnitedHealthcare (UHC). To evaluate the validity, we calculated the approval and denial rates of the 5 guidelines when we used them to assess the medical necessity for a control group of carefully selected patients.

Hyperkeratosis of the left cheek.

A 66-year-old man with a recent history of herpes zoster in the second division of the trigeminal nerve presented with hyperkeratotic plaques along his left cheek and temple. A shave biopsy was found to be consistent with postherpetic hyperkeratosis. This case represents a unique presentation of Wolf's postherpetic isotopic response: a new skin disorder emerging at the site of a previously healed herpetic, predominantly zoster, infection.

Therapeutic and Diagnostic Challenges in Myasthenia Gravis.

"Myasthenia gravis (MG) is the most common autoimmune neuromuscular disorder. This article highlights several cases that the practicing neurologist may encounter in the treatment of MG. Diagnostic uncertainty continues to be an issue in patients who are seronegative to the 2 most common antibodies, acetylcholine receptor and muscle-specific tyrosine kinase (MuSK).

Ureteroenteric anastomosis in orthotopic neobladder creation: do urinary tract infections impact stricture rate?

Purpose: Radical cystectomy (RC) and urinary diversion in the treatment of muscle-invasive bladder cancer is associated with peri-operative complication rates as high as 60%. Ureteroenteric anastomotic stricture (UEAS) is a potential source significant morbidity often requiring secondary interventions. We sought to evaluate our experience with benign UEAS in our open ileal orthotopic neobladder (ON) population.

Immunosuppressive agents for treating IgA nephropathy.

Background: IgA nephropathy is the most common glomerulonephritis world-wide. IgA nephropathy causes end-stage kidney disease (ESKD) in 15% to 20% of affected patients within 10 years and in 30% to 40% of patients within 20 years from the onset of disease. This is an update of a Cochrane review first published in 2003 and updated in 2015.

An automatic approach to establish clinically desired final dental occlusion for one-piece maxillary orthognathic surgery.

Purpose: One critical step in routine orthognathic surgery is to reestablish a desired final dental occlusion. Traditionally, the final occlusion is established by hand articulating stone dental models. To date, there are still no effective solutions to establish the final occlusion in computer-aided surgical simulation.

An Automatic Approach to Reestablish Final Dental Occlusion for 1-Piece Maxillary Orthognathic Surgery.

Accurately establishing a desired final dental occlusion of the upper and lower teeth is a critical step in orthognathic surgical planning. Traditionally, the final occlusion is established by hand-articulating the stone dental models. However, this process is inappropriate to digitally plan the orthognathic surgery using computer-aided surgical simulation.

A Case of Unilateral Coccidioidal Chorioretinitis in a Patient with HIV-Associated Meningoencephalitis.

Intraocular coccidioidomycosis is a rare condition, with the most commonly reported presentation being an idiopathic iritis in patients who live in or have traveled thorough endemic areas. A paucity of reports exists describing the chorioretinal manifestations of coccidioidomycosis. Here we report a case of unilateral coccidioidal chorioretinitis and meningoencephalitis in an AIDS patient that led to near complete unilateral loss of vision.

Peripheral Delivery of Neural Precursor Cells Ameliorates Parkinson's Disease-Associated Pathology.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by loss of motor control due to a wide loss of dopaminergic neurons along the nigro-striatal pathway. Some of the mechanisms that contribute to this cell death are inflammation, oxidative stress, and misfolded alpha-synuclein-induced toxicity. Current treatments are effective at managing the early motor symptoms of the disease, but they become ineffective over time and lead to adverse effects.

Influence of the phosphoenolpyruvate:carbohydrate phosphotransferase system on toxin gene expression and virulence in Bacillus anthracis.

AtxA, the master virulence gene regulator of Bacillus anthracis, is a PRD-Containing Virulence Regulator (PCVR) as indicated by the crystal structure, post-translational modifications and activity of the protein. PCVRs are transcriptional regulators, named for PTS Regulatory Domains (PRDs) subject to phosphorylation by the phosphoenolpyruvate phosphotransferase system (PEP-PTS) and for their impact on virulence gene expression. Here we present data from experiments employing physiological, genetic and biochemical approaches that support a model in which the PTS proteins HPr and Enzyme I (EI) are required for transcription of the atxA gene, rather than phosphorylation of AtxA.

Major venous injury and large volume crystalloid resuscitation: A limb threatening combination.

Introduction: Major venous injury (MVI) affecting the lower extremity can result in subsequent amputation. The contribution of intraoperative resuscitation efforts on the need for amputation is not well defined. We hypothesized that intraoperative large volume crystalloid resuscitation (LVCR) increases the risk of amputation after MVI, while massive transfusion (MT) does not.

Natural Products as Modulators of the Proteostasis Machinery: Implications in Neurodegenerative Diseases.

Proteins play crucial and diverse roles within the cell. To exert their biological function they must fold to acquire an appropriate three-dimensional conformation. Once their function is fulfilled, they need to be properly degraded to hamper any possible damage.

Unexplained Case of Intrauterine Fetal Demise Resolved: Case Report and Literature Review.

The association between umbilical cord ulceration and intestinal atresia has been previously established. Umbilical cord ulceration is a seemingly rare, potentially life threatening complication of intestinal atresia. The exact etiological mechanism is unknown and recent literature indicates more intensive prenatal monitoring may alter fetal outcome.

Modifiable Risk Factors for Alzheimer's Disease.

Since first described in the early 1900s, Alzheimer's disease (AD) has risen exponentially in prevalence and concern. Research still drives to understand the etiology and pathogenesis of this disease and what risk factors can attribute to AD. With a majority of AD cases being of sporadic origin, the increasing exponential growth of an aged population and a lack of treatment, it is imperative to discover an easy accessible preventative method for AD.

Independent recalculation outperforms traditional measurement-based IMRT QA methods in detecting unacceptable plans.

Purpose: To evaluate the performance of an independent recalculation and compare it against current measurement-based patient specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) in predicting unacceptable phantom results as measured by the Imaging and Radiation Oncology Core (IROC).

Methods: When institutions irradiate the IROC head and neck IMRT phantom, they are also asked to submit their internal IMRT QA results. Separately from this, IROC has previously created reference beam models on the Mobius3D platform to independently recalculate phantom results based on the institution's DICOM plan data.

Cutaneous cytomegalovirus manifestations, diagnosis, and treatment: a review.

The possible presentations of cytomegalovirus (CMV) are vast not only in its systemic manifestations, but also in the various cutaneous lesions that may result. Cutaneous cytomegalovirus is rarely reported in the literature because the clinical and pathologic features can be difficult to identify. Its identification, however, is vital as cutaneous human CMV infection can signal systemic disease and an unfavorable prognosis.

Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review.

Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease.

Clinical Characteristics and Etiologies of Miliary Nodules in the US: A Single-Center Study.

Background: Miliary nodules have been typically described as a radiological manifestation of disseminated tuberculosis. However, miliary nodules are known to occur in a wide variety of conditions. The primary objective of the study was to identify clinical characteristics and etiologies of miliary nodules within our institution.

Machine Learning in Acute Ischemic Stroke Neuroimaging.

Machine Learning (ML) through pattern recognition algorithms is currently becoming an essential aid for the diagnosis, treatment, and prediction of complications and patient outcomes in a number of neurological diseases. The evaluation and treatment of Acute Ischemic Stroke (AIS) have experienced a significant advancement over the past few years, increasingly requiring the use of neuroimaging for decision-making. In this review, we offer an insight into the recent developments and applications of ML in neuroimaging focusing on acute ischemic stroke.