Evidence for dental and dental specialty treatment of obstructive sleep apnoea. Part 1: the adult OSA patient and Part 2: the paediatric and adolescent patient

Until recently, obstructive sleep apnoea was a largely unknown condition. Because of the well-publicised death of some high-profile people resulting from untreated obstructive sleep apnoea, now mostly everyone has heard of the condition. Following diagnosis, several medical treatment modalities are available to patients. However, the role that dentistry and its various specialties can play in successful treatment for obstructive sleep apnoea should not be overlooked. The common causes for adult and paediatric obstructive sleep apnoea will be presented as well as a review of the more successful forms of dental treatment. Finally, a summary of the current evidence regarding obstructive sleep apnoea treatment will be presented.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79355/1/j.1365-2842.2010.02136.x.pd

ETUDE DES CENTRES D'APPELS CENTRES SUR LE TRAITEMENT ET/OU L'INFECTION A VIH ET ELABORATION D'UN CAHIER DES CHARGES EN VUE DE LA CREATION D'UN CENTRE D'APPELS CONSACRE AUX MEDICAMENTS DE LA SEROPOSITIVITE

CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

Les ostéotomies maxillo-mandibulaires dans la prise en charge de la pathologie obstructive du sommeil (résultats d'une série de 30 cas)

To report the efficacy of maxillomandibular advancement (MMA) surgery, INTRODUCTION : retrospective study of a clinical series of 30 consecutive cases. All patients were refered for severe sleep apnea obstructive syndrome (25) or patent maxillofacial dysmorphosis associated with SAOS (5 cases). PATIENTS: Patients were referred to the multidisciplinary consultation for MMA evaluation when applicable conservative therapies such as nasal continuous positive airway pressure (nCPAP) were not tolerated, refused, or unsuccessful. Case selection was based primarily on the sites of disproportionate upper airway anatomy.after clinical evaluation and cephalometric analysis. INTERVENTIONS: MMA consisted of a Lefort I osteotomy, bilateral sagittal split ramus osteotomies for 25 patients and maxilla or mandible reposition for 5 patients with patent dysmorphosis.. Some patients also received concomitant adjunctive naso-pharyngeal procedures MEASUREMENTS AND RESULTS: Obtained at a mean of 3 months postoperatively, revealed significant improvement in all cases. Mean BPs (n = 27) were lowered, subjective symptoms were ameliorated for all patients, and mean body mass index was slightly reduced. Cephalometric analysis , based on Steiner and Tweed analysis, quantified structural changes in soft-tissue and bony landmarks. Postoperative PSG results showed dramatic improvement over preoperative data, with 90% patients cured (IAH<15).Mean values improved from preoperative to postoperative apnea-hypopnea index (59.2 to 4.7), lowest arterial oxyhemoglobin desaturations (72.7% to 88.6%), and time of desaturations < 90% (118.8 to 6.6 vs 2.4, respectively). The success rate was 90%. Main complication was temporarely hypoesthesia of the lower lip. Facial change were not considered by patient as a major drawback. CONCLUSION: MMA is highly successful and safe and may be a definitive primary single-staged surgical treatment of selected OSAS cases with diffusely complex or multiple sites of disproportionate velo-orohypopharyngeal anatomy.TOULOUSE3-BU Santé-Centrale (315552105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

L'écrit dans les acquisitions socioculturelles en classe de FLE

International audienc

Traitement par la toxine botulique de la spasticité distale du membre inférieur de l'adulte après un accident vasculaire cérébral

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Active surveillance for intraosseous mandibular haemangioma. Case report and literature review

Introduction: Intraosseous mandibular haemangiomas are rare benign tumors.To this date there is no general consensus regarding their treatment. Observation: The authors present a case of a 56-year-old patient with swelling of the basilar left edge, without any other associated symptom. Radiolucent images with a well-defined honeycomb structure supports the vascular injury found using dental orthopantomography and cone beam computed tomography. Dynamic magnetic resonance angiography (MRA) showed mild intense intralesional vascularity and a biopsy confirmed the diagnosis of mandibular cavernous haemangioma. Clinical and radiological active surveillance were carried out. The size of the lesion had regressed by more than half in one year and there was no more palpable lump. Discussion: The most commonly approved treatment approach of haemangioma is selective embolization followed by complete surgical resection, which may be complicated by bleeding. From the follow-up of this case it seems that an active clinical and radiological surveillance can be proposed in the management of intraosseous mandibular haemangioma with few persistent symptoms and a low risk of complication, these may even regress with time

Urachal Carcinoma with Choroidal, Lung, Lymph Node, Adrenal, Mammary, and Bone Metastases and Peritoneal Carcinomatosis Showing Partial Response after Chemotherapy Treatment with a Modified Docetaxel, Cisplatin and 5-Fluorouracil Regimen

Urachal carcinoma (UC) is a rare tumor mainly affecting middle-aged males. Metastases occur most frequently in lymph nodes and the lungs. There are no standard adjuvant and metastatic treatments. We report the case of a 36-year-old female with UC treated with partial cystectomy who relapsed 3 years after surgery with left choroidal, lung, mediastinal lymph node, right adrenal, mammary, and bone metastases as well as peritoneal carcinomatosis. She obtained a partial response after 10 cycles of chemotherapy with a modified docetaxel, cisplatin and 5-fluorouracil (mTPF) regimen. This is the first report on the use of the mTPF regimen in UC and on the existence of choroidal, adrenal, and mammary metastases