Tori et exostoses multiples : présentation d’un cas et revue de la littérature

Introduction : Les exostoses et les tori sont des excroissances osseuses bénignes ayant différentes localisations. Les facteurs intervenant dans leur apparition sont encore discutés. Ces excroissances sont asymptomatiques, mais elles peuvent parfois occasionner différentes gênes. De ce fait, leur exérèse n’est que rarement nécessaire. Observation : Il s’agit d’une femme de 58 ans présentant des exostoses et des tori maxillaires et mandibulaires volumineux, associés à un bruxisme aggravé ayant entraîné des attritions occlusales, une baisse de la dimension verticale d’occlusion et des troubles de l’articulation temporo-manbibulaire. Compte tenu du volume des exostoses mandibulaires vestibulaires, une exérèse a été réalisée, associée à la confection d’une plaque de libération occlusale. Commentaires et conclusion : Ce cas interroge sur la part imputable aux surcharges occlusales dans l’apparition d’exostoses. Une revue de la littérature a été réalisée afin de valider cette possible étiologie, de comprendre comment améliorer la prise en charge et éviter leur réapparition

Development of a freezing test in controlled conditions for Pisum sativum

BAPGEAPSIFreezing is a major environmental limitation to crop productivity for a number of species including legumes. In the context of global climate change, winter crops will experiment milder autumn temperatures that could be detrimental to the achievement of cold acclimation, which is the ability for plants to increase their level of frost tolerance (FT) in response to low but non-freezing temperatures. For the pea crop, a modelling approach has shown that climate warming will increase the occurrence of freezing damage events, even if these latter will be less severe (Castel et al., 2014). Thus, breeding for frost tolerant winter peas requires not only to improve their FT threshold, but also to raise their cold acclimation rate. In order to evaluate the genetic variability of both traits, we are adjusting a protocol in controlled conditions, which provides an indirect evaluation of FT by the measurement of tissues’electrolyte leakage (EL). Pea stem samples have been collected after variable durations of cold acclimation at 4°C day/2°C night in a climatic chamber. They have been then progressively cooled at 2°C h-1 in a programmable temperature-test chamber to reach test temperatures ranging from +4°C to -36°C. After 14 days of cold acclimation, EL evaluation enabled the same ranking of genotypes according to their FT threshold as obtained in the Chaux-des-Prés field platform. Improvements of the protocol are however still needed to use it as a routine ranking test

Ameloblastic fibrosarcoma of the mandible: case report and literature review

Introduction: Ameloblastic fibrosarcoma is a rare malignant odontogenic tumor. Over 50% reported cases have histological evidence of ameloblastic fibroma at the same site. The mortality rate of the tumor is 19% and its recurrence rate is 37%, which mandates a total resection along with long-term follow-up. Observation: We present the case of a 14-year-old male diagnosed with ameloblastic fibrosarcoma, who underwent multiple stages of treatments and was followed up over 8 years. The initial management consisted of a total tumor resection with chemoradiotherapy. Then, for bone, soft, mucosal, and dental restoration after resection, mandibular reconstruction with a fibula free flap, onlay iliac graft, iliac graft fixation, facial lipofilling treatments (two), vestibular deepening procedures (two), and implant-supported dental prosthesis were performed. Comments and conclusion: This is the first case reported in the literature for the global management of mandibular ameloblastic fibrosarcoma, from oncological treatment to functional and aesthetic long-term rehabilitation

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially