A case report: retigabine induced oral mucosal dyspigmentation of the hard palate

Background Dyspigmentation of the oral mucosa has a multitude of aetiological causes. Retigabine, a new antiepileptic drug, has the potential side effect of inducing a blue/purple pigmentation of the oral mucosa in addition to the skin, lips, nails and retina of the eyes. This article presents a unique case of dyspigmentation present in the oral mucosa of the hard palate which has previously been unreported in the dental literature. Case presentation A 70 year old white male presented to a secondary care oral surgery department with an unusual asymptomatic pigmented lesion present in the hard palate of the oral cavity. The pigmentation was remarkable for its distinct blue/purple colouration which was associated with a similar discolouration of the nail beds of the hands. This is believed to be a side effect of the anti-epileptic medication retigabine. Conclusion The dental profession and wider healthcare community should be made fully aware of the potential side effect of oral dyspigmentation associated with the novel anti-epileptic medication retigabine. Enhanced knowledge of the causative role of retigabine in dyspigementation of the oral mucosa will allow the practitioner to make an appropriate diagnosis. As far the authors are aware this is reaction is unreported in the dental literature and should be disseminated to the wider oral health professional’s community

Why Do Leaders Matter? The Role of Expert Knowledge

Why do some leaders succeed while others fail? This question is important, but its complexity makes it hard to study systematically. We draw on a setting where there are well-defined objectives, small teams of workers, and exact measures of leaders’ characteristics and organizational performance. We show that a strong predictor of a leader’s success in year T is that person’s own level of attainment, in the underlying activity, in approximately year T-20. Our data come from 15,000 professional basketball games and reveal that former star players make the best coaches. This ‘expert knowledge’ effect is large

Position-selective activation of peripheral nerve fibers with a cuff electrode

The degree of spatial selectivity which can be obtained with longitudinal dot tripoles in an insulating cuff was quantified in terms of the overlap between fiber populations activated by different tripoles. Previous studies have failed to take into account the relative influences of transverse current and longitudinal current on position-selective activation, and furthermore have not controlled for the differing sensitivities of large and small nerve fibers to electrical stimuli. In this study, these factors were taken into account. Transverse current from an anode positioned opposite the stimulating cathode was found to improve spatial selectivity, and selectivity was enhanced when the ratio of transverse current to longitudinal current was increased. Large fibers were excited before small fibers, irrespective of fiber position, indicating a combination of position and size selectivit

The Old English elegies :

The enormous bibliography surrounding the Old English elegies breaks down primarily into studies of structure, cultural context, and genre. This study is concerned first with attempting to define as precisely as possible the limits of the utterances of speakers in the poems. Then an attempt is made to summarize the major currents of criticism which investigate the cultural milieu of Old English literature. Finally, there is a discussion of genre. Starting with a consideration of all the poems which are generally considered to be elegies--The Wanderer, The Seafarer, The Wife's Lament, The Husband's Message, Resignation, The Riming Poem, Wulf and Eadwacer, Deor, and The Ruin--a case is made for including all but the last three as elegies

Why Do Leaders Matter? The Role of Expert Knowledge

Why do some leaders succeed while others fail? This question is important, but its complexity makes it hard to study systematically. We examine an industry in which there are well-defined objectives, small teams, and exact measures of leaders’ characteristics. We show that a strong predictor of a leader’s success in year T is that person’s own level of attainment, in the underlying activity, in approximately year T-20. Our data come from 15,000 professional basketball games. The effect on team performance of the coach’s ‘expert knowledge’ is large and is discernible in the data within 12 months of his being hired.organizational performance, firms, leadership, fixed-effects, productivity

Simulation of activation and propagation delay during tripolar neural stimulation

Computer simulations were perfonned to investigate the influence of stimulus amplitude on cathodal activation delay, propagation delay and blocking during stimulation with a bipolar cuff electrode. Activation and propagation delays were combined in a total delay term which was minimized between the excitation and blocking thresholds

Violence brief interventions: a rapid review

Provision of a Violence Brief Intervention (VBI) to young men undergoing treatment for a violent injury may represent a teachable moment for the prevention of future interpersonal violence in Scotland. Prior to intervention design, a rapid review of the research literature was necessary to examine existing programmes. After title and abstract screening, eight distinct VBIs were identified from full texts. Whilst none of the programmes were a perfect match for our intervention goals, they did demonstrate the potential effectiveness of brief interventions for violence prevention at both cognitive and behavioural levels. Key themes of successful interventions included brief motivational interviewing as an effective method of engaging with at-risk participants and encouraging change, the utility of social norms approaches for correcting peer norm misperceptions, the usefulness of working with victims of violence in medical settings (particularly oral and maxillofacial surgeries), the importance of addressing the role of alcohol after violent injury, the advantages of a computer-therapist hybrid model of delivery, and the need for adequate follow-up evaluation as part of a randomised control trial. This information has been used to design a VBI which is currently under evaluation