Primary aneurysmal bone cyst of coronoid process

BACKGROUND: Aneurysmal bone cysts are relatively uncommon in the facial skeleton. These usually affect the mandible but origin from the coronoid process is even rarer. To the best of our knowledge, this is the first reported case of a coronoid process aneurysmal bone cyst presenting as temporal fossa swelling. CASE PRESENTATION: A 17 year old boy presented with a progressively increasing swelling in the left temporal region developed over the previous 8 months. An expansile lytic cystic lesion originating from the coronoid process of the left mandible and extending into the infratemporal and temporal fossa regions was found on CT scan. It was removed by a superior approach to the infratemporal fossa. CONCLUSION: Aneurysmal bone cyst of the coronoid process can attain enormous dimensions until the temporal region is also involved. A superior approach to the infratemporal fossa is a reasonable approach for such cases, providing wide exposure and access to all parts of the lesion and ensuring better control and complete excision

The orthodontic-oral surgery interface. Part one: A service evaluation and overview of the diagnosis and management of common anomalies

Introduction: Complex dental anomalies often require multidisciplinary management in secondary care. These anomalies may present to general dental practitioners in the first instance, therefore it is important that all clinicians are aware of such anomalies and their management. / Aims: This service evaluation aimed to profile the dental anomalies presenting to the multidisciplinary joint dento-alveolar clinic at a district general hospital and to outline the management of the common anomalies. / Method: This two-part series details a service evaluation and profiles the dental anomalies presenting to the joint dento-alveolar clinic at a district general hospital. In addition, the features and management of the common dental anomalies are outlined. / Results: Fifty-four percent of patients were female, with a mean age of 17 years. The most common anomalies were impacted canines (49%), followed by supernumerary teeth (16%) and impacted premolars (10%). Other anomalies accounted for only a small percentage of referrals. / Conclusion: A wide range of anomalies presented to the joint dento-alveolar clinic. It is important for all clinicians to be aware of such anomalies, their diagnosis and management. Part one and two of this article therefore provide an overview of the common anomalies and highlight their management

Designing the ideal model for assessment of wound contamination after gunshot injuries: a comparative experimental study

<p>Abstract</p> <p>Background</p> <p>Modern high-velocity projectiles produce temporary cavities and can thus cause extensive tissue destruction along the bullet path. It is still unclear whether gelatin blocks, which are used as a well-accepted tissue simulant, allow the effects of projectiles to be adequately investigated and how these effects are influenced by caliber size.</p> <p>Method</p> <p>Barium titanate particles were distributed throughout a test chamber for an assessment of wound contamination. We fired .22-caliber Magnum bullets first into gelatin blocks and then into porcine hind limbs placed behind the chamber. Two other types of bullets (.222-caliber bullets and 6.5 × 57 mm cartridges) were then shot into porcine hind limbs. Permanent and temporary wound cavities as well as the spatial distribution of barium titanate particles in relation to the bullet path were evaluated radiologically.</p> <p>Results</p> <p>A comparison of the gelatin blocks and hind limbs showed significant differences (<it>p </it>< 0.05) in the mean results for all parameters. There were significant differences between the bullets of different calibers in the depth to which barium titanate particles penetrated the porcine hind limbs. Almost no particles, however, were found at a penetration depth of 10 cm or more. By contrast, gas cavities were detected along the entire bullet path.</p> <p>Conclusion</p> <p>Gelatin is only of limited value for evaluating the path of high-velocity projectiles and the contamination of wounds by exogenous particles. There is a direct relationship between the presence of gas cavities in the tissue along the bullet path and caliber size. These cavities, however, are only mildly contaminated by exogenous particles.</p

A Case of Recurrent Multifocal Central Giant Cell Granulomas

One case of recurrent multifocal central giant cell granulomas (CGCG) is presented. Initially, the lesions presented concurrently in the maxilla and mandible with subsequent recurrence in the mandible. Now, two recurrences are seen in the maxillary sinus and ethmoid region. The literature regarding multifocal CGCG is reviewed

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.

BACKGROUND: Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. METHODS: We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. RESULTS: Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. CONCLUSION: This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field

Biceps tenodesis with Clancy method for chronic posterolateral rotary instability of the knee

Background: Posterolateral rotatory instability is one of the most complex problems in ligamentous injuries of the knee. It represents a challenging diagnostic and therapeutic problem for the orthopaedic surgeon. We present the results of biceps tenodesis in chronic posterolateral rotatory instabilily of the knee.Methods: In this case series we included all of the patients with positive reverse pivot shift test and prone external rotation test at least 3 weeks after their trauma. We excluded the patients with varus malalignment of the knee and concomitant anterior cruciate ligament (ACL) rupture. Biceps tenodesis (Clancy method) was performed. We did not reconstruct posterior cruciate ligament (PCL) if its insufficiency was diagnosed in addition to posterolateral rotatory instability. Knee scoring scale of Lysholm was used during and after follow ups. The results were statistically compared using Wilcoxon signed rank test (WSRT), paired samples t-test and friedman test. Data analysis was done using SPSS (version 11.5) and Stata (version 8) computer softwares.Results: Our series consists of 13 patients (12 male and one female). 31% of the patients had isolated posterolateral injury and 69% of the patients had combined posterolateral and PCL injuries. The patients were between 17 to 45 years old (mean 30.25 years). Follow up was between 4 to 44 months (mean: 31 months). At the end of follow up 85% of patients had negative reverse pivot shift test. Prone external rotation test at 30&amp;deg; of knee flexion was negative in 92% of patients. In 92% of patients giving way was negative and in 77% of patients pain was decreased. Before operation the average Knee scoring scale of Lysholm was 73 and at the end of the follow up it increased to 85 (p value&amp;lt;0.001).Conclusions: Biceps tenodesis using Clancy method is a safe, effective and reliable method in management of chronic posterolateral rotatory instability of the knee. During surgery careful exploration of the common peroneal nerve is recommended. Although we found this method effective in combined posterolateral and PCL injuries the results are much better in the cases with isolated posterolateral injuries