Unilateral elongated styloid process: a case report

An unusual case of a unilaterally elongated styloid process with a length of 5.8 cm was found on a dry skull of a male cadaver. During his life the subject was complaining for reported ipsilateral otalgia presumably due to nerve compression from the elongated styloid process. The symptomatology appeared by such an anatomical variant as well as relative literature is discussed in this paper

Status and perspectives of hospital mortality in a public urban Hellenic hospital, based on a five-year review

<p>Abstract</p> <p>Background</p> <p>Analysis of hospital mortality helps to assess the standards of health-care delivery.</p> <p>Methods</p> <p>This is a retrospective cohort study evaluating the causes of deaths which occurred during the years 1995–1999 in a single hospital. The causes of death were classified according to the International Statistical Classification of Diseases (ICD-10).</p> <p>Results</p> <p>Of the 149,896 patients who were discharged the 5836 (3.4%) died. Males constituted 55% and females 45%. The median age was 75.1 years (1 day – 100 years).</p> <p>The seven most common ICD-10 chapters IX, II, IV, XI, XX, X, XIV included 92% of the total 5836 deaths.</p> <p>The most common contributors of non-neoplasmatic causes of death were cerebrovascular diseases (I60–I69) at 15.8%, ischemic heart disease (I20–I25) at 10.3%, cardiac failure (I50.0–I50.9) at 7.9%, diseases of the digestive system (K00–K93) at 6.7%, diabetes mellitus (E10–E14) at 6.6%, external causes of morbidity and mortality (V01–Y98) at 6.2%, renal failure (N17–N19) at 4.5%, influenza and pneumonia (J10–J18) at 4.1% and certain infectious and parasitic diseases (A00–B99) at 3.2%, accounting for 65.3% of the total 5836 deaths.</p> <p>Neoplasms (C00–D48) caused 17.7% (n = 1027) of the total 5836 deaths, with leading forms being the malignant neoplasms of bronchus and lung (C34) at 3.5% and the malignant neoplasms of large intestine (C18–21.2) at 1.5%. The highest death rates occurred in the intensive care unit (23.3%), general medicine (10.7%), cardiology (6.5%) and nephrology (5.5%).</p> <p>Key problems related to certification of death were identified. Nearly half of the deaths (49.3%: n = 2879) occurred by the completion of the third day, which indicates the time limits for investigation and treatment. On the other hand, 6% (n = 356) died between the 29^thand 262^nddays after admission.</p> <p>Inadequacies of the emergency care service, infection control, medical oncology, rehabilitation, chronic and terminal care facilities, as well as lack of regional targets for reducing mortality related to diabetes, recruitment of organ donors, provision for the aging population and lack of prevention programs were substantiated.</p> <p>Conclusion</p> <p>Several important issues were raised. Disease specific characteristics, as well as functional and infrastructural inadequacies were identified and provided evidence for defining priorities and strategies for improving the standards of care. Effective transformation can promise better prospects.</p

Fatal drug poisonings in a Swedish general population

ABSTRACT: BACKGROUND: Pharmaceutical drug poisonings have previously been reported using single sources of information, either hospital data or forensic data, which might not reveal the true incidence. We therefore aimed to estimate the incidence of suspected fatal drug poisonings, defined as poisonings by pharmaceutical agents, by using all relevant case records from various sources in a Swedish population. METHODS: Every seventh randomly selected deceased in three counties in southeastern Sweden during a one-year period was identified in the Cause of Death Register. Relevant case records (death certificates, files from hospitals and/or primary care centres and medico-legal files) were reviewed for all study subjects. RESULTS: Of 1574 deceased study subjects, 12 cases were classified as pharmaceutical drug poisonings according to the death certificates and 10 according to the medico-legal files. When reviewing all available data sources, 9 subjects (0.57%; 95% confidence interval: 0.20-0.94%) were classified as drug poisonings, corresponding to an incidence of 6.5 (95% confidence interval: 2.3-10.7) per 100 000 person-years in the general population. The drug groups most often implicated were benzodiazepines (33%), antihistamines (33%) and analgesics (22%). CONCLUSIONS: Fatal drug poisonings is a relatively common cause of death in Sweden. By using multiple sources of information when investigating the proportion of fatal poisonings in a population, more accurate estimates may be obtained.Original Publication:Anna Jonsson, Olav Spigset, Micaela Tjäderborn, Henrik Druid and Staffan Hägg, Fatal drug poisonings in a Swedish general population., 2009, BMC clinical pharmacology, (9), 7, 1-5.http://dx.doi.org/10.1186/1472-6904-9-7Licensee: BioMed Centralhttp://www.biomedcentral.com

The global distribution of fatal pesticide self-poisoning: Systematic review

<p>Abstract</p> <p>Background</p> <p>Evidence is accumulating that pesticide self-poisoning is one of the most commonly used methods of suicide worldwide, but the magnitude of the problem and the global distribution of these deaths is unknown.</p> <p>Methods</p> <p>We have systematically reviewed the worldwide literature to estimate the number of pesticide suicides in each of the World Health Organisation's six regions and the global burden of fatal self-poisoning with pesticides. We used the following data sources: Medline, EMBASE and psycINFO (1990–2007), papers cited in publications retrieved, the worldwide web (using Google) and our personal collections of papers and books. Our aim was to identify papers enabling us to estimate the proportion of a country's suicides due to pesticide self-poisoning.</p> <p>Results</p> <p>We conservatively estimate that there are 258,234 (plausible range 233,997 to 325,907) deaths from pesticide self-poisoning worldwide each year, accounting for 30% (range 27% to 37%) of suicides globally. Official data from India probably underestimate the incidence of suicides; applying evidence-based corrections to India's official data, our estimate for world suicides using pesticides increases to 371,594 (range 347,357 to 439,267). The proportion of all suicides using pesticides varies from 4% in the European Region to over 50% in the Western Pacific Region but this proportion is not concordant with the volume of pesticides sold in each region; it is the pattern of pesticide use and the toxicity of the products, not the quantity used, that influences the likelihood they will be used in acts of fatal self-harm.</p> <p>Conclusion</p> <p>Pesticide self-poisoning accounts for about one-third of the world's suicides. Epidemiological and toxicological data suggest that many of these deaths might be prevented if (a) the use of pesticides most toxic to humans was restricted, (b) pesticides could be safely stored in rural communities, and (c) the accessibility and quality of care for poisoning could be improved.</p

Effect of a CPP-ACP agent on the demineralization and remineralization of dentine in vitro

Objectives: The aim of this study was to determine in vitro the effect of a commercial paste based on CPP-ACP complex on the demineralization of sound human dentine and on remineralization potential of artificial caries-like lesions formed on dentine surfaces. Methods: Forty dentine specimens were prepared with hard tissue microtome. The specimens were divided in four groups the A, B, C and D (n = 10). The specimen surfaces were subjected to surface analysis by Fourier transformance micro multiple internal reflectance infrared spectroscopy (micro MIR-FTIR). Tooth mousse was applied on surface specimens of A group, while no agent were applied on the specimens of B group. Afterwards, groups A, B, C and D were immersed in demineralization solution for 7 days. Afterwards, the surfaces were subjected to micro MIR-FTIR analysis and the mineral to matrix ratio was used to assess the extent of dentin demineralization (DM). Tooth mousse was applied on specimens of group C, while no agent was applied on specimens of group D. The groups C and D immersed in artificial saliva for 7 days and were subjected to analysis by micro MIR-FTIR and the mineral to matrix ratio was used to assess the extent of dentin remineralization (RM). Results: Group A showed significant lower %DM in comparison to group B. Group C resulted in a significant higher %RM compared to group D. Conclusions: The presence of agent CPP-ACP on dentine surfaces provoked lower demineralization and higher remineralization in comparison with the dentine surfaces without agent. © 2007 Elsevier Ltd. All rights reserved

INVIVO CORROSION BEHAVIOR OF GOLD-PLATED VERSUS TITANIUM DENTAL RETENTION PINS

Two types of titanium dental retention pins and a gold-plated stainless steel pin were tested for their in vivo corrosion behavior. Six paired samples of titanium and gold-plated pins were placed in box preparations of 12 periodontally involved premolars. Half of the samples were restored with a high copper admixed type amalgam while the rest were restored with a BisGMA-POCl2 bonding resin and a hybrid visible light-cured composite resin. After 3 months in vivo, the teeth were extracted, and the pins were removed and examined with an electron microprobe. The surface of the titanium pins was found to be smooth and without defects. Only traces of Ca and P could be identified from dentin. The gold-plated pins demonstrated cracks and pores, especially at the outer part of the serrations, resulting in disruption of the electroplated film. Traces of Hg, Sn, Cu, S, Zn, Ca, K, Cl, P, and S were detected at the gold-plated pin/amalgam interface, while Cl and P were found at the gold-plated pin/composite resin interface. The in vivo corrosion resistance of the titanium pins was found to be superior to that of the gold-plated stainless steel pins

Characterization of oral films formed in the presence of a CPP-ACP agent: An in situ study

Objectives: The aim of this study was to compare the morphological appearance and the molecular composition of intraoral integuments formed in situ on germanium (Ge) crystals in the presence or absence of the commercially available casein-phosphopeptide-amorphous calcium phosphate (CPP-ACP) cream agent. Methods: Six volunteers participated in the study. Impression of maxillary arch was taken for each patient, and a removable orthodontic appliance with a custom-made retainer was fabricated. Clean Ge crystals mounted in the retainers were placed intraorally for 30 min, 8, 24 h and 1-week period. The free sampling surface of another series of Ge crystals was treated with the commercial CPP-ACP agent (Tooth Mousse), mounted in the retainers and placed intraorally for the same period as above. The free exposed surfaces in oral cavity of the specimens in all subjects were examined as follows: (a) reflected light microscopy, (b) micro-MIR-FTIR spectroscopy and (c) scanning electron microscopy (SEM) plus energy-dispersive X-ray microanalysis analysis (XEDS). Results: The light microscopic observations revealed that there was a delay in biofilm formation on Ge surfaces treated with agent in comparison to those ones without treatment. The micro-MIR-FTIR spectra from the surfaces with Tooth Mousse showed an increase in intensity and a left shift of PO43- peak (1064 cm-1). Finally, the PO43- peak at lower bands (564 cm-1) and the low-wave bands at 525-530 cm-1 increased at 1-week interval. The SEM revealed the dendritic development of microbes. The XEDS analysis showed a significant increase in Cl/O, K/O, K/Cl and a decrease in Ca/O and P/O ratios on the crystal Ge without surface treatment. On contrary, on the crystal Ge with surface treatment an increase in Ca/O, Ca/P and a decrease in K/Cl ratios were found. Conclusion: The results show that the presence of CPP-ACP agent delays the biofilm formation and favored the nucleation and crystallization of calcium phosphates, possibly in apatitic form, in matured biofilms. © 2008 Elsevier Ltd. All rights reserved

Evaluation of a blended learning course for teaching oral radiology to undergraduate dental students

Aims: The purpose of this study was to develop and implement a blended course (a combined face-to-face and online instruction) on undergraduate oral radiology and evaluate it by comparing its educational effectiveness (derived from students&apos; performance and answers to questionnaires) to a conventional course&apos;s. Students&apos; attitudes concerning the blended methodology were also registered. Methodology: An original course was developed and implemented, and its electronic version was uploaded to an e-learning educational platform. The course was attended by two groups of final-year students, who were taught by either the conventional face-to-face methodology or the blended learning methodology. Students answered a series of questionnaires, before and after following the course, regarding their perceptions, attitudes and evaluation of the course. Additionally, they completed knowledge assessment tests and their grades (before and after the course) were compared. Educational effectiveness of the course was determined by analysing the results of the questionnaires and the tests. Results: Students in the blended group performed significantly better than their colleagues of the conventional group in the post-course knowledge test, and female students of the blended group performed better than male students. Students evaluated high the course content, organisation, educational material, and the blended group students additionally appreciated the course design and clarity of instructions. Students&apos; attitudes towards elements of blended learning (effectiveness, motivation and active engagement) were very positive. Most of the blended group students, who attended the face-to-face meeting (approx. 91%), evaluated it as helpful for summarising the subject and clarifying difficult issues. Conclusions: Blended learning is effective and well evaluated by dental students and can be implemented in undergraduate curriculum for teaching oral radiology. © 2011 John Wiley &amp; Sons A/S

In vivo validation of Diagnodent and Vista proof devices vs ICDAS clinical criteria on incipient carious lesions in adults

Aim: This study aimed to validate the in vivo performance of Diagnodent and Vista proof devices with ICDAS clinical criteria on incipient carious lesions in adults. Methods: A total of 44 adult patients with 230 incipient occlusal caries took part in the present study. These patients were assessed for caries with ICDAS clinical criteria, and then they were examined with Diagnodent pen™ (DP) and Vista proof™ (VP) fluorescence devices. Sensitivity, specificity accuracy, and ICC agreement between devices with ICDAS criteria, which served as a gold standard, were evaluated. Results: Regarding the caries diagnostic devices, sensitivity and specificity found 0,61 and 0,51 for DP, and 0,64 and 0,54 for VP, respectively. The different detection methods showed no differences in diagnostic capacity (Az values) each other, and ICC values with ICDAS criteria were calculated low. Conclusions: DP and VP do not contribute to incipient occlusal carious lesions&apos; better detective ability compared with visual ICDAS clinical criteria. The DP and VP devices presented no differences in diagnostic ability and measured lesion depth concerning the visual examination. © 2021 Elsevier B.V