Brain of the African wild dog. I. Anatomy,architecture, and volumetrics

The African wild dog is endemic to sub-Saharan Africa and belongs to the family Canidae which includes domestic dogs and their closest relatives (i.e., wolves, coyotes, jackals, dingoes, and foxes). The African wild dog is known for its highly social behavior, co-ordinated pack predation, and striking vocal repertoire, but little is known about its brain and whether it differs in any significant way from that of other canids. We employed gross anatomical observation, magnetic resonance imaging, and classical neuroanatomical staining to provide a broad overview of the structure of the African wild dog brain. Our results reveal a mean brain mass of 154.08 g, with an encephalization quotient of 1.73, indicating that the African wild dog has a relatively large brain size. Analysis of the various structures that comprise their brains and their topological inter-relationships, as well as the areas and volumes of the corpus callosum, ventricular system, hippocampus, amygdala, cerebellum and the gyrification index, all reveal that the African wild dog brain is, in general, similar to that of other mammals, and very similar to that of other carnivorans. While at this level of analysis we do not find any striking specializations within the brain of the African wild dog, apart from a relatively large brain size, the observations made indicate that more detailed analyses of specific neural systems, particularly those involved in sensorimotor processing, sociality or cognition, may reveal features that are either unique to this species or shared among the Canidae to the exclusion of other Carnivora.     

Analgesia in labour and delivery

Pain is defined as “an unpleasant sensory or emotional experience associated with actual or potential tissue injury”. Labour pain is encountered during contractions in labour, and patient satisfaction correlates closely to how well it is managed. Doctors commonly encounter acute pain in clinical practice which can be treated simply by applying some basic rules. However, pain due to labour requires specific management which falls outside the basic principles of acute pain management and it is important for practitioners who look after these patients to understand what can be offered. This review considers the basic principles of each of these techniques using some common clinical scenarios. The type of analgesia given will determine where labour takes place and this will be reflected in each case. Specifically, the World Health Organisation (WHO) analgesia ladder is not applicable in these patients because the periodic nature and the intensity of labour pain renders this model obsolete, although is applicable after delivery or after a caesarean section (CS) under general anaesthetic.     

Fairness in cost‐benefit analysis: A methodology for health technology assessment

We evaluate the introduction of various forms of antihypertensive treatments in France with a distribution‐sensitive cost‐benefit analysis. Compared to traditional cost‐benefit analysis, we implement distributional weighting based on equivalent incomes, a new concept of individual well‐being that does respect individual preferences but is not subjectively welfarist. Individual preferences are estimated on the basis of a contingent valuation question, introduced into a representative survey of the French population. Compared to traditional cost‐effectiveness analysis in health technology assessment, we show that it is feasible to go beyond a narrow evaluation of health outcomes while still fully exploiting the sophistication of medical information. Sensitivity analysis illustrates the relevancy of this richer welfare framework, the importance of the distinction between an ex ante and an ex post approach, and the need to consider distributional effects in a broader institutional setting.     

Metastatic transitional cell carcinoma of the urinary bladder presenting as a mandibular gingival swelling

Oral cavity metastases mostly originate from the breasts, lungs, or kidneys. Transitional cell carcinoma (TCC), the most frequent malignant tumor of the urinary bladder, rarely metastasizes to the jaws. To the best of our knowledge, only 8 cases of bladder carcinoma have been reported in the English literature to metastasize to the jawbones. A new case of mandibular metastasis of urinary bladder TCC with extension to the gingiva is presented in a 64-year-old white man. The patient was referred for a periodontal infection of the upper right first molar. The clinical examination also showed a gingival swelling located in the lower left premolar region with a hypoasthesia of the left side of the lower lip. The gingival mass was biopsied, and the microscopy showed a mandibular metastatic TCC of the urinary bladder extending to the gingiva. Periodontists should be aware that, although gingival metastases are rare, when they occur they may mimic other local benign pathological conditions.