Management of impacted third molars among Nigerian dentists.

Seventy-five Nigerian dentists were interviewed on their approach to the management of impacted third molars. The mean age of the dentists was 34.8 years, with a male/female ratio of 3.4:1. Most of the female dentists were found in the training institutions (p = 0.005). More than half of the dentists (58.7%) practiced in institutions with dental schools (training institutions), majority preferred the buccal approach (92%), and all the dentists (100%) preferred third molar disimpaction under local analgesia. Most dentists (88%) prescribe antibiotics following third molar surgery. Fifty dentists (66.7%) routinely reviewed all patients postoperatively while 12 dentists (16%) were of the opinion that all impacted third molars should be extracted. Only 21 dentists (28%) were aware of any protocol on the management of impacted teeth. More dentists in the training institutions performed third molar surgery less frequently than dentists in other hospitals (p = 0.07) who tend to employ chisels/mallet for bone removal (p = 0.0004). The need for continuing education and the formulation of guidelines in order to assist dentists to make informed decisions is emphasised. This will help conserve scarce resources and enhance the operation of the newly introduced National Health Insurance Scheme.     

Risk of Respiratory Complications and Wound Infection in Patients Undergoing Ambulatory Surgery: Smokers versus Nonsmokers

Background: Smoking is considered to be a risk factor for patients undergoing surgery and anesthesia, but it is unclear whether this is applicable to patients undergoing ambulatory surgery. The aim of this study was to determine the risk of respiratory complications and wound infection among smokers.

Methods: The authors studied a random selection of 489 adult patients undergoing ambulatory surgery. Smoking status was determined by self-report and confirmed with end-expired carbon monoxide analysis. The risk of respiratory complications (i.e., desaturation, cough, laryngospasm, bronchospasm, breath-holding, or apnea) and wound infection (i.e., wound redness or discharge +/- positive microbial culture, requiring antibiotic therapy) in smokers versus nonsmokers was ascertained. Odds ratios were estimated from multivariable logistic regression and adjusted for age, gender, body mass index, partner's smoking status, domiciliary smoking exposure, and extent and duration of surgery.

Results: Most smokers continued to smoke up until the day of surgery. Smokers had a higher rate of respiratory complications (32.8%vs. 25.9%; adjusted odds ratio, 1.71; 95% confidence interval, 1.03-2.84;P = 0.038) and wound infection (3.6%vs. 0.6%; odds ratio, 16.3; 95% confidence interval, 1.58-175;P = 0.019). Odds ratios comparing current plus ex-smokers with nonsmokers were of similar magnitude for most of these complications.     

Benzonitrile and derivatives. Synthesis and pharmacological study of alkyl para-cyanophenoxy alkanoates on the central nervous system

The results obtained by the pharmacological study of alkyl para-cyanophenoxy alkanoates seem to indicate that these derivatives present a sedative effect on the central nervous system. This activity increases with the number of methyl groups substituted, on ethyl para-cyanophenoxy acetate (except the motricity composent), most probably because of an increase in lipophily and therefore in the fixation on the central nervous system.     

Trends in childhood and adolescent cancer survival in Sweden 1960 through 1984.

The temporal changes in childhood and adolescent cancer survival in Sweden 1960-1984 were analyzed. Complete follow-up through 1986 of 6,262 patients younger than 20 years at diagnosis revealed that the overall 5-year survival rates increased from 36.1 to 65.7% in males and from 43.6 to 73.6% in females. The temporal trends differed markedly between age groups and tumour sites and types. Over the study period, 5-years, survival for testicular cancer increased from 46.9 to 87.2%, kidney cancer, predominantly Wilms' tumour from 35.5 to 77.1% (with a higher rate of 89.1% in 1975-1979), Hodgkin's disease from 61.2 to 91.9%, non-Hodgkin's lymphoma from 32.5 to 76.6%, and all leukemias from 8.9 to 58.7%. Only a moderate improvement was noted for tumours of the bone, muscle and connective tissue, and survival rates for tumours of the nervous system remained largely unchanged. Our data reflect the remarkable therapeutic improvements that have occurred for cancer in the young and indicate that these improvements have rapidly become available in Sweden.     

Diffuse heterotopic submucosal cystic malformation of the stomach: ultrasonographic diagnosis.

The preoperative diagnosis of diffuse heterotopic submucosal cystic malformation of the stomach is very difficult to make with upper gastrointestinal (GI) series or endoscopy. We report a case of submucosal cysts associated with an early gastric carcinoma in which ultrasonography (US) and endoscopic ultrasonography (EUS) were very useful in the preoperative diagnosis.