A rare complication of idiopathic osteosclerosis

Idiopathic osteosclerosis (IO) is described as a localized no expansible radiopacity with unknown etiology. The IO is generally asymptomatic and could appear as round, elliptical or irregular in shape. The internal aspect is usually uniformly radiopaque. IO should be distinguished from condensing osteitis of dental origin, or other alveolar bone related radiopacities such as periapical cemental dysplasia. This condition may cause changes in tooth position or problems during orthodontic treatment. The purpose of the present study is to report a case of tooth resorption caused by ectopic eruption rote caused by IO. This condition represents a rare complication of IO.     

Ganglion cyst of the temporomandibular joint

Ganglion cysts of the temporomandibular joint are rare and arise from myxoid degeneration of die collagenous tissue of the capsule of the joint as a result of trauma.     

A simple strategy to reduce stereotype threat for orthopedic residents

Background

Stereotype threat, defined as the predicament felt by people in either positive or negative learning experiences where they could conform to negative stereotypes associated with their own group membership, can interfere with learning. The purpose of this study was to determine if a simple orientation session could reduce stereotype threat for orthopedic residents.

Methods

The intervention group received an orientation on 2 occasions focusing on their possible responses to perceived poor performance in teaching rounds and the operating room (OR). Participants completed a survey with 7 questions typical for stereotype threat evaluating responses to their experiences. The questions had 7 response options with a maximum total score of 49, where higher scores indicated greater degree of experiences typical of stereotype threat.

Results

Of the 84 eligible residents, 49 participated: 22 in the nonintervention and 27 in the intervention group. The overall scores were 29 and 29.4, and 26.2 and 25.8 in the nonintervention and intervention groups for their survey responses to perceived poor performance in teaching rounds (p = 0.85) and the OR (p = 0.84), respectively. Overall, responses typical of stereotype threat were greater for perceived poor performance at teaching rounds than in the OR (p = 0.001).

Conclusion

Residents experience low self-esteem following perceived poor performance, particularly at rounds. A simple orientation designed to reduce stereotype threat was unsuccessful in reducing this threat overall. Future research will need to consider longer-term intervention as possible strategies to reduce perceived poor performance at teaching rounds and in the OR.     

Intracardiac embolization of inferior vena cava filter associated with right atrium perforation and cardiac tamponade

Insertion of inferior vena cava filters has been well established in literature, reducing occurrence of pulmonary embolism after an episode of deep venous thrombosis in patients with contraindication to anticoagulation. There are a small number of complications related to procedure and embolization is rare. In this context, we described a case of intracardiac embolization associated with cardiac tamponade.     

Effective hand function assessment after burn injuries

This study compared two methods of hand function assessment, the Michigan Hand Outcomes Questionnaire (MHQ) and the Test d'Evaluation des Membres Supérieurs des Personnes Agées (TEMPA) in 20 patients discharged from a regional adult burn center (1995-1999). Spearman's rank correlation coefficient analysis was used to compare the MHQ and TEMPA scores, with P <.05 considered significant. The MHQ revealed that 68% of patients reported hand function deterioration, mainly with the nondominant hand (65%). Activities of daily living (76%) and work (59%) were the most affected. According to the MHQ, patient satisfaction correlated with work performance (r =.66, P =.002), aesthetics (r =.64, P =.003), pain (r =.59, P =.008), and activities of daily living (r =.54, P =.017). The MHQ indicated more hand function deterioration than the TEMPA. There was a significant correlation between the MHQ and TEMPA total scores (r =.68, P =.001). This study supports using the MHQ to determine which patients would benefit from the more resource-consuming TEMPA.     

Educational interventions in end-of-life care: part I: an educational intervention responding to the moral distress of NICU nurses provided by an ethics consultation team.

PURPOSE: This study was conducted to assess whether neonatal nurses who care for dying infants could be assisted in their knowledge and comfort via an educational intervention provided by hospital ethics committee members and hospice specialists. PARTICIPANTS: Eighty-two registered nurses working in a level III neonatal intensive care unit (NICU) were included. METHODS AND DESIGN: This was a quantitative pretest, intervention, post-test design with a single group undergoing educational sessions in the 6 areas of pain management, symptom management, ethical/legal issues, communication/culture, spiritual/anxiety, and prevention of compassion fatigue. MAIN OUTCOME MEASUREMENTS: An instrument, "Comfort in Caring for Dying Infants" (CLCDI), was developed to assess pre- and posteducational knowledge and comfort in these areas. RESULTS: There were statistically significant higher levels of comfort and knowledge in care for dying infants in the areas of ethical/legal issues and symptom management after the educational programs. Although not statistically significant, mean scores were higher after the educational sessions on pain management, spirituality/anxiety, and prevention of compassion fatigue. The communication/culture module scores were lower in the post-test administration. CONCLUSIONS: Education by hospice experts in the NICU can assist nurses' comfort with care of the dying infant. In addition, ongoing support is highly desirable for all staff participating in such care. The authors suggest incident debriefings from outside experts, debriefing after each infant's death, multidisciplinary meetings for the whole team, and having sessions of lessons learned on infant death cases.     

Time course of structural and functional maturation of human olfactory epithelial cells in vitro

The unique ability of olfactory neurons to regenerate in vitro has allowed their use for the study of olfactory function, regeneration, and neurodegenerative disorders; thus, characterization of their properties is important. This present study attempts to establish the timeline of structural (protein expression) and functional (odorant sensitivity) maturation of human olfactory epithelial cells (hOE) in vitro using biopsy‐derived cultured tissue. Cells were grown for 7 days; on each day, cells were tested for odorant sensitivity using calcium imaging techniques and then protein expression of each cell was tested using immunocytochemistry for proteins typically used for characterizing olfactory cells. Previous studies have shown that mature olfactory neurons in vitro attain a unique “phase‐bright” morphology and express the olfactory marker protein (OMP). By day 3 in vitro, a variety of cells were odorant‐sensitive, including both “phase‐bright” and “phase‐dark” cells that have previously been considered glial‐like cells. The functional maturation of these hOEs appears to take place within 4 days. Interestingly, the emergence of an odorant sensitivity profile of both phase‐bright and phase‐dark cells preceded the expression of marker protein expression for OMP (which is expressed only by mature neurons in vivo). This structural maturation took 5 days, suggesting that the development of odorant sensitivity is not coincident with the expression of marker molecules that are hallmarks of structural maturation. These results have important implications for the use of hOEs as in vitro models of olfactory and neuronal function. © 2013 Wiley Periodicals, Inc.     

Augmentation of spelling therapy with transcranial direct current stimulation in primary progressive aphasia: Preliminary results and challenges

Background: Primary progressive aphasia (PPA) is a neurodegenerative disease that primarily affects language functions and often begins in the fifth or sixth decade of life. The devastating effects on work and family life call for the investigation of treatment alternatives. In this article, we present new data indicating that neuromodulatory treatment, using transcranial direct current stimulation (tDCS) combined with a spelling intervention, shows some promise for maintaining or even improving language, at least temporarily, in PPA.

Aims: The main aim of the present article is to determine whether tDCS plus spelling intervention is more effective than spelling intervention alone in treating written language in PPA. We also asked whether the effects of tDCS are sustained longer than the effects of spelling intervention alone.

Methods & Procedures: We present data from six PPA participants who underwent anodal tDCS or sham plus spelling intervention in a within-subject crossover design. Each stimulation condition lasted 3 weeks or a total of 15 sessions with a 2-month interval in between. Participants were evaluated on treatment tasks as well as on other language and cognitive tasks at 2-week and 2-month follow-up intervals after each stimulation condition.

Outcomes & Results: All participants showed improvement in spelling (with sham or tDCS). There was no difference in the treated items between the two conditions. There was, however, consistent and significant improvement for untrained items only in the tDCS plus spelling intervention condition. Furthermore, the improvement lasted longer in the tDCS plus spelling intervention condition compared to sham plus spelling intervention condition.

Conclusions: Neuromodulation with tDCS offers promise as a means of augmenting language therapy to improve written language function at least temporarily in PPA. The consistent finding of generalisation of treatment benefits to untreated items and the superior sustainability of treatment effects with tDCS justifies further investigations. However, the small sample size still requires caution in interpretation. Present interventions need to be optimised, and particular challenges, such as ways to account for the variable effect of degeneration in each individual, are discussed.