External inflammatory and replacement resorption of luxated, and avulsed replanted permanent incisors: a review and case presentation

Abstract –  External inflammatory resorption and replacement resorption are complicating factors that may result from traumatic dental injuries when the tooth is luxated or avulsed and replanted. Resorption may, ultimately, result in loss of the tooth. However, with appropriate treatment, the prognosis for these teeth is greatly improved, with the possibility of preventing or arresting resorption. The purpose of this paper is to review these trauma entities, to discuss factors that influence the occurrence of resorption and to describe the most appropriate treatment. A case is presented, illustrating both resorption entities, but with varying outcomes.     

Augmentative and Alternative Communication (AAC) for adults with severe aphasia: where we stand and how we can go further

Purpose: To review literature specific to the use of AAC with adults who have severe aphasia. Method: The authors reviewed studies involving AAC interventions for adults with severe aphasia. Results: Published data support the use of aided and unaided AAC with adults with severe aphasia in controlled treatment contexts. Reported gains in communication typically have not generalized to everyday settings. Conclusions: The application of AAC with persons with severe aphasia must address factors potentially limiting treatment success outside of training environments.     

Comparison of epidural anaesthesia with ropivacaine 0.5% and bupivacaine 0.5% for Caesarean section

PURPOSE: To compare ropivacaine 0.5% with bupivacaine 0.5% for epidural anaesthesia for Caesarean section. METHODS: Healthy pregnant women, scheduled for elective Caesarean section were enrolled into this randomized, double-blind, parallel-group study. Epidural block was obtained with 20-30 ml of ropivacaine (group R) or bupivacaine (group B) and surgery started when anaesthesia was reached T6. Maternal heart rate and blood pressure and fetal heart rate were assessed before the test dose and at five minute intervals until the end of surgery. At the same intervals, sensory and motor block characteristics were determined. Apgar scores and Neurologic and Adaptive Capacity Scores (NACS) were determined after delivery. Adverse events were recorded. RESULTS: Sixty-five patients were enrolled and data from 61 were available for analysis; 30 ropivacaine and 31 bupivacaine. Time from the end of the last injection to the start of surgery was 46 +/- 13 min (mean +/- SD) in gp R and 53 +/- 25 min in gp B (P:NS). The median duration of analgesia varied between 1.7 and 4.2 hr in gp R and between 1.8 and 4.4 hr in gp B (P:NS). In patients who developed Bromage 4 block, it persisted longer in those in gp B (2.5 hr) than in gp R (0.9 hr) (P < 0.05). The quality of analgesia was satisfactory in 27/29 patients (93%) in gp R and 27/31 patients (87%) in gp B (P:NS), although supplemental i.v. opioid was required in ten and seven patients, respectively. The most common adverse events in the mother were hypotension (63% gp R and 61% in gp B) (NS) and nausea (30% and 58%, in group R and B, respectively) (P = 0.05). Apgar scores were 7 after five minutes in all neonates. CONCLUSION: Ropivacaine 0.5% and bupivacaine 0.5% provided effective epidural anaesthesia for Caesarean section although supplementation with i.v. opioid was commonly required.     

Canadian contributions to the introduction and use of divinyl ether

In conclusion, Dr. Gelfan and Bell’s early work was a brief practical study, typical of the uninhibited work of many of the pioneers in anesthesia, who willingly participated as “guinea pigs“ in their continuing search to advance the body of medical knowledge in the pharmacology of anesthetic agents. Their work provides inspiring examples of how Canadian researchers have quietly contributed to advances in anesthesia for many decades. Drs. Gelfan and Bell deserve considerable credit for taking that very important first step to evaluate the use of DVE in humans, as Dr. Bourne deserves credit for popularizing the use of this historically important inhaled anesthetic in clinical anesthesia, in Canada and the United States.