Orthodontic reduction of a displaced alveolar fracture: a case study

Abstract –  A 42-year-old woman had sustained a severe dental trauma with an alveolar fracture after an epileptic attack. A tooth block 31, 32, 33 and 34 was dislocated about 7 mm in buccal direction. Panoramic X-rays and CT-scan disclosed the alveolar fracture without total disjunction of the fragment. An orthodontic appliance was used to reduce the fracture with gentle forces during a 5-month period. Normal function was established and the teeth remained vital.     

Snapping biceps femoris tendon: A dynamic real‐time sonographic evaluation

Snapping of the distal arms of the biceps femoris tendon may explain pain and discomfort at the lateral aspect of the knee. We report two cases in which dynamic sonography was able to confirm the diagnosis and document which of the main arms was involved in the process. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound 38:435–437, 2010     

Prognostic value of tumoral thymidylate synthase and p53 in metastatic colorectal cancer patients receiving fluorouracil-based chemotherapy: phenotypic and genotypic analyses.

PURPOSE: The aim of this multicenter prospective study was to evaluate the role of intratumoral parameters related to fluorouracil (FU) sensitivity in 103 metastatic colorectal cancer patients receiving FU-folinic acid. PATIENTS AND METHODS: Liver metastatic biopsy specimens were obtained for all patients and primary tumor biopsy specimens for 54 patients. Thymidylate synthase (TS), folylpolyglutamate synthetase, and dihydropyrimidine dehydrogenase were measured by radioenzymatic assays; TS promoter polymorphism (2R/2R v 2R/3R v 3R/3R) was determined by polymerase chain reaction; and p53 protein and mutations were analyzed by immunoluminometric assay and denaturing gradient gel electrophoresis, respectively. RESULTS: p53 mutations were observed in 56.7% of metastases. TS activity was significantly higher in 2R/3R tumors as compared with 2R/2R or 3R/3R. TS activity in metastasis was the only parameter linked to clinical responsiveness (responders exhibited the lower TS, P =.047). Univariate Cox analyses demonstrated that TS activity in primary tumor (the greater the TS, the poorer the survival; P =.040), TS promoter polymorphism in primary tumor (risk of death of 2R/3R v 2R/2R, 2.68; P =.035), and p53 stop mutation in metastasis (risk of death of stop mutations v wild type, 3.14; P =.018) were the only significant biologic predictors of specific survival. Stepwise analysis did not discriminate between TS activity and TS polymorphism. CONCLUSION: Present results confirm the value of tumoral TS activity for predicting FU responsiveness, point out the importance of detailed p53 mutation analysis for predicting survival, and suggest that TS genotype in primary tumor carries a prognostic value similar to that of TS activity.     

Preoperative chemotherapy followed by surgery compared with primary surgery in resectable stage I (except T1N0), II, and IIIa non-small-cell lung cancer.

PURPOSE: To evaluate whether preoperative chemotherapy (PCT) could improve survival in resectable stage I (except T1N0), II, and IIIA non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: A randomized trial compared PCT to primary surgery (PRS). PCT consisted of two cycles of mitomycin (6 mg/m(2), day 1), ifosfamide (1.5 g/m(2), days 1 to 3) and cisplatin (30 mg/m(2), days 1 to 3), and two additional postoperative cycles for responding patients. In both arms, patients with pT3 or pN2 disease received thoracic radiotherapy. RESULTS: Three hundred fifty-five eligible patients were randomized. Overall response to PCT was 64%. There were two preoperative toxic deaths. Postoperative mortality was 6.7% in the PCT arm and 4.5% in the PRS arm (P =.38). Median survival was 37 months (95% confidence interval [CI], 26.7 to 48.3) for PCT and 26.0 months (95% CI, 19.8 to 33.6) for PRS (P =.15). Survival differences between both arms increased from 3.8% (95% CI, 1.3% to 25.1%) at 1 year to 8.6% (95% CI, 2.64% to 24.4%) at 4 years. A quantitative interaction between N status and treatment was observed, with benefit confined to N0 to N1 disease (relative risk [RR], 0.68; 95% CI, 0.49 to 0.96; P =.027). After a nonsignificant excess of deaths during treatment, the effect of PCT was significantly favorable on survival (RR, 0.74; 95% CI, 0.56 to 0.99; P =.044). Disease-free survival time was significantly longer in the PCT arm (P =.033). CONCLUSION: Although impressive differences in median, 3-year, and 4-year survival were observed, they were not statistically significant, except for stage I and II disease.     

Biovector™ Nanoparticles Improve Antinociceptive Efficacy of Nasal Morphine

Purpose. We have studied the antinociceptive activity and blood andbrain delivery of nasal morphine with or without Biovectornanoparticles in mice. Methods. A tail flick assay was used to evaluate theantinociceptive activity. The kinetics of morphine were evaluated in blood andbrain, using tritiated morphine as tracer. Results. These nanoparticles were shown to increase the durationof the antinociceptive activity of morphine after nasal administration.This effect was not due to an increase of morphine in the blood; andthe analgesic activity of morphine in association with nanoparticleswas reversed by naloxone. The ED₅₀ value was 33.6 ±15.6 mg/kg for morphine alone and 14.4 ± 7.6 mg/kg in presenceof nanoparticles. They were only effective at low doses (1.5 to 2.5 g),a higher or a lower dose had no effect. No interaction was found betweennanoparticles and morphine. NaDOC, a permeation enhancer, was unable toimprove nasal morphine activity. Conclusions. These results show the presence of nanoparticles onlyat a very specific dose increases the antinociceptive activity of nasalmorphine in mice. The occurrence of a direct transport of morphinefrom the nasal mucosa to the brain is discussed.     

Identifying determinants of Mozambican men’s willingness to use a male contraceptive pill

Objective: Given the possibility of a male contraceptive pill in the near future, understanding men’s attitudes towards this contraceptive method is crucial, especially in high-risk populations with limited access to education. This research was conducted to identify the determinants of Mozambican men’s willingness to use a contraceptive pill when it is made available.

Methods: A sample of 412 Mozambican men was presented with 36 vignettes comprising four within-subject factors (cost of pills, pill efficacy, side effects and context). Each vignette presented a scenario in which a man is asked by his partner to use the contraceptive pill, and participants indicated their own willingness to use the pill under each circumstance.

Results: Cluster analysis revealed that participants took one of four different positions regarding their willingness to use a contraceptive pill: never (11%); depends on side effects alone (25%); depends on side effects and costs (11%); depends on side effects and context (46%). These positions were associated with participants’ sociodemographic characteristics.

Conclusion: Among the Mozambican men in this study, a minority appeared to believe that the responsibility for contraception should be shared between sexual partners. Men’s willingness to use a contraceptive pill was, however, more pronounced in the case of serious medical risk to their partner. Overall, only about one-fifth of participants were either reluctant or unwilling to consider using a male contraceptive pill.