Profiles of orofacial dysfunction in different diagnostic groups using the Nordic Orofacial Test (NOT-S)—A review

Objective. The Nordic Orofacial Test-Screening (NOT-S) was developed as a comprehensive method to assess orofacial function. Results from the screening protocol have been presented in 11 international publications to date. This study reviewed these publications in order to compile NOT-S screening data and create profiles of orofacial dysfunction that characterize various age groups and disorders. Materials and methods. NOT-S results of nine reports meeting the inclusion criteria were reviewed. Seven of these studies not only provided data on the mean and range of total NOT-S scores, but also on the most common domains of orofacial dysfunction (highest rate of individuals with dysfunction scores), allowing the construction of orofacial dysfunction profiles based on the prevalence of dysfunction in each domain of NOT-S. Results. The compiled data comprised 669 individuals, which included healthy control subjects (n = 333) and various patient groups (n = 336). All studies reported differences between individuals with diagnosed disorders and healthy control subjects. The NOT-S data could measure treatment effects and provided dysfunction profiles characterizing the patterns of orofacial dysfunction in various diagnoses. Conclusions. This review corroborates previous results that the NOT-S differentiates well between patients and healthy controls and can also show changes in individuals after treatment. NOT-S could be used as a standard instrument to assess orofacial dysfunction, evaluate the outcomes of oral habilitation and rehabilitation and improve comparability in clinical practice and research.     

The use of erythropoiesis-stimulating agents in patients with non-myeloid hematological malignancies: a systematic review

The effectiveness of erythropoiesis-stimulating agents (ESAs) for the treatment of anemia in patients with non-myeloid hematological malignancies needs to be assessed as the response to their administration is not uniform and their cost is high. We conducted a systematic review (SR) of the literature to identify reports of the effect of ESAs on survival, quality of life (QOL), transfusion requirements, and anemia. The entries to MEDLINE, EMBASE, and the Cochrane Library databases, and abstracts published in the proceedings of the annual meetings of the American Society of Clinical Oncology and the American Society of Hematology were searched. Seventeen reports and five abstracts of randomized trials fulfilled prospective criteria for inclusion. Five trials reported on survival; three failed to detect differences between groups and two demonstrated inferior survival in patients allocated to an ESA. Seven trials and three abstracts reported on QOL with four articles and three abstracts describing improvements in patients allocated to erythropoietin. However, important methodologic limitations were identified in these reports. Seven randomized controlled trials reported a reduction in the proportion of patients transfused. The absolute risk reduction in transfusions ranged from 15% to 24%. This is the only SR that assesses the use of erythropoiesis-stimulating agents specifically in patients with hematological malignancies. We conclude that available data evaluating ESAs in patients with hematologic malignancies demonstrate that these agents reduce transfusion requirements. Limitations of these data preclude conclusions that these agents improve QOL. More data are required to confirm the inferior survival associated with ESAs.     

针刺结合药罐治疗颞颌关节紊乱症临床观察

ObjectiveTo observe the application of acupuncture at distal points combined with medicated cupping on the affected parts in the treatment of temporomandibular disorders (TMD) and to evaluate its effectiveness.MethodsA total of 120 patients with TMD were randomly divided into two groups according to the random number table and random number remainder method. Sixty-two patients in acupuncture combined with cupping group (group A) were treated with acupuncture at Hégŭ (

LI 4) and Tàichōng (

LR 3) combined with medicated cupping on the affected parts with Sānqī (

Radix et Rhizoma Notoginseng) and Báizh

(

Radix Angelicae Dahuricae). Fifty-eight patients in cupping group (group B) were just treated with medicated cupping. Patients were treated for 30 min each time, once daily, and 10 times were considered as one course of treatment. After one course of treatment, the therapeutic effect was evaluated. Before and after treatment, craniomandihular index (CMI), dysfunction index (DI), palpation index(PI) and changes in pain degree (VAS score) were compared.ResultsBefore and after treatment, CMI in group A were 0.27±0.02 and 0.04±0.01, respectively, and in group B were 0.29±0.02 and 0.06±0.01, respectively; PI in group A were 0.19±0.01 and 0.05±0.03, respectively, and in group B were 0.18±0.02 and 0.11±0.02, respectively; DI in group A were 0.33±0.04 and 0.06±0.02, respectively, and in group B were 0.34±0.05 and 0.11±0.04, respectively; VAS in group A were 5.39±0.24 and 2.13±0.47, respectively, and in group B were 5.70±0.31 and 3.97±0.26, respectively. After treatment, CMI, DI, PI and VAS in both groups significantly decreased when compared with those before treatment (all P<0.01), and the indices in group A were significantly lower than that in group B after treatment (all P<0.05), indicating that the difference was significant.ConclusionThe therapeutic effect of acupuncture at distal points combined with cupping at adjacent points in treatment of TMD is superior to that of single medicated cupping therapy.     

New approaches for measuring coagulation

Summary.  Although specific assays of coagulation factors are essential for diagnostic purposes they only give partial information about an individual's haemostatic state. This can be better assessed by various global tests, and recent developments and evaluations of five such tests are described in this symposium: the PFA-100; waveform analysis; thrombin generation; overall haemostasis potential; thrombelastography. Each test has advantages in various applications, but the thrombin generation test and waveform analysis have been found most useful in haemophilia, whilst the PFA-100 is helpful in von Willebrand's disease.     

Acute thermal injury of the esophagus

Acute thermal injury to the esophagus has not been reported previously in the radiographic literature. We present a case of a young adult who developed an intramura blister that ultimately communicated with the esophageal lumen. A double-contrast esophagogram outlined the resulting mucosal flap. A brief review of other injuries to the esophagus is included.