Motor neuron disease and serum monoclonal proteins: poor response to treatment of the paraproteinemia.

An association between motor neuron disease (MND) and paraproteinemia has been previously reported. In a retrospective study, we found that 13 of 117 (11%) patients with MND who had serum protein electrophoresis studies were found to have a serum M-protem. Eleven of 13 patients had probable or definite amyotrophic lateral sclerosis (ALS), Of the 11 patients with ALS, six were treated with immunotherapy or chemotherapy. Subjective or objective neurologic improvement was not identified in any. Our data support an association between MND and paraproteinemia, but response to treatment of the paraproteinemia was disappointing. Searching for an M-protein in probable or definite ALS may not be therapeutically relevant.

An evaluation of the behaviour of children undergoing dental extraction under general anaesthesia.

The cooperation of a random sample of 190 children with an average age of 5 years (range 1-17 years), presenting with a dental emergency requiring tooth extraction under general anaesthesia, was evaluated using the Frankl Behaviour Scale. The results showed that 60% of the children cooperated in the operating theatre. Furthermore, removal of only one or two teeth per patient accounted for 40% of the cases. This survey has identified a group of child dental patients who might benefit from conscious sedation and local anaesthetic techniques.

The management of craniofacial pain in a pain relief unit.

This paper reports the results of 34 craniofacial pain sufferers who were treated at the Dudley Pain Relief Unit over a 1-year period. Most of the patients were referred by their general medical practitioners. They were adults representing all age groups, with a female-male ratio of 4:1. The average history of pain was 5.5 years. Neuralgic pain (as distinct from temporomandibular joint dysfunction syndrome, migrainous disorders, and pain of iatrogenic origin) was most frequently seen. Oral drug therapy, local injection of corticosteroids and analgesics, peripheral neurolysis, magnetotherapy, hypnotherapy, and acupuncture were the lines of management available. By the end of this study period, pain had been relieved or eliminated in 30 of the patients (88%).

The management of craniofacial pain in a pain relief unit.

Craniofacial pain can be one of the more intractable problems that presents to the GDP. One management route can be referral to a specialist pain relief unit, where the facilities and expertise will be available for diagnosis, counselling, drug management and invasive therapy. In this article the authors describe the results achieved at one such unit, over a one-year period, for a group of 34 craniofacial pain sufferers. At the end of the year 30 patients reported total or partial relief from their pain.

The status of community advisory committees in dental education.

A questionnaire survey was undertaken to determine how prevalent community advisory committees have become in the nation's dental schools and what types of committees have been formed. Responses were received from 52 (90 percent) of the 58 dental schools. The data revealed the following: 1. Nine schools (17 percent) have developed consumer committees. 2. The number of committee members varies from five to 29. 3. All the committees are composed of consumer members and school representatives, and, in all but one committee, health care providers are represented. 4. Four (44 percent) committees have advisory functions only, while the remaining five (56 percent) play an advisory and policy-making role. 5. No committee planned formal training sessions for their consumer members. 6. Of the 43 schools (83 percent) without such a committee, seven (16 percent) replied they foresee implementing a consumer committee in the future.