Sedation and analgesia in interventional radiology: Where do we stand, where are we heading and why does it matter?

The aims of this review were to describe the rationale and the techniques of sedation in interventional radiology, and to compile the safety and efficacy results available so far in the literature. A systematic MEDLINE/PubMed literature search was performed. Preliminary results from several studies demonstrated the feasibility, the efficacy and the safety of using sedative techniques in interventional radiology. Beyond pharmacological sedation and clinical hypnosis, digital sedation could reduce the anxiety and pain associated with interventional radiology procedures.

[Classification of premolars as a function of root anatomy and statistics]. / Classification des prémolaires en fonction de leur anatomie radiculaire et statistiques.

The frequent endodontic failures on premolar teeth can be partly attributed to their complicated root canal anatomy. Anatomical studies were initiated almost a century ago by W. Hess, resulting in the actual meticulous classification. Vertucci was the first to describe in an exhaustive way the scores of anatomical variations by assigning them to 9 types. The Wein model is just as complete but offers a more clinical approach. It will be used as reference in this article to weigh the various statistics appearing in the anatomical studies on premolars.

[Premolar anatomy and endodontic treatment]. / Anatomie des prémolaires et traitements endodontiques.

Endodontic failures on premolars are statistically important. This is mainly due to insufficient knowledge of the typical anatomical diversity shown by premolars. Filling a second root canal is often omitted. Completely treating a complicated root canal system is technically quite difficult which results in a relatively high level of endodontic failure. There are not only the classical technical problems to deal with: calcification of the root canals and delicate probing, given the frequently bent and twisted premolar roots; special attention should also be given to upper premolars with three root canals and those showing a high bifurcation of a principal root canal (configuration IV), and to lower premolars with multiple root canals often showing configuration IV. An additional problem associated with the second lower premolars is a hazardous anatomical zone: the mandibular vasculonervous plexus of the chin.

Juvenile distal cerebral ischemia: angiographic features. A study of 55 cases.

This study of juvenile distal cerebral ischaemia is based on 55 patients aged from 18 to 30 years. The authors describe the circumstances of discovery, as well as the clinical features and the course of the disease which may be severe and lead to non-resolutive neurological accidents and sometimes dementia. Paraclinical evaluation includes capillaroscopy, finger and toe pads biopsy (which clearly shows a pathological process with fibrocellular promontories narrowing the lumen of arterioles), and above all angiography which displays two typical signs: arterial narrowness and bands of peripheral ischaemia. In advanced forms of the disease angiography reveals classical signs of ischaemic lesions, but charateritically these are very distal. Associated abnormalities of the carotid siphon can also be found. Finally, positive CT scans show an isolated widening of the sulci which is fairly suggestive of the disease.