Secondary Bleedings in Oral Surgery Emergency Service: A Cross-Sectional Study.

INTRODUCTION: Bleeding after dental surgery is still a common cause for emergency presentation in patients using anticoagulants. Our aim was to analyze pertinent characteristic features on the one hand and to bare existing problems in handling on the other. MATERIALS AND METHODS: The study included 76 patients. We documented basic data, anticoagulant medication, type of surgery, and tooth socket sutures in respective patients. RESULTS: The vast majority of patients took a coumarin derivative (41) and acetylsalicylic acid (27). Nine (12%) of the patients had to be hospitalized due to ongoing bleeding despite local haemostyptic steps and/or circulatory dysregulation. Most patients could be successfully treated in outpatient settings. No statistically significant correlation between bleeding, level of INR value, number of extracted teeth, and sewed alveoli could be shown. Sixty-five percent of cases with tooth extractions did not have suture of tooth sockets. Eighty-seven percent of the patients denied being informed about possible self-treatment options by their surgeon/dentist, and none of the patients got presurgical-fabricated bandage plate(s). CONCLUSIONS: Patients taking coumarin derivative currently, furthermore, represent the biggest anticoagulant after-bleeding group in dentoalveolar surgery. The major part of after-bleedings (90%) can be handled in an outpatient setting with simplest surgical interventions. Unfortunately, the biggest part of the patient collective got no suture, no prefabricated dental bandage plate(s), and no explanation by their dentist how to handle in case of after-bleeding. Therefore, dental practitioners should furthermore get enlightenment on how to prevent after-bleeding situations.

Oligodoncia no sindrómica: presentación de caso / Non syndromic Oligodontia: a case report

Fundamento: las anomalías dentales de número y forma pueden verse tanto en la dentición temporal como en la permanente. La evidencia documental de esta condición está muy limitada en la literatura y la causa es muy discutida.Objetivo: describir un caso clínico atípico de oligodoncia sin asociación de condición sistémica o síndromes.Caso clínico: paciente femenina de 12 años de edad, que al examen clínico se observa ausencia generalizada de dientes permanentes. El padre presenta también falta de dientes, los cuales no habían sido extraídos con anterioridad, por lo que se trata de un caso congénito. Al examen radiológico se comprueba la presencia de seis dientes temporales y solo seis permanentes.Conclusiones: las evidencias de individuos con desórdenes dentales raros contribuyen al establecimiento de varias herramientas diagnósticas y por ende, se definen las necesidades del tratamiento(AU)

Background: dental anomalies of number and shape can be in both temporary and permanent dentition. Evidence of this condition is very limited in literature and the etiology is controversial.Objective: to describe an atypical clinical case of oligodontia with no association of systemic condition or syndromes.Clinical case: a twelve-year-old female patient who presented a general lack of permanent teeth when she was examined. Her father also has missing teeth, which had not been previously removed; therefore it is a congenital case. The radiological examination showed the presence of six deciduous teeth and only six permanent.Conclusions: evidence in individuals with rare dental disorders contributes to the establishment of various diagnostic tools and consequently treatment needs are defined(AU)

Oligodoncia no sindrómica: presentación de caso / Non syndromic Oligodontia: a case report

Fundamento: las anomalías dentales de número y forma pueden verse tanto en la dentición temporal como en la permanente. La evidencia documental de esta condición está muy limitada en la literatura y la causa es muy discutida. Objetivo: describir un caso clínico atípico de oligodoncia sin asociación de condición sistémica o síndromes. Caso clínico: paciente femenina de 12 años de edad, que al examen clínico se observa ausencia generalizada de dientes permanentes. El padre presenta también falta de dientes, los cuales no habían sido extraídos con anterioridad, por lo que se trata de un caso congénito. Al examen radiológico se comprueba la presencia de seis dientes temporales y solo seis permanentes. Conclusiones: las evidencias de individuos con desórdenes dentales raros contribuyen al establecimiento de varias herramientas diagnósticas y por ende, se definen las necesidades del tratamiento.

Background: dental anomalies of number and shape can be in both temporary and permanent dentition. Evidence of this condition is very limited in literature and the etiology is controversial. Objective: to describe an atypical clinical case of oligodontia with no association of systemic condition or syndromes. Clinical case: a twelve-year-old female patient who presented a general lack of permanent teeth when she was examined. Her father also has missing teeth, which had not been previously removed; therefore it is a congenital case. The radiological examination showed the presence of six deciduous teeth and only six permanent. Conclusions: evidence in individuals with rare dental disorders contributes to the establishment of various diagnostic tools and consequently treatment needs are defined.

Ensuring an optimal environment for peer education in South African schools: Goals, systems, standards and policy options for effective learning.

Peer education has long been seen as a key health promotion strategy and an important tool in preventing HIV infection. In South African schools, it is currently one of the strategies employed to do so. Based on both a recent research study of peer education across 35 schools and drawing on multiple previous studies in South Africa, this paper examines the key elements of peer education that contribute to its effectiveness and asks how this aligns with current educational and health policies. From this research, it summarises and proposes shared goals and aims, minimum standards of implementation and reflects on the necessary infrastructure required for peer education to be effective. In light of these findings, it offers policy recommendations regarding who should be doing peer education and the status peer education should have in a school's formal programme.

Measuring change in vulnerable adolescents: findings from a peer education evaluation in South Africa.

INTRODUCTION: In the context of poverty and HIV and AIDS, peer education is thought to be capable of providing vulnerable youth with psychosocial support as well as information and decision-making skills otherwise limited by scarce social and material resources. As a preventative education intervention method, peer education is a strategy aimed at norms and peer group influences that affect health behaviours and attitudes. However, too few evaluations of peer-led programmes are available, and they frequently fail to reflect real differences between those who have been recipients of peer education and those who have not. This article reports on an evaluation of a pilot peer-led intervention, entitled Vhutshilo, implemented on principles agreed upon through a collaborative effort in South Africa by the Harvard School of Public Health and the Centre for the Support of Peer Education (the Rutanang collaboration). Vhutshilo targeted vulnerable adolescents aged 14-16 years living in some of South Africa's under-resourced communities. METHODOLOGY: The research design was a mixed-method (qualitative and quantitative), longitudinal, quasi-experimental evaluation. Tools used included a quantitative survey questionnaire (n = 183) and semi-structured interviews (n = 32) with beneficiaries of peer education. Surveys were administered twice for beneficiaries of peer education (n = 73), immediately after completion of the programme (post-test) and 4 months later (delayed post-test), and once for control group members (n = 110). The three main methodological limitations in this study were the use of a once-off control group assessment as the baseline for comparison, without a pre-test, due to timing and resource constraints; a small sample size (n = 183), which reduced the statistical power of the evaluation; and the unavailability of existing tested survey questions to measure the impact of peer education and its role in behaviour change. FINDINGS: This article reports on the difficulties of designing a comprehensive evaluation within time and financial constraints, critically evaluates survey design with multi-item indicators, and discusses six statistically significant changes observed in Vhutshilo participants out of a 92-point survey. Youth struggling with poor quality education and living in economically fraught contexts with little social support, nonetheless, showed evidence of having greater knowledge of support networks and an expanded emotional repertoire by the end of the Vhutshilo programme, and 4 months later. At both individual and group level, many with low socio-economic status showed great improvement with regard to programme indicator scores. CONCLUSION: For the poorest adolescents, especially those living in the rural parts of South Africa, peer education has the potential to change future orientation, attitudes and knowledge regarding HIV and AIDS, including an intolerance for multiple concurrent partnerships. When well organised and properly supported, peer education programmes (and the Vhutshilo curriculum, in particular) provide vulnerable youth with opportunities to develop psychosocial skills and informational resources that contribute to the changing of norms, attitudes and behaviours. However, the article also flags the need for effective peer education evaluations that take into account limited financial resources and that possess tested indicators of programme effectiveness.

In vitro anti-leukemic activity of the ethno-pharmacological plant Scutellaria orientalis ssp. carica endemic to western Turkey.

AIM OF THIS STUDY: Within the genus Scutellaria various species are used in different folk medicines throughout Asia. Traditional Chinese Medicine (TCM) uses S. baicalensis (Labiatae) to treat various inflammatory conditions. The root shows strong anticancer properties in vitro and was suggested for clinical trials against multiple myeloma. Further, S. barbata was successfully tested against metastatic breast cancer in a phase I/II trial. Therefore, we investigated the anti-cancer properties of S. orientalis L. ssp. carica Edmondson, an endemic subspecies from the traditional medicinal plant S. orientalis L. in Turkey, which is used to promote wound healing and to stop haemorrhage. MATERIALS AND METHODS: Freeze-dried plant material was extracted with petroleum ether, dichloromethane, ethyl acetate, and methanol and the bioactivity of these extracts was analysed by proliferation assay, cell death determination, and by investigating protein expression profiles specific for cell cycle arrest and apoptosis. RESULTS: The strongest anti-leukemic activity was shown by the methanol extract, which contained apigenin, baicalein, chrysin, luteolin and wogonin, with an IpC50 of 43 microg/ml (corresponding to 1.3mg/ml of dried plant material) which correlated with cyclin D1- and Cdc25A suppression and p21 induction. At 132 microg/ml (=4 mg/ml of the drug) this extract caused genotoxic stress indicated by substantial phosphorylation of the core histone H2AX (gamma-H2AX) followed by activation of caspase 3 and signature-type cleavage of PARP resulting in a 55% apoptosis rate after 48 hours of treatment. CONCLUSIONS: Here, we report for the first time that S. orientalis L. ssp. carica Edmondson exhibited potent anti-leukaemic properties likely through the anti-proliferative effect of baicalein and the genotoxic property of wogonin.

Immunohistochemical characterization of nanocrystalline hydroxyapatite silica gel (NanoBone(r)) osteogenesis: a study on biopsies from human jaws.

OBJECTIVES: Bone substitute biomaterials may be osteogenic, osteoconductive or osteoinductive. To test for these probable characteristics in a new nanoporous grafting material consisting of nanocrystalline hydroxyapatite embedded in a porous silica gel matrix (NanoBone(s)), applied in humans, we studied biopsies from 12 patients before dental implantation following various orofacial augmentation techniques with healing times of between 3.5 and 12 months. MATERIAL AND METHODS: Sections from decalcified specimens were investigated using histology, histochemistry [periodic acid Schiff, alcian blue staining and tartrate-resistant acid phosphatase (TRAP)] and immunohistochemistry, with markers for osteogenesis, bone remodelling, resorption and vessel walls (alkaline phosphatase, bone morphogenetic protein-2, collagen type I, ED1, osteocalcin, osteopontin, runx2 and Von-Willebrand factor). RESULTS: Histologically, four specific stages of graft transformation into lamellar bone could be characterized. During early stages of healing, bone matrix proteins were absorbed by NanoBone(s) granules, forming a proteinaceous matrix, which was invaded by small vessels and cells. We assume that the deposition of these molecules promotes early osteogenesis in and around NanoBone(s) and supports the concomitant degradation probably by osteoclast-like cells. TRAP-positive osteoclast-like cells were localized directly on the granular surfaces. Runx2-immunoreactive pre-osteoblasts, which are probably involved in direct osteogenesis forming woven bone that is later transformed into lamellar bone, were attracted. Graft resorption and bone apposition around the graft granules appear concomitantly. CONCLUSIONS: We postulate that NanoBone(s) has osteoconductive and biomimetic properties and is integrated into the host's physiological bone turnover at a very early stage.

Absence of classical MAP kinase pathway signalling in Merkel cell carcinoma.

Merkel cell carcinoma (MCC) is a highly metastatic skin tumor. To assess the relevance of the Ras/Raf/MEK/MAP kinase pathway, we analyzed for activating B-Raf mutations and we elucidated the presence of the Raf Kinase Inhibitor Protein (RKIP) and extracellular signal-regulated kinase (ERK) as well as the phosphorylation status of ERK. All MCC samples were negative for the B-Raf(V600E) mutation. Remarkably, RKIP, which was shown to interfere with the activation of MEK by Raf, was highly expressed in primary as well as in metastatic MCC. Immunohistochemical analysis of the phosphorylation status of ERK revealed in 42 out of 44 samples a complete lack of activated ERK in the tumor cells although ERK is expressed; in the two positive cases phosphorylated ERK was restricted to a minor fraction of the tumor cells. Western blot analysis of three MCC-derived cell lines revealed in one case the pattern present in situ (i.e. high RKIP expression and complete absence of phosphorylated ERK). In summary, our data demonstrate the inactivity of the classical MAP kinase signal transduction pathway in MCC, which seems to be because of lack of activation as well as active deactivation. These findings should be accounted for in future therapeutic approaches for this tumor.