Early evidence of extra-masticatory dental wear in a Neolithic community at Bestansur, Iraqi Kurdistan.

This paper presents the first evidence of extra-masticatory dental wear from Neolithic Bestansur, Iraqi Kurdistan (7700-7200 BC). Bestansur is a rare, recently excavated burial site of this period in the Zagros region, of Iraqi Kurdistan. A total of 585 teeth from 38 individuals were analyzed for features indicative of activities including oblique wear planes, notches, grooves, and chipping. Indications of extra-masticatory wear were found in 27 of 38 individuals, and 277 of 585 teeth (47%) available for study. The most frequent features were chipping and notches suggesting activities such as processing fibers by using the teeth as a "third hand." Evidence for these wear features was present in both males, females, and in children aged five and older. These aspects of childhood life-course and dentition are rarely investigated. The presence of dental wear features in the deciduous dentition can indicate an age range at which activities began in different groups and highlights the importance of including juvenile remains in such studies. The variety of forms of dental wear may relate to the mixed diet and activities of these people. This study adds to our understanding of human behaviors and socio-cultural aspects of life during this transitional period.

Neuroinflammation: Breaking barriers and bridging gaps.

Neurons are the cells of the nervous system and are responsible for every thought, movement and perception. Immune cells are the cells of the immune system, constantly protecting from foreign pathogens. Understanding the interaction between the two systems is especially important in disease states such as autoimmune or neurodegenerative disease. Unfortunately, this interaction is typically detrimental to the host. However, recent efforts have focused on how neurons and immune cells interact, either directly or indirectly, following traumatic injury to the nervous system. The outcome of this interaction can be beneficial - leading to successful neural repair, or detrimental - leading to functional deficits, depending on where the injury occurs. This review will discuss our understanding of neuron-immune cell interactions after traumatic injury to both the peripheral and central nervous system.

Laparoscopic cholecystectomy in pregnancy: An Australian retrospective cohort study.

INTRODUCTION: Biliary tract disease is a common non-obstetric surgical presentation during pregnancy. Although small international series demonstrate favourable outcomes following laparoscopic cholecystectomy (LC) during pregnancy, there is a paucity of Australian data to complement these findings. METHOD: Between 1st January 2003 and 30th June 2013, all patients undergoing planned LC during pregnancy at Western Health were retrospectively identified. RESULTS: Twenty-two patients underwent planned LC with 3 (13%) cases converted to open surgery. The median maternal age was 31 years (27.8-36) with an estimated median gestational age (EGA) of 19.5 weeks (16.5-23.5). Eighteen (82%) cases were performed during the second trimester. Nine (40%) patients had 2 or more hospital admissions for similar presentations. Twelve (54%) were performed as index cases. Operative indications included 12 (54%) with recurrent biliary colic, five (22%) with acute cholecystitis and 3 (14%) with gallstone pancreatitis. Median operating time for completed LCs was 65 min (60-95). Intra-operative cholangiogram was performed in seven (32%) cases, 5 (71%) of which employed protective uterine lead shielding. There was no fetal loss or uterine injury. Median hospital stay was 3 days (2-7) for completed LCs. Major morbidity occurred in 2 (10%) completed LCs that required a return to theatre. Five (23%) births were lost to follow up. The median time to delivery post-surgery was 13 weeks (11-15). Two (12%) preterm deliveries occurred, with subsequent neonatal complications. CONCLUSION: Antenatal laparoscopic cholecystectomy demonstrated comparably safe outcomes. Increasing its utilization to manage symptomatic cholelithiasis during pregnancy may be considered.

Brief report: Focused transthoracic echocardiography training in a cohort of Canadian anesthesiology residents: a pilot study.

PURPOSE: Bedside transthoracic echocardiography (TTE) is useful for rapid assessment and treatment of hemodynamic disturbances. Transthoracic echocardiography is not standard in Canadian anesthesia training even though undifferentiated hemodynamic disturbances are common in the perioperative setting. The objectives of this pilot study were to determine 1) whether it is feasible to implement a focused bedside TTE curriculum within core anesthesiology training, 2) whether changes could be detected and quantified following the program of study, and 3) whether curriculum implementation might lead to a significant increase in anesthesiology residents' TTE knowledge-base. METHODS: In this single-centre cohort pilot investigation, anesthesiology residents at Queen's University received focused bedside TTE training during the winter of 2011. The curriculum consisted of four three-hour sessions with both didactic and practical components. Pre- and post-curriculum examinations were administered, and examination results were compared using non-parametric tests. The primary outcome was the difference in mean pre- and post-curriculum examination scores. RESULTS: Ten participants completed pre- and post-curriculum examinations. Four residents were unable to participate in the curriculum but served as controls. Mean pretest scores (out of 50) were similar between the two groups (participants 23.9 vs controls 23.5; P = 0.83, Mann-Whitney U). Mean scores improved by 13.0 points following intervention but improved by only 1.3 points for controls, (P = 0.009, Mann-Whitney U). CONCLUSION: This pilot investigation suggests that implementation of a focused bedside TTE curriculum within anesthesia training is feasible, quantifiable, and effective for increasing anesthesia residents' TTE knowledge-base. This pilot study suggests that further investigation is warranted to determine the impact of this perioperative TTE curriculum.

Unusual cause of an ejection murmur: myxoma in the left ventricular outflow tract.

We present the case of a healthy, asymptomatic 50-year-old woman with a systolic ejection murmur who was found to have an obstructive left ventricular outflow tract mass. Transthoracic echocardiography revealed a large mobile mass attached to the basal anterior septum of the left ventricle. Surgical resection was performed and a benign left ventricular outflow tract myxoma was diagnosed. The patient's postoperative course was unremarkable. We describe the clinical presentation and role of 2- and 3-dimensional transthoracic and transesophageal echocardiography in surgical management.