'Say no': a feasibility trial of a brief intervention to reduce instances of indulgent energy-intake episodes.

The aim of this study is to examine the feasibility of a brief intervention to reduce instances of indulgent energy intake. Forty-five participants with a body mass index (BMI) ≥25 kg m-2 were randomized to one of three groups for 8 weeks. The control group was asked to complete a questionnaire every 4 days, the self-monitoring group was given the same instructions but also asked to 'say no' to indulgences. The self-monitoring and feedback group was asked to do the same but in addition to send a photograph or description of that to which they had 'said no' and were then provided with feedback. All participants reported on indulgences for 7 days prospectively at baseline and 8-week follow-up. The follow-up rate was 80%; completion of questionnaires was 63% and 87 text messages were sent. The control group reduced their indulgences by 4.1 (SD 10.0), the self-monitoring group by 13.8 (SD 16.8) and self-monitoring and feedback group by 9.0 (SD 11.7) per week. All bar one, feasibility progression criteria were met and this was the return of the indulgence diaries during the intervention period. The study demonstrates the feasibility of a brief intervention to reduce the number of indulgences people ate. The progression criteria were met and areas of improvement are highlighted.

Oroantral fistula from bisphosphonate induced osteonecrosis of the jaw.

Bisphosphonates like alendronic acid, disodium etidronate, and risedronate are effective for preventing postmenopausal and corticosteroid induced osteoporosis. They are also useful in the treatment of Paget's disease, hypercalcaemia of malignancy and in bony metastases. However osteonecrosis of the jaw has been reported following intravenous bisphosphonate use and rarely in those taking them orally. Increasingly, oroantral fistulae have been shown to occur as sequelae of bisphosphonate-induced osteonecrosis of the jaw and this case report highlights a patient that presented to our ENT department and required sinus surgery in collaboration with maxillofacial surgeons. This case report aims to raise awareness among ENT surgeons to these patients on bisphosphonates that could present to them with sinus disease from oroantral fistulae. There is an on-going audit in the maxillofacial community on this emerging trend.

Surgical anatomy of the buccal nerve.

The buccal nerve may be damaged during surgical procedures which require an incision along the external oblique ridge of the mandible and this study was undertaken to clarify its surgical anatomy. The course and relationships of the nerve were determined in 20 formalin-fixed cadaver specimens. The number of major branches of the nerve ranged from 4 to 8 and a mean of 3 branches was present as the nerve crossed the external oblique ridge. In 14 dissections the main trunk of the nerve crossed the external oblique ridge within 3 mm of the deepest concavity, but in the other 6 it was 7-12 mm below this point. We conclude that incisions even 12 mm below the deepest concavity in the external oblique ridge could result in buccal nerve damage.

The sensory distribution of the buccal nerve.

The buccal nerve is frequently anaesthetised, and occasionally cut during surgical procedures, but its distribution is poorly documented. The aim of this study was to determine its distribution by mapping areas of sensory loss following administration of a local anaesthetic solution. Observations in 40 patients revealed marked variation in the area supplied solely by the buccal nerve and a substantial overlap with the area supplied by the inferior alveolar nerve.

Younger dryas age advance of franz josef glacier in the southern alps of new zealand.

A corrected radiocarbon age of 11,050 +/- 14 years before present for an advance of the Franz Josef Glacier to the Waiho Loop terminal moraine on the western flank of New Zealand's Southern Alps shows that glacier advance on a South Pacific island was synchronous with initiation of the Younger Dryas in the North Atlantic region. Hence, cooling at the beginning of the Younger Dryas probably reflects global rather than regional forcing. The source for Younger Dryas climatic cooling may thus lie in the atmosphere rather than in a North Atlantic thermohaline switch.

Pterygoid plate fractures caused by the Le Fort I osteotomy.

Le Fort I osteotomies have been carried out on eight cadavers to determine whether pterygomaxillary dysjunction with a curved chisel causes fractures of the pterygoid plates. Fractures occurred on 12 of the 16 sides, were either at the level of the osteotomy cut or near to the base of the skull, and were sometimes multiple. There was no apparent correlation between the presence, type or extent of pterygoid plate fracture and whether or not that side of the osteotomy was completed first.