Novel therapies in CIDP.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a heterogeneous but clinically well-described disease within circumscribed parameters. It is immunologically mediated through several poorly understood mechanisms. First-line therapies with steroids, intravenous immunoglobulin (IVIG) or plasma exchange are each effective in about two-thirds of patients. These treatments are seldom associated with complete resolution or cure, and often pose considerable practical, financial and medical implications.Our understanding of many of the key pathological processes in autoimmune diseases is expanding, and novel targeted therapeutics are being developed with promise in several autoimmune neurological disorders.This narrative review looks first at detailing key pathogenic mechanisms of disease in CIDP, followed by an in-depth description of potential novel therapies and the current evidence of their application in clinical practice.

Consultations with patients for whom English is not their first language.

Good communication is essential in neurological consultations, yet this is obviously compromised by the absence of a common language. Interpreters can make valuable contributions to improving consultations, but translation has its shortcomings. The consultation dialogue is not always interpreted correctly or accurately, even (or especially) when friends or family are translating. Clinicians should therefore try to ensure that key information has been communicated and understood, perhaps by repetition or asking the patient to say what they have understood. Cultural factors are also important in the patient-physician interaction. Physicians should try to adopt a culturally sensitive approach during consultations, familiarising themselves with cultural norms within the prevalent ethnic minority groups in their area. They should resist directive approaches to save time and try to involve the patient in decision-making. This requires allocating extra time to consultations with patients for whom English is not their first language.

Referral Patterns of Pediatric Oral Surgery Cases: A Pilot Survey of United Arab Emirate Dentists

Objective: To assess the referral patterns of General Dental Practitioners (GDPs) and Pediatric Dentists (PDs) when faced with a range of Pediatric-Oral Surgery (POS) cases. Material and Methods: Eighty-two dentists treating children [51.2% GDPs (n=42) and 48.8% PDs (n=40)] were shown clinical photographs or radiographs of twelve common POS cases. Opinions on whether to "manage it yourself", "refer to a/another pediatric dentist", "refer to an oral surgeon (OS)", "refer to a multidisciplinary clinic (MDC)", or "do nothing" were sought. Statistical analysis was carried out using SPSS software with Chi-square test (p≤0.05). Results: Both GDPs and PDs reported significantly higher referrals to OS of: 1) lower lip mucoceles (50%, 52.5% respectively), 2) exposure of impacted maxillary canine (64%, 51.3%) and 3) dento-alveolar trauma cases (73.8%, 65%). A majority of GDPs and PDs reported self-managing of: 1) removal of multiple deciduous carious teeth (81%, 97.5%), 2) odontogenic infections with facial swelling (57.1%, 92.5%), 3) removal of ankylosed submerged primary molars (66.7%, 95%) and 4) dental trauma (71.4%, 100%). PDs reported self-managing primary herpetic gingivostomatitis (PHGS, 95%) compared to 45.2% of GDPs. GDP referral of PHGS to the PDs was 42.9%. There were no significant differences between both groups regarding removal of a mesiodens, release of a tongue-tie, a labial frenectomy, or a lip laceration, but the majority would refer to oral surgeons in these cases. Conclusion: Whilst United Arab Emirates dentists sampled referred some pediatric-oral surgery cases to oral surgeons, general dental practitioners were reluctant to refer pediatric-oral surgery cases to pediatric dentists, preferring to self-manage them.

Assessment of the uniqueness of human dentition.

Comparing ante-mortem and post-mortem dental characteristics has been a reliable, accurate and quick human identification method. This is based on the assumption that each individual's set of teeth is unique; however, there is little evidence to support this assumption. This research aimed to determine the uniqueness of basic dental features in a cohort of multinational dental patients. Dental charts were retrieved from the archives of the College of Dentistry at the University of Sharjah. Dental patterns were coded into letters representing basic dental characteristics, and entered into a computer program that was written specifically for analysing the results of this research. Two thousand dental charts were included in this research; the average age of the sample was 31.9 years (11-87 years). The male:female ratio was 1.4:1 from 55 nationalities. One thousand one hundred and fifty-nine dental charts (57.95%) had absolutely unique dental patterns. The remaining charts (n=841 [42.05%]) were found to have identical patterns with others, the most common of which was 'all virgin' teeth (n=482 [24.1%]). Introducing a single dental modification dropped this percentage to 1.05%. This percentage was further narrowed down to 0.7% when the gender variable was introduced to the comparison. The results of this research support the assumption that dental characteristics show a diversity that is useful for human identification, even when those characteristics are recorded in their simplest forms.