[Oral health care volunteering in developing countries 2. Providing care effectively]. / Mondzorgvrijwilligerswerk in ontwikkelingslanden 2. Effectief zorgverlenen.

Oral health care volunteering in developing countries based on the traditional Western model does not contribute to sustainable improvement and has, presumably, negative consequences for the local health care system. The oral health care can and should be delivered more efficacious. To achieve efficacious and sustainable results, the 'Basis package of oral care' of the World Health Organization offers a good manual. In addition, the Dutch branch of Dental Health International can support non-governmental organizations in establishing volunteering oral health care delivery programmes in order to improve the preventive care, the accessibility of care, the working conditions of the local oral health care providers, and the medical hygiene.

[Oral health care volunteering in developing countries 1. More than charity]. / Mondzorgvrijwilligerswerk in ontwikkelingslanden 1. Meer dan liefdadigheid.

Although limited in extent, oral health care volunteering in developing countries can contribute to sustainable improvement of oral health. However, it is questionable whether traditional care delivery based on the Western model, which many volunteers apply, has a sustainable effect and, presumably, it has negative consequences for the local health care system in many developing countries. Four i's should be involved when trying to make tactful policy: 1. 'ideas' evidence-based interventions, 2. 'institutions', current regulatory processes and approvals of governments and participating societies, 3. 'interests', incentives and motives of societies to collaborate, 4. 'incidents', unexpected economic alterations in the country or an inspiring successful public prevention programme.

Line bisection performances of 650 normal children.

When bisecting lines, an important number of brain damaged patients tend to place their bisection marks in the hemispace ipsilateral to their lesion. Biases have also been reported in normal adults. In vertical bisection both patients and normal subjects present with upward shifts, although a downward displacement may occur eventually. Surprisingly, little is known on line bisection (LB) in normal or brain damaged children. A total of 650 subjects, aged 7-12 years, performed a horizontal and vertical LB task with their preferred hand. Asymmetry indices (AIs) were used to measure directional bias. Unsigned AIs served to evaluate accuracy and mastery of the LB skill. In vertical bisection a general and significant upward bias was found, whereas in horizontal bisection subject (gender, handedness, utilized hand, age) and stimulus variables (orientation, length, position) yielded significantly different AIs. Although with increasing age significantly increasing accuracy was observed, none of the participating children mastered LB to mathematical precision. Differences in IQ-level and attention test score did not yield significantly different AIs. Impact from reading proficiency could not be demonstrated. It is suggested that stimulus length effect results are compatible with the Halligan and Marshall [Halligan, P., and Marshall, J. Toward a principled explanation of unilateral neglect. Cognitive Neuropsychology, 1994, 11, 167-206] model of hemispatial neglect. Moreover, data may support the hypothesis of greater hemispheric specialization of visuo-spatial skills in boys than in girls.

Bilateral recurrent adult rhabdomyomas of the pharyngeal wall.

Adult rhabdomyomas of the head and neck are uncommon benign skeletal muscle tumors. Only a few cases occurring in the pharyngeal wall have been described in the world literature. We present a case of recurrent bilateral rhabdomyomas in the pharynx and discuss the clinicopathological features of this lesion, comparing it to those of other neoplasms from which it must be differentiated. To our knowledge, bilaterality of this type of lesion has not been described previously. Although adult rhabdomyomas have a distinct histology, they often are mistaken for a variety of other lesions, particularly granular cell tumor.

Increased writing activity in neurological conditions: a review and clinical study.

Increased writing activity in a 70 year old, right handed man presenting with a history of alcohol misuse and maturity onset diabetes is reported. Brain CT disclosed corticosubcortical atrophy and 99mTc-HMPAO SPECT disclosed severe bilateral frontal hypoperfusion more prominent on the right. The patient's neuropsychological symptomatology consisted of severe (verbal) aspontaneity, intermittent utilisation behaviour, and pronounced increased writing activity, which mainly consisted of a perseverative, micrographic written reproduction of visually or verbally perceived language fragments. Several neurological causes of increased writing activity and the equivocal terminology met in the medical literature are reviewed. A distinction between hypergraphia and automatic writing behaviour is proposed. It is concluded that our patient's increased writing activity may be characterised as automatic writing behaviour.

Transient musical hallucinosis of central origin: a review and clinical study.

A 52 year old, right handed, hearing impaired woman was admitted with headache and neck stiffness. The only neuropsychological symptom was transient auditory perceptions in the left ear, which were musical, seemed familiar and were not influenced by verbal communication. CT and MRI showed a right subarachnoid haemorrhage, while brainstem auditory evoked potentials failed to reveal a brainstem lesion. In patients with organic cerebral disease, unilateral auditory hallucinations (AHs) may indicate a lesion in the contralateral hemisphere. However, according to this review the type of AHs (verbal versus musical) is not consistently associated with a cerebral lesion on either side.

[An unusual expression of a complication following hysterectomy; the patient kneels in front of the doctor]. / Een merkwaardige uiting van een complicatie na hysterectomie; patiënt knielt voor dokter.

During operation of a woman aged 54 years for inguinal hernias, abdominal hysterectomy was carried out as well. A severe wound infection occurred. Subsequently, the patient was unable to sit down because she could not flex the left upper leg. Laparotomy revealed thrombosis and sclerosis of the left ovarian vein which impaired contraction of the iliopsoas muscle. Adverse effects of hysterectomy are briefly discussed.

Inversio uteri puerperalis.

Uterine inversion is a rare condition that occurs in various degrees. Predisposing and etiologic factors are discussed, as are therapy and prophylaxis. These points are illustrated by 4 own cases and by 172 cases collected from literature.

The protrusions from the cervical canal at the scar of a previous cesarean section.

By comparing the condition of the cervix at the time of a cesarean section with the findings at subsequent hysterography in 68 patients, it is considered likely that the thickness of the scar depends primarily on the thickness of the lower uterine segment at the time of the section and on the site of the incision. The prognostic significance of these findings is discussed on the basis of a theoretical approach to the development at or near the scar of previous cesarean section.