The effect of acupuncture on salivary flow rates in patients with radiation-induced xerostomia.

AIM: This study evaluated the effect of acupuncture on salivary flow rates in patients with radiation-induced xerostomia. METHODS: Twelve patients with severe xerostomia were treated with acupuncture after radiation therapy. The baseline data were obtained preceding acupuncture treatment, and used as reference values. Acupuncture was performed in 12 sessions, 20 min each, twice a week, during a 6-week period. Clinical response was evaluated objectively by saliva collection measuring resting and stimulated whole salivary flow rates, and subjectively by a visual analogue scale patients' self-evaluation questionnaire. Statistical analyses were performed with a repeated-measures analysis of variance by using a mixed-effect modeling procedure. RESULTS: The results showed a statistically significant improvement for salivary flow rates on both objective and subjective evaluations (P<0.05). On objective evaluation there was an increase for resting salivary flow of 142.2% (mean=0.04 mL/min to 0.12 mL/min) and of 73.5% (mean=0.09 mL/min to 0.21 mL/min) for stimulated salivary flow. On subjective evaluation, visual analogue scale raised 36 points (mean=18.4 to 53.8) for sensation of more saliva production. CONCLUSION: According to the results of the present study, acupuncture showed a significant effect on saliva production, suggesting this therapy as a useful treatment for patients suffering from radiation-induced xerostomia.

Four second molars with single roots and single canals in the same patient.

CASE REPORT: Studies on canal configuration have demonstrated a substantial variation in the number of roots and root canals in different teeth. Maxillary and mandibular molars may have three and two roots, respectively, and generally present with three of four root canals. This case describes the presence of one single root and one root canal in all second molars of the same patient.

An expanded perinatal bereavement support committee: a community-wide resource.

While perinatal health care professionals have discussed individual methods to support bereaved parents after a perinatal death (miscarriages, stillbirths, or neonatal deaths), there needs to be a comprehensive approach to perinatal bereavement support that extends not only to bereaved family members, but to the perinatal staff and the medical and nonmedical community. To facilitate such support, a perinatal hospital bereavement support committee was established. Its functions are described, including the development of hospital bereavement protocols, educational programs for all medical and nonmedical staff, and the establishment of local support groups.

Neonatal vocal cord paralysis following extracorporeal membrane oxygenation.

Five cases of unilateral vocal cord paralysis/paresis were diagnosed following extracorporeal membrane oxygenation for newborn respiratory failure. All were right sided and transient in nature. None of the five patients had other findings commonly associated with vocal cord palsy. The extracorporeal membrane oxygenation procedure requires surgical dissection in the carotid sheath on the right side of the neck, an area immediately adjacent to both the vagus and recurrent laryngeal nerve. It is speculated that vocal cord paralysis in these infants was acquired as a result of the extracorporeal membrane oxygenation cannulation. Although the vocal cord paralysis resolved in all cases, two patients had difficult courses after extracorporeal membrane oxygenation. Therefore, laryngoscopic examination should be considered for patients after extracorporeal membrane oxygenation.

Pyloric atresia and epidermolysis bullosa letalis: a lethal combination in two premature newborn siblings.

Pyloric atresia and epidermolysis bullosa letalis are rare congenital anomalies. The association of the two diseases in siblings has not been reported previously. This paper describes such as association in two newborn infants of caucasian parents with no family history of similar anomalies. Problems in management included severe fluid and electrolyte losses, systemic infection, and prematurity, which led to the death of the two infants. The question is raised whether the two abnormalities are expressions of closely linked genes. The presence of epidermolysis bullosa should alert the pediatrician to the possiblity of a coexisting pyloric atresia.