The management of segmental femur fractures: the radiographic 'cover-up' test to guide decision making.

BACKGROUND: Segmental femur fractures often pose management challenges regarding the optimal fixation choice and sequence of surgical events. METHODS: Retrospective review of clinical records and radiographic data of adult patients with segmental femur fractures treated by a conceptual radiographic cover-up test to determine the ideal fixation method between January 2019 and December 2020. RESULTS: Forty patients with 84 individual fractures underwent fracture fixation. The most consistent fracture combinations were intertrochanter-diaphysis (AO31A-AO32) fractures (25%, n = 10) and femur neck-diaphysis (AO31B-AO32) fractures (20%, n = 8). Compared to evidence-based fracture management, the gold standard treatment was used for the fixation of 78 fractures (93%). One patient required revision for fixation failure of a diaphyseal fracture, and two fractures, both open diaphysis injuries, developed fracture-related infections. CONCLUSION: Anatomical alignment and high union rates are possible for segmental femur fractures treated by evidence-based fracture fixation principles. A conceptual radiographic cover-up test assists in matching the best possible implant for each fracture.

The future of oral pathology practice.

Oral and maxillofacial pathology (OMP) may be viewed as a specialty of dentistry, which addresses the diagnosis and treatment of diseases of the oral and perioral regions. Consensus definitions may be found in the accreditation standards for OMP as published by the American Dental Association, and in the Constitution and Bylaws of the American Academy of Oral and Maxillofacial Pathology (AAOMP). These sources describe roles for OMP in laboratory diagnosis (histopathology), and clinical practice. Eversole recognizes these divisions of OMP in his discussion of evidence-based practice, noting that oral medicine shares with OMP responsibilities in the care of patients with oral disease. Broadly viewed, all clinical disciplines and specialties of dentistry provide services in disease diagnosis and treatment. However, Eversole makes a distinction between the diagnostic and treatment services provided throughout dentistry, and those offered by OMP, excluding from OMP those primarily focused on dental caries, diseases of the periodontium, missing teeth and tooth structure, and dental misalignment. The focus of this essay addresses the future of OMP practice.

Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology.

Despite being one of the most common oral mucosal diseases and recognized as early as 1866, oral lichen planus (OLP) is still a disease without a clear etiology or pathogenesis, and with uncertain premalignant potential. More research is urgently needed; however, the research material must be based on an accurate diagnosis. Accurate identification of OLP is often challenging, mandating inclusion of clinico-pathological correlation in the diagnostic process. This article summarizes current knowledge regarding OLP, discusses the challenges of making an accurate diagnosis, and proposes a new set of diagnostic criteria upon which to base future research studies. A checklist is also recommended for clinicians to provide specific information to pathologists when submitting biopsy material. The diagnostic process of OLP requires continued clinical follow-up after initial biopsy, because OLP mimics can manifest, necessitating an additional biopsy for direct immunofluorescence study and/or histopathological evaluation in order to reach a final diagnosis.

Induced elephant (Loxodonta africana) tusk removal.

Elephant tusk removal usually requires costly surgical procedures that are time-consuming and present a significant risk to the animal when performed using general anesthesia. Such techniques require gauges, chisels, and forceps to remove the tusk. This article reports the simple removal of the tusk of an 18-yr-old African elephant (Loxodonta africana) without the use of surgical instruments and anesthesia. Rubber elastics were placed around a tusk, causing loss of alveolar bone with subsequent exfoliation of the tusk within 3 wk. The healing process was uneventful.

Kepler-62: a five-planet system with planets of 1.4 and 1.6 Earth radii in the habitable zone.

We present the detection of five planets--Kepler-62b, c, d, e, and f--of size 1.31, 0.54, 1.95, 1.61 and 1.41 Earth radii (R⊕), orbiting a K2V star at periods of 5.7, 12.4, 18.2, 122.4, and 267.3 days, respectively. The outermost planets, Kepler-62e and -62f, are super-Earth-size (1.25 R⊕ < planet radius ≤ 2.0 R⊕) planets in the habitable zone of their host star, respectively receiving 1.2 ± 0.2 times and 0.41 ± 0.05 times the solar flux at Earth's orbit. Theoretical models of Kepler-62e and -62f for a stellar age of ~7 billion years suggest that both planets could be solid, either with a rocky composition or composed of mostly solid water in their bulk.

Kepler planet-detection mission: introduction and first results.

The Kepler mission was designed to determine the frequency of Earth-sized planets in and near the habitable zone of Sun-like stars. The habitable zone is the region where planetary temperatures are suitable for water to exist on a planet's surface. During the first 6 weeks of observations, Kepler monitored 156,000 stars, and five new exoplanets with sizes between 0.37 and 1.6 Jupiter radii and orbital periods from 3.2 to 4.9 days were discovered. The density of the Neptune-sized Kepler-4b is similar to that of Neptune and GJ 436b, even though the irradiation level is 800,000 times higher. Kepler-7b is one of the lowest-density planets (approximately 0.17 gram per cubic centimeter) yet detected. Kepler-5b, -6b, and -8b confirm the existence of planets with densities lower than those predicted for gas giant planets.