A rare incidence and management of complex odontoma and surgical dehiscence in maxillary anterior region: A case report.

Odontoma is a benign odontogenic tumour, which is rather considered hamartoma. Hamartoma is not a true neoplasm, rather a growth of abnormal mixture of cells found in the body area they normally grows. Fully developed odontomas generally consist of enamel, dentin and pulpal tissues, in an unorganised manner. Some of them may contain cementum too. These are further grouped into compound and complex, depending on their clinical, radiographic and histologic features. Odontomas are generally asymptomatic and slow growing, but may cause bone expansion and hinderance in tooth eruption. These lesions are generally diagnosed by coincidence in radiograph. We are presenting a case and surgical management of complex odontoma and post-operative dehiscence in the anterior right maxillary region of a 38-year-old male.

Multilevel Approach to Support Diversity, Equity and Inclusion in Radiology.

Integrating diversity into healthcare systems has its challenges and advantages. Academic medicine strives to expand the diversity of the healthcare workforce. The Association of University Radiologists (AUR) put together a task force to review the concept of Diversity, Equity and Inclusion (DEI) as it pertains to Radiology and to propose strategies for better integrating DEI in Radiology. We present several measures aimed at the trainee, leadership, management and professional society levels to empower DEI in Radiology.

Developability assessment for monoclonal antibody drug candidates: a case study.

Various screening approaches are used by industry to evaluate development risks associated with discovery candidates. This process has become more complicated with biological therapeutics, a class dominated by monoclonal antibodies (mAb), and, increasingly, their derivative constructs. Effective early assessment for drug-like properties (DLP) can save time and costs by allowing a more complete consideration of issues that could impact the desired end result of a stable drug product. Here we report a case study of four IgG1 mAbs, with sequence variations in the variable domain region, screened as a set of possible drug candidates. Our comprehensive, tiered approach used a battery of analytical tools to assess molecular characteristics, conformational stability, colloidal stability, and short-term storage stability. While most DLP for the four candidates were developmentally acceptable and comparable, mAb-2 was associated with adverse colloidal properties. Further investigation of mAb-2 in an expanded pH range revealed a propensity for phase separation, indicating a need for the additional product development effort. Our results support that comprehensive DLP assessments in an expanded pH range are beneficial in identifying development options for promising molecules that show challenging stability trends. This adaptable approach may be especially useful in the development of increasingly complex antibody constructs.

Retail venue based screening mammography: assessment of women's preferences.

RATIONALE AND OBJECTIVES: The aim of this study was to explore women's interest and preferences in undergoing screening mammography in a retail health care setting. MATERIALS AND METHODS: Self-administered surveys were distributed to 400 mammography patients in May to June 2009. All of the women who were asked were eligible for screening (age >40 years, no abnormal mammographic findings in the recent past). Three hundred eighty-six screening-eligible women filled out and returned the self-administered survey. RESULTS: The average respondent age was 57 years. Three hundred ten of the patients (80.3%) had college or postgraduate educations. Two hundred three (52.6%) reported annual incomes >$60,000. Two hundred forty-one respondents (62.4%) had been undergoing screening mammography for >10 years, while this was the first examination for eight patients (2%). More than half of the patients (n = 215 [55.7%]) affirmed their interest in undergoing annual screening mammography in a private area within a retail shopping facility. Most preferred a pharmacy (77%) over Wal-Mart or a grocery store. Appealing factors about a retail setting were proximity to home (90%), free parking (62%), and operating hours (48.8%). CONCLUSIONS: There is interest among women in undergoing screening mammography at retail health care clinics, preferably pharmacies. The provision of services at a convenient location can increase adherence to guidelines for screening mammography.

Meaningful use a call to arms.

The benefits of an interactive online world have affected the way we purchase products and plan our vacations. It is only a matter of time before consumers start demanding health care with the same convenience that comes with booking an airline flight or managing a bank account. The health care industry itself requires periodic and mandatory data analysis for outcome analysis, clinical benchmarking, quality improvement, forming guidelines, and making decisions. The federal government and health care community have been working together to come up with more robust and cost-effective health care informatics solutions. Meaningful use (MU) intends to establish a new standard for health care informatics in the United States. The term "meaningful use" implies that health care information and technology systems not just exist, but also serve as an integral part of physician and hospital workflow; leading to cost savings as well as improved outcomes. Under this concept, the federal government is offering maximum incentive payments of up to $44,000 per physician (including radiologists) if they can meet all the requirements as laid down in the MU measures. Unfortunately, penalties will kick in if physicians are not compliant with MU by 2015. This will be done in at least three stages, with Stage 1 already in effect (as of January 3, 2011). This will be the first in a series of articles outlining MU and what is in store for radiology. We will go in depth about who is eligible, and how the payment schedule is set up. We will break down the core and menu set measures to suggest what can be excluded by most radiologists. We will also go through some case studies and examine what lies in store for radiology.

Developing a cancer-specific geriatric assessment: a feasibility study.

BACKGROUND: As the U.S. population ages, there is an emerging need to characterize the "functional age" of older patients with cancer to tailor treatment decisions and stratify outcomes based on factors other than chronologic age. The goals of the current study were to develop a brief, but comprehensive, primarily self-administered cancer-specific geriatric assessment measure and to determine its feasibility as measured by 1) the percentage of patients able to complete the measure on their own, 2) the length of time to complete, and 3) patient satisfaction with the measure. METHODS: The geriatric and oncology literature was reviewed to choose validated measures of geriatric assessment across the following domains: functional status, comorbidity, cognition, psychological status, social functioning and support, and nutritional status. Criteria applied to geriatric assessment measurements included reliability, validity, brevity, and ability to self-administer. The measure was administered to patients with breast carcinoma, lung carcinoma, colorectal carcinoma, or lymphoma who were fluent in English and receiving chemotherapy at Memorial Sloan-Kettering Cancer Center (New York, NY) or the University of Chicago (Chicago, IL). RESULTS: The instrument was completed by 43 patients (mean age, 74 yrs; range, 65-87 yrs). The majority had AJCC Stage IV disease (68%). The mean time to completion of the assessment was 27 minutes (range, 8-45 mins). Most patients were able to complete the self-administered portion of the assessment without assistance (78%) and were satisfied with the questionnaire length (90%). There was no association noted between age (P = 0.56) or educational level (P = 0.99) and the ability to complete the assessment without assistance. CONCLUSIONS: In this cohort, this brief but comprehensive geriatric assessment could be completed by the majority of patients without assistance. Prospective trials of its generalizability, reliability, and validity are justified.

Patterns of presentation, diagnosis, and treatment in older patients with colon cancer and comorbid dementia.

OBJECTIVES: To estimate patterns of colon cancer presentation, diagnosis, and treatment according to history of dementia using National Cancer Institute (NCI) Surveillance, Epidemiology, and End-Result (SEER) Medicare data. DESIGN: Population-level cohort study. SETTING: NCI's SEER-Medicare database. PARTICIPANTS: A total of 17,507 individuals aged 67 and older with invasive colon cancer (Stage I-IV) were identified from the 1993-1996 SEER file. Medicare files were evaluated to determine which patients had an antecedent diagnosis of dementia. MEASUREMENTS: Parameters relating to the cohort's patterns of presentation and care were estimated using logistic regressions. RESULTS: The prevalence of dementia in the cohort of newly diagnosed colon cancer patients was 6.8% (1,184/17,507). Adjusting for possible confounders, dementia patients were twice as likely to have colon cancer reported after death (i.e., autopsy or death certificate) (adjusted odds ratio (AOR)=2.31, 95% confidence interval (CI)=1.79-3.00). Of those diagnosed before death (n=17,049), dementia patients were twice as likely to be diagnosed noninvasively than with tissue evaluation (i.e., positive histology) (AOR=2.02 95% CI=1.63-2.51). Of patients with Stage I -III disease (n=12,728), patients with dementia were half as likely to receive surgical resection (AOR=0.48, 95% CI=0.33-0.70). Furthermore, of those with resected Stage III colon cancer (n=3,386), dementia patients were 78% less likely to receive adjuvant 5-fluorouracil (AOR=0.22, 95% CI=0.13-0.36). CONCLUSION: Although the incidences of dementia and cancer rise with age, little is known about the effect of dementia on cancer presentation and treatment. Elderly colon cancer patients are less likely to receive invasive diagnostic methods or curative-intent therapies. The utility of anticancer therapies in patients with dementia merits further study.