[Head and neck cellulitis caused by a broken anesthesia needle]. / Cellulite cervicofaciale sur bris d'aiguille d'anesthésie.

INTRODUCTION: Third molar extraction is one of the most common surgical procedures in oral and maxillofacial surgery. Infectious complications can be estimated at 3.6% after local anesthesia. OBSERVATION: A 39-year-old female patient, presenting with important swelling of the face and neck after extraction of teeth 28 and 38 after local anesthesia. Clinical and radiographic data led to the diagnosis of facial cellulitis due to a foreign body on the sub angulo-mandibular region. Drainage under general anesthesia was performed and a fragment of anesthesia needle was removed. One month after surgery, the patient was considered cured. DISCUSSION: Breaking an anesthesia needle is a rare accident, which can occur during oral surgery under local anesthesia. Respecting the rules of good practice is essential in preventing this type of complication, especially since forensic rules for dental and oral surgery are becoming stricter.

Integration of subclassification strategies in randomised controlled clinical trials evaluating manual therapy treatment and exercise therapy for non-specific chronic low back pain: a systematic review.

BACKGROUND: There is lack of evidence for specific treatment interventions for patients with non-specific chronic low back pain (NSCLBP) despite the substantial amount of randomised controlled clinical trials evaluating treatment outcome for this disorder. HYPOTHESIS: It has been hypothesised that this vacuum of evidence is caused by the lack of subclassification of the heterogeneous population of patients with chronic low back pain for outcome research. STUDY DESIGN: A systematic review. METHODS: A systematic review with a meta-analysis was undertaken to determine the integration of subclassification strategies with matched interventions in randomised controlled clinical trials evaluating manual therapy treatment and exercise therapy for NSCLBP. A structured search for relevant studies in Embase, Cinahl, Medline, PEDro and the Cochrane Trials Register database, followed by hand searching all relevant studies in English up to December 2008. RESULTS: Only 5 of 68 studies (7.4%) subclassified patients beyond applying general inclusion and exclusion criteria. In the few studies where classification and matched interventions have been used, our meta-analysis showed a statistical difference in favour of the classification-based intervention for reductions in pain (p=0.004) and disability (p=0.0005), both for short-term and long-term reduction in pain (p=0.001). Effect sizes ranged from moderate (0.43) for short term to minimal (0.14) for long term. CONCLUSION: A better integration of subclassification strategies in NSCLBP outcome research is needed. We propose the development of explicit recommendations for the use of subclassification strategies and evaluation of targeted interventions in future research evaluating NSCLBP.

N150 in amygdalar ERPs in the rat: is there modulation by anticipatory fear?

The hypothesis was tested whether the amygdalar N150 of rats, a slow, negative component in the event-related potential from the lateral amygdala, is sensitive to a state of anxious anticipation. A conditioning procedure was applied in which a series of six auditory stimuli was followed by a shock when presented alone, but not when the auditory stimuli were preceded by a visual stimulus. Heart rate recordings confirmed that the auditory stimulus train induced a state of increasing anticipatory fear and that this condition was modulated by the visual stimulus. During behavioral training, a N150 appeared in the amygdalar event-related potential evoked by the auditory stimuli, replicating previous findings. However, the amplitude of the N150 was not affected by whether or not the visual stimulus had been presented before. These results failed to support the idea that the N150 is related to the expectancy of an aversive event. An alternative interpretation, emphasizing the increase in arousal and attention that is inherent to aversive learning, is discussed.

Evaluation of the mutagenic and antimutagenic effects of South African plants.

Dichloromethane and 90% methanol extracts of 42 South African plants were screened for mutagenicity and antimutagenicity using the Salmonella/microsome mutagenicity assay (Ames) against Salmonella typhimurium TA98 and TA100 bacterial strains in the presence and absence of metabolic activator S9. The methanol extracts from whole plants of Helichrysum simillimum, Helichrysum herbaceum and Helichrysum rugulosum indicated mutagenicity. These are the first reported tests on the mutagenicity of Helichrysum species. Six species indicated antimutagenic properties, all in the presence of S9: methanol leaf extract of Bauhinia galpinii, and dichloromethane leaf extracts of Bauhinia galpinii, Clerodendrum myricoides, Datura stramonium, Buddleja saligna, Millettia sutherlandii and Sutherlandia frutescens.

Effects of stimulus repetitions on the event-related potential of humans and rats.

The present study compared the effects of repeated stimulus presentations on the event-related potential (ERP) of humans and rats. Both species were presented with a total of 100 auditory stimuli, divided into four blocks of 25 stimuli. By means of wavelet denoising, single-trial ERPs were established in both humans and rats. The auditory ERPs were characterized by the presence of two positive and two negative waves in both humans and rats, albeit with different latencies in the two species (P1, N1, P2, and N2). The results showed decreased amplitudes within blocks for the N1, P2, and N2 components in humans and for the N1 and P2 components in rats. Decreased amplitudes across blocks were found for the N2 component in humans and for the P2 and N2 components in rats. In both humans and rats, response decrements within a block were thus most prominent for the early ERP components, whereas the changes across blocks were most prominent for the later components. These results suggest a correspondence of the ERP correlates of elemental stimulus processing between humans and rats. It is further suggested that the observed amplitude reductions may reflect habituation and/or recovery cycle processes.

Auditory event-related potentials in humans and rats: effects of task manipulation.

The purpose of this study was to compare components of the rat and human auditory event-related potential (ERP) as generated in active oddball and passive single-stimulus tasks. The rats were trained to discriminate between target and standard stimuli in an oddball task, whereas the human subjects received instructions. Task effects on various ERP components were found in both species. Interestingly, effects on the P3 component were similar in the species with regard to amplitude: Target stimuli elicited a higher amplitude in the oddball task than did standard stimuli. This might indicate that the P3 shares the same characteristics between species. However, the first four components occurred 1.82 times earlier in rats than in humans, expecting a P3 of about 200 ms in rats. The P3 in rats appeared at 380 ms. We conclude that either the relation between human and rat peak latencies is not linear, or the P3 in rats is not the equivalent of the human P3.

Slow late component in conditioned stimulus-evoked potentials from the amygdala after fear conditioning in the rat.

Male Wistar rats were subjected to a differential Pavlovian fear conditioning procedure in which one of two tones (6 or 10 kHz) was followed by an electric shock (CS+) and the other was not (CS-). Before and after fear conditioning, we recorded the evoked potentials elicited by CS+ and CS- from electrodes aimed at the lateral nucleus of the amygdala. Before conditioning, a slow, negative component with peak amplitude around 150 ms was present in the evoked potentials. This component was sensitive to habituation. After fear conditioning, both CS+ and CS- elicited the same late component, albeit with a larger amplitude. This enhancement was temporary: decreasing amplitude was observed in the course of CS test presentations under extinction. Prior research revealed a comparable slow component in the amygdala of the cat under similar experimental conditions. The collective results indicate that the large late component in the amygdala is enhanced by fear conditioning, suggesting that such enhancement reflects the anticipation of a biologically significant event.