Un cas d'oligodontie, associé à une ectopie bilatérale des dents en position sous-condylienne, découverte sur l'orthopantomogramme : rapport de cas

Introduction. Nous décrivons un cas d'agénésies dentaire multiples associées à une ectopie bilatérale des troisièmes molaires ainsi de la deuxième prémolaire mandibulaire gauche. Cas clinique: Une patiente de 30ans était référée par son médecin gastroentérologue pour une prise en charge odontologique. La patiente décrit de ne jamais avoir bénéficié d'avulsion dentaire et ne souffrait d'aucun douleur ou gène au niveau orofacial. Une exploration clinique suivie d'examens radiologiques était réalisé. L'examen clinique révèle l'absence de plusieurs dents. La radiographie panoramique avait permis de confirmer le diagnostic d'agénésies multiples de huit dents. Les deux troisièmes molaires mandibulaires incluses en position verticale au niveau de la branche mandibulaire. La 35 aussi incluse en position apicale de la 38. L'examen CBCT montre une déhiscence des corticales des faces interne et externe du ramus en regarde des couronnes des troisièmes molaires. Discussion. L'oligodontie associée à une inclusion dentaire multiple reste un cas rare. Les éléments de l'examen clinique associés à la radiographie panoramique permettent de confirmer le diagnostic d'agénésie et d'ectopie dentaires. La radiologie tri dimensionnelle est capitale dans la prise de décision thérapeutique des dents ectopiques en position condy lienne.Conclusion. Sans symptomatologie clinique et radiologique, la décision thérapeutique était de s'abstenir de traitement chirurgical et de surveiller

Pharmacology and Therapeutics Education in the European Union Needs Harmonization and Modernization: A Cross-sectional Survey Among 185 Medical Schools in 27 Countries.

Effective teaching in pharmacology and clinical pharmacology and therapeutics (CPT) is necessary to make medical students competent prescribers. However, the current structure, delivery, and assessment of CPT education in the European Union (EU) is unknown. We sent an online questionnaire to teachers with overall responsibility for CPT education in EU medical schools. Questions focused on undergraduate teaching and assessment of CPT, and students' preparedness for prescribing. In all, 185 medical schools (64%) from 27 EU countries responded. Traditional learning methods were mainly used. The majority of respondents did not provide students with the opportunity to practice real-life prescribing and believed that their students were not well prepared for prescribing. There is a marked difference in the quality and quantity of CPT education within and between EU countries, suggesting that there is considerable scope for improvement. A collaborative approach should be adopted to harmonize and modernize the undergraduate CPT education across the EU.

Essential competencies in prescribing: A first european cross-sectional study among 895 final-year medical students.

European medical students should have acquired adequate prescribing competencies before graduation, but it is not known whether this is the case. In this international multicenter study, we evaluated the essential knowledge, skills, and attitudes in clinical pharmacology and therapeutics (CPT) of final-year medical students across Europe. In a cross-sectional design, 26 medical schools from 17 European countries were asked to administer a standardized assessment and questionnaire to 50 final-year students. Although there were differences between schools, our results show an overall lack of essential prescribing competencies among final-year students in Europe. Students had a poor knowledge of drug interactions and contraindications, and chose inappropriate therapies for common diseases or made prescribing errors. Our results suggest that undergraduate teaching in CPT is inadequate in many European schools, leading to incompetent prescribers and potentially unsafe patient care. A European core curriculum with clear learning outcomes and assessments should be urgently developed.

HEALTH CARE ECONOMICS IN ROMANIA--DYNAMICS AND EVOLUTION.

Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of health with the final purpose of achieving better results with the minimum of resources; it represents the study of health price in its complexity. The economics of the population's health needs and in particular the health needs in case of the poor groups of the population, consider health to be the main component of global human vulnerability. Health economics tries to change the simple interpretation of health price and disease cost into a wider consideration of a system administration similar to educational and social economics and the study of health in the context of the multiple specializations of the macro economy of the national group, as it is an instrument in the country's great economics symphony.

Carboxymethyl guar gum nanoparticles for drug delivery applications: Preparation and preliminary in-vitro investigations.

Carboxymethyl guar gum (CMGG) synthesized from commercially available polysaccharide was formulated into nanoparticles via ionic gelation using trisodium trimetaphosphate (STMP) as cross-linking agent. Characterisation using a range of analytical techniques (FTIR, NMR, GPC, TGA and DLS) confirmed the CMGG structure and revealed the effect of the CMGG and STMP concentration on the main characteristics of the obtained nanoformulations. The average nanoparticle diameter was found to be around 208 nm, as determined by dynamic light scattering (DLS) and confirmed by scanning electron microscopy (SEM) and nanoparticle tracking analysis (NTA). Experiments using simulated gastric and intestinal fluids evidenced significant pH-dependent drug release behaviour of the nanoformulations loaded with Rhodamine B (RhB) as a model drug (loading capacity in excess of 83%), as monitored by UV-Vis. While dose-dependent cytotoxicity was observed, the nanoformulations appeared completely non-toxic at concentrations below 0.3 mg/mL. Results obtained so far suggest that carboxymethylated guar gum nanoparticles formulated with STMP warrant further investigations as polysaccharide based biocompatible drug nanocarriers.

Silica nanoparticles: preparation, characterization and in vitro/in vivo biodistribution studies.

BACKGROUND: The current progress in pharmaceutical nanotechnology field has been exploited in the design of functionalized radiolabelled nanoparticles that are able to deliver radionuclides in a selective manner to improve the outcome of diagnosis and treatment. Silica nanoparticles (SNPs) have been widely developed for biomedical applications due to their high versatility, excellent functional properties and low cost production, with the possibility to control different topological parameters relevant for multidisciplinary applications. PURPOSE: The aim of the present study was to characterize and evaluate both in vitro, by microscopy techniques, and in vivo, by scintigraphic imaging, the biodistribution of silica nanostructures derivatives (Cy5.5 conjugated SNPs and (99m)Tc radiolabelled SNPs) to be applied as radiotracers in biomedicine. METHODS: SNPs were synthesized by hydrolysis and condensation of silicon alkoxides, followed by surface functionalization with amino groups available for fluorescent dye and radiolabelling possibility. RESULTS: Our data showed the particles size distribution (200-350 nm), the surface charge (negative for bare and fluorescent SNPs and positive for amino SNPs), polydispersity index (broad distribution), the qualitative composition and the toxicity assessments (safe material) that made the obtained SNPs candidates for in vitro/in vivo studies. A high uptake of fluorescent SNPs in all the investigated organs was evidenced by confocal microscopy. The (99m)Tc radiolabelled SNPs biodistribution was quantified in the range of 12-100% counts/g organ using the scintigraphic images. CONCLUSIONS: The obtained results reveal improved properties, namely, reduced toxicity with a low level of side effects, an improved biodistribution, high labelling efficiency and stability of the radiolabelled SNPs with potential to be applied in biomedical science, particularly in nuclear medicine as a radiotracer.

Flaxseed lignan wound healing formulation: characterization and in vivo therapeutic evaluation.

Flaxseed lignans are a natural source of useful biologically active components that show a diverse spectrum of health-promoting properties. The valuable effects of the phenolic molecules are mainly due to their antioxidant activity by preventing oxidative stress and stimulate collagen synthesis, therefore, providing benefits to the skin. The present work highlights the development of flaxseed extract formulation as novel wound healing agent. The recognition of key structural features within flaxseed extract was crucial for the design and development of the therapeutic cream. Chromatographic analyses were employed for bioactive compounds identification and quantification. Folin-Ciocalteu method determined the total phenolic content and the antioxidant properties were evaluated by DPPH assay. The storage and loss modulus and tan δ were calculated for cream rheological properties evaluation. In vitro diffusion capacity and in vivo wound healing activity of phenolic cream were evaluated on Wistar rats. The collective properties and healing effect of the flaxseed suggested wound healing capacity.

[Prevalence of cardiovascular diseases in patients with hypothyroidism]. / Prevalenta bolilor cardiovasculare la pacientii cu hipotiroidism asistati in clinica a vi-a medicala.

UNLABELLED: The cardiovascular risk in patients with hypothyroidism is related to an increased risk of functional cardiovascular abnormalities and atherosclerosis. AIMS--The purpose of the present study was to examine a possible association between subclinical and clinical hypothyroidism and cardiovascular disease (CVD). The retrospective study, which covered a 12 months period, had the purpose to establish the prevalence of various risk factors for CVD, within subclinical and clinical hypothyroidism. MATERIAL AND METHODS: We have studied 64 subjects with subclinical and clinical hypothyroidism admitted to the Rehabilitation Hospital, in the Cardiovascular Clinic. They were divided by sex, age, living environment (urban, rural), value of cholesterol, heart rate, BMI, blood pressure. CONCLUSIONS--The study revealed an increased risk of cardiovascular abnormalities and an increased risk of atherosclerosis: 65,61% subjects were obese, 90,6% with high blood pressure, 62,5% had dyslipidaemia. Subclinical thyroid dysfunction is common in older people. The identification of subclinical and clinical hypothyroidism earlier, pursuit of markers for subclinical atherosclerosis and deployment of lifestyle changes, are elements that can also be the key in improving clinical and paraclinical parameters.

[Diabetes mellitus and early failures in oral implantology]. / Diabète et échecs précoces en implantologie orale.

It has become increasingly common for diabetic patients to be considered as candidates for dental implants. However even though success rates of implant therapy in diabetic are high, this does not preclude failures. Failure to osseointegrate in the initial healing phase results in a fibrous tissue encapsulation of the implant and clinical mobility, leading ultimately to the failure of the implant. This review presents the current knowledge regarding the effect of diabetes mellitus on the osseointegration of implants including pathophysiologic aspects as well as their potential implications on bone metabolism and osseointegration, implant success rate at the second-phase surgery and guidelines for pre and post-operative management. In experimental models of diabetes mellitus, a reduced level of bone-implant contact has been shown, and this can be reversed by means of treatment with insulin. Compared with the general population, a higher failure rate is seen in diabetic patients. Most of these occur at the second-phase surgery, seemingly pointing to the microvascular complications of this condition as a possible causal factor. It is necessary to take certain special considerations into account for the placement of implants in diabetic patient. A good control of plasma glycemia, together with other measures, has been shown to improve the percentages of implant survival in these patients.

[Clinical and therapeutic aspects of trigeminal neuralgia. Apropos of 27 cases treated at the General Hospital of Grand-Yoffin Dakar]. / Aspects cliniques et thérapeutiques de la névralgie faciale essentielle du trijumeau. A propos de 27 cas colligés a l'Hôpital Général de Grand-Yoff de Dakar.

The trigeminal neuralgia or "painful tic" of the face is an invalidating affection, which affects the quality of life of the patient. The odontologist must be able to diagnose it and take part in his good therapeutic assumption of responsibility. The diagnosis is sometimes difficult, being able to involve unsuited therapeutic methods prejudicial for the patient. The objective of our study was to analyse the clinical and therapeutic aspects of the trigeminal neuralgia. It was a transverse and descriptive study which 27 files of patients suffering of trigeminal neuralgia and treated in the odontology service of the General hospital of Grand-Yoff in Dakar between July 2002 and July 2008. We exploited the following parameters: the age, the sex, the oral state, duration of the symptoms, characteristics of the pain, the type of treatment. 22 patients of the 27 cases were female. The time of consultation was often late, the patients generally preferring begin with the traditional treatments. The neuralgia of V2 dominated the clinical picture, followed that neuralgia of V3. The pain was strictly unilateral, it was started by movement, speaking, eating or touching the trigger zone. The prescription of carbamazepine (Tegretol) was systematic, and constituted a true test diagnosis, it made possible to obtain an immediate sedation of the pains. In front of the medicamentous treatment failure, the alcoholization of the trigeminal branch has given good performances, indeed it made possible to obtain, a clear lull of more than 12 months for 9 patients out of the 10 who profited from it. The alcoholization of the trigeminal nerve remains an effective cure and constitutes an accessible alternative under our work conditions in Africa.

[Should the administration of anticoagulants be altered for oral surgery: a study of 32 cases]. / Faut-il interrompre l'administration d'anticoagulants pour un Acte de Chirurgie Buccale: a propos d'une étude de 32 cas.

INTRODUCTION: The study is transversal and descriptive. It take place in the odontology department in a public hospital in Dakar (Senegal), during 09 month (January-September 2005). The objective of this work was to determine the TP-INR value making possible to carry out an act of oral surgery without haemorrhagic risk. (INR = International Normalized Ratio). MATERIAL AND METHOD: It concerned 32 patients referred to the Odontology service by the Cardiology They presented a cardiovascular pathology having required an anticoagulant therapy, and also need an act of oral surgery. We exploited the following parameters: identification of the patient, oral state, types of oral surgery, types of cardiopathy, AVK posology, value of TP-INR, haemostatics means. RESULTS: 81.25% of the patients were women (26), with a sex ratio of 0.23. The mean age was 53ans, with 21 and 84 years like the extremes. 56.25% of our patients had undergone a single extraction, 25% had beneficed multiple extractions, and 18.75% had profited from a scaling-curetting. The average value of the TP-INR was 2.22 with extremes between 2 and 2.84. CONCLUSION: In favour of the haemostat means, no haemorrhagic complication post operational was revealed. It is allowed that the risk of thromboembolic accident by stopping the treatment is much more prejudicial than the hemorrhagic risk for the patient.