Central giant-cell granuloma in a patient with neurofibromatosis type 1: 7 years of follow-up.

Neurofibromatosis type 1 (NF1) is an autosomally dominant tumor suppressor syndrome and multisystem disease. Central giant-cell granulomas (CGCGs) can be seen in patients with NF1. A 21-year-old female was diagnosed with two CGCGs, one in the mandible and then one in the maxilla, in a 7-year period. Increased incidence of CGCGs in NF1 patients was thought to be caused by an underlying susceptibility to developing CGCG-like lesions in qualitatively abnormal bone, such as fibrous dysplasia. However, germline and somatic truncating second-hit mutations in the NF1 gene have been detected in NF1 patients with CGCGs, validating that they are NF1-associated lesions. Oral manifestations in patients with NF1 are very common. Knowledge of these manifestations and the genetic link between NF1 and CGCGs will enhance early detection and enable optimal patient care.

Osteopathia striata in the mandible with cranial sclerosis: a case report and review of the literature.

Osteopathia striata with cranial sclerosis (OS-CS) is a bone dysplasia characterized by a linear striated pattern of sclerosis, especially in the long bones, and cranial sclerosis. It has variable clinical findings but distinctive radiological findings. Multiple oral and dental findings have been associated with this disease and can be seen during dental and/or medical imaging of the head and neck. Dentists and clinicians must be familiar with these signs to differentiate them from pathosis or erroneous radiographs. In the following case, we present a patient with OS-CS that presented at The University of Florida College of Dentistry with multiple craniofacial manifestations of this syndrome that were seen on a panoramic radiograph, which is one of the most commonly requested radiographs by dentists.

Retropharyngeal internal carotid artery: a review of three cases.

INTRODUCTION: The internal carotid artery (ICA) can take multiple pathways as it extends from the carotid bifurcation to the skull base. An aberration of its normal pathway may place the ICA in a retropharyngeal position in close proximity to the posterior pharyngeal wall. Radiographic classification is based on its proximity to the pharynx and/or pathway. We present a series of three cases of retropharyngeal ICAs, our goal is to report and classify these variations. CASE PRESENTATION: CASE 1: Retropharyngeal right ICA. Minimum distance to the pharyngeal wall was ~ 4.9 mm (high risk of vascular injury) with a tortuous pathway. CASE 2: Bilateral retropharyngeal ICA. ICAs were in contact with the posterior pharyngeal wall (very high risk of vascular injury). The left has a kinking pathway, the right tortuous. CASE 3: Bilateral retropharyngeal ICA. Minimum distances of the right and left ICAs to the posterior pharyngeal wall were ~ 3.5 mm and ~ 3.3 mm, respectively (high risk of vascular injury). The right has a kinking pathway, the left tortuous. DISCUSSION: Closeness of the vessel to the retropharyngeal wall increases the risk of surgical and non-surgical complications. Noteworthy is that the position of the artery is not constant and can change in position over periods of time. CONCLUSION: Knowledge of the anatomy and variations of the ICA is important for oral and maxillofacial radiologists and surgeons to enable clinicians to take necessary precautions to decrease complications if performing any procedure in the region.

The recovery education in the academy program: transforming academic curricula with the principles of recovery and self-determination.

TOPIC: This article describes a curricular transformation initiative, the Recovery Education in the Academy Program (REAP), spearheaded by the University of Illinois at Chicago's National Research and Training Center on Psychiatric Disability. PURPOSE: REAP is designed to integrate principles of recovery, self-determination, and other evidence-based practices for people with psychiatric disabilities into medical, social, and behavioral sciences curricula. The principles on which the curricula transformation efforts are based, the instructional activities employed, early outcomes of the endeavor, and future plans for replication are delineated. SOURCES USED: As described in this paper, REAP builds on a theoretical framework derived from the evidence-based literature, multiple technical reports, and curricular initiatives, including the Institute of Medicine, the Annapolis Coalition for Behavioral Workforce Development, and the Final Report of President's New Freedom Commission on Mental Health. CONCLUSIONS: REAP has delivered state-of-the-science education to over 1,000 trainees, including medical students, psychiatry residents, psychology and social work interns, and rehabilitation counselors, pre/post-doctoral students and professionals within a variety of academic settings. REAP serves as a replicable structure to successfully integrate recovery education into existing, accredited academic programs and curricula using the parameters outlined by multiple experts and stakeholders. Barriers to curricular transformation and strategies to overcome these barriers are highlighted.