A unique presentation of a squamous cell carcinoma in a pregnant patient.

The literature reports an increasing occurrence of carcinoma in the young adult nonsmoking and nondrinking population. With it, this trend brings the potential for new comorbidities. This report discusses one such case in which a 30-year-old woman, 28 weeks pregnant, was diagnosed with a hybrid verrucous carcinoma/squamous cell carcinoma.

Pandemic H1N1 influenza in the pediatric emergency department: a comparison with previous seasonal influenza outbreaks.

Study Objective: We compare the acuity of pediatric emergency department (ED) patients between the ongoing H1N1 influenza pandemic and previous seasonal influenza outbreaks.

Methods: An observational, cross-sectional analysis of patient visits at 2 pediatric tertiary care EDs was made for the following periods: (1) regional fall 2009 H1N1 influenza surge (August 17 to September 20, 2009), and (2) combined regional 2007 to 2009 early peak influenza seasons (January 28 to March 2, 2008, and February 2 to March 8, 2009). Proportions of admissions, return visits, and return visits resulting in admission were compared between the 2 periods.

Syndromic micrognathia and peri-natal management with the ex-utero intra-partum treatment (EXIT) procedure.

Many advances in healthcare are built on advances in technology. In the case of fetal medicine, technology has availed an entirely new patient population. The authors report a case of severe micrognathia and Pierre Robin Sequence that was diagnosed prenatally.

Molecular diagnostics for head and neck pathology.

Molecular diagnostic techniques are quickly finding a role in the detection and diagnosis of tumors, and in predicting their behavior. They may also prove useful in developing new therapeutic approaches to head and neck cancer. The surgeon working in the craniomaxillofacial region should have an understanding of these technologies, their availability in various settings, and how they affect various aspects of treatment, particularly in the detection and treatment of malignancies.

Temporary skeletal anchorage devices for orthodontics.

This article discusses the recent advances and basic concepts of skeletal anchorage devices of various types and reviews the current literature on their use. Temporary skeletal anchorage devices allow orthodontic movements that were previously thought to be difficult if not impossible. Much like the concepts introduced during the beginnings of orthognathic dentofacial teams, treatment that uses skeletal anchorage requires interdisciplinary collaboration and planning with regular interaction, continuing education, and a regular review of the latest relevant literature.

Cleft lip and palate surgery: an update of clinical outcomes for primary repair.

The comprehensive management of cleft lip and palate has received significant attention in the surgical literature over the last half century. It is the most common congenital facial malformation and has a significant developmental, physical, and psychological impact on those with the deformity and their families. In the United States, current estimates place the prevalence of cleft lip and palate or isolated cleft lip at approximately 1 in 600.

Regenerative medicine for craniomaxillofacial surgery.

Regenerative medicine has recently seen much activity in basic and translational research. These advances are now making their way into surgical practice. A convergence of technologies has afforded opportunities previously not available with conventional surgical reconstructive techniques.

Prenatal diagnosis and treatment of craniomaxillofacial anomalies.

Many advances in health care are built on the evolution of technology. An entirely new patient has emerged in fetal medicine, with these advances in prenatal imaging allowing one to see and diagnose disease not previously appreciated. Clinicians can better plan for the delivery of the neonate, with identified anomalies being optimally managed and the impact on the neonate's health minimized.

Analysis of faecal volatile organic compounds in preterm infants who develop necrotising enterocolitis: a pilot study.

Objective: : To determine differences in the profiles of volatile organic compounds (VOCs) in faecal samples from preterm infants who develop necrotising enterocolitis (NEC) compared with non-NEC controls.

Materials And Methods: : Daily faecal samples from preterm infants were collected prospectively during an 8-month period from a level 3 regional neonatal intensive care unit. Six infants subsequently developed NEC and were matched with 7 non-NEC infants.

Personality characteristics of health care satisfaction survey non-respondents.

Purpose: Patient satisfaction surveys are increasingly used to assess the quality of health care delivery. Unfortunately, survey non-response may compromise generalizability (and inferential value). Although prior studies demonstrate an association between patient socio-demographic variables and response rate, relatively little information is available linking personality factors to non-response.

Complexity in geriatric home healthcare.

The aging population and the associated rise in the prevalence of chronic conditions suggest that the home health population is increasingly complex and challenging to manage. The purpose of this study was to use national administrative data (Outcome and Assessment Information Set assessments of persons discharged in 2004 and 2005) to examine the clinical complexity of older adults admitted to home healthcare. Our descriptive analyses confirm that multiple chronic conditions and cognitive impairment are common and result in longer lengths of stay.

Quantifying the architectural complexity of microscopic images of histology specimens.

Tumour grade (a measure of the degree of cellular differentiation of malignant neoplasm) is an important prognostic factor in many types of cancer. In general, poorly differentiated tumours are characterized by a higher degree of architectural irregularity and complexity of histological structures. Fractal dimension is a useful parameter for characterizing complex irregular structures.

Fetal diagnosis and treatment of craniomaxillofacial anomalies.

So many advances in health care are built on the evolution of technology. In the case of fetal medicine, technology has availed an entirely new patient. Advances in prenatal imaging allow us to see and diagnose disease not previously appreciated.

A sensor system for monitoring the simple gases hydrogen, carbon monoxide, hydrogen sulfide, ammonia and ethanol in exhaled breath.

A sensor array system was constructed incorporating electrochemical sensors for hydrogen, carbon monoxide, hydrogen sulfide and ethanol, a ceramic sensor for total volatiles and a dye-based optical ammonia sensor. The system was calibrated using standard gases balanced with dry air. Limit of detection and % relative standard deviation values (n = 10) for the sensors in the array are hydrogen (0.

Pessimism and hostility scores as predictors of patient satisfaction ratings by medical out-patients.

Purpose: The purpose of this research is to determine whether a pessimistic or hostile personality style adversely affects satisfaction with out-patient medical visits. Many patient and health care provider demographic characteristics have been related to patient satisfaction with a health care encounter, but little has been written about the association between patients' personality characteristics and their satisfaction ratings.

Design/methodology/approach: An eight-item patient satisfaction survey was completed by 11,636 randomly selected medical out-patients two to three months after their episode of care.

Mandibular distraction osteogenesis in children.

Distraction osteogenesis is currently considered a useful treatment option for the correction of specific facial skeletal deformities. Although it is apparent that distraction may have significant potential and broader application in the management of maxillofacial problems, very few comprehensive scientific data exist, making it difficult to describe its exact role in the reconstructive oral and maxillofacial surgeon's armamentarium. This article reviews the biological basis for distraction osteogenesis, potential applications, and current surgical approaches for mandibular distraction in children.

Pediatric mandibular hypomobility: current management and controversies.

Limited range of motion of the pediatric mandible (eg, mandibular hypomobility) presents many challenges. Untreated or recurrent hypomobility can cause problems with mastication, oral hygiene, speech, growth, and the airway. Treatments for ankylosis or adhesions include coronoidectomy, gap arthroplasty, costochondral rib reconstruction, prosthetic joint replacement, and transport distraction osteogenesis.

Treacher Collins syndrome: comprehensive evaluation and treatment.

When contemplating the reconstructive options for patients with Treacher Collins syndrome, surgeons must recognize the complex interplay between growth of the craniofacial region and the possible effects of early surgery on further growth. Consequently, surgical procedures for the deformities in Treacher Collins syndrome are staged based on the dysmorphology and the growth velocity of each anatomic region. This article reviews the evaluation and management considerations for patients with Treacher Collins syndrome.

Nonsyndromic craniosynostosis: diagnosis and contemporary surgical management.

Contemporary surgical management of nonsyndromic craniosynostosis requires the combined expertise of a pediatric craniofacial surgeon and pediatric neurosurgeon. The goals of surgical intervention are the release of the affected suture, which allows for unrestricted development of the visceral components (eg, brain, eyes) and three-dimensional reconstruction of the skeletal components, which establishes a more normal anatomic position and contour. Surgeon who care for infants with these cranial and orbital malformations must maintain a thorough understanding of the three-dimensional anatomy, characteristic dysmorphology associated with the different types of synostosis, and the complex interplay that exists between surgical intervention and ongoing skeletal growth.

Positional plagiocephaly: evaluation and management.

Positional plagiocephaly is a cranial vault deformation in the presence of open cranial vault sutures with no negative neurologic consequences. A distinct morphologic pattern and patent cranial sutures noted on confirmatory radiographic studies distinguish positional plagiocephaly from abnormal head shapes secondary to craniosynostosis. Management consists of conservative (nonsurgical) means, depending on the extent of the cranial asymmetry and any contributing etiologic factors.