Natural history of oral papillomavirus infections in spouses: a prospective Finnish HPV Family Study.

BACKGROUND: The natural history of genital human papillomavirus infection is well known, but nearly nothing is known about the outcome of oral HPV-infection. OBJECTIVES AND STUDY DESIGN: To study natural history of oral HPV in spouses during the follow-up 331 women (mean 25.5+/-3.4 years) and 131 men (mean 28.8+/-5.0 years) were recruited from maternity unit. Scrapings from healthy oral mucosa of spouses at baseline, 2, 6, 12 and 24 months and genital samples were taken for HPV testing. HPV DNA was detected by nested PCR and confirmed by hybridization using a cocktail of 12 high-risk (HR) oligoprobes. RESULTS: The detection rate of HR HPVs varied from 15% to 27%. Baseline oral HPV status between the spouses was closely related (odds ratio 4.3; 95% confidence interval 1.6-12.0; P=0.006). Persistent oral infection in one spouse was a significant risk factor (odds ratio 10.0; 95% confidence interval 1.5-68.7; P=0.005) for oral HR HPV persistence in the other partner. Cumulative incidence of new HR HPV infections was identical in both spouses, while men seemed to clear their infection more rapidly. In univariate survival analysis, the partner's oral or genital HPV status, oral sex habits or age did not predict clearance or acquisition of oral HR HPV. CONCLUSION: Natural history of HPV infection in oral mucosa mimics that of genital HPV infection. Oral sex had no association to oral HPV infection, but a persistent oral HPV infection of the spouse increased the risk of persistent oral HPV infection 10-fold in the other spouse.     

Scandinavian Fellowship for Oral Pathology and Oral Medicine: statement on oral pathology and oral medicine in the European Dental Curriculum

J Oral Pathol Med (2010) 39 : 800–e1 Background: For many years, dentists have migrated between the Scandinavian countries without an intentionally harmonized dental education. The free movement of the workforce in the European Union has clarified that a certain degree of standardization or harmonization of the European higher education acts, including the dental education, is required. As a result of the Bologna process, the Association for Dental Education in Europe and the thematic network DentEd have generated guidelines in the document ‘Profile and Competences for the European Dentist’ (PCD). This document is meant to act as the leading source in revisions of dental curricula throughout Europe converging towards a European Dental Curriculum. In order to render the best conditions for future curriculum revisions providing the best quality dentist we feel obliged to analyse and comment the outlines of oral pathology and oral medicine in the PCD. Methods: The representatives agreed upon definitions of oral pathology and oral medicine, and competences in oral pathology and oral medicine that a contemporary European dentist should master. The competences directly related to oral pathology and oral medicine were identified, within the PCD. Results: The subject representatives suggested eighteen additions and two rewordings of the PCD, which all were substantiated by thorough argumentation. Perspectives: Hopefully, this contribution will find support in future revisions of the PCD in order to secure the best quality dental education.     

Chronic instability of the ankle

Evans tenodesis is one of the techniques used much for correcting the chronic lateral instability of the ankle. Long-term results (average follow-up 8 years) are reported for 113 operations on 109 patients. It is concluded that the method used gives a good functional result when the major complaint is recurrent sprains of the ankle. Functional stability does not necessarily correlate with mechanical stability when tested clinically or by radiographs.     

The Moore vitallium femoral-head prosthesis in fractures of the femoral neck.

A follow-up is given of early and late results in 109 arthroplasties with the self-locking Austin T. Moore vitallium femoral head prosthesis in fractures of the femoral neck on 106 patients. Operative indication was usually fresh medical fracture of the femoral neck in an elderly woman, or its late complication. The surgery was performed in a unit for general surgery also engaged in pre- and postgraduate teaching activities. Many operations were performed by residents engaged in general surgery or orthopaedics. Point scores according to a modification of Merle D'Aubigné's classification showed excellent or at least good results in 81 per cent of the 69 mobile patients. Because of deteriorated general physical condition 11 patients were chronically bed-ridden. Five patients could not be reached. In three instances the prosthesis was removed. 21 patients died, three during the stay in hospital and 18 later for reasons not connected with the operative procedure. The mortality during 40 months of observation corresponded fairly well to that expected in the age group for the population as a whole.     

Exertion injuries in adolescent athletes.

A series of 147 cases of exertion injuries in less than or equal to 15 years old athletes is presented. All injuries occurred during training or athletic performances without trauma and caused symptoms that prevented athletic exercises. There were 67 girls (46%) and 80 boys (54%) in the material. About 90% of them had been training for more than one year before the onset of the symptoms; 65% were interested in track and field athletics, 13% in ball games, 11% in skiing, 4% in swimming, and 3% in orienteering. The rest were interested in other sports. About 33% of the injuries were growth disturbances or osteochondroses seen also in other children. About 15% were anomalies, deformities or earlier osteochondritic changes, which caused first symptoms during the physical exercise; 50% were typical overuse injuries that may bother adult athletes, too; 43% of the injuries were localized in ankle, foot and heel, 31% in knee, 8% in back and trunk, 7% in pelvic and hip region, and the rest in other parts of the body. The injuries were generally slight, no permanent disability was noticed. Rest and conservation therapy cured most cases; operative treatment was used in only eight cases.     

3-D reconstructed magnetic resonance imaging in localization of subdural EEG electrodes. Case illustration

We report an illustrative case of presurgical evaluation for epilepsy surgery, where the three-dimensional reconstructed magnetic resonance imaging played a pivotal role in determining the exact location of the subdural strip electrodes in temporomesial area. The tip of one the frontal strip electrodes was actually recording the temporopolar ictal activity. This contributed conclusively to the decision for surgical treatment and to the excellent outcome.     

Extensive cerebral white matter abnormality without clinical symptoms: a new hereditary condition?

A 30-year-old father and his 2 sons with slight hyperkinesia and mildly dysmorphic features and their close relatives were examined clinically and with computed tomography (CT) and magnetic resonance imaging (MRI). Neurophysiological and biochemical examinations were normal; however, brain MRI of the father and sons revealed extensive cerebral white matter changes. No radiological progression could be detected at a 13-year follow-up examination of the father, and proton magnetic resonance spectroscopy (MRS) of the father at the age of 30 years was normal. MRI findings in the relatives were normal, suggesting an autosomal dominant syndrome due to a new mutation in the father.     

The significance of residual stenosis after decompression for lumbar spinal stenosis

Thirty-one patients with degenerative or combined degenerative and developmental lumbar spinal stenosis diagnosed by myelography and at subsequent surgery were thoroughly examined by computed tomography (CT) to reveal the completeness of the decompression and its correlation with the outcome. Complete elimination of the stenosis was achieved in 10 cases (32%) of whom 9 (90%) showed improvement. Various combinations of residual stenosis (some type of stenosis of the lateral part of vertebral canal at the laminectomy sites and also central stenosis outside the laminectomy field) were observed in 21 cases (68%). Of these, 14 (67%) had nearly complete, subtotal decompression with minimal or some residual stenosis, 7 (33%) had only minor decompression of the most constricted part of the spinal canal with a considerable amount of residual stenosis. The latter groups showed improvement in 8 cases (57%) and 6 cases (86%), respectively. Three patients (10%) with increased postoperative symptoms had only minimal or some residual stenosis. The significance of these findings is discussed.     

Dento-facial morphology and caries experience: an epidemiological study.

The aim of this study was to analyze the association between occurrence of enamel focal demineralization (EFD) lesions and caries on the smooth surfaces of permanent teeth and some parameters concerning dentofacial morphology in different age groups of Finnish children. Altogether 587 children aged 7, 9 and 12 years living in Helsinki and Kuopio, Finland were examined clinically and some parameters of dento-facial morphology were measured. Of the dento-facial morphological parameters, the size of the gonial angle seemed to be associated with caries indicators. The possible predictive value of dento-facial morphology for caries should be confirmed by longitudinal study.