Problems with diagnosis and treatment of an odontogenic fistula of facial skin

Out of 16 patients with odontogenic fistulae of the facial skin, treated with in the last two years in the Department of Maxillofacial Surgery, Province Hospital No 1 in Rzeszów, the authors subjected to detailed analysis seven patients in whom, during the period preceding specialist stomatological treatment, difficulties occurred in the diagnosis and treatment. In all cases of development of facial skin fistulae, odontogenic origin should be considered in the first place.     

Correlation of skin phototype with facial wrinkle formation

We previously described the augmentation of sensory nerve action potential amplitudes after near and remote isometric muscle contraction. In this study, we wished to determine if the sensory cortex was involved in this process. In this prospective, intrinsically controlled study, we studied threshold somatosensory evoked potentials in 12 normal subjects with stimulation of the median nerve at 5.1 Hz. The subjects were tested during the following conditions: baseline, 25%, and 75% maximum isometric abductor digiti minimi contraction for 4 min. Each of these conditions was recorded before, during, and 4 min and 8 min after contraction. Results showed that at 25% contraction, there was a significant temporal increase in N9 amplitude (2.1-2.6 microV; P = 0.05, analysis of variance, repeated measures) and a decrease in N20 amplitude with 75% contraction (1.9-1.6 microV; P = 0.03, analysis of variance, repeated measure). No significant changes were noted in the spinal cord or brainstem recordings. In conclusion, it appears that augmentation of the brachial plexus peripheral nervous system recording occurs concurrently with central inhibitory gating. The possibility of peripheral nervous system adaptability will be discussed.     

A case of a urachal fistula

The authors report a case of urachal fistula diagnosed after repeated omphalitis, this disease was associated with coronal hypospadias. Diagnosis was done thanks to a fistulography; subsequently, during the operation, to evidence the fistula, this was injected with methylene blue, this expedient showed that the fistula was longer than that disclosed from fistulography. To carry out a complete extirpation of the fistula the authors were bound to make a cystotomy. The course after operation was good and the patient discharged after a few days. After 5 years the patient is in perfect health. This case allowed some anatomic, clinical and semeiotic considerations.     

White examiners generally do not impede the intelligence test performance of Black children: To debunk a myth.

A view held by some psychologists is that White examiners impair the intelligence-test performance of Black children. Despite the absence of objective supporting evidence, this view has become one of the leading myths in psychology. The present report clarifies the known facts and encourages additional research on race-of-examiner effects by evaluating the research literature and detailing flaws in 2 studies by B. Pasamanick and H. Knobloch (see record 1956-02723-001) and H. G. Canady (see record 1936-04136-001) often summoned to support the myth. The available research literature clearly refutes the existence of race-of-examiner effects and indicates that Black children's performance is not enhanced by examinations administered in Black dialect. Possible reasons for the persistence of the race-of-examiner myth are discussed. (60 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diver''s hand: a skin disorder common in occupational saturation diving

We describe the prenatal ultrasonographic features that led to the diagnosis of a lingual lymphangioma. The risk of upper airway obstruction, which is associated with this rare abnormality, prompted us to plan careful perinatal management. We believe that, in cases of suspected lymphangioma of the tongue or other oropharyngeal tumors, elective delivery should be carried out in a tertiary referral center in which emergency ventilation and tracheostomy are possible.     

A theoretical examination of the dynamics of facial skin with implications for scar reduction

A 30-year-old woman, diagnosed as having systemic lupus erythematosus at the age of 18, presented with excessive sleepiness and cataplectic attacks. Sleep laboratory findings were consistent with narcolepsy. To the best of our knowledge an association between these 2 diseases has never been reported. The unrelated course of narcolepsy and lupus symptoms in our patient suggests a lack of common pathogenetic mechanisms and this association is more likely explained by genetic factors.     

Use of foam bolsters for securing facial skin grafts

Many methods of securing skin grafts to their recipient beds have been described. A review of the senior author's experience with facial skin cancers over a two-year period revealed that reconstruction with full-thickness skin grafts was employed in 60 of more than 500 cases. This series of 60 cases was reviewed. Uses of foam as a bolster has proven to be a simple, time-conserving and reliable technique that produces consistently excellent results with a low complication rate. The technique is reviewed, along with its advantages and disadvantages.     

Clinical thinking and decision making in practice. A patient with decreased vision and a skin disorder

In a 48-year-old man who suffered from progressive loss of vision in his left eye and metamorphopsia, pseudoxanthoma elasticum was diagnosed. Angioid streaks were observed in both eyes and the skin showed small yellow papules in a linear pattern. The right retina was twice treated by laser coagulation which resulted in temporary regression of neovascularization. Pseudoxanthoma elasticum is a genetic disorder with variable penetrance. There is no treatment. Patients should be told to refrain from contact sports and to avoid using aspirin.     

A rare case of a preauricular fistula

A female patient with a preotic fistula caused by a defect in the development of the first branchial arch is described. Repeated surgeries for lateral fistula of the neck brought no success. The pathogenesis of the defect and difficulties in its diagnosis are discussed; the authors claim that fistulography with contrast agents may be effective. Histologic verification is needed in all the cases.     

Discrimination of facial appearance stimuli in body dysmorphic disorder.

Cognitive-behavioral models of body dysmorphic disorder (BDD) propose that information-processing biases--in particular, selective attention to a defect in one's appearance as well as improved aesthetical perception--might contribute to the development or maintenance of the disorder. In the present study, the authors tested the hypothesis that patients with BDD discriminate facial appearance stimuli more accurately than controls. Sixty female patients from a dermatological clinic participated in the study: 21 patients with BDD, 19 patients with disfiguring dermatological conditions, and 20 patients with nondisfiguring dermatological disorders. Participants rated dissimilarities between pictures of neutral faces that had been manipulated with regard to aesthetic characteristics. Manipulation ratings of participants with BDD were significantly more accurate than those of both control groups. Implications of these results for cognitive theories of BDD are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biases in eye movements to threatening facial expressions in generalized anxiety disorder and depressive disorder.

The study investigated biases in selective attention to emotional face stimuli in generalized anxiety disorder (GAD) and depressive disorder, using a modified probe detection task. There were 4 face types: threatening, sad, happy, and neutral. Measures of attentional bias included (a) the direction and latency of the initial eye movement in response to the faces and (b) manual reaction time (RT) to probes replacing the face stimuli 1,000 ms after their onset. Results showed that individuals with GAD (without depressive disorder) were more likely to look first toward threat faces rather than neutral faces compared with normal controls and those with depressive disorder. They also shifted their gaze more quickly toward threat faces, rather than away from them, relative to the other two groups. There were no significant findings from the manual RT data. Implications of the results for recent theories of clinical anxiety and depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Speed and accuracy of facial expression classification in avoidant personality disorder: A preliminary study.

The aim of this preliminary study was to examine whether individuals with avoidant personality disorder (APD) could be characterized by deficits in the classification of dynamically presented facial emotional expressions. Using a community sample of adults with APD (n = 17) and non-APD controls (n = 16), speed and accuracy of facial emotional expression recognition was investigated in a task that morphs facial expressions from neutral to prototypical expressions (Multi-Morph Facial Affect Recognition Task; Blair, Colledge, Murray, & Mitchell, 2001). Results indicated that individuals with APD were significantly more likely than controls to make errors when classifying fully expressed fear. However, no differences were found between groups in the speed to correctly classify facial emotional expressions. The findings are some of the first to investigate facial emotional processing in a sample of individuals with APD and point to an underlying deficit in processing social cues that may be involved in the maintenance of APD. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Differentiating attention-deficit/hyperactivity disorder from pervasive developmental disorder not otherwise specified

To discriminate between the various compressing vessels of the facial nerves in patients with hemifacial spasm, pre-operative oblique sagittal gradient-echo MR imaging was performed. Forty-two patients underwent pre-operative MR imaging and microvascular decompression. The MR images were divided according to findings into three groups as follows: Group A, a thick and/or long high-intensity line along the root exit zone (REZ) of the facial nerve; Group B, a thin and/or short high-intensity line along the REZ; and Group C, an unreliable image around the REZ. Fifteen images were classified as Group A, 19 as Group B, and 8 as Group C. In Group A, vertebral artery (VA) compression was confirmed intra-operatively in 12 cases and posterior inferior cerebellar artery (PICA) or anterior inferior cerebellar artery (AICA) compression in 3. In Group B, PICA or AICA compression was confirmed intra-operatively in all cases. In Group C, PICA or AICA compression was confirmed intra-operatively in 7 cases and no compression in one. In all cases of VA compression of the facial nerve, the oblique sagittal gradient-echo images demonstrated a thick and/or long high intensity line along the REZ. Oblique sagittal gradient-echo MR imaging is a useful preoperative planning aid, which can predict the possibility of VA compression prior to microvascular decompression for hemifacial spasm.     

"A naturalistic study of dissociative identity disorder and dissociative disorder not otherwise specified patients treated by community clinicians": Correction to Brand et al. (2009).

Reports an error in "A naturalistic study of dissociative identity disorder and dissociative disorder not otherwise specified patients treated by community clinicians" by Bethany Brand, Catherine Classen, Ruth Lanins, Richard Loewenstein, Scott McNary, Claire Pain and Frank Putnam (Psychological Trauma: Theory, Research, Practice, and Policy, 2009[Jun], Vol 1[2], 153-171). Author Ruth Lanius’s name was misspelled as Ruth Lanins; author Scot McNary’s name was misspelled Scott McNary; author Clare Pain’s name was misspelled Claire Pain; and the affiliation for Richard Loewenstein should have read Sheppard Pratt Health System. (The following abstract of the original article appeared in record 2009-08949-005.) The goals of this naturalistic, cross-sectional study were to describe the patient, therapist, and therapeutic conditions of an international sample of dissociative disorder (DD) patients treated by community therapists and to determine if community treatment for DD appears to be as effective as treatment for chronic PTSD and conditions comorbid with DD. Analyses found that across both patient (N = 280) and therapist (N = 292) reports, patients in the later stages of treatment engaged in fewer self-injurious behaviors, had fewer hospitalizations, and showed higher levels of various measures of adaptive functioning (e.g., GAF) than those in the initial stage of treatment. Additionally, patients in the later stages of treatment reported lower symptoms of dissociation, posttraumatic stress disorder, and distress than patients in the initial stage of treatment. The effect sizes for Stage 5 versus Stage 1 differences in DD treatment were comparable to those published for chronic PTSD associated with childhood trauma and depression comorbid with borderline personality disorder. Given the prevalence, severity, chronicity, and high health care costs associated with DD, these results suggest that extended treatment for DD may be beneficial and merits further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A naturalistic study of dissociative identity disorder and dissociative disorder not otherwise specified patients treated by community clinicians.

[Correction Notice: An erratum for this article was reported in Vol 1(3) of Psychological Trauma: Theory, Research, Practice, and Policy (see record 2009-18612-003). Author Ruth Lanius’s name was misspelled as Ruth Lanins; author Scot McNary’s name was misspelled Scott McNary; author Clare Pain’s name was misspelled Claire Pain; and the affiliation for Richard Loewenstein should have read Sheppard Pratt Health System.] The goals of this naturalistic, cross-sectional study were to describe the patient, therapist, and therapeutic conditions of an international sample of dissociative disorder (DD) patients treated by community therapists and to determine if community treatment for DD appears to be as effective as treatment for chronic PTSD and conditions comorbid with DD. Analyses found that across both patient (N = 280) and therapist (N = 292) reports, patients in the later stages of treatment engaged in fewer self-injurious behaviors, had fewer hospitalizations, and showed higher levels of various measures of adaptive functioning (e.g., GAF) than those in the initial stage of treatment. Additionally, patients in the later stages of treatment reported lower symptoms of dissociation, posttraumatic stress disorder, and distress than patients in the initial stage of treatment. The effect sizes for Stage 5 versus Stage 1 differences in DD treatment were comparable to those published for chronic PTSD associated with childhood trauma and depression comorbid with borderline personality disorder. Given the prevalence, severity, chronicity, and high health care costs associated with DD, these results suggest that extended treatment for DD may be beneficial and merits further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A retroperitoneal abscess with cutaneous fistula developed after stercoral fistula operation: a case report

Sparing treatment of chronic purulent sinusitis in children is an urgent problem of rhinology. Usage of preparations of donor (parental, of the same group) autoleukomass and blood plasm which possess all the components of humoral and cellular immunity proved highly effective against chronic purulent sinusitis in children. The drawback of this method is the necessity of regular lavage of the sinuses after insertion of the leukomass and heparinized plasm. The use of donor serum (parental, of the same group) also produced a good effect in purulent sinusitis. The serum advantage over the leukomass or plasm is that it can be left in the sinuses until the next procedure.