Diagnosis and Management of Osteomyelitis

Resident: Roberts
Date: 5/7/10
Article: Diagnosis and Management of Osteomyelitis
Author: Carek, Peter et al.
Journal: American Family Physician
Volume 63, Number 12
Year: June 15, 2001
Discussion
Osteomyelitis is an inflammation of bone caused by a pyogenic organism. This infection occurs predominantly in children and is often seeded hematogenously. In adults, osteomyelitis is usually a subacute or chronic infection that develops secondary to an open injury to bone and surrounding soft tissue. The specific organism is usually associated with the childs age, or associated with trauma or a recent surgery. Staph. Aureus is associated with acute osteomyelitis. S. Aureus, Psuedomonas Aeruginosa, Serratia Marcescens and Escherichia Coli are associated with chronic osteomyelitis. Osteomyelitis is usually detected through means of clinical and radiographical evaluation and diagnosed using a histopathological and microbiological examination. Acute osteomyelitis is best managed with a four to six week course of antibiotics administered parenterally. Chronic osteomyelitis is generally treated with antibiotics and surgical debridement. In addition to antibiotics, debridement, dead-space management and stabilization of bone may be necessary.

Assessment: I was surprised the article did not mention anything about associations with bisphosphonate therapies in adults

Drooling of saliva in children with cerebral palsy- etiology, prevalence, and relation ship to salivary flow rate in an Indian population

Resident: Roberts
Date: 5/7/2010
Article title: Drooling of saliva in children with cerebral palsy- etiology, prevalence, and relation ship to salivary flow rate in an Indian population
Author: Hegde, Amitha; Pani Sharat.
Journal: Special Care Dentistry
Volume: 29(4)
Year: 2009
Background:
Drooling is the escape of excess saliva from the mouth. It is commonly seen in normal infants and usually subsides by 15-18 months of age as a consequence of physiological maturity of orofacial motor function. Some studies indicate that drooling beyond an appropriate age is due to increased salivation and decreased or ineffective swallowing. Other studies and reviews of literature show it is mainly due to a swallowing defect caused by poor neuromuscular coordination.
In this study, the prevalence of drooling, the impact of various etiological factors on it severity, and its relationship to salivary flow rate were assessed in 113 individuals (6-18 yrs old) with cerebrals palsy(74 males and 39 females). The severity of drooling was assessed by visual examination, demographics and data regarding severity and control of drooling were collected via a questionnaire. Data concerning the type of CP and medications the patient was on was obtained by medical records
Results:
48.7% of patients reported drooling. 17.7% reported severe drooling. Individuals with athetosis had the least severe amount of drooling. There was a significant relationship between the ability to close the mouth and the severity of drooling. The severity of drooling was reduced with age. There was no significant difference in the mean salivary flow rate of those children who drooled and those who did not. No signicant difference between drooling in children with and without intellectual disability was found.
Conclusion:
The incidence of drooling among CP patients was almost 50%. Drooling of saliva may regress spontaneously with age, but speech therapy and the ability to close the mouth has the greatest effect against drooling.

Assessment: This would be one of those facts that would be fun and helpful to pull out of your back pocket when you need at the right time.