Search

Background:. Enhanced recovery after surgery (ERAS) protocols have demonstrated success in reducing hospital stay and opioid consumption, but are less well studied in patients undergoing tissue expander-based breast reconstruction (TEBR). This study evaluates the effectiveness of an ERAS postoperative protocol for TEBR at a high-volume center. Methods:. All patients undergoing immediate tissue expander reconstruction after the introduction of ERAS were prospectively included from April 2019 to June 2023. An equivalent number of similar patients were retrospectively reviewed before this date as the non-ERAS control. Data included demographics, operative details, postoperative length of stay, inpatient and discharge narcotic quantities, inpatient pain assessments, postoperative radiation, and complications within 90 days. Results:. There were 201 patients in each cohort with statistically similar demographics. Patients in the ERAS cohort were more likely to undergo prepectoral reconstruction (83.1% versus 4.5%, P < 0.001), be discharged by day 1 (96.5% versus 70.2%, P < 0.001) and consume lower inpatient milligram morphine equivalent (MME) median (79.8 versus 151.8, P < 0.001). Seroma rates (17.4% versus 3.5%, P < 0.001) and hematoma incidence (4.5% versus 0%, P = 0.004) were higher in the ERAS cohort. Adjusting for implant location, ERAS was associated with a 60.7 MME reduction (β=-60.7, P < 0.001) and a shorter inpatient duration by 0.4 days (β =-0.4, P < 0.001). Additionally, prepectoral reconstruction significantly decreased MME (β=-30.9, P = 0.015) and was the sole predictor of seroma development (odds ratio = 5.2, P = 0.009). Conclusions:. ERAS protocols significantly reduce opioid use and hospital stay after TEBR.

Idiopathic lung fibrosis (ILF) is a severe and life threatening lung disorder that is characterized by scarring of lung tissue, leading to thickening and stiffening of affected areas. This study looked at the role played by PI3K-Akt/PKB-mToR signaling pathway in the pathogenesis of N-Nitrosodimethylamine (NDMA)-induced lung fibrotic injury, and the effects of syringic acid (SYR) and ascorbic acid (ASC) treatments in male Wistar rats. Pulmonary fibrosis was induced by intraperitoneal injection of 10 mg/kg NDMA once daily, thrice (consecutively) a week for four weeks, and this condition was treated daily with SYR (50 mg/kg) and ASC (100 mg/kg) acids orally for four weeks. Fibrogenesis, following NDMA administration was marked by a significant increase in collagen-1 and α-SMA levels, while oxidative stress was marked by a significant decrease in GSH level, GST, GPx, CAT, and SOD activities. Also, NDMA significantly increased lung Bax, p53, caspase-3, TNF-α, IL-1β, NFkB, and decreased Bcl-2, mdm2, cyclin D1 and Nrf-2 levels. Looking at the PI3K-Akt-mTOR signaling pathway, NDMA administration significantly activated lung PI3K, Akt, and mTOR, and deactivated PTEN, FoxO1 and TSC2. Treatments with SYR and ASC significantly reduced oxidative stress by restoring the antioxidant systems via Nrf2 activation, decreased the levels of inflammatory markers through inhibition of NFkB, downregulated p53, Bax, and caspase-3 via up-regulation of mdm2 and cyclin D1. SYR and ASC also regulated the PI3K-Akt-mTOR signaling pathway via the deactivation of PI3K, Akt, and mTOR, and up-regulation of PTEN, FoxO1 and TSC2. Overall, SYR and ASC modulate the PI3K-Akt-mTOR signaling pathway via inhibition of oxidative stress, inflammation and apoptosis in NDMA-induced lung fibrosis.

The inauguration of the United States first Black President has prompted mass discussions of race relations in America. It is often articulated that America is now in a post-racial society. [...]

The uncertainties and biases associated with Global Climate Models (GCMs) ascend from global to regional and local scales which delimits the applicability and suitability of GCMs in site-specific impact assessment research. The study downscaled two GCMs to evaluate effects of climate change (CC) in the Black Volta Basin (BVB) using Statistical DownScaling Model (SDSM) and 40-year ground station data. The study employed Taylor diagrams, dimensionless, dimensioned, and goodness of fit statistics to evaluate model performance. SDSM produced good performance in downscaling daily precipitation, maximum and minimum temperature in the basin. Future projections of precipitation by HadCM3 and CanESM2 indicated decreasing trend as revealed by the delta statistics and ITA plots. Both models projected near- to far-future increases in temperature and decreases in precipitation by 2.05-23.89, 5.41–46.35, and 5.84–35.33% in the near, mid, and far future respectively. Therefore, BVB is expected to become hotter and drier by 2100. As such, climate actions to combat detrimental effects on the BVB must be revamped since the basin hosts one of the largest hydropower dams in Ghana. The study is expected to support the integration of CC mitigation into local, national, and international policies, and support knowledge and capacity building to meet CC challenges. HIGHLIGHTS The study downscaled two GCMs to evaluate the effects of climate change over the Black Volta Basin using the SDSM.; The study revealed that the SDSM provided a good performance across the selected stations.; Both models projected near-to-future decreases in precipitation in the near-, mid-, and far-future.; The Black Volta Basin is expected to become hotter and drier by 2100.; The SDSM is a powerful tool for climate change assessment.;

Oxidative stress is increased in several cancers including prostate cancer, and is currently being exploited in cancer therapy to induce ferroptosis, a novel nonapoptotic form of cell death. High mobility group A2 (HMGA2), a non-histone protein up-regulated in several cancers, can be truncated due to chromosomal rearrangement or alternative splicing of HMGA2 gene. The purpose of this study is to investigate the role of wild-type vs. truncated HMGA2 in prostate cancer (PCa). We analyzed the expression of wild-type vs. truncated HMGA2 and showed that prostate cancer patient tissue and some cell lines expressed increasing amounts of both wild-type and truncated HMGA2 with increasing tumor grade, compared to normal epithelial cells. RNA-Seq analysis of LNCaP prostate cancer cells stably overexpressing wild-type HMGA2 (HMGA2-WT), truncated HMGA2 (HMGA2-TR) or empty vector (Neo) control revealed that HMGA2-TR cells exhibited higher oxidative stress compared to HMGA2-WT or Neo control cells, which was also confirmed by analysis of basal reactive oxygen species (ROS) levels using 2′, 7′-dichlorofluorescin diacetate (DCFDA) dye, the ratio of reduced glutathione/oxidized glutathione (GSH/GSSG) and NADP/NADPH using metabolomics. This was associated with increased sensitivity to RAS-selective lethal 3 (RSL3)-induced ferroptosis that could be antagonized by ferrostatin-1. Additionally, proteomic and immunoprecipitation analyses showed that cytoplasmic HMGA2 protein interacted with Ras GTPase-activating protein-binding protein 1 (G3BP1), a cytoplasmic stress granule protein that responds to oxidative stress, and that G3BP1 transient knockdown increased sensitivity to ferroptosis even further. Endogenous knockdown of HMGA2 or G3BP1 in PC3 cells reduced proliferation which was reversed by ferrostatin-1. In conclusion, we show a novel role for HMGA2 in oxidative stress, particularly the truncated HMGA2, which may be a therapeutic target for ferroptosis-mediated prostate cancer therapy.

The growth of the aquaculture sector leads to a demand for sustainable feed ingredients. Prebiotics are potential sustainable feed ingredients that can promote the improved performance of aquaculture species without the use of antimicrobials. This study investigated the potential of Azolla pinnata as a candidate prebiotic source. Prebiotic characteristics and dietary effect of commercial diet (CD) with varying pulverised azolla (PA) inclusion was evaluated. Results showed that PA (9.40% moisture) constitutes around 16.1% ash, 22.3% crude fibre, 20.9% crude protein, 1.7% crude fat and 29.6% nitrogen-free extract. Crude xylan and cellulose content of PA were 13.7% and 12.6% dry matter (DM) respectively. Growth of Lactobacillus rhamnosus in PA-supplemented MRS broth remarkably improved after 4 to 6 hours of incubation. Feeding trials results revealed that PA inclusion had no adverse effect on average survival of milkfish fingerlings, albeit significant improvement (p < 0.01) was noted in group fed with 2% PA-replaced CD in terms of the total weight gain (119.9%), specific growth rate (2.62% day–1) and feed efficiency (79.9%). The present study demonstrated the prebiotic activity of PA, as well as its potential use as dietary feed component for improved growth and feed efficiency of cultured milkfish.

The purpose of this study was to determine the level of language exposure toward the learning of the English language of the students in the Visayas State University. A learners’ exposure to the target language does have impact in language learning. Adapting a language exposure questionnaire, the researcher identified the activities that exposed students to the target language. With a scoring guideline, the researcher revealed the level of students’ exposure to the English language. Results of the study showed that more than half of the respondents have a moderate level of language exposure. Students were exposed most to the English language when they are at school or with the use of different media compared to when they are at home or communicating with friends. This result can be utilized both by teachers and students in engaging to appropriate activities both inside and outside the classroom that can help increase the learning of the English language.

BackgroundNeonatal mortality is high in low-resource settings. NeoTree is a digital intervention for neonatal healthcare professionals (HCPs) aiming to achieve data-driven quality improvement and improved neonatal survival in low-resource hospitals. Optimising usability with end-users could help digital health interventions succeed beyond pilot stages in low-resource settings. Usability is the quality of a user's experience when interacting with an intervention, encompassing their effectiveness, efficiency, and overall satisfaction.ObjectiveTo evaluate the usability and usage of NeoTree beta-app and conduct Agile usability-focused intervention development.MethodA real-world pilot of NeoTree beta-app was conducted over 6 months at Kamuzu Central Hospital neonatal unit, Malawi. Prior to deployment, think-aloud interviews were conducted to guide nurses through the app whilst voicing their thoughts aloud (n = 6). System Usability Scale (SUS) scores were collected before the implementation of NeoTree into usual clinical care and 6 months after implementation (n = 8 and 8). During the pilot, real-world user-feedback and user-data were gathered. Feedback notes were subjected to thematic analysis within an Agile “product backlog.” For usage, number of users, user-cadre, proportion of admissions/outcomes recorded digitally, and median app-completion times were calculated.ResultsTwelve overarching usability themes generated 57 app adjustments, 39 (68%) from think aloud analysis and 18 (32%) from the real-world testing. A total of 21 usability themes/issues with corresponding app features were produced and added to the app. Six themes relating to data collection included exhaustiveness of data schema, prevention of errors, ease of progression, efficiency of data entry using shortcuts, navigation of user interface (UI), and relevancy of content. Six themes relating to the clinical care included cohesion with ward process, embedded education, locally coherent language, adaptability of user-interface to available resources, and printout design to facilitate handover. SUS scores were above average (88.1 and 89.4 at 1 and 6 months, respectively). Ninety-three different HCPs of 5 cadres, recorded 1,323 admissions and 1,197 outcomes over 6 months. NeoTree achieved 100% digital coverage of sick neonates admitted. Median completion times were 16 and 8 min for admissions and outcomes, respectively.ConclusionsThis study demonstrates optimisation of a digital health app in a low-resource setting and could inform other similar usability studies apps in similar settings.

Since the 1970s, cases have been heard by the US Supreme Court questioning the constitutionality of affirmative action policies in both hiring and higher education. This study seeks to explore the cause of an anti-affirmative action affect among White women. Specifically, it seeks to uncover a cause of the fragility that exists among some White women who fear that affirmative action has caused them to lose something of value to a less-qualified minority. It sheds light on a cause of White fragility and what this means for the future discourse of affirmative action. Using multivariate analyses, this research shows that due to White fragility, White women have a higher propensity to oppose affirmative action in higher education. Because of the far-reaching implications of affirmative action in hiring and higher education, this research argues that the need for affirmative action has not dissipated in the twenty-first century, and how we discuss affirmative action needs to be revisited. [ABSTRACT FROM AUTHOR]

Sea grapes are among the seaweeds being commercialized in the Philippines. They are sold in fresh state, and are highly perishable. It is necessary to develop preservation techniques in order to lengthen its shelf life. This study aims to assess the physico-chemical, microbial and sensorial quality of sea grape Caulerpa lentillifera preserved in 0%, 5%, 10% and 15% brine concentrations. Results revealed that brining effectively extended the shelf life of C. lentillifera by inhibiting the growth of bacteria and maintaining the osmotic pressure between the product and the solution. Within the 10 days storage period, 10% and 15% were bacteriologically stable and more acceptable upon rehydration. Treatments 0% and 5% were not acceptable because it exceeded the bacterial limit set for fresh vegetables. The sensorial attributes were compromised and became less acceptable due to degradation through bacterial action. In terms of physico-chemical analysis, high salt concentration (15%) decreased chlorophyll and carotenoid content significantly due to shrinkage and water loss. Overall, this study proved that sea grapes in 10% brine solution can extend its shelf life.

In this data article, Blood and corresponding saliva samples from subjects presenting with fever and parasetaemia ≥2000 were obtained from selected hospitals in Ado-Odo/Ota, Ogun State over a period of two years and analyzed using Polymerase chain reaction-Restriction fragment Length Polymorphism (PCR/Nested PCR-RFLP) to detect genetic mutations of Plasmodium falciparum chloroquine resistance transporter (Pfcrt), Plasmodium falciparum multidrugs resistance (Pfmdr1) and non-synonymous Pkelch (pk13) mutated genes. The study confirmed the presence of resistance genes in the blood and saliva samples collected from the study site. Keywords: Malaria, Prevalence, Plasmodium falciparum, Resistance genes

Introduction In low-resource countries, respiratory failure is associated with a high mortality risk among critically ill children. We evaluated the role of bubble continuous positive airway pressure (bCPAP) in the routine care of critically ill children in Lilongwe, Malawi.Methods We conducted an observational study between 26 February and 15 April 2014, in an urban paediatric unit with approximately 20 000 admissions/year (in-hospital mortality

The lack of racial diversity in the occupational therapy profession as well as its educational programs are obstacles in providing culturally responsive care to serve all people, populations, and communities. Research has shown that student engagement in case studies, activities that emphasize exposure to diverse populations, reflective journaling, and interviewing someone from a different culture are effective in developing practitioners who are more culturally responsive. Students from one culturally diverse occupational therapy program took a nine-hour Social and Cultural Concepts Module (SCCM) that incorporated best practice pedagogy for teaching cultural responsiveness. A one group pretest-posttest design was utilized to explore how well-prepared the students believed they were to meet the needs of diverse communities following the module. Data was collected from 35 entry-level doctor of occupational therapy students from four major race/ethnicities using the Interprofessional Education Health Disparities Series Survey (IPE-HDSS). Of the 30 items measured, 22 items showed a significant positive difference from the pretest to the posttest. Results demonstrated a change in the students’ self-reported knowledge of culturally responsive care following classroom instruction. This study provides insight into the need for culturally responsive curriculum to be integral to occupational therapy education.

Even if one were able to predict with 100% accuracy, the ultimate position of the lower third molar in the dental arch on the panoramic radiograph, the decision to surgically remove or retain the M3 involves the judgment of the surgeon and the informed consent of the patient. [ABSTRACT FROM AUTHOR]

Background: The neutropenic diet has been a long-standing approach to preventing infection in patients with hematopoietic stem cell transplants (HSCTs), although data on its efficacy are inconclusive and its restrictive nature might contribute to harm by reducing dietary intake in this patient population who typically experiences poor oral intake. The aim was to determine if a liberalized diet (LD), in comparison with a neutropenic hospital diet (ND), would improve energy intake and lessen weight loss during neutropenia in patients with HSCTs., Methods: A randomized controlled trial was conducted in a single-center HSCT/hematologic malignancy unit. The diet interventions were initiated when absolute neutrophil counts dropped to <500 cells/mm 3 ; oral dietary intake was assessed during neutropenia until neutrophil recovery, which averaged 9.5 days., Results: Meal intake compliance (consuming at least 50% of meals/day) was not different between groups (LD, 47%; ND, 43%; P = 0.66). Of the 191 patients assessed (LD, n = 92; ND, n = 99), mean (SD) energy, 678 (349) vs 724 (393) kcal/d (P = 0.46), and protein, 30.3 (18.5) vs 30.4 (18.1) g/day (P = 0.89) did not differ between groups nor did weight change, 0.3 (2.5) vs 1.2 (4.1) kg (P = 0.22) during neutropenia. None vs higher than or equal to grade 1 mucositis, allogeneic vs autologous stem cell transplantation, and fewer days on intervention favored higher energy and protein intakes., Conclusion: Energy intake during neutropenia did not improve with a LD encouraging fresh fruits and vegetables. Thus, alternative approaches to improving dietary intake, such as energy-dense and nutrient-dense foods with sensory characteristics acceptable to patients experiencing significant mucositis, require exploration., (© 2024 The Author(s). Nutrition in Clinical Practice published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.)

This systematic review aimed to explore the efficacy of both pharmacological and non-pharmacological interventions in managing hypertension during pregnancy. It analyzed high-quality randomized controlled trials (RCTs), focusing on outcomes related to maternal and fetal health. The findings demonstrated that antihypertensive medications, particularly labetalol and nifedipine, effectively reduced the risks of severe preeclampsia (PE), preterm birth, and other complications. Remote monitoring of blood pressure (BP) showed promise in improving postpartum care and addressing health disparities. While dietary interventions such as the Dietary Approaches to Stop Hypertension (DASH) diet offered metabolic benefits, their impact on preventing PE was inconclusive. The review highlights the need for a comprehensive approach to hypertension management, integrating medication, lifestyle interventions, and innovative monitoring strategies. It also emphasizes the importance of further research to refine non-pharmacological interventions and assess their long-term effectiveness. We believe these insights will help guide clinical practice, enhance maternal and fetal outcomes, and inform future research directions., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bano et al.)

This paper will explain the concept behind mental resilience training (MRT) and how the training package was developed and implemented within the British ArmyInfantry Training Centre (ITC) Catterick between 2014 and 2016. MRT is a mindfulness-based psychological skills training package that integrates cognitive behavioural and mindfulness based principles and techniques, which have been proven to improve stress regulation, emotional and cognitive control and self-confidence in military personnel. MRT is based on an extensive evidence base that has demonstrated that psychological skills training delivers tangible improvements in performance in elite sport and in healthcare, business and military contexts. The initial trials at the ITC Catterick have delivered tangible improvements in infantry recruits' use of psychological skills within real-life training contexts., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

The goals of primary closure of cleft lip and palate include not only re-establishing normal insertions for all of the nasolabial muscles but also restoring the normal position of all the other soft tissues, including the mucocutaneous elements. Conventional surgical wisdom, which recommends waiting until growth is complete before undertaking surgical correction of the postoperative sequelae of primary cheiloplasty, carries with it many disadvantages. If, after primary surgery of the lip, orolabial dysfunctions remain, they will exert their nefarious influences during growth and will themselves lead to long term dentofacial imbalances. These imbalances can significantly influence facial harmony. Unless accurate, symmetric and functional reconstruction of the nasolabial muscles is achieved during the primary surgery, not only will the existing dentoskeletal imbalances be exaggerated, but other deformities will be caused during subsequent growth, among which the most important are nasal obstruction and mouth breathing, reduced translation of the maxilla, dysymmetry of the nose and inability of the patient to symmetrically project the upper lip

Objectives: The purpose of this study was to determine the incidence of unfavorable mandibular fracture in sagittal-split osteotomies in the presence or absence of impacted third molar teeth., Study Design: This retrospective study evaluated 1256 mandibular sagittal-split osteotomies in two groups of patients: Group I had impacted third molar teeth removed during sagittal-split osteotomy; in Group II, the third molar teeth had been removed at least 6 months before the sagittal-split osteotomy. Statistical testing consisted of chi-square analysis of contingency table for p < 0.05., Results: In 1256 mandibular sagittal-split osteotomies there were 24 (1.9%) with unfavorable fractures. Five of 24 occurred when third molar teeth were removed at the time of osteotomy and 19 of 24 mandibular fractures occurred when no impacted third molar tooth was present at the time of osteotomy. However, no significant difference was demonstrated between the groups., Conclusion: The result of this study suggests that mandibular fractures may occur with greater frequency when the impacted third molar teeth have been removed at least 6 months before sagittal-split osteotomy as compared with that when third molar teeth are removed concomitant with sagittal-split osteotomy.

Surgery for cleft lip and palate is known to have an effect on growth and development of the mid-face. This paper studies the outcomes in 34 consecutive 10-year-old patients with unilateral cleft lip and palate. Clinical observations of the importance of both surgical technique and the influence of cranial base morphology on maxillo-mandibular position are discussed.

Purpose: The purpose of this prospective study was to compare the effectiveness of patient-controlled intravenous (i.v.) opioid analgesic administration (PCA) with fixed schedule and dosage oral/rectal administration of naproxen, and opioid analgesics intramuscularly/orally as needed (i.m./p.o. prn) for postoperative analgesia over a period of 48 to 56 hours after surgery., Patients and Methods: There were 75 orthognathic patients aged 25.73 +/- 8.01 years, subdivided into three study groups of 25: codeine group (8 males, 17 females); naproxen group (5 males, 20 females) and PCA group (8 male, 17 females). The degree of analgesia was assessed every 4 hours from 8:00 AM to 8:00 PM hours on days 1 and 2 postsurgery using a visual analog scale (VAS). Mean daily and mean overall VAS scores were treated as parametric data and were analyzed accordingly. Mean daily VAS scores also were categorized as comfort days when mean scores were less than 3.0 cm, and as discomfort days when mean scores were equal to or greater than 3.0 cm. ANOVA were used to analyze patient demographics, pain scores, surgical time, fentanyl used during general anaesthesia, analgesic morphine equivalents, and vital signs. Chi-square tests were used to analyze sex, comfort (discomfort) days, and nausea and vomiting. Mean VAS ratings were analyzed using independent t-tests., Results: The three groups were matched in demographics, surgical time, fentanyl used, and sex. The PCA group used less than half the amount of morphine equivalent as the codeine group (P = .0001). Both the naproxen and the PCA groups were significantly more comfortable than the codeine group during day 1 and day 2 postsurgery. The codeine group had significantly more episodes of nausea than either the naproxen or the PCA groups., Conclusion: In patients undergoing orthognathic surgery, the naproxen and PCA regimens provided better analgesia than the codeine regimen.

Purpose: This study compared blood loss, quality of surgical field, and duration of procedure with and without induced hypotensive anesthesia in adolescent orthognathic surgery patients., Patients and Methods: Fifty orthognathic surgery patients were studied in a prospective, randomized, blocked, stratified, and single-blind fashion. All patients underwent either sagittal ramus split osteotomy or Le Fort I osteotomy or genioplasty. One group of patients (n = 25) had induced hypotension; the other group (n = 25) received anesthesia with no attempt to deliberately reduce blood pressure during the operation. The surgeon, unaware of to which group the patient had been assigned, rated the surgical field every 15 minutes. At completion of surgery, three different methods were used to estimate or calculate blood loss. Duration of the procedure was recorded from time of first incision to time of last suture placement. The data were analyzed using ANOVA, chi-squared, and linear regression, where appropriate., Results: Estimated blood loss was significantly less when induced hypotensive anesthesia was used. The surgical field was better, but there was no significant difference in duration of the procedure with induced hypotensive anesthesia., Conclusion: Induced hypotensive anesthesia results in both reduced blood loss and improvement in surgical field.

In general, orthognathic surgery is a reliable, appropriate and prudent treatment option to correct maxillofacial deformities that cannot be managed by nonsurgical means alone. Unfavorable outcomes are relatively rare, but the statistical frequency of these complications loses its meaning in those cases where they occur. If a complication happens to an individual patient, it represents a one-hundred per cent incidence for that individual. For this reason, prior to the provision of treatment it is vitally important to obtain informed consent, ideally by establishing the widest possible information base on which meaningful communication can be built for the patient, the orthodontist, the surgeon, and the family dentist.

The Classe II maxillofacial deformities are common, varied in their expression and most frequently have both dental and skeletal components. For this reason, combined orthodontic-surgical treatment is well suited to correction of problems from which the patient suffers. Several clinical deductions are presented which pertain to diagnosis and treatment of Class II vertical excess deformities.

Most studies on third molar extractions focus on the potential of tooth-associated pathoses when justifying or questioning the extraction. Scant attention is paid to potential medical problems of the patient "attached" to the third molar. This study presents 28 consecutive cancer cases seen by one dentist over a 2-year period in which third molars had a significant impact on the health of the patient and on their course of cancer therapy. In 15 patients on whom extractions were performed, 40% experienced postoperative complications. Prophylactic extraction of partially erupted or impacted third molars in cancer patients before their cancer therapy is recommended on the basis of the following observations: (1) the increased risks and difficulties associated with post-cancer-treatment extraction, (2) the potential for third molars to produce pathoses in immunocompromised patients before, during, or immediately after their anticancer treatment, and (3) the management of third molars may interfere with the patient's cancer treatment.