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It is unclear whether certain bacteria initiate the development of inflammatory jaw conditions, or whether these diseases create a milieu for dysbiosis and secondary colonization of indigenous flora. At present, there are no comparative studies on the types of bacteria that colonize different inflammatory jaw conditions. Accordingly, this study aims to identify and compare the types of bacteria isolated in osteomyelitis, osteoradionecrosis, and MRONJ.This is a retrospective cohort study of patients diagnosed with inflammatory jaw conditions. The predictor variables were classification of bacteria as oral flora, categorized herein as resident bacteria, non-resident bacteria, or opportunistic organisms. The outcome variables were a diagnosis of osteomyelitis, osteoradionecrosis, and MRONJ. Covariates were age, sex, penicillin allergy, a diagnosis of diabetes and a history of smoking. Data analysis was performed using ANOVA and chi-squared tests.A total of 105 patients with inflammatory jaw conditions were enrolled. The final sample size was 69 subjects of which 16 were diagnosed with osteomyelitis, 20 with osteoradionecrosis, and 33 with MRONJ. There was no difference in the frequency that resident bacteria were isolated. Non-resident bacteria, which included Staphylococcus and Enterococcus among others, were isolated more frequently at 75% in osteomyelitis compared to 60% in osteoradionecrosis and 48% in MRONJ cases. There is weak evidence of significant difference when comparing osteomyelitis and MRONJ cases (P = .08). Opportunistic organisms, which included Mycobacterium and Candida, were isolated more frequently in osteoradionecrosis at 30% compared to 12.5% in osteomyelitis and 12.12% in MRONJ cases. There is weak evidence of significant difference when comparing osteoradionecrosis and MRONJ cases (P = .1).Non-resident bacteria including Staphylococcus and Enterococcus may be more frequently isolated in patients with osteomyelitis, while opportunistic organisms like Mycobacterium and Candida may be more frequently found in patients diagnosed with osteoradionecrosis.

Oral and maxillofacial surgeons are often called upon to evaluate patients with head and neck infections. These infections may or may not be derived from an odontogenic source. A unique position of the oral and maxillofacial surgeon is being able to manage both odontogenic and non-odontogenic infections. Prompt recognition and being able to stratify these infections based on severity are paramount. The pathogenic bacteria of maxillofacial infections are constantly developing resistance to new and old antibiotics. Therefore, oral and maxillofacial surgeons must continually refresh their knowledge of the microbiology and antibiotic therapy of these infections. This chapter reviews the pathogenesis, workup, anatomical considerations, sequelae, medical management, and surgical management of maxillofacial infections. We also cover rare disease processes such as cavernous sinus thrombosis and necrotizing fasciitis, with a focus on recognition and management.

Oh, for the days when I could just write a prescription for penicillin and know that it would be effective for my patient! Those days are over. Now, I have to worry about whether the antibiotic will cover the usual organisms in the infection; if there are highly antibiotic-resistant bacteria present; if my prescription will select for resistant organisms in the patient, or her family, or his community; if the patient will have a toxic or allergic reaction; or if it will interact with one of the many other drugs the patient is taking. What if my patient can’t afford the antibiotic or doesn’t take it as prescribed? How long will he really take the antibiotic for? Just until he feels better? Should I be prescribing this antibiotic at all?

I defend three claims regarding Foucault’s historical a priori (HP) and the intelligibility of history that counter commonly received accounts of Husserl’s approach to the same. First, Foucault is not a transcendental thinker in the Kantian sense of the term. His use of the HP is contingent, postdictive, regional and hypothetical. Second, the three “axes” of the dyads knowledge/truth, power/government, and subjectivation/ethics along with Foucault’s “history of the present” enclose a space called “experience” Erfahrung as nonreflective and “freed from inner life.” At this point, “experience” and “multiplicity” (relation without unity) coalesce to confirm Foucault’s anti-phenomenological bias and nominalist commitment. Finally, the relations of transformation and displacement that define archaeological change support a “fittingness” between the epistemes in question. Neither necessitating nor aleatory, their relation could be called “aesthetic” in a broad sense. I conclude by listing ways Husserl’s approach to historical intelligibility is the inverse of Foucault’s.

Toward the midpoint of his career, Sartre famously announced the separation from his previous work which he described as a rationalist philosophy of consciousness. Henceforth, he implied, his focus would be on free organic praxis. It would be dialectical and historical not just analytical and psychological. It seemed that he was distancing himself from classical (constitutive) Husserlian phenomenology in favor of something more fluid, more concrete like the hermeneutic phenomenology that he discovered in the Heidegger of Being and Time and was recommending as an ingredient in his Existential psychoanalysis. But classical phenomenology was not so much passed over as it was placed in abeyance to return in Sartre’s study of Gustave Flaubert, his life and times. The author proposes to chart and critique this methodological circle of applied phenomenology.

Foucault once wondered, “What philosopher has not tried to refute Plato”, and then he proceeded to add his name to the list. Sartre might well have echoed that thought, substituting ‘Kant’ for ‘Plato’ in the process. Having passed what he recalled were some of the happiest years of his life at the Ecole normale superieure, rue d’Ulm (ENS), where he studied philosophy among the neo-Kantians at the Sorbonne, Sartre was clearly imbued with the Critical attitude, even if he spent the rest of his life trying to redefine or escape it. One could say of the Kantian aspect of Sartre’s thought what John Locke said of the sense origin of our abstract ideas, that they bore “the tang of the cask they came in”. Of course, Sartre’s “cask” retained the flavours of Cartesian, Bergsonian, Husserlian, Hegelian, Marxian and many other philosophical elixirs that the bright normalien imbibed in the ensuing years, each with its proper trace. While my point is not to uncover an unprincipled eclectic — such was not the case — it serves to underscore the claim that Kant’s thought provided an enduring component of Sartre’s philosophical thought throughout his life.

Purpose Historically, the identification of microorganisms has been limited to species that could be cultured in the microbiology laboratory. The purpose of the present study was to apply molecular techniques to identify microorganisms in orofacial odontogenic infections (OIs). Materials and Methods Specimens were obtained from subjects with clinical evidence of OI. To identify the microorganisms involved, 16S rRNA sequencing methods were used on clinical specimens. The name and number of the clones of each species identified and the combinations of species present were recorded for each subject. Descriptive statistics were computed for the study variables. Results Specimens of pus or wound fluid were obtained from 9 subjects. A mean of 7.4 ± 3.7 (standard deviation) species per case were identified. The predominant species detected in the present study that have previously been associated with OIs were Fusobacterium spp, Parvimonas micra, Porphyromonas endodontalis, and Prevotella oris. The predominant species detected in our study that have not been previously associated with OIs were Dialister pneumosintes and Eubacterium brachy. Unculturable phylotypes accounted for 24% of the species identified in our study. All species detected were obligate or facultative anaerobes. Streptococci were not detected. Conclusions Molecular methods have enabled us to detect previously cultivated and not-yet-cultivated species in OIs; these methods could change our understanding of the pathogenic flora of orofacial OIs.

A 37-year-old man was seen in the oral and maxillofacial surgery clinic because of a painful lesion on the tongue. On examination, there was a tender, irregular, shallow ulcer on the left ventral surface of the tongue and a mobile, smooth, tender lymph node in the left anterior cervical chain. Scattered areas of erythema and blisters were present on the lower legs.

Purpose The purpose of this study was to identify significant predictors of 4 outcomes in patients with severe odontogenic infections: abscess formation, penicillin therapeutic failure (PTF), length of hospital stay (LOS), and need for reoperation. Patients and Methods We used a prospective case series study design and enrolled 37 consecutive patients admitted for severe odontogenic infection between March 1996 and June 1999. Treatment consisted of intravenous penicillin (PCN) or clindamycin in PCN-allergic patients, surgical incision and drainage, and extraction(s) as soon as possible. Study variables were categorized as demographic, preadmission, time-related, preoperative, anatomic, treatment, microbiologic, and complications. The primary outcome variables were abscess formation, PTF, LOS, and reoperation. Multivariate linear and logistic regression techniques were used to measure associations between study variables and the outcome variables. Results The sample consisted of 37 subjects (23 male, 14 female) with a mean age of 34.9 ± 15.8 years. Multivariate analyses, controlling for confounding variables, indicated that culture of Peptostreptococci was a negative predictor of abscess formation. LOS was predicted by the number of infected spaces and duration of operation. There was no significant predictor of PTF or reoperation on multivariate analysis, although PCN-resistant organisms were isolated in all cases of PTF. Conclusion Increased LOS in severe odontogenic infections is predicted by the anatomic extent and severity of the infection and the occurrence of complications such as PTF and the need for reoperation. PTF is significantly associated with later identification of PCN-resistant organisms. The role of Peptostreptococci in abscess formation warrants further investigation.

After reviewing how Jean Wahl interprets the early Marcel, specifically his Metaphysical Journal, in a seminal work whose title captured the philosophical spirit of the 1930s, Vers le concret ("Toward the Concrete"), I discuss the existentialist style of philosophizing, offer five criteria for judging a philosopher to be an existentialist and submit Marcel's work to each. I turn to the appropriateness of calling him a neo-Socratic philosopher, an appellation he seemed to prefer, and conclude with some observations of how this mixture of the Socratic and the existentialist places Marcel in the lineage of those like Michel Foucault and Pierre Hadot who speak of philosophy less as a doctrine and more as a way of life.

S artre is a philosopher of the imaginary. In an interview late in life, he admitted: “I believe the greatest difficulty [encountered in my research for my Flaubert study] was introducing the idea of the imaginary as the central determining factor in a person.” If one takes “imaginary” in the broad sense we have been using it, namely, as the locus of possibility, negativity and lack, articulated in creative freedom, this can be taken for an autobiographical remark as well. The tension between creative literature and philosophy, between image and concept, that he experienced as a lycee student was symptomatic of this basic feature of his thought. But that tension abated, though it did not disappear, when he turned his philosophical attention to the imagination and his literary undertakings to philosophical themes, as we noticed in Chapter 2. Recall Sartre’s remark that at this early stage he scarcely distinguished between psychology and philosophy. Though noted for his absence from classes at the Sorbonne, Sartre joined Nizan, Aron and Daniel Lagache to follow the lectures of psychologist Georges Dumas at the psychiatric hospital of Sainte-Anne. In fact, his graduation thesis for the DES was written under the direction of a distinguished professor of psychology, Henri Delacroix. His director later invited Sartre to submit a version of the text for the series he was editing for the Presses Universitaires de France. This short work, L’Imagination , became Sartre’s first book-length publication (1936). Unlike the DES thesis, where the lone reference to Husserl ( sic ) is second-hand, The Imagination awards Husserl’s thought pride of place. He is reserved for the final chapter where most, if not all, of the errors and inadequacies of the previously discussed philosophers and psychologists are set aright. This is clearly a Husserlian book, but one that bears the usual Sartrean qualifiers. The Imagination Between the DES thesis and the published book came the Berlin experience as well as nearly a decade of philosophical “novels” that, as we have remarked, anticipated several of the distinguishing aspects of Being and Nothingness . One can observe these and others presenting themselves in the course of Sartre’s book – which, like the next two, would be a study in philosophical psychology.

I n this chapter we return to the texts that form the common source for the ethical and political streams mentioned in the previous chapter. But now our intent is to review some of the same institutions, structures and events from the perspective of Sartre’s developing political theory and practice. Perforce, such a move will entail some repetition – a certain “rerun” of the film for the sake of a perspective politically enriched much as Heidegger famously ventured when he undertook a Wiederholung (repetition) of the first portion of Being and Time under the aspect of “temporality” in the second. The political significance rather eclipsed in the previous chapter should now achieve full view. As a student in the lycee, the young Sartre did not display a serious interest in political theory or in practical politics generally. His natural tendencies were anarchic. Toward the end of his years at the ENS, however, he did publish an informed essay on contemporary French legal theories “The Theory of State in Modern French Thought” (1927). It was in the fall of that year that his close friend Paul Nizan joined the French Communist Party (PCF). Nizan would later spend an idealistic year in the USSR and return to lecture Sartre, Beauvoir and their mutual friends on the promise of the Soviet Revolution. Sartre’s interests, at that time, were more literary and philosophical than political. He resisted the siren call of socialism, for example, that had turned the heads of many of his classmates at the Ecole, including Raymond Aron. Eschewing party adherence, Sartre nonetheless was strongly opposed to colonialism, which he regarded as a sordid form of state takeover. The young Sartre harbored a basic egalitarian spirit from his early teens and, as he recalled, thought of the French control of Algeria whenever the injustice of colonialism came to mind ( Cer 478). As his life-long companion Simone de Beauvoir remarks, they showed little concern for politics after graduation and did not even vote in the critical general election of 1936 that ushered in the socialist program of the Front Populaire. But even in those years his tendencies veered toward the Left.

Jean-Paul Sartre (1905–1980) was one of the most influential thinkers of the twentieth century. Regarded as the father of existentialist philosophy, he was also a political critic, moralist, playwright, novelist, and author of biographies and short stories. Thomas R. Flynn provides the first book-length account of Sartre as a philosopher of the imaginary, mapping the intellectual development of his ideas throughout his life, and building a narrative that is not only philosophical but also attentive to the political and literary dimensions of his work. Exploring Sartre's existentialism, politics, ethics, and ontology, this book illuminates the defining ideas of Sartre's oeuvre: the literary and the philosophical, the imaginary and the conceptual, his descriptive phenomenology and his phenomenological concept of intentionality, and his conjunction of ethics and politics with an 'egoless' consciousness. It will appeal to all who are interested in Sartre's philosophy and its relation to his life.

Oral and maxillofacial surgeons see patients with infections as part of their everyday practice. It is imperative to understand the mechanisms of antimicrobial resistance, its potential problems, and the means of overcoming it. This situation raises several important questions with respect to antimicrobial therapy for odontogenic infections: 1. Is there a problem of antibiotic resistance? 2. How does antibiotic resistance arise?

Chromosomal DNA transfers and stores information regarding the structure and function of the cell. Genetic information, encoded within sequences of nucleotides that compose DNA, is grouped into functional units called genes. Genetic diseases are caused by changes in the chromosomal DNA, leading to a change in the quantity or function of the protein gene product. In the past, genetic diagnosis was limited by the availability of sufficient quantity and quality of DNA and the absence of an efficient amplification procedure. The polymerase chain reaction (PCR), an inexpensive, rapid, and accurate means of amplifying DNA, is already making a major contribution to the diagnostic sciences. PCR techniques have been widely used in diverse applications, including molecular analysis of microbial pathogens, inheritable diseases and syndromes, and neoplasms. The purpose of this article is to 1) Review gene structure and function, 2) review principles of PCR technology and its applications in molecular biology, and 3) discuss an experimental clinical application of PCR to identify novel infectious agents responsible for odontogenic infections.