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Magnetic resonance imaging (MRI) confirmed the presence of demyelinating lesions affecting the brain stem and the cerebral hemispheres ( Fig. 2 ).

Case No. 2

A 47-year-old woman consulted her dentist because of a severe pain on the right side of her mandible for the previous 4 days. The pain was paroxysmal, manifesting itself as repeated sharp “electric shocks” which could be triggered by chewing, tooth brushing, opening her mouth, or even lightly touching the cheek. The pain, which didn’t wake the patient, was partially relieved by Lenoltec # 1 (acetaminophen 300 mg, caffeine 15 mg, codeine phosphate 8 mg). The medical history revealed that the patient had experienced parasthesia of the lower half of the right side of her face and of the right side of her tongue approximately 6 months previously ( Fig. 3 ). This condition had resolved after 2 months following a course of prednisone. She had suffered Bell’s Palsy 17 years previously and was allergic to aspirin (urticaria). The review of systems was normal. The patient was not taking medications on a regular basis, and family history was normal.

Oral examination revealed normal mucosal tissues. The “electric shocks” could be precipitated by pulling the right cheek and by rubbing the alveolar mucosa on the buccal aspect of the fourth quadrant. The teeth were healthy, without caries or defective restorations. They were neither mobile nor tender to percussion. The periodontal tissues were normal.

Intraoral examination revealed no sensory or motor deficiencies. There was no apparent trigger zone in the right labio-mental area. The cranial nerves were normal on examination, except for bilateral nystagmus which appeared when the eyes were turned to the limit of movement. No other signs were apparent on examination of the face or the neck. Panoramic radiography revealed no pathological changes.

MRI revealed demyelination in the periventricular regions, the parietal and occipital lobes, the posterior part of the medulla and the junction of the midbrain and the middle cerebellar peduncles, which explained the trigeminal symptoms ( Fig. 4 ). The diagnosis was of tic douloureux in conjunction with multiple sclerosis, the first manifestations of which were the parasthesias of the right side of the face and tongue.

These 2 case presentations illustrate that the principal symptoms of multiple sclerosis in these patients presented as facial numbness and pain and that the dentist was the first health professional to be consulted.

The dentist plays an important role in the management of these conditions as part of a multidisciplinary team (general practice physicians, neurologists, psychologists, etc.) dealing with multiple sclerosis.

Epidemiology, Etiology and Pathogenesis

Multiple sclerosis is a condition which affects the central nervous system and is characterized by areas of demyelination throughout the brain and spinal cord. These areas of demyelination are responsible for the various neurological signs which are pathognomonic of the condition. Multiple sclerosis usually develops slowly, in phases of progression and remission. 1,2 The precise cause remains unknown. Many hypotheses have been put forward, including immune deficiency and viral infection. 1,3 High levels of antibodies to certain viruses, including that which causes measles, have been found in cases. Environmental factors or genetic susceptibility could be important etiologic factors. 1,2

Security Is Sexy

By Darlene Storm , Computerworld | Aug 8, 2016 6:05 AM PT

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Most security news is about insecurity, hacking and cyber threats, bordering on scary. But when security is done right, it's a beautiful even. Security IS sexy.

News Analysis

Ransomware-infected smart thermostats, it's no longer hypothetical. An attacker could crank up the heat and lock the IoT device until sweltering occupants paid a ransom to unlock it.

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Oh goody, a hacker could crank up the temperature of a smart thermostat to a sweltering 99 degrees and leave the IoT device like that until its owner pays a ransom to regain control.

This is no longer a hypothetical attack; two hackers showed off the first proof-of-concept ransomware for smart thermostats; an attacker could set any temperature to try to melt or freeze the occupants until the ransom is paid. This first ransomware locked the temperate at 99 degrees until the owner paid a ransom to obtain a PIN which would unlock it.

Andrew Tierney and Ken Munro of PenTest Partners demonstrated the smart thermostat ransomware at DEF CON . It only took them a few days to hack the thermostat, and this was right before the security conference, so they would not reveal the manufacturer until they could report the vulnerability to the company. This particular IoT thermostat runs a modified version of Linux, has a large LCD screen – the better to show the ransom demand – and has an SD card.

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As for what the ransomware does, Tierney Infosecurity Magazine, “It heats to 99 degrees, and asks for a PIN to unlock which changes every 30 seconds. We put an IRC botnet on it, and the executable dials into the channel and uses the MAC address as the identifier, and you need to pay one Bitcoin to unlock.”

In medical transcription they have omitted follow-up and use it as one word followup but the rules apply as if you use follow-up.

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Hi, Naomi. So a nurse would make a followup appointment and then follow up with the patient?

I am not surprised to learn that the word is beginning to be closed up.


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| October 24, 2010 at 08:02 PM

Thanks very much Lyn for your explanations. I'd like to know if I should say follow up to or follow up on something. Thanks, Adjoa

Posted by: Adjoa des Bordes | February 04, 2011 at 12:37 AM

Hi, Adjoa. Typically the correct expression is "follow up on."

Examples: I want to follow up on what we discussed. Did you follow up on Dina's request?

There are circumstances in which "follow up to" is more suitable. Here is an example: Will there be any follow-up to the training program?

I hope those examples help you.


Posted by: Lynn Gaertner-Johnston | February 04, 2011 at 02:38 PM

Hello, I am a court reporter and have this phrase come up almost everyday. 1- They recommend follow up visits. 2- I had follow ups.

Should these "follow up" phrases be hyphenated? Thank You

Posted by: Amanda | February 18, 2011 at 07:59 AM

Hi, Amanda. Your examples are similar to those I shared above in the post.

In sentence 1, the term is an adjective. In sentence 2, it is a noun.

Both examples need a hyphen.


Posted by: Lynn Gaertner-Johnston | February 18, 2011 at 09:24 PM

I'm a medical transcriptionist.

Follow-up = adjective, as in "follow-up care."

Follow up = verb, as in "will follow up tomorrow."

Followup = noun, as in "will be seen in followup."

Unfortunately, even most medical transcriptionists get it wrong. :)

Posted by: Pat | June 12, 2011 at 07:13 PM

Hi, Pat. Nearly all my reference books are still showing the noun form with a hyphen. I wonder which style manual you follow. If you see this comment, please let me know.


Posted by: Lynn Gaertner-Johnston | June 13, 2011 at 10:36 AM

Eventually it became apparent that there were serious problems with the basic approach to psychometric theory. A movement that had started by postulating one important ability had come, in one of its major manifestations , to recognize 150. Moreover, the psychometricians (as practitioners of factor analysis were called) lacked a scientific means of resolving their differences. Any method that could support so many theories seemed somewhat suspect. Most important, however, the psychometric theories failed to say anything substantive about the processes underlying intelligence. It is one thing to discuss “general ability” or “fluid ability” but quite another to describe just what is happening in people’s minds when they are exercising the ability in question. The solution to these problems, as proposed by cognitive psychologists, was to study directly the mental processes underlying intelligence and, perhaps, to relate them to the facets of intelligence posited by psychometricians.

The American psychologist John B. Carroll, in Human Cognitive Abilities (1993), proposed a “three-stratum” psychometric model of intelligence that expanded upon existing theories of intelligence. Many psychologists regard Carroll’s model as definitive, because it is based upon reanalyses of hundreds of data sets. In the first stratum, Carroll identified narrow abilities (roughly 50 in number) that included the seven primary abilities identified by Thurstone. According to Carroll, the middle stratum encompassed broad abilities (approximately 10) such as learning, retrieval ability, speediness, visual perception, fluid intelligence, and the production of ideas. The third stratum consisted solely of the general factor, g , as identified by Spearman. It might seem self-evident that the factor at the top would be the general factor, but it is not, since there is no guarantee that there is any general factor at all.

Both traditional and modern psychometric theories face certain problems. First, it has not been proved that a truly general ability best outlet buy Sanayi 313 Exclusive to mytheresacom – Gabriella slippers buy cheap choice sale Inexpensive ADEY7
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(author of this article) and Elena Grigorenko , contributors to the edited volume provided competing views of the g factor, with many suggesting that specialized abilities are more important than a general ability, especially because they more readily explain individual variations in intellectual functioning. Second, psychometric theories cannot precisely characterize all that goes on in the mind. Third, it is not clear whether the tests on which psychometric theories are based are equally appropriate in all cultures . In fact, there is an assumption that successful performance on a test of intelligence or cognitive ability will depend on one’s familiarity with the cultural framework of those who wrote the test. In her 1997 paper “You Can’t Take It with You: Why Ability Assessments Don’t Cross Cultures,” the American psychologist Patricia M. Greenfield concluded that a single test may measure different abilities in different cultures. Her findings emphasized the importance of taking issues of cultural generality into account when creating abilities tests.

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