No abstract

The trigeminocardiac reflex (TCR) is defined as the sudden onset of parasympathetic dysrhythmia, sympathetic hypotension, apnea, or gastric hypermotility during stimulation of any of the sensory branches of the trigeminal nerve. Clinically, the TCR has been reported in all the surgical procedures in which a structure innervated by the trigeminal nerve is involved. Although, there is an abundant literature with reports of incidences and risk factors of the TCR; the physiological significance and function of this brainstem reflex has not yet been fully elucidated. In addition, there are complexities within the TCR that requires examination and clarification. There is also a growing need to discuss its cellular mechanism and functional consequences. Therefore, the current review provides an updated examination of the TCR with a particular focus on the mechanisms and diverse nature of the TCR.

The purpose of this systematic review was to compare the effectiveness of problem-based learning (PBL) with that of traditional (non-PBL) approaches in dental education. The search strategy included electronic and manual searches of studies published up to October 2012. The PICO (Population, Intervention, Comparator, and Outcome) framework was utilized to guide the inclusion or exclusion of studies. The search strategy identiied 436 articles, seventeen of which met the inclusion criteria. No randomized controlled trial was found comparing the effectiveness of PBL with that of lecture-based approach at the level of an entire curriculum. Three randomized controlled trials had evaluated the effectiveness of PBL at a single course level. The quality assessment rated four studies as being of moderate quality, while the other studies were assessed as being of weak quality. This review concludes that there are a very limited number of well-designed controlled studies evaluating the effectiveness of PBL in dental education. The data in those studies reveal that PBL does not negatively inluence the acquisition of factual knowledge in dental students and PBL enhances the ability of students in applying their knowledge to clinical situations. In addition, PBL positively affects students' perceived preparedness.

We describe the discovery of the trigemino-cardiac reflex by Schaller in 1999 and the continued improvement of the knowledge about the trigemino-cardiac reflex involved in neurosurgery, especially in skull base surgery, during the past several years. The achieved medical progress could be gained only by the practical experience described by different case reports and later case series that have been published in several principal scientific journals. Additionally, we explain the scientific as well as clinical importance of the communication of the case reports on TCR. Special reference has been given to the validity of the case reports for new phenomena in clinical medicine.