Versatility of nasolabial flaps in oral cavity reconstructions

Objectives: Describe the techniques involved and the results obtained witn nasolabial flaps in small and medium- sized defects of the oral cavity. The procedure is an easy resconstructive option with a high success rate and with very good aesthetic and functional outcomes. Study Design: A retrospective analysis of 16 nasolabial flap reconstructions in 15 oncological patients with oral cavity defects undergoing single-stage surgical interventions. We evaluate the tumor type, its location, size, the resective and reconstructive techniques involved, as well as any complications. Results: Out of 15 patients, 9 were male and 6 female, with ages ranging from 60-85 years. The primary tumor was located in the mandibular or maxillary gingiva in 7 patients, the lateral margin of the tongue in 5, the floor of the mouth in 3 and the mandibular symphysis in a single patient. The tumors were of a small to medium size. All patients underwent intraoral resections. In most cases, a cervical dissection was performed. All flaps were completed as single-stage surgical interventions, with 14 unilateral and 2 bilateral procedures. Five patients had received radiotherapy treatment for previous tumors. During the follow up period, which ranged from 4 months to 8 years, only one patient required their flap to be thinned, there were two incidents of surgical wound dehiscence, two hematomas and one orocutaneous fistula, none of which affected the survival of the flap. Conclusions: The nasolabial flap proves highly versatile in oral cavity reconstructions, coupled with a minimal morbidity of the donor region and good aesthetic and functional results. Its high vascularity allows for cervical dissections to be carried out or even for radiotherapy to be administered prior to it. It is straightforward, safe, and carrying it out as a single-stage intervention makes it the ideal surgical option for small to medium intraoral defects in edentulous patients with other comorbidities

Parotid gland solitary fibrous tumor with mandibular bone destruction and aggressive behavior

Introduction: Solitary fibrous tumor is associated with serosal surfaces. Location in the salivary glands is extremely unusual. Extrathoracic tumors have an excellent prognosis associated with their benign clinical behavior. We report an aggressive and recurrent case of this tumor. We review the clinical presentation, inmunohistochemical profiles and therapeutic approaches. Case Report: A 73-years-old woman presented a mass in her right parotid gland. She had a past history of right superficial parotidectomy due to a neurilemoma. FNAB and magnetic resonance were non-specific. After a tumor resection, microscopic findings were spindled tumor cells with reactivity to CD34, bcl-2 and CD99 and the tumor was diagnosed as Solitary Fibrous Tumor. The patient suffered two recurrences and the tumor had a histological aggressive behavior and a destruction of the cortical bone of the mandible adjacent to the mass. A marginal mandi - bulectomy with an alveolar inferior nerve lateralization was performed. Conclusions: Solitary fibrous tumor is a very rare tumor. Usually, they are benign, but occasionally they can be aggressive. Complete resection is the most important prognostic factor and no evidence supports the efficacy of any therapy different to surgery. Due to the unknown prognosis and to the small number of cases reported, a long-term follow-up is guaranteed

Farmacovigilancia: ¿y si notificamos?

Introducción: Farmacovigilancia es la actividad de salud pública que tiene como objetivo la identificación, cuantificación, evaluación y prevención de los riesgos del uso de los medicamentos una vez comercializados, permitiendo así el seguimiento de los posibles efectos adversos. Según las últimas estadísticas del Centro Andaluz de Farmacovigilancia las notificaciones por farmacéuticos solo suponen el 9 % de las realizadas por los profesionales sanitarios. A la vista de estos datos se propuso un estudio para conocer los motivos de la falta de notificación y resolver los posibles problemas.Método: Se elaboró un cuestionario ad hoc, que se envió a todos los farmacéuticos de la provincia de Huelva.Resultados: Participaron 66 farmacéuticos. El 91 % conoce la tarjeta amarilla, dispone de ella el 45 %, conoce la vía web el 34 %, ha notificado alguna vez 34 % (7 % lo hace siempre que se encuentra una reacción adversa). El 60 % no ha notificado nunca y un 15 % piensa que no es obligatorio. Los motivos por los que no se notifica son falta de información 44 %, falta de formación 41 %, falta de tiempo 36 % y no disponer de tarjeta amarilla 29 %. Los titulares demandan una mayor información y formación. Los adjuntos ven la falta de tiempo como principal motivo de la no notificación.Discusión: Ante la poca notificación por los farmacéuticos y la importancia de este tema, se propone una campaña de concienciación entre los farmacéuticos de Huelva para mejorar estos resultados. Para ello se enviará a todos los colegiados un díptico formativo con la finalidad de resolver los principales inconvenientes de la notificación

Beckwith-Wiedemann syndrome : open bite evolution after tongue reduction

Macroglossia causes functional deficits such as airway obstruction, drooling, phonation difficulties, and leads to protrusion of dentoalveolar structures resulting in an anterior open bite and a prognathic mandibular appearance. Macroglossia is present in the majority of patients with Beckwith-Wiedemann syndrome (BWS) and surgical treatment may be indicated. A retrospective review was conducted including BWS patients who underwent surgical tongue reduction between 2000 and 2015 at the Hospital Universitario La Paz, Madrid. Out of 16 patients with BWS, surgery was performed in 11 cases. Tongue protrusion with open bite was the main indication for surgical treatment. Reduction glossectomy was performed using the keyhole technique. We analysed the relationship between age at surgery and evolution of open bite. Complications were minimal and satisfactory outcomes were observed with a decrease in anterior open bite. In this study we have observed that surgical treatment in patients with BWS and open bite accompanied by macroglossia seems to provide positive results with a satisfactory outcome in dentoskeletal alterations

Estudio para la mejora de la calidad del vino albariño

Premio de Investigación, Real Academia Galega de Ciencias, convocatoria 2009.[EN]Twenty-two clones from Albariño variety (Vitis vinifera L.), from an initial collection of 115 clones, were selected on the basis of their ampelographic, molecular and sanitary characteristics. These selected clones were studied from the agronomic and oenological point of view, and were also quantified for their levels of susceptibility to Powdery Mildew, Oidium and Botrytis. An ecotypic yeast was selected, its use has been patented and it is being exploited. Musts obtained from the previously selected Albariño clones were fermented with this yeast, essentially by increasing the content in volatile substances of interest (terpens: linalool and geraniol; norisoprenoids: α-ionone and β- damascenone), leading to wines with improved fermentative dynamic and sensorial attributes.[ES]En base a características ampelográficas, moleculares y sanitarias, se seleccionaron 22 clones de la variedad Albariño (Vitis vinifera L.), partiendo de 115 iniciales. Sobre los clones seleccionados se ha llevado a cabo un estudio agronómico y enológico, así como la cuantificación de los niveles de susceptibilidad a Mildiu, Oídio y Botrytis. Se ha seleccionado una levadura ecotípica, cuyo uso ha sido patentado y se encuentra en explotación. Con ella se fermentaron los mostos obtenidos a partir de los clones de Albariño previamente seleccionados, dando lugar a vinos con una dinámica fermentativa xPremio de Investigación, Real Academia Galega de Ciencias, convocatoria 2009 y unos atributos sensoriales mejorados, fundamentalmente en base al aumento del contenido en sustancias volátiles de interés (terpenos: linalool y geraniol; norisoprenoides: α-ionona y β- damascenona).La actividad realizada ha sido financiada, además de por la Bodega Terras Gauda S.A., por la Xunta de Galicia (PGIDIT04TAL035E), y por el propio CSIC (PIE 2004 7 0E 214).Peer reviewe

CARACTERIZACIÓN DE LA HUELLA PLANTAR EN ÁRBITROS DE FÚTBOL EN NORTE DE SANTANDER

El objetivo del presente estudio fue caracterizar la huella plantar en árbitros de fútbol de Norte de Santander. Este estudio fue descriptivo con enfoque cuantitativo y un diseño de campo con una muestra a conveniencia conformada por veintiocho hombres (edad de 22,43±3,30 años; peso corporal de 66,89±8,39 kg; Talla de 1,76±0,06 m; IMC de 21,49±2,52 kg/m2; experiencia en el arbitraje de 6,17±6,54 años). Se empleó el método HERZCO para obtener el ancho del ante pie, ancho del medio pie e índice de huella en ambos pies. El análisis de datos se realizó en el paquete estadístico Microsoft Excel 2007.  Entre los resultados obtenidos se evidenció que el pie izquierdo obtuvo las tipologías plano-normal (10,71%), normal (28,57%) normal-cavo (25%), cavo (28,57%), cavo-fuerte (3,57%) y cavo extremo (3,57%), mientras que el pie derecho presentó tipología plana (7,14%), normal (35,71%), normal-cavo (32,14%), cavo (21,42%) y cavo-fuerte (3,57%). Este estudio permitió concluir que, la huella plantar en árbitros de fútbol presentó una mayor tendencia en las categorías normal, normal-cavo y cavo en el pie izquierdo (82,19%) y derecho (89,27%)

The Palma Echo Platform: Rationale and Design of an Echocardiography Core Lab

Background: The metabolic syndrome (MetS) is associated with increased cardiovascular morbidity and mortality. Characterization of cardiac structural and functional abnormalities due to the MetS can help recognize individuals who would benefit the most from preventive interventions. Transthoracic echocardiography (TTE) provides an opportunity to identify those abnormalities in a reproducible and cost-efficient manner. In research settings, implementation of protocols for the acquisition and analysis of TTE images are key to ensure validity and reproducibility, thus facilitating answering relevant questions about the association of the MetS with cardiac alterations. Methods and Results: The Palma Echo Platform (PEP) is a coordinated network that is built up to evaluate the underlying structural and functional cardiac substrate of participants with MetS. Repeated TTE will be used to evaluate 5-year changes in the cardiac structure and function in a group of 565 individuals participating in a randomized trial of a lifestyle intervention for the primary prevention of cardiovascular disease. The echocardiographic studies will be performed at three study sites, and will be centrally evaluated at the PEP core laboratory. Planned analyses will involve evaluating the effect of the lifestyle intervention on cardiac structure and function, and the association of the MetS and its components with changes in cardiac structure and function. Particular emphasis will be placed on evaluating parameters of left atrial structure and function, which have received more limited attention in past investigations. This PEP will be available for future studies addressing comparable questions. Conclusion: In this article we describe the protocol of a central echocardiography laboratory for the study of functional and structural alterations of the MetS.Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Numbers R01HL137338 and K24HL148521, and administrative supplement to promote diversity 3R01HL137338-03S1. This work was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which was co-funded by the European Regional Development Fund (PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, and PI20/01158); the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus; the European Research Council (Advanced Research Grant 2014–2019; agreement #340918); the Recercaixa (number 2013ACUP00194); grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018); the PROMETEO/2017/017 grant from the Generalitat Valenciana; the SEMERGEN grant; none of the funding sources took part in the design, collection, analysis, interpretation of the data, or writing the report, or in the decision to submit the manuscript for publication

Orthodontically guided bone transport in the treatment of alveolar cleft: a case report

Introduction: Conventional treatments are sometimes not possible in certain alveolar cleft cases due to the severity of the gap which separates the fragments. Various management strategies have been proposed, including sequential surgical interventions or delaying treatment until adulthood to then carry out maxillary osteotomies. A further alternative approach has also been proposed, involving the application of bone transport techniques to mobilise the osseous fragments and thereby reduce the gap between lateral fragments and the premaxilla. Case Report: We introduce the case of a 10-year-old patient who presented with a bilateral alveolar cleft and a severe gap. Stable occlusion between the premaxilla and the mandible was achieved following orthodontic treatment, making it inadvisable to perform a retrusive osteotomy of the premaxilla in order to close the alveolar clefts. Faced with this situation, it was decided we would employ a bone transport technique under orthodontic guidance using a dental splint. This would enable an osseous disc to be displaced towards the medial area and reduce the interfragmentary distance. During a second surgical intervention, closure of the soft tissues was performed and the gap was filled in using autogenous bone. Conclusions: The use of bone transport techniques in selected cases allows closure of the osseous defect, whilst also preserving soft tissues and reducing the amount of bone autograft required. In our case, we were able to respect the position of the premaxilla and, at the same time, generate new tissues at both an alveolar bone and soft tissue level with results which have remained stable over the course of time

Bisphosphonate-related osteonecrosis. Application of adipose-derived stem cells in an experimental murine model

Bisphosphonate-related osteonecrosis of the jaw is a pathological condition without effective established treatment and preventive strategies. The aim of this study was to analyse the effect of adipose-derived stem cells (ASC) in an experimental murine model of osteonecrosis. 38 Wistar rats were injected intraperitoneally with zoledronic acid. After treatment, upper jaw molars were extracted. The animals were randomly assigned to one of two groups. In the control group, saline solution was applied over the alveolar sockets after the tooth extractions. In the treatment group, ASCs were applied instead of saline solution. The control and treatment groups were subdivided based on the time of euthanasia. A clinical and histological analysis was performed. The presence of osteonecrosis in alveolar bone was observed in a similar distribution in both groups. In the ASC-treated group, new bone formation was greater than in controls. In this study, application of ASCs showed greater new bone formation in an osteonecrosis-like murine model. Previous inhibited post-extraction bone remodelling could be reactivated, and these findings appeared to be secondary to implantation of ASCs

A Peculiar Distribution of the Emerging Nematode Angiostrongylus cantonensis in the Canary Islands (Spain): Recent Introduction or Isolation Effect?

Angiostrongylus cantonensis is an emerging zoonotic nematode recognized as the leading cause of eosinophilic meningitis in the word. After its discovery in China, it was recorded in 30 countries worldwide. Recently, it has expanded to new areas such as South America and it has been recently found in the Atlantic island of Tenerife (Canary Islands). In order to characterize the distribution of A. cantonensis in the Canary Islands, the lungs of 1462 rodents were sampled in eight islands of the archipelago over 13 years and were then analyzed for A. cantonensis. Remarkably, the parasite was detected only in Tenerife, in Rattus rattus (19.7%) and Rattus norvegicus (7.14%). They were concretely in the northern part of the island, which had a warmer and more humid climate than the south and main cities. The absence of this nematode in other islands with similar environmental conditions could be explained by an isolation effect or by a recent introduction of the parasite in the islands. Besides, the presence in Tenerife of the most invasive lineage of A. cantonensis reinforced the hypothesis of a recent introduction on this island. This study highlights the need to implement control measures to prevent the expansion to other areas in order to avoid the transmission to humans and other animals