Implant survival in patients with oral cancer : a 5-year follow-up

Background: To evaluate the evolution of patients rehabilitated with endosseous implants after oral cancer treatment. Material and Methods: An observational retrospective study was carried out between 1991 and 2011 with a sample consisting of patients with oral cancer who had been referred for rehabilitation to the Prosthetics Rehabilitation Unit from the Oral and Maxillofacial Surgery Unit of the Virgen del Rocío University Hospital. All these patients have overcome oral cancer, and have a five-year follow-up after their oral rehabilitation. Age, sex, smoking habits, oral pathology, type of treatment of oral pathology, edentulism, receptor bone, prosthetic rehabilitation, timeouts, working time and evolution were studied. SPSS Statistics was used for statistical analysis of the variables studied. A chi-square test centered on the survival rate of implants placed in relation to the other recorded variables was performed. Results: 17 patients were treated for cancer and rehabilitated with implant prosthetics, with a total of 106 implants placed. 32% were partially edentulous patients (4 patients), and 68.2% were completely edentulous patients (13 patients). An implant survival rate of 87.7% was observed at 5 years. In the upper maxilla, the survival rate was 79.2%, and in the mandible 93.7% ( p = 0.03). 91 implants were placed in native receptor bones (85.8%), with only 15 implants placed in grafted receptor bone (14.2%). According to the type of receptor bone, in native receptor bones, 9 implants failed (90.1% of implant survival), while in grafted receptor bones, 4 implants failed (overall 73.3% implant survival rate) ( p = 0.08). Conclusions: Although a high survival rate was obtained in this study (with lower survival rates seen in mandible and grafted bone), prospective long-term studies are needed to assess the relationship between radiotherapy doses and the time required for implant placement, prosthetic protocol used, and type of implants used in patients selected for prosthetic rehabilitation

Innovación docente en ingeniería

El objetivo del presente trabajo consiste en comparar la estructura de enseñanza-aprendizaje empleada en los cursos 2012-2013 y 2013-2014. Esta comparación se realizará tanto a nivel metodológico como mediante el estudio de los resultados obtenidos en la evaluación realizada a los alumnos. De esta manera se pretende determinar si los cambios realizados han supuesto una mejora significativa en el proceso de aprendizaje en función de los rendimientos obtenidos por los alumnos. El trabajo se va a llevar a cabo para la asignatura de Ingeniería Grafica que se imparte en la titulación de Grado en Ingeniería Química en segundo curso. Con los datos cuantitativos sobre la forma de evaluación y participación de los alumnos, junto con los resultados parciales y finales, se realizará un análisis estadístico para valorar la mejora del método y las conclusiones que se obtienen al respecto. Estos resultados nos permitirán emprender acciones futuras en cuanto a organización de las clases y metodología a emplear

Los conceptos de diversidad funcional y discapacidad: una mirada a través de directivos y responsables tecnológicos

Ministerio de Economía y Competitividad Español EDU2016 75232-

Rehabilitación protésica mediante implantes endoóseos en un paciente con fisura labio palatina bilateral

Introducción: La rehabilitación convencional mediante implantes del maxilar parcialmente edéntulo. Caso clínico:Se presenta el caso clínico de una paciente con labio leporino y fisura palatina bilateral, edéntula parcial superior, que acude al Hospital Virgen del Rocío de Sevilla para valorar las alternativas de tratamiento rehabilitador. El tratamiento más adecuado, debido a las circunstancias generales, es rehabilitar el maxilar superior con una prótesis removible mediante cuatro implantes y una sobredentadura, ocluyendo el defecto, mejorando la retención de la prótesis y slendo fácil la necesidad de higiene que se precisa en este tipo de pacientes con fisura palatina bilateral. Discusión y conclusiones: Los pacientes con labio leporino y fisura palatina son pacientes cornplejos que deben ser evaluados de forma pormenorizada antes de su lnclusión en un protocolo de tratamientos de implantes. No obstante, una vez realizado este punto, son pacientes que pueden beneficiarse de los últimos avances en este campo revolucionario de la Implantología

Management of acute diverticulitis with pericolic free gas (ADIFAS). an international multicenter observational study

Background: There are no specific recommendations regarding the optimal management of this group of patients. The World Society of Emergency Surgery suggested a nonoperative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or without pericolic fluid. Methods: A multicenter, prospective, international study of patients diagnosed with AD and pericolic-free air with or without pericolic free fluid at a computed tomography (CT) scan between May 2020 and June 2021 was included. Patients were excluded if they had intra-abdominal distant free air, an abscess, generalized peritonitis, or less than a 1-year follow-up. The primary outcome was the rate of failure of nonoperative management within the index admission. Secondary outcomes included the rate of failure of nonoperative management within the first year and risk factors for failure. Results: A total of 810 patients were recruited across 69 European and South American centers; 744 patients (92%) were treated nonoperatively, and 66 (8%) underwent immediate surgery. Baseline characteristics were similar between groups. Hinchey II-IV on diagnostic imaging was the only independent risk factor for surgical intervention during index admission (odds ratios: 12.5, 95% CI: 2.4-64, P =0.003). Among patients treated nonoperatively, at index admission, 697 (94%) patients were discharged without any complications, 35 (4.7%) required emergency surgery, and 12 (1.6%) percutaneous drainage. Free pericolic fluid on CT scan was associated with a higher risk of failure of nonoperative management (odds ratios: 4.9, 95% CI: 1.2-19.9, P =0.023), with 88% of success compared to 96% without free fluid ( P <0.001). The rate of treatment failure with nonoperative management during the first year of follow-up was 16.5%. Conclusion: Patients with AD presenting with pericolic free gas can be successfully managed nonoperatively in the vast majority of cases. Patients with both free pericolic gas and free pericolic fluid on a CT scan are at a higher risk of failing nonoperative management and require closer observation

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Observational analysis of values of the limitation of mouth opening, the limitations of the cervical mobility of the atlas (c1), the limitations of the condyles jaw of atm and presence of masseter trigger points in a population of patients with temporomandibular pathology. cross sectional study

Introducción: La patología temporomandibular es un desorden relacionado con la articulación temporomandibular (ATM) y las estructuras circundantes asociadas como los músculos masticatorios y las estructuras musculoesqueléticas asociadas de cabeza y cuello que presentan síntomas y/o signos con mucha prevalencia en la sociedad. Objetivos: Los objetivos del presente estudio fueron recoger información acerca de las variables de la limitación de la apertura oral, las limitaciones de la movilidad cervical del atlas C1, las limitaciones de los cóndilos mandibulares de la ATM y la presencia de puntos gatillo de los maseteros en pacientes con patologías temporomandibulares que no precisan de intervenciones quirúrgica para resolver su tratamiento. Así como observar si existen asociaciones entre las variables del ámbito de la Odontología y las variables clínicas del ámbito de la Fisioterapia. Material y método: Presentamos un estudio descriptivo observacional prospectivo desarrollado en 47 pacientes diagnosticados de disfunción temporomadibular, en la que se recogen datos de un cuestionario rellenado por el paciente y a través del examen físico realizado por un profesional de la Fisioterapia. De todas las variables estudiadas, destacamos la limitación de la apertura oral, las limitaciones de la movilidad cervical del atlas C1, las limitaciones de los cóndilos mandibulares de la ATM y la presencia de puntos gatillo de los maseteros en las que existen inferencias estadísticas de chi cuadrado. Resultados. Tras los resultados obtenidos podemos decir que no existe asociación entre las variables categóricas puntos gatillo masetero y limitación de cóndilo ATM derecho (p>0,05), sí existe asociación entre las variables categóricas puntos gatillo masetero y limitación cervical de atlas (C1) (p=0,048) y sí existe asociación entre las variables categóricas puntos gatillo masetero y limitación apertura oral (p=0,018). Conclusiones: A través de los resultados obtenidos, podemos concluir que sí existe una relación entre variables clínicas del ámbito de la Odontología y las variables clínicas del ámbito de la FisioterapiaIntroduction: The temporomandibular disease is a disorder related to the temporomandibular joint (TMJ) and surrounding structures associated as the masticatory muscles and musculoskeletal structures of the head and neck associated with symptoms and / or signs very prevalent in society. Objectives: The aims of this study were to collect information about variables of limited mouth opening, the limitations of cervical mobility atlas C1, limitations of mandibular condyles of the TMJ and the presence of trigger points masseter in patients with temporomandibular disorders that do not require surgical intervention to resolve their treatment, as well as to observe if there are associations between variables in the field of dentistry and clinical variables in the field of Physiotherapy. Material and Methods: we present a descriptive prospective observational study conducted in 47 patients diagnosed with Temporomandibular dysfunction, in which data are collected from a patient and filled through physical examination by a professional Physiotherapy questionnaire. We highlight from all the variables the limitation of mouth opening, the limitations of cervical mobility atlas C1, limitations of mandibular condyles of the TMJ and the presence of masseter trigger points where there are statistical inferences chi square. Results.- After the obtained results we can say that there is no association between categorical variables masseter trigger points and limitation of law TMJ (p> 0.05) condyle, the association between the categorical variables masseter trigger points and cervical limitation atlas ( C1) (p = 0.048) and the association between the categorical variables masseter trigger points and limited mouth opening (p = 0.018). Through the results, we conclude that there exists a relationship between clinical variables in the field of dentistry and clinical variables in the field of Physiotherapy

Los estudios de Antropología ante el proceso de convergencia europea

Se realiza una investigación y se adaptan los estudios de Antropología de las universidades españolas, al proceso de convergencia europea. Se constituye un grupo permanente de trabajo formado por 18 profesores y catedráticos cuya función es la de suministrar información y participar en discusiones y reuniones en distintos ámbitos académicos. Se pone en marcha el proyecto y se crea una plataforma de observación, seguimiento y participación en el proceso de convergencia europea de los estudios superiores en el ámbito de la Antropología Social. En las reuniones, se pone de manifiesto la problemática específica de los estudios de Antropología en el marco del nuevo Espacio Europeo de Educación Superior, prestando mayor atención a la modificación de la estructura curricular, a los planes de estudios y la reorganización de las competencias profesionales. Se genera material y documentación útil tanto para los profesores como para el personal académico y los alumnos interesados en el Grado de Antropología.Castilla y LeónConsejería de Educación. Dirección General de Universidades e Investigación; Monasterio de Nuestra Señora de Prado, Autovía Puente Colgante s. n.; 47071 Valladolid; +34983411881; +34983411939;ES

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit