Speech therapy and Dentistry in the use of Cephalometry as a tool in the diagnosis of velopharyngeal dysfunction

Los análisis de cefalometría ofrecen información sobre las estructuras de la cabeza, que posibilitan un mejor entendimiento del desarrollo de las funciones orales. Las áreas de intervención odontológica y fonoaudiológica, son específicamente las más beneficiadas por los datos normativos obtenidos por la cefalometria, que optimiza el manejo de alteraciones de funciones como la respiración, succión, masticación, deglución y habla. Con respecto al habla, es posible un mejor entendimiento sobre el esfínter velofaríngeo, mediante el estudio de las medidas obtenidas por la cefalometría, particularmente, la extensión del velo del paladar (EXT), el espesor del velo del paladar (ESP) y la profundidad de la nasofaringe (PNF). Esas medidas pueden ser calculadas usando tanto una imagen congelada de la velofaringe en reposo, obtenida durante videofluoroscopía (disponible apenas para pacientes con DVF), como usando la teleradiografia (obtenida para lineamiento del tratamiento ortodóncico). En el abordaje de las anomalías craneofaciales, las medidas cefalométricas de EXT, ESP y PNF son una importante herramienta para el mejor conocimiento del desarrollo facial, de las estructuras velofaríngeas, de los espacios faríngeos y del manejo de la disfunción velofaríngea (DVF). Dicho conocimiento permite realizar mejores diagnósticos y facilita la planificación del tratamiento, tanto en la clínica como en la investigación.Cephalometric analysis offers information of the head structures, which allow a better understanding of the development of oral functions. Odontology and speech pathology are the areas of intervention specifically most benefited by the normative data obtained by cephalometry, which optimizes the management of alterations of structures and the relationship with functions, such as reathing, sucking, chewing, swallowing and speaking. Regarding to speech, a better understanding of the velopharyngeal sphincter is possible, by studying the measurements obtained by cephalometry, particularly velar length (VL), velar width (VW), depth of the nasopharynx (DN). These measurements can be calculated using both a frozen image of the resting velopharynx, obtained during videofluoroscopy (available only for patients with DVF), and using cephalometric radiographs (obtained for orthodontic treatment). In the approach to craniofacial anomalies, cephalometric measurements VL, VW and DN are an important tool for a better understanding of facial development, velopharyngeal structures, pharyngeal spaces and the management of velopharyngeal dysfunction (DVF). This knowledge allows a better diagnoses and facilitates treatment planning, both in the clinical and research.Fil: Denegri, María Alicia. Universidad Nacional de Cuyo. Facultad de OdontologíaFil: de Cássia Rillo Dutka, Jeniffer . Universidad Estadual de Sao Paulo (Brasil)Fil: Godoy, Patricia . Universidad Nacional de Cuyo. Facultad de OdontologíaFil: Fernández Salto, María Laura . Universidad Nacional de Cuyo. Facultad de Odontologí

Report of experience in the use of palate prosthesis

La disfunción velofaríngea (DVF) es el resultado de un inadecuado funcionamiento de estructuras dinámicas que trabajan para controlar el mecanismo velofaringeo, (paladar blando, las paredes laterales y pared posterior de faringe) que separa las cavidades nasal y oral durante el habla. La DVF, causada por falta de tejidos se denomina insuficiencia velofaríngea (IVF), y es un factor generador de problemas en el habla por defecto estruc-tural, que requiere tratamiento de manejo físico pudiendo ser este abordado desde la reparación quirúrgica o con prótesis de paladar1, 2.La corrección de la IVF debe ser realizada por un equipo interdisciplinario3. Método: se confeccionaron las correspondientes prótesis de paladar en cuatro pacientes adolescente/adultos seleccionados, sin posibilidades de reparación quirúrgica del esfínter velofaríngeo. Se realizó seguimiento, control y terapia. Se analizaron los resultados obtenidos. Conclusiones: Los resultados positivos solo fueron observados claramente en los pacientes que realizaron su tratamiento fonoaudiológico específico luego de la colocación de su prótesis de paladar obturadora con bulbo.Velopharyngeal dysfunction (DVF) is the result of an inadequate functioning of dynamic structures who work to control the velopharyngeal mechanism (soft palate, lateral walls and posterior pharyngeal wall) that separates the nasal and oral cavities during speech. FVD, caused by lack of tissues, is called velopharyngeal insufficiency (IVF), and it is a factor that generates problems in speech due to a structural defect, which requires physical manage ment treatment, which can be approached from surgical repair or with palatal prosthesis1,2. The correction of the IVF must be carried out by an interdisciplinary team3. Method: the corresponding palate prostheses were made in four selected adolescent / adult patients, without the possibility of surgical repair of the velopharyngeal sphincter. Follow-up, control and therapy were carried out. The results obtained were analyzed. Conclusions: The positive results were only clearly observed in the patients who underwent their specific speech therapy treatment after the placement of their bulbous obturator palate prosthesis.Fil: Fernández Salto, María Laura . Universidad Nacional de Cuyo. Facultad de OdontologíaFil: Denegri, María Alicia. Universidad Nacional de Cuyo. Facultad de OdontologíaFil: Monllor, María Laura. Mendoza. Ministerio de SaludFil: González Marotta, Alejandra. Mendoza. Ministerio de SaludFil: Díaz, Daniel. Universidad Nacional de Cuyo. Facultad de OdontologíaFil: Aferri, Homero Carneiro. Universidade de São Paulo (Brasil)Fil: Dutka, Jeniffer de Cássia Rillo. Universidade de São Paulo (Brasil

doi.org/10.1371/journal. pone.0250796

The aim was to analyze the characteristics and predictors of unfavorable outcomes in solid organ transplant recipients (SOTRs) with COVID-19. We conducted a prospective observational cohort study of 210 consecutive SOTRs hospitalized with COVID-19 in 12 Spanish centers from 21 February to 6 May 2020. Data pertaining to demographics, chronic underlying diseases, transplantation features, clinical, therapeutics, and complications were collected. The primary endpoint was a composite of intensive care unit (ICU) admission and/or death. Logistic regression analyses were performed to identify the factors associated with these unfavorable outcomes. Males accounted for 148 (70.5%) patients, the median age was 63 years, and 189 (90.0%) patients had pneumonia. Common symptoms were fever, cough, gastrointestinal disturbances, and dyspnea. The most used antiviral or host-targeted therapies included hydroxychloroquine 193/200 (96.5%), lopinavir/ritonavir 91/200 (45.5%), and tocilizumab 49/200 (24.5%). Thirty-seven (17.6%) patients required ICU admission, 12 (5.7%) suffered graft dysfunction, and 45 (21.4%) died. A shorter interval between transplantation and COVID-19 diagnosis had a negative impact on clinical prognosis. Four baseline features were identified as independent predictors of intensive care need or death: advanced age, high respiratory rate, lymphopenia, and elevated level of lactate dehydrogenase. In summary, this study presents comprehensive information on characteristics and complications of COVID-19 in hospitalized SOTRs and provides indicators available upon hospital admission for the identification of SOTRs at risk of critical disease or death, underlining the need for stringent preventative measures in the early post-transplant periodThis study was supported by Plan Nacional de I+D+i 2013-2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016); co-financed by European Development Regional Fund “A way to achieve Europe”, Operative Program Intelligence Growth 2014-2020. EC and JSC received grants from the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Proyectos de Investigación sobre el SARSCoV-2 y la enfermedad COVID-19 (COV20/ 00370; COV20/00580). JSC is a researcher belonging to the program “Nicola´s Monardes”(C0059–2018), Servicio Andaluz de Salud, Junta de Andalucía, Spain. SS-A is supported by a grant from the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Proyectos de Investigación sobre el SARS-Co

Risk factors for unfavorable outcome and impact of early post-transplant infection in solid organ recipients with COVID-19: A prospective multicenter cohort study

The aim was to analyze the characteristics and predictors of unfavorable outcomes in solid organ transplant recipients (SOTRs) with COVID-19. We conducted a prospective observational cohort study of 210 consecutive SOTRs hospitalized with COVID-19 in 12 Spanish centers from 21 February to 6 May 2020. Data pertaining to demographics, chronic underlying diseases, transplantation features, clinical, therapeutics, and complications were collected. The primary endpoint was a composite of intensive care unit (ICU) admission and/or death. Logistic regression analyses were performed to identify the factors associated with these unfavorable outcomes. Males accounted for 148 (70.5%) patients, the median age was 63 years, and 189 (90.0%) patients had pneumonia. Common symptoms were fever, cough, gastrointestinal disturbances, and dyspnea. The most used antiviral or host-targeted therapies included hydroxychloroquine 193/200 (96.5%), lopinavir/ritonavir 91/200 (45.5%), and tocilizumab 49/200 (24.5%). Thirty-seven (17.6%) patients required ICU admission, 12 (5.7%) suffered graft dysfunction, and 45 (21.4%) died. A shorter interval between transplantation and COVID-19 diagnosis had a negative impact on clinical prognosis. Four baseline features were identified as independent predictors of intensive care need or death: advanced age, high respiratory rate, lymphopenia, and elevated level of lactate dehydrogenase. In summary, this study presents comprehensive information on characteristics and complications of COVID-19 in hospitalized SOTRs and provides indicators available upon hospital admission for the identification of SOTRs at risk of critical disease or death, underlining the need for stringent preventative measures in the early post-transplant period

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Los inicios del Catastro de Rústica en la provincia de Santa Cruz de Tenerife y la colección de fotografía aérea de 1954

El primer vuelo fotográfico con aplicación catastral de las Islas Canarias se realizó en 1954. En la actualidad, las fotografías aéreas se conservan en el Archivo Histórico Provincial de Santa Cruz de Tenerife. Su calidad y estado de conservación son bastante deficientes, pero los importantes cambios socieconómicos ocurridos en las islas a mediados del siglo pasado refuerzan el valor de muchas imágenes, que pueden ser particularmente útiles en los estudios de dinámica del paisaje.The beginnings of Rural Land Cadastral Recording in Santa Cruz de Tenerife and the 1954 aerial photography.- The first aerial photographs with cadastral purposes in the Canary Islands were taken in 1954. At present, the photographs are kept in the Archivo Histórico Provincial of Santa Cruz de Tenerife. Even though their quality and conservation conditions aren't good, the important socioeconomic changes which took place in the islands during the last half of the past century increased the interest in these images, which can be particularly useful from the point of view of landscape dynamics studies.Le premier survol photographique des Îles Canaries a finalité cadastrale eut lieu en 1954. Les photographies aériennes qui en résultèrent sont aujourd'hui gardées dans l'Archive Historique Provinciale de Santa Cruz de Tenerife. Leur qualité et leur état de conservation sont certes assez déficients, mais l'évolution socioéconomique que les Îles Canaries ont connue depuis la moitié du siècle dernier a renforcé la valeur de beaucoup de ces images, car elles peuvent être particulièrement utiles pour des études de dynamique du paysage

Fuentes para el estudio de la evolución de las superficies forestales de la isla de Tenerife

El objeto de esta comunicación es exponer las características principales de las fuentes de información y procedimientos de análisis utilizados para analizar la evolución histórica de los bosques de Tenerife, relacionando la dinámica de las formaciones forestales con la presión antrópica padecida, en función de las vicisitudes sociales y económicas experimentadas a lo largo del período histórico que abarca desde el siglo XVII hasta la actualidad. Las principales fuentes documentales de esta investigación se han localizado en los archivos municipales y en el archivo de la Jefatura Provincial de Montes. De los primeros, se han obtenido 46 expedientes de deslindes de montes (autos judiciales, apeos y reconocimientos de mojones, y deslindes); la mayoría de ellos fechados en el siglo XVIII. Este tipo de fuentes se interrumpe en el siglo XIX por la destrucción física de la documentación, laguna documental que ha podido solventarse parcialmente mediante la consulta de los catálogos de montes. De ellos, el más antiguo localizado data de 1859

Cytokine and granzyme B production after PBMC stimulation with SLA for 5 days.

<p>IFN-γ, granzyme B, TNF-α, IL-10, IL-5, IL-17A, IL-2 and IL-4 concentrations (pg/ml) were measured in culture supernatants of 12 NVL_lp+ subjects, 7 NVL_lp- subjects, and 5 CVL subjects. *p<0.05, **p<0.01, ***p<0.001.</p

Linear regression of IFN-γ and IL-2 responses in plasma from SLA-stimulated whole blood plasma in NVL_lp+ subjects.

<p>A significant correlation was detected between these variables (r = 0.616, P = 0.018).</p

Linear regression of stimulation index and IFN-γ in plasma from SLA-stimulated whole blood plasma from NVL_lp+ subjects.

<p>A significant correlation was detected between these variables (r = 0.881, P = 0.002).</p