Linfoma angiocéntrico centrofacial

El linfoma angiocéntrico centrofacial es una neoplasia linfoide rara, con un diagnóstico a menudo difícil, debido al cuadro clínico inespecífico y a que muchas veces son necesarias varias biopsias para llegar a un diagnóstico correcto. Se trata de un linfoma no Hodgkin(LNH) agresivo, de localización preferente en el tracto respiratorio superior (sobre todo en cavidad nasal), y con un pronóstico ominoso, ya que la supervivencia media es de 12-18 meses aproximadamente(1). Predomina en orientales y sudamericanos, entre los 50-60 años de edad, y con ligera preferencia por el sexo masculino (2:1). Se presenta el caso de una paciente ecuatoriana que acude a nuestro servicio con edema hemifacial, rinorrea achocolatada y obstrucción respiratoria nasal de 1 mes de evolución, sin respuesta al tratamiento antibiótico y antiinflamatorio, que tras realizar varias pruebas diagnósticas se evidenció histológicamente la presencia de un linfoma T extranodal de tipo nasal (también llamado linfoma de células T angiocéntrico).The centrofacial angiocentric lymphoma is a rare lymphoid neoplasm, with an often-difficult diagnosis due to the non-specific clinical picture. On many occasions it is necessary to perform various biopsies to reach the correct diagnosis. This lymphoma is an aggressive Non-Hodgkin's (NHL) type, which is normally found in the upper respiratory tract (predominantly in the nasal cavity), and has an ominous prognosis, as the average survival rate is between 12 and 18 months (1). It is predominantly found in subjects of oriental and South American extraction, who are between the ages of 50 and 60 years and with a slight tendency towards males (2:1). This is the case study of a female Ecuadorian patient who was referred to our department with a hemifacial edema, chocolate- like rhinorrhea and nasal respiratory obstruction, which had been treated with antibiotics and anti-inflammatories for a month without success. After performing a number of diagnostic tests, it was found histologically that the patient had an extranodal T-cell lymphoma of the nasal type (also known as T-cell angiocentric lymphoma)

Fibroma cemento-osificante gingival mandibular: presentación de un caso

Presentamos el caso clínico de una mujer con un fibroma cemento- osificante gigante dependiente de la encía mandibular de 20 años de evolución. El fibroma cemento-osificante es un tumor poco frecuente, clasificado dentro de las lesiones fibroóseas. Aparece generalmente en hueso y en raras ocasiones afecta a tejidos gingivales, como ocurre en nuestro caso. Es una neoplasia de crecimiento lento y bien delimitada, lo que le confiere un carácter benigno. Con los hallazgos histológicos es difícil diferenciar el fibroma cemento-osificante de otras lesiones tales como el osteoblastoma, el osteosarcoma de bajo grado y particularmente de la displasia fibrosa. Para obtener un diagnóstico preciso es fundamental guiarnos además por la información clínica y radiológica y así llevar a cabo un tratamiento oportuno, que condicione un pronóstico excelente.We report a case of a woman presenting a giant cementoossifying fibroma depending of the mandibular gingivae. The evolution of the process was 20 years. Cemento-ossifying fibroma is a relatively rare tumour classified between fibroosseous lesions. This lesion appears within the bone although in some occasions it involves the gingivae soft tissues, as the case we present. It is a slow-growing and well-defined tumorous lesion, because of this, it is considered as a benign lesion. The histologic findings alone may be similar to other pathologies such as osteoblastoma, low-grade osteosarcoma and particularly to fibrous dysplasia. An accurate diagnosis requires careful clinical, radiological and histological correlation in order to make an optimal treatment and an excellent outcome

Climatic control on palaeohydrology and cyclical sediment distribution in the Plio-Quaternary deposits of the Guadix Basin (Betic Cordillera, Spain)

A cyclical pattern can be observed in the central sector of the Guadix Basin (southern Spain) in the Late Pliocene-Quaternary alluvial fan deposits prograding into its axial valley. A climatic significance has been attributed to this cyclicity on the basis of sedimentological and preliminary isotopic studies. The progradation phases of the alluvial fans are here attributed to more arid time intervals in which the vegetation cover would be less developed, erosion and sediment supply would be higher, and base level would be lower. In contrast, the time intervals during which the fluvial system sediments dominated the area are inferred to be wetter and base level higher, with vegetation cover retaining the soils and preventing erosion. Permanent water supply to the river would therefore facilitate the aggradation of the floodplain and prevent progradation of the fans. Starting from a litho-, bio- and magnetostratigraphical frame provided for the area, an age is assigned to the alternation of the reddish sediments of the transverse alluvial fans and the greyish to white fluvio-lacustrine sediments of the axial drainage system. A cyclicity of ca. 100 ky has been identified in most of the alluvial fan progradation phases, falling within Milankovitch high-frequency eccentricity periodicities. Correlation of the phases with insolation curves is accordingly discussed as a possible origin for the cyclicity. Finally, the results offer new insights into early hominin occupation patterns in the region, through the identification of predictable resources of permanent fresh water that would have remained available throughout the recorded time span (that includes the Early–Middle Pleistocene transition) even during times of aridification.The study was supported by the Project CGL2009-07830/BTE and the Working Group RNM-369JA

Estudio epidemiológico de las urgencias en cirugía oral y maxilofacial en un hospital general

Objective. The demand placed on emergency care units continues to increase at a growing rate, in special Maxillofacial Surgery. The objective of the study is to perform an epidemiological analyses in the emergency maxillofacial area. Design. Transversal observational study of the patients attended in the maxillofacial department in the Rio Hortega Hospital Emergency Services during one year (2002). 1.970 patients and 10 variables were analysed. Results. 1.970 patients were attended. Males (55,8%) were predominant all over females. The month of highest incidence was June (10,9%) and the day of the week Sunday (15,8%). The dominant group of age was 0-10 years (22,6%). Most common aetiology was the accidents (55,1%) and the diagnosis was maxillofacial trauma (55,6%). The treatment was medical in 58,5% of cases. Hospital admissions rate was 9,4% and a 33,1% need a revisions. The rate of patients in our hospital area was 90,3%. Conclusions. The age¿s rank more common in patients attended was between 0-10 years and most of them were male. The day with more assistencial demand was Sunday and the month June. The aetiology for assistance was accidents and traumatism was the principal diagnosis in our hospital. The treatment usually was medical.Objetivo. La demanda de asistencia en los Servicios de Urgencias Hospitalarias está en constante crecimiento desde hace varias décadas y en especial en la Cirugía Maxilofacial. El objetivo de este estudio es realizar un análisis epidemiológico de las urgencias que se producen en dicha especialidad. Diseño del estudio. Estudio transversal y observacional de pacientes atendidos por Cirugía Maxilofacial en el Servicio de Urgencias del Hospital Río Hortega de Valladolid durante el año 2002. Se analizaron 1.970 pacientes y 10 variables. Resultados. Se atendieron 1.970 pacientes, de los cuales el 55,8% fueron hombres. La mayor presión asistencial se produjo en domingo (15,8%) y en el mes de junio (10,9%). El rango de edad con mayor demanda asistencial fue de los 0 a los 10 años (22,6%). La etiología más común por la que los pacientes fueron atendidos resultaron ser los accidentes (55,1%) y el grupo diagnóstico los traumatismos (55,6%). El tipo de tratamiento inmediato más frecuente fue el médico (58,5%). Fueron ingresados el 9,4% de los pacientes y revisados en consulta un 33,1%. El 90,3% de los pacientes pertenecían al área del hospital. Conclusiones. El rango de edad más frecuente de los pacientes atendidos es de 0 a 10 años y la mayoría de los pacientes que acuden a urgencias son hombres. El día con mayor presión asistencial es el domingo y el mes con mayor número de urgencias y de ingresos es junio. La etiología por la que acuden más frecuentemente a urgencias son los accidentes y la traumatología configura la patología maxilofacial con mayor demanda de atención urgente en nuestro hospital. El tratamiento más frecuente es el médico