Accuracy of digital planning in zygomatic implants

Background: Zygomatic implants have been described as a therapeutic alternative for patients with severe maxillary atrophy in order to avoid bone augmentation procedures. Taking that into account, in these treatments, the key factor is the position of the implant, the virtual surgical planning (VSP) is widespread among most clinicians before surgery on the patient. However, there are no studies which evaluate the clinical relevance of these VSP. The aim of this study is to determine whether digital planning on zygomatic implants has any influence on the implant dimensions and position, even when performing conventional surgery afterwards. Results: Fourteen zygomatic implants were placed in four patients. Pre-operative and post-operative helicoidal computed tomography were performed to each patient to allow the comparison between the digital planning and the final position of implants. Tridimensional deviation (TD), mesio-distal deviation (MDD), bucco-palatine deviation (BPD), and apico-coronal deviation (ACD) were evaluated as well as angular deviation (AD). Significative differences in apical TD were observed with a mean of 6.114 ± 4.28 mm (p < 0.05). Regarding implant position, only implants placed in the area of the first right molar reported significant differences (p < 0.05) for ACD. Also, implant length larger than 45 mm showed BPD significative differences (p < 0.05). Conclusions: Zygomatic implant surgery is a complex surgical procedure, and although VSP is a useful tool which helps the clinician determine the number and the length of zygomatic implants as well as its proper position, surgical experience is still mandatory.peer-reviewe

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Análisis de la Selectividad universitaria 1979

A/ Ver cuáles son las características -demográficas, sociales y económicas- de la población joven que, una vez terminada la Enseñanza Secundaria, postulan al ingreso en la Universidad presentándose a las pruebas de selección. B/ Averiguar cuál es el grado de desigualdad en las posibilidades de llegar al umbral universitario. C/ Examinar la eventual influencia de algunas variables sociales y económicas sobre los resultados obtenidos por los aspirantes al acceso a la Universidad en las pruebas de aptitud. D/ Indagar si algunos grupos sociales salen mejor parados que otros en los resultados de las pruebas. 74.238 aspirantes al ingreso en la Universidad. El presente informe tiene dos grandes apartados: el primero se refiere a los aspirantes al ingreso en la Universidad española en 1979; características básicas, donde se ofrece una panorámica de: A/ El contexto universitario español. B/ Las Universidades con mayor demanda y el origen de los aspirantes. C/ Edad y distribución por sexos. D/ Incidencia del tamaño y del status socioeconómico familiar. E/ El entorno educativo inmediato de los aspirantes: la lengua materna, procedencia de centros estatales o privados, la nota media del expediente escolar y los repetidores. Todos estos datos se sitúan en un contexto cronológico comparativo del país y de otros países de Europa. El segundo trata de 'los resultados de las pruebas de aptitud para el acceso a la Universidad', donde la hipótesis de trabajo de la que se parte es que el pertenecer a una u otra clase social, el que el padre o los padres, tengan tal o cual nivel de estudios, el que se proceda de un medio rural o de uno urbano, el que el aspirante tenga o no un trabajo remunerado, etc, son todas ellas circunstancias que harán que la probabilidad de pasar las pruebas de aptitud sea mayor para unos grupos que para otros. Estudio exploratorio. Porcentajes. Un resultado general de la primera parte del estudio, es la reducción de las desigualdades educativas: la discriminación por razón de sexo a este nivel o por el tipo de centro educativo secundario (público o privado), ha desaparecido. La discriminación regional o por el origen urbano-rural parece que está llegando a ser residual. Subsisten diferencias basadas en el status socioeconómico familiar. Por otra parte, la Universidad se está convirtiendo en 'fábrica de parados'. De la segunda parte del estudio se verifica la hipótesis: quienes aprueban más las pruebas de acceso a la Universidad son aquellos aspirantes, cuyos padres poseen titulación superior o de grado medio y ejercen una profesión urbana, pertenecen a la clase media alta, han estudiado en centros privados religiosos, habitan en localidades grandes, son becarios, no trabajan de manera remunerada, se presentan por primera vez a las pruebas de acceso, tienen entre 17 y 18 años, son pocos hermanos y poseen un buen expediente académico.MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; Fax +34917748026; [email protected]