Sinus elevation in patients with alveolar atrophy in implantology treatment.

Introducción. La elevación sinusal es un procedimiento quirúrgico predecible que se realiza con la finalidad de aumentar verticalmente la cantidad de hueso en la región posterior del maxilar para la rehabilitación protésica implanto-soportada. Objetivo: Caracterizar los pacientes con atrofia alveolar en el tratamiento de Implantología oral del maxilar posterior previa elevación del piso del seno maxilar. Metodología: Se realizó una investigación observacional, descriptiva y transversal en el servicio de Cirugía Máxilo Facial, Hospital “Faustino Pérez” de Matanzas, entre octubre 2017- septiembre 2019. El universo lo constituyó la totalidad de los pacientes con atrofia alveolar posterior; se tomó una muestra de 38 pacientes. Resultados: El 47% de los pacientes correspondió al rango etario 41-50 años, el sexo femenino el 82%. Se colocaron 86 implantes, el 69% en zona de premolares, 31% en molares. El 47% de los rebordes residuales tenían altura crestal menor de 5mm. Hubo un total de 51 elevaciones sinusales, el 71% fue con la técnica ventana lateral, 29% transcrestal. El 24% del abordaje ventana lateral con altura crestal menor de 5mm, 100% transcrestal entre 8-10mm. 25 cirugías fueron unilaterales y 13 bilaterales. El 17% de los implantes se colocaron simultáneos, 83% diferidos. Se registró 9.8% de complicaciones. Conclusiones: La elevación sinusal predominó en edades de 41-50 años y en el sexo femenino. Los dientes más relacionados fueron los premolares. Más de la mitad de los pacientes con gran déficit óseo. Se realizó ventana lateral en los casos con altura crestal menor de 8mm con la colocación diferida del implante. La técnica transcrestal se realizó a partir de 8-10mm con la colocación simultánea del implante. La técnica más usada fue la ventana lateral y de localización unilateral. La complicación más frecuente fue la perforación de la membrana de Schneider en la técnica ventana lateral.Introduction. Sinus elevation is a predictable surgical procedure performed in order to vertically increase the amount of bone in the posterior region of the maxilla for implant-supported prosthetic rehabilitation. Objective: Characterize patients with alveolar atrophy in the oral implantology treatment of the posterior maxilla after elevation of the floor of the maxillary sinus. Methodology: An observational, descriptive and cross-sectional investigation was carried out in the Maxillofacial Surgery service, Hospital “Faustino Pérez” in Matanzas, between October 2017-September 2019. The universe was made up of all the patients with posterior alveolar atrophy; a sample of 38 patients was taken

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Impacto social de la estrategia para disminuir la incidencia de celulitis facial odontógena: Matanzas Social impact of the strategy to determine the incidence of odontogenic facial cellulites: Matanzas

La celulitis facial odontógena es relativamente frecuente, puede convertirse en un grave riesgo vital cuando el tratamiento no es adecuado. Su incidencia es un problema de salud, demuestra que las medidas y acciones de promoción y prevención de salud no son suficientes a nivel de servicios básicos. Nuestro objetivo es caracterizar la celulitis facial odontógena en Matanzas en cuanto a edad, sexo, complicaciones, regiones anatómicas, precisar causas y factores de riesgo, evaluar tratamientos en Atención Primaria de Salud y diseñar una estrategia de intervención para disminuir su incidencia. Se realizó un estudio observacional, analítico, transversal desde enero 2006 a diciembre 2008. La muestra incluyó 49 pacientes que acudieron o fueron remitidos a los servicios de urgencias con el diagnóstico de celulitis facial odontógena. Los niños y jóvenes resultaron los más afectados, así como el sexo masculino. Los dientes incurables y los restos radiculares constituyeron las causas más frecuentes, la región anatómica prevaleciente fue la cavidad bucal. El 51% de los casos tuvieron diagnóstico de celulitis leves, siendo necesario el ingreso hospitalario para 25 pacientes, los demás tuvieron tratamiento ambulatorio. Los dientes incurables y el tratamiento inadecuado resultaron factores de riesgo. Se diseñó una estrategia de intervención para disminuir la incidencia de celulitis facial odontógena en el territorio de Matanzas, con un plan de Acción que se pondrá en práctica en el último trimestre del año.<br>The Odontogenic Facial Cellulites is relatively frequent, and it can become a serious vital risk when the treatment is inadequate. Its incident represents a health problem, showing that promotion and health prevention measures and actions are not enough at the basic service levels. Our objective was characterizing the Odontogenic Facial Cellulites in Matanzas according to age, genre, complications, anatomic regions, stating causes and risk facts, evaluating treatments in primary health care and designing an intervention strategy to diminish its incidence. The study was designed as a transversal, analytic, observational study from January 2006 to December 2008. The sample included 49 patients assisting or remitted to the urgency service with the diagnosis of Odontogenic Facial Cellulites. The results showed that the most affected were children and young persons, and the male sex. The incurable teeth and root remains are the most frequent causes; the prevalent anatomic region was the oral cavity. 51 % of the cases were diagnosed as minor cellulites, being necessary the hospital admission for 25 patients; the rest had ambulatory treatment. The incurable teeth and the inadequate treatment classified as risk facts. We designed an intervention strategy to diminish the incidence of Odontogenic Facial Cellulites in the territory of Matanzas, with a plan of action that will be put in practice in the last trimester of the year

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN