The deep circumflex iliac artery free flap in maxillofacial reconstruction: a comparative institutional analysis

Purpose: The aim of the present study was to perform a comparative analysis of the utility, outcomes, and complications of DCIA (deep circumflex iliac artery) flap for the reconstruction of maxillofacial defects between two institutions that continue to use the DCIA flap as a reconstructive resource. Materials and methods: This retrospective analysis included a total of 68 patients (mean age 51.1 years) at the University Hospital of Parma, Parma, Italy, and the University of Maryland, Baltimore, USA, between January 2010 and April 2019. Results: No statistical differences were found in relation to the site of reconstruction (p = 0.09), bone graft quantity (p = 0.93), rehabilitation with dental implants (p = 0.464), length of hospitalization (p = 0.086), BMI (0.677), swallow function (p = 0.419), medical comorbidities (p = 0.933), pre-existing radiation (p = 0.691), adjuvant treatment (p = 0.298), ECOG-PS pre-and post-surgery (p = 0.329; p = 0.545), and flap failure: one partial failure observed (p = 0.412) and donor site morbidities (p = 0.742). A noted trend to increased risk of hernia without the use of a primary mesh repair was observed (p = 0.059). Conclusion: The DCIA free flap represents a useful and reliable reconstructive flap for maxillofacial reconstruction. Reconstructive microvascular surgeons should be proficiently trained in this flap technique for its consideration as a first-line option in maxillofacial reconstruction

Political instability and country risk: new evidence

This note presents new estimates of a probit model for the debt rescheduling, using a sample of 65 countries over the period 1984-93. Apart from economic variables, a whole range of indicators for political instability are included in the model as explanatory variables. It turns out, that none is significant with the 'correct' sign. Apparently, a detoriation of the political situation is already reflected in economic aggregates, which suggest that the influence of political factors is discounted in macroeconomic variables as included in the model

Effect of hyperbaric oxygen therapy in a patient with Wegener’s granulomatosis - case report

Ziarniniak Wegenera jest chorobą autoimmunologiczną, charakteryzującą się martwiczym i ziarniniakowym zapaleniem małych naczyń. Schorzenie to dotyczy górnych i dolnych dróg oddechowych, nerek, gałki ocznej. W 50% przypadków choroba zajmuje skórę, prowadząc do powstawania trudno gojących się owrzodzeń. W poniższej pracy przedstawiamy przypadek 23-letniej pacjentki, u której rozpoznano ziarniniaka Wegenera z zajęciem skóry małżowiny usznej prawej, z naciekiem na śluzówce jamy ustnej i asymetrią twarzy. W leczeniu, obok pulsów sterydowych oraz leczenia immunosupresyjnego, stosowano tlenoterapię hiperbaryczną, uzyskując bardzo dobry efekt terapeutyczny oraz całkowite ustąpienie zmian skórnych.Wegener’s granulomatosis is an autoimmune disease characterized by necrotizing granulomatous inflammation of small vessels. This condition concerns the upper and lower airways, kidneys, and eyes. In 50% of cases the disease affects skin, leading to the formation of non-healing skin ulcers. In this article, the case of a 23-year-old patient is presented who was diagnosed with Wegener’s granulomatosis on skin around the right outer ear, infiltration of the mucosa of the mouth and facial asymmetry. In treatment, apart from steroid pulses and immunosuppressive therapy, hyperbaric oxygen therapy was used, which led to a very good therapeutic effect, and total regression of skin lesions