39 research outputs found
Vertical distraction osteogenesis of a free vascularized fibula flap in a reconstructed hemimandible for mandibular reconstruction and optimization of the implant prosthetic rehabilitation. Report of a case
Free vascularized fibular flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects (over 6 centimeters) resulting from trauma, infections or tumor resections. But, when the reconstruction involves a dentate mandible, the fibula has the limit as it does not offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Therefore, the deficiency in bone height makes implant placement impractical. We report a case of vertical distraction osteogenesis of a free vascularized fibula flap used to reconstruct a hemimandible after resection of an odontogenic myxoma, for optimization of the implant prosthetic rehabilitation. The distraction device was applied intraorally. After 10 days of latency period, distraction protocol was performed at a distraction rate of 0.5 mm per day. A consolidation period of 3 months followed. Afterwards the distraction device was removed and 3 osseointegrated dental implants were placed in the distracted area. As a result, the vertical discrepancy between the fibula and the native hemimandible was corrected. The amount of vertical height achieved after distraction was 17 milimeters. The increase of vertical bone height was stable and enabled placement of dental implants without any complications. In conclusion, we consider that vertical distraction osteogenesis of free vascularized flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation, after mandibular reconstruction following tumor surger
Melanoma de la mucosa oral: casos clínicos y revisión de la literatura
La aparición de melanomas primarios de la mucosa oral es
infrecuente. La agresividad de esta entidad y la ausencia de
protocolos de tratamiento estandarizado, hacen que el pronóstico
sea infausto. Se han relacionado la dificultad de la resección
quirúrgica con márgenes libres, la tendencia elevada a la invasión
en profundidad y las metástasis hematógenas tempranas,
como consideraciones que justifican un peor pronóstico en
relación al melanoma cutáneo. Sin embargo, no existen series
clínicas grandes, y las series de casos clínicos constituyen la
fuente principal de información en el momento actual. Ante la
ausencia de modalidades de tratamiento que aumenten substancialmente
la supervivencia a largo plazo, sugerimos el empleo
de cirugía de resección con márgenes amplios y el diagnóstico
precoz mediante la biopsia de lesiones pigmentadas melánicas
sospechosas. En el presente trabajo presentamos 2 nuevos casos
de melanoma primario de mucosa oral, con un seguimiento de
72 y 12 meses respectivamente, y realizamos una revisión de
la literatura en relación con esta rara neoplasia.The appearance of primary melanomas of the oral mucosa is
uncommon. The aggressiveness of this entity and the absence
of any standardized treatment protocol make the prognostic unfortunate.
The difficulty to obtain free surgical margins, the elevated
tendency to invade in depth and the early haematogenous
metastasis have been referred as features which may explain its
bad prognosis, even in comparison with cutaneous melanoma.
However, no large clinical series exist and actually, clinical cases
are the main source of information. Due to the absence of
any treatment modality which may substantially increase longterm
survival, we suggest the use of resective surgery with wide
margins and early diagnosis by means of biopsy for suspicious
melanotic-pigmented lesions. In this work we present 2 new
cases of primary melanoma of the oral mucosa, with a follow-up
period of 72 and 12 months respectively, and we make a review
of the literature in relation with this rare entity
Bilateral mental nerve neuropathy as the sole presenting symptom of Burkitt´s Lymphoma
There are several pathologies that may cause alteration of the lower lip sensation, therefore a differential diagnosis is needed. Among these pathologies, we have focused on intrabone growing tumours such as Burkitt’s Lymphoma.Burkitt’s Lymphoma is a malignant tumour of B-Cell lymphocyte origin, classified as a Non-Hodgkin;s Lymphoma. Three clinical subtypes are described: endemic, sporadic and HIV associated. It is characterized by very fast growing, undifferentiated lymphocytes and bone marrow infiltration. A high incidence of Burkitt’s Lymphoma has been reported in African children. It is known to have a good response to radiotherapy and chemotherapy treatment. This report describes the case of a 29 year-old Spanish man diagnosed with Burkitt’s Lymphoma, in which his first and only symptom was bilateral anaesthesia of the lower lip. We have also described the clinical evolution, steps for diagnosis and treatment
Lateral pterygoid muscle dystonia. A new technique for treatment with botulinum toxin guided by electromyography and arthroscopy
Lateral pterygoid muscle dystonia is characterized by mandibular displacement towards the opposite side of the affected muscle. It may be associated with functional disorders affecting speech, swallowing, chewing and facial symmetry. Injection with botulinum toxin is recognized as the most effective treatment. Locating the lower head of the lateral pterygoid muscle for the injection is not difficult using electromyographic guidance; however, location of the upper head is more complicated, even with electromyography. We report a case of lateral pterygoid muscle dystonia in which precise injection of the upper head was achieved with the aid of arthroscopy
Drone Applications for Emergency and Urgent Care: A Systematic Review
Introduction: In recent years, the use of drones in health emergencies has increased. Among
their main benefits are avoiding endangering rescuers, travelling long distances in a short
time, or contacting victims in risky situations; but despite their multiple advantages, their
use has not been fully demonstrated.
Study Objective: This study aims to identify the available evidence on the use of drones in
emergency health care compared to traditional health care.
Methods: Systematic review of the literature was conducted. Search protocols were developed
to locate studies that met the established selection criteria. Six experimental or quasiexperimental
studies with high methodological quality published from the beginning of
indexing until 2020 were included.
Results: Drones covered a significantly larger area than other traditional tracking methods
and were very useful for performing preliminary triage, determining needs, and knowing the
scene prior to the arrival of rescuers. In addition, drones reduced the time required to locate
the victim.
Conclusions: Drones are an element to be taken into account when attending health emergencies
as they significantly improve the distance travelled to locate accident victims, have
the possibility of performing triage prior to the arrival of the health care units, and improve
the time and quality of the care provided
Sinus elevation by in situ utilization of bone scrapers : technique and results
Objectives: The objective was to present a novel technique for antrostomy performed before sinus elevation in atrophic maxilla for subsequent implant placement. Material and methods: The study included 10 sinus elevations performed by the proposed technique in nine consecutive patients presenting with inadequate posterior maxillary height. The technique is described, calculating the antrostomy surface area, volume of bone tissue obtained and final height attained in each case. A total of 16 implants were placed. Results: All ten elevations were accomplished. Mean antrostomy surface area was 0.55 mm2 , mean bone volume obtained was 0.56 cm3 and mean height attained was 11.7 mm from a baseline mean height of 5.6 mm. Out of the 16 implants, 14 were inserted immediately after the elevation and 2 were inserted in a second step, after ossification; 93.7% of the implants were osseointegrated at 6 months after prosthesis placement. Conclusion: The use of bone scrapers to create antrostomy for sinus elevation is a simple and very safe procedure. It provides a variable amount of particulate bone graft that is easily handled and highly useful for packing the cavity that will elevate the sinus membrane
Development of the Aerial Remote Triage System: Result of a survey of international expert
The use of drones for triage in mass-casualty incidents has recently emerged as a promising
technology. However, there is no triage system specifically adapted to a remote usage. Our
study aimed to develop a remote triage procedure using drones. The research was performed
in three stages: literature review, the development of a remote triage algorithm using
drones and evaluation of the algorithm by experts. Qualitative synthesis and the calculation
of content validity ratios were done to achieve the Aerial Remote Triage System. This algorithm
assesses (in this order): major bleeding, walking, consciousness and signs of life; and
then classify the injured people into several priority categories: priority 1 (red), priority 2 (yellow),
priority 3 (green) and priority * (violet). It includes the possibility to indicate save-living
interventions to injured people and bystanders, like the compression of bleeding injuries or
the adoption of the recovery position. The Aerial Remote Triage System may be a useful
way to perform triage by drone in complex emergencies when it is difficult to access to the
scene due to physical, chemical or biological risks
Multimedia means for professional guidance
El contexto de cambio en que nos ha tocado vivir plantea considerables retos a los procesos
educativos y formativos. La orientación pretende aportar en esta situación un
proceso de ayuda técnica que dote al individuo de los instrumentos y herramientas
necesarias para hacer frente a dichas demandas. Con este propósito hemos abordado
el diseño de una herramienta telemática para la formación de los orientadores, que
presentamos en este trabajoThe changing context in which we are living raises considerable challenges in the educational
and formative processes. Vocational guidance tries to bring the technical assistance
that provides the individuals with the instrument and tools which are necessary
to face these demands. With this intention, the authors have designed a telematic tool
for the formation of the guiders, which they present in this paper
Land- and water-based exercise intervention in women with fibromyalgia: the al-andalus physical activity randomised controlled trial
Background
The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia.
Methods/Design
One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables.
Discussion
Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia.This study was supported by the Consejeria de Turismo, Comercio y Deporte (CTCD-201000019242-TRA), the Spanish Ministry of Science and Innovation (I + D + I DEP2010-15639, grants: BES-2009-013442, BES-2011-047133, RYC-2010-05957, RYC-2011-09011), the Swedish Heart-Lung Foundation (20090635), the Spanish Ministry of Education (AP-2009-3173), Granada Research of Excelence Initiative on Biohealth (GREIB), Campus BioTic, University of Granada, Spain and European University of Madrid. Escuela de Estudios Universitarios Real Madrid. 2010/04RM
Diminishing benefits of urban living for children and adolescents’ growth and development
Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified