Computer-assisted dental implant placement following free flap reconstruction: virtual planning, CAD/CAM templates, dynamic navigation and augmented reality

Image-guided surgery, prosthetic-based virtual planning, 3D printing, and CAD/CAM technology are changing head and neck ablative and reconstructive surgical oncology. Due to quality-of-life improvement, dental implant rehabilitation could be considered in every patient treated with curative intent. Accurate implant placement is mandatory for prosthesis long-term stability and success in oncologic patients. We present a prospective study, with a novel workflow, comprising 11 patients reconstructed with free flaps and 56 osseointegrated implants placed in bone flaps or remnant jaws (iliac crest, fibula, radial forearm, anterolateral thigh). Starting from CT data and jaw plaster model scanning, virtual dental prosthesis was designed. Then prosthetically driven dental implacement was also virtually planned and transferred to the patient by means of intraoperative infrared optical navigation (first four patients), and a combination of conventional static teeth supported 3D-printed acrylic guide stent, intraoperative dynamic navigation, and augmented reality for final intraoperative verification (last 7 patients). Coronal, apical, and angular deviation between virtual surgical planning and final guided intraoperative position was measured on each implant. There is a clear learning curve for surgeons when applying guided methods. Initial only-navigated cases achieved low accuracy but were comparable to non-guided freehand positioning due to jig registration instability. Subsequent dynamic navigation cases combining highly stable acrylic static guides as reference and registration markers result in the highest accuracy with a 1-1.5-mm deviation at the insertion point. Smartphone-based augmented reality visualization is a valuable tool for intraoperative visualization and final verification, although it is still a difficult technique for guiding surgery. A fixed screw-retained ideal dental prosthesis was achieved in every case as virtually planned. Implant placement, the final step in free flap oncological reconstruction, could be accurately planned and placed with image-guided surgery, 3D printing, and CAD/CAM technology. The learning curve could be overcome with preclinical laboratory training, but virtually designed and 3D-printed tracer registration stability is crucial for accurate and predictable results. Applying these concepts to our difficult oncologic patient subgroup with deep anatomic alterations ended in comparable results as those reported in non-oncologic patients.This work was supported by grant PI18/01625 (Ministerio de Ciencia e Innovación-Instituto de Salud Carlos III and European Regional Development Fund "Una manera de hacer Europa"). This study was also supported by Ticare® implants (Mozo-Grau, Valladolid, Spain). The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication

La enseñanza en el máster de abogacía a través del análisis de casos reales de carácter multidisciplinar. Aprendizaje "a partir del estudio de razonamientos parciales temáticos"

Generar blog para publicaciones de alumnos del Máster Abogacía, con "entradas" dirigidas. Habría análisis desde varias disciplinas añadiéndose estudios con enfoque basado en otras áreas de conocimiento, generando interdisciplinariedad

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population

XXV Curso Monográfico de Psiquiatría Infantil y la Adolescencia: Tópicos de Psicofarmacología Infantil - 2023

El XXV Curso Monográfico de Psiquiatría Infantil y de la Adolescencia, titulado "Tópicos de Psicofarmacología Infantil," fue un evento destacado en el campo de la salud mental infantil y adolescente. Durante tres días en septiembre de 2023, expertos líderes en la materia se reunieron para explorar a fondo la psicofarmacología en este grupo de edad. El evento, dedicado a la memoria del Dr. Francisco Javier Valencia Granados, comenzó con una ceremonia de inauguración en la que participaron autoridades institucionales. Luego, se sucedieron conferencias magistrales que abordaron una amplia variedad de temas cruciales. Estos incluyeron aspectos fundamentales como la neurobioquímica farmacológica y una introducción a la psicofarmacología. El programa se adentró en cuestiones específicas, como el uso de antipsicóticos en paidopsiquiatría, el abordaje de trastornos del aprendizaje, el tratamiento del suicidio desde una perspectiva psicofarmacológica, y la gestión farmacológica del insomnio en niños. Se exploraron temas especializados, como el tratamiento de la esquizofrenia en pacientes infantiles. El segundo día se centró en trastornos emocionales en niños y adolescentes, destacando el tratamiento del trastorno depresivo, los trastornos ansiosos y el espectro autista. Se presentaron enfoques vanguardistas, como el uso de psicodélicos en adolescentes y las novedades en psicofarmacología, como el dextrometorfano y el bupropión. También se discutió el manejo de la epilepsia y la adicción a los videojuegos. El tercer día se enfocó en el tratamiento farmacológico de trastornos pediátricos específicos, como el trastorno bipolar, el déficit de atención e hiperactividad, la enuresis y encopresis, parasomnias, y el abordaje neuropsiquiátrico en pacientes pediátricos con VIH. Se exploraron también trastornos de la conducta alimentaria y la disforia de género. El evento culminó con una reflexión sobre la salud mental en niños y un emotivo tributo al Dr. Francisco Javier

Análisis de Desempeño de Mecanismo de QoS en Redes Convergentes

En este trabajo se presenta el análisis de de resultados de una serie de simulaciones donde se analiza que mecanismo de QoS logra mantener dentro de valores admisibles los parámetros de calidad de servicio que presentan las recomendaciones Y.1540 y Y.1541 para la aplicación de voz, apoyados en un grupo de configuraciones realizadas en el núcleo de una red convergente con infraestructura MPLS

Performance analysis of scheduling algorithms in Next Generation Networks

QoS in Convergent networks is widely discussed item in IP networks. But with the implementation of the Next Generation Networks by most operators around the world, QoS for different services and applications must fulfill. In order to deal with this problem, we simulate end to end QoS parameters, according to lTV Y.1540 and Y.1541 recommendations and different scheduling algorithms proposed by manufacturers and the literature. In this paper we show the results for such simulations for voice over IP service in different load conditions

"I'm strong...I feel sicker when I'm at home than when I'm working". Man-commodity and health in bricklayers.

This paper presents the experiences and the meaning that two bricklayers, father and son, give to their bodies, in the context of a capitalist society governed by the trend towards the universalization of commerce. Some of Karl Marx's and Georg Lukács' approaches to the concepts of alienation and reification are taken up. It is considered that their heuristic scope transcends the space and time of the foundational process of immediate production in such a way that they open up a dialogue between the structural and the experiential, between the material and the emotional, between meanings. It is of particular interest to rescue, through the help of social history and oral history, the perceptions of the workers mentioned in relation to their health-illness process. Key words: alienation, reification, working time, social history, oral history, health-illness, bricklayers

Systematic Review and Meta-Analysis of the Use of Hyaluronic Acid Injections to Restore Interproximal Papillae

The absence of interdental papillae leads to the appearance of black triangles. For most patients, the appearance of these triangles is an important reason for concern and affects their social relationships. Multiple reconstruction techniques have been developed with different degrees of success and predictability. The main aim of this study was to evaluate the efficiency of hyaluronic acid (HA) injected into interproximal papillae 6 months after injection and to perform a systematic review and meta-analysis. After a systematic review, seven articles were selected: two clinical randomised controlled trials and five clinical trials. In total, 127 patients with a deficiency in upper papillae in the front of the maxilla and jaw were included in the study. The height variable was evaluated (mm) 6 months after HA injection. In total, 166 interproximal papillae were studied. Four articles showed an important difference in favour of intervention. The total result regarding in the injection of HA was favourable with an approximate average filling of 0.47 mm in the height of the interdental papilla. The injection of HA for the reconstruction of deficient papillae in the region of the upper and lower maxilla was a possible option treatment strategy in mild black triangles

Inquietos, la webserie

Treball final de Grau en Comunicació Audiovisual. Codi: CA0932. Curs acadèmic 2014-2015Este trabajo consiste en el rodaje del capítulo piloto de una webserie de ficción. Nuestra idea es poder utilizarlo, posteriormente, a modo de base para rodar los siguientes capítulos de la serie. De esta manera el trabajo está compuesto por la preproducción, rodaje y postproducción de dicha serie. Nos hemos servido de colaboraciones profesionales exteriores para nuestro Trabajo Fin de Grado. Gracias a ellos, que han contribuido a completar aquellos campos que no podíamos llevar a cabo durante rodaje. De esta manera, el grupo que hemos rodado Inquietos está formado por cinco compañeros. Cada uno se ha especializado en un campo del audiovisual: Carlos Navarro, realizador y director de fotografía, Maria Vicent, Ayudante de Dirección, Catherine B. Indio, directora de arte, Santiago Cuéllar, operador y asistente de cámara y Begoña I. Escobar, directora de producción. Hemos colaborado entre los cinco, no sólo a la hora de rodar, sino también crear desde cero el capítulo piloto que en este trabajo se va a presentar. Hoy en día resulta muy complicado crear un producto de ficción que sea de interés para todos los grupos de la sociedad y, a su vez, tenga el éxito suficiente para mantenerlo en antena. Además, resulta casi imposible que una cadena se interese en un guion de un joven estudiante. Así pues, nos encontramos en la situación de que ni los grandes medios tienen una oferta variada, ni los jóvenes encuentran salida a su situación de creadores sin éxito. El medio online podría convertirse en la mejor opción tanto para quien quiere consumir un producto específico de ficción como para quien quiere distribuir aquello que ha creado. Así surge el modelo de ficción online al que nos hemos acogido en este trabajo. Desde el grupo, hemos trabajado para sacarlo adelante, estudiando y aprendiendo competencias que hasta el momento no conocíamos, pero que necesitábamos saber para poder obtener el resultado que deseábamos, como Diseño Web y Animación. En cuanto a la serie, tal y como se comenta más adelante, hemos creado un producto de ficción, cómico y de entretenimiento. Nuestra idea era 3 poder crear un producto que el público disfrutase y se entretuviese cara al ordenador. Para poder adecuar nuestra obra, hemos tenido que investigar y analizar unos parámetros previos como nuestro público objetivo, las tendencias online en ficción y modos de distribución eficaces. La idea que tenemos por parte del equipo que formamos el Trabajo Fin de Grado es que sirva a modo de aprendizaje de nuevos conocimientos y, como empujón para continuar creando, en este caso, hasta completar la webserie.This work consists of filming the pilot episode of a web series fiction. Our Idea is to use it later as a base for the following chapters of the webserie. So, the work is composed of pre-production, filming and post-production. We have served of external professional collaborations for our final project. Thanks to them, we were able to complete those fields that could not be performed during shooting In this way, the group who has shot inquietos consists of five partners. Each one has specialized in the audiovisual field: Carlos Navarro, director and cinematographer, Maria Vicent, Assistant Director, Cathy Indio, art director, Santiago Cuellar, assistant and camera operator and Begoña I. Escobar, director of production. We have worked together and not only while shooting, we have created from scratch the pilot episode that in this work will be presented. Nowadays is very difficult to create a product of fiction that is of interest to all groups of society and, in turn, has enough success to keep you on the air. Besides, it is almost impossible for a TV network to be interested in a script of a young student. So, we are in the situation that neither the mainstream media have a wide offer or young people find out their situation as unsuccessfully creators. The online mode could become the best option for those who want to consume a specific fiction product or who wants to distribute what he has created. This is how our working model emerges. From the group, we have worked to take it forward, studying and learning skills that so far did not know, but we needed to know to get the result that we wanted, as Web Design and Animation. As for the webserie, as discussed below, we created a product of fiction, comedy and entertainment. Our idea was to create a product to entertain and amuse the public who were at the Computer. To bring our work, we had to investigate and analyze some previous parameters as our target audience, the online trends in fiction and effective distribution modes. 5 The idea that we have from the team that formed the final project is to serve as a learning of new knowledge and, as an incentive to continue creating, in this case, to complete the webseries