Distracción osteogénica: definición, indicaciones y técnicas quirúrgicas

La distracción osteogénica (DO), es una técnica quirúrgica muy versátil de gran uso en la actualidad, la técnica fue ideada y realizada desde hace miles de años, pero con el pasar del tiempo y los nuevos avances, parece estar logrando increíbles resultados e innovaciones, logrando aplicarse en la Odontología justamente en el área de la cirugía máxilo facial, descrita por Snyder en 1973, quién adaptó la técnica por primera vez para el complejo craneofacial. Las múltiples ventajas que presenta la técnica, la han llevado a adquirir una creciente importancia dentro de la Odontología, ya que logra solucionar complicadas deformaciones craneofaciales (las cuales antes eran consideradas intratables), maloclusiones, atrofias de rebordes alveolares, entre otros. Como las técnicas de distracción van a generar hueso nuevo y evitan por lo tanto la morbilidad del traslado de injertos, se trata de un procedimiento menos traumático, en comparación con los otros tipos de tratamientos realizados en esta clase de deformidades óseas, incluso puede ser realizada en el consultorio del especialista bajo anestesia local. Cabe mencionar que la distracción osteogénica se viene realizando exitosamente para ganar un incremento no solo del defecto óseo a tratar, sino también de los tejidos blandos adyacentes, incluyendo la piel, musculatura y estructuras neurovasculares, todo esto a un ritmo gradual, es por ello que diversos autores consideran que la técnica quirúrgica se debería denominar distracción histogénica. El protocolo de la técnica está llegando a cierta estandarización para una mayor seguridad en su aplicación e innovadores métodos coadyuvantes están siendo descubiertos para asegurar el éxito de la distracción osteogénica, sin embargo, aún quedan muchas investigaciones por realizarse, ya que esta técnica parece prometer un futuro de soluciones. Mediante el siguiente trabajo monográfico se explicara detalladamente la definición, las indicaciones y contraindicaciones, y las diversas técnicas quirúrgicas, de esta maravillosa técnica que es la distracción osteogénica.Distraction Osteogenesis (DO) is a very versatile surgical technique of great use today, the technique was developed for thousands of years, but with the pass of time and new advances, seems to be achieving incredible results and innovations , being able to be applied in Dentistry precisely in the area of maxillofacial surgery, described by Snyder in 1973, who adapted the technique for the first time for the craniofacial complex. The multiple advantages of the technique have led to a growing importance in dentistry, as it manages to solve complicated craniofacial deformations (which were previously considered intractable), malocclusions, alveolar ridges atrophies, among others. As the distraction techniques are going to generate new bone and avoid the morbidity of the graft transfer, it is a less traumatic procedure, compared to the other types of treatments performed in this class of bone deformities, it can even be performed in the specialist's office under local anesthesia. It is important to mention that distraction osteogenesis has been successfully performed to gain an increase not only in the bone defect to be treated, but also in adjacent soft tissues, including skin, musculature and neurovascular structures, all at a gradual rate. Several authors consider that the surgical technique should be called histogenic distraction. The protocol of the technique is reaching some standardization for safer application and innovative methods are being discovered to ensure the success of the Distraction Osteogenesis, however, there are still a lot of researches to be undertaken, this technique seems promising future solutions. The following monographic work will explain in detail the definition, indications and contraindications, and the various surgical techniques, of this wonderful technique that is the Distraction Osteogenesi

L'écriture de Maryse Condé: un exemple de quête identitaire au féminin à travers la littérature

Le but de ce travail de fin d’études est d’approfondir dans l’œuvre littéraire de Maryse Condé, écrivaine guadeloupéenne qui conçoit l’écriture comme un processus pour se connaître, se poser des questions et les répondre, tout en considérant certains aspects de sa vie mouvementée et agissante qui reste liée à sa production artistique à partir de trois œuvres qui conforment le corpus principal de notre travail parce qu’ils présentent quelques-uns des thèmes et des caractéristiques particuliers de l’écriture de Maryse Condé, comme ses réflexions sur la langue, la littérature, sa condition de femme et notamment de femme noire : Le cœur à rire et à pleurer : contes vrais de mon enfance, Hérémakhonon et Traversée de la Mangrove. Notre démarche suit une perspective intersectionnelle qui tient compte essentiellement de la colonisation, de la négritude, antillanité et créolité, ainsi que du genre dans le contexte social et littéraire de l’auteure. Notre travail comporte trois parties. La première aborde l’enjeu de la langue lié à l’appartenance sociale des Antilles, et analyse la présence du débat sur l’utilisation de la langue française ou créole dans son œuvre littéraire, et, de ce point de vue, le rôle de l’éducation reçue par Condé en tant que Guadeloupéenne. La deuxième partie se centre sur la tradition littéraire des Antilles, notamment, sur les courants littéraires de la Négritude, l’Antillanité et la Créolité, à partir des thèses de Patrick Chamoiseau, Jean Bernabé et Raphaël Confiant à ce propos, exposées dans leur Éloge de la créolité, ainsi que celles de Frantz Fanon et Aimé Césaire, pour analyser leur influence dans l’œuvre de Maryse Condé, qui leur a reconnu une grande autorité à plusieurs reprises. La troisième partie constitue une approche de l’œuvre de Condé vis-à-vis de son intérêt par rapport à la situation des femmes antillaises, mais aussi une approche de sa projection dans son œuvre en tant que femme et en tant qu’écrivaine, tenant compte de son essai La parole des femmes sur les écrivaines dans la littérature antillaise, pour envisager les aspects de son œuvre qui montrent les problèmes et les aspirations des femmes dans la société guadeloupéenne

Requisas personales y violación a la dignidad e intimidad de las féminas visitantes, Chimbote

La presente tesis titulada “Requisas Personales y Violación a la dignidad e Intimidad de las Féminas visitantes. Chimbote” tiene como objetivo general: determinar si las requisas personales aplicadas a las féminas visitantes violan el derecho a la dignidad e intimidad personal en el Centro Penitenciario Cambio Puente, para ello, se han desarrollado los conceptos de Requisas personales, tipos de requisas, violación de derechos, derecho a la dignidad, derecho a la intimidad. Es un enfoque cualitativo porque surgen nuevas interrogantes en el proceso; es descriptivo porque se basa en describir un fenómeno particular a partir de la información obtenida; se fundamenta en el diseño de teorías; porque se nutre de aspectos jurídicos y lógicos argumentales. Porque se basa en la doctrina y jurisprudencia original y vigente. Es un tipo diseñado para la investigación cualitativa porque se utiliza para desarrollar teorías sobre fenómenos relevantes que se encuentran en la sociedad. Las técnicas de recogida de información han sido validadas por 3 expertos en derecho penal y procesal penal. Así se ha aplicado a 12 participantes seleccionados en base a sus conocimientos y experiencia, así tenemos: por 5 Fiscales del Distrito Fiscal del Santa, 4 trabajadores del INPE y 3 abogadas

A potential test of the CP properties and Majorana nature of neutrinos

The scattering of solar neutrinos on electrons may reveal their CP properties, which are particularly sensitive to their Majorana nature. The cross section is sensitive to the neutrino dipole moments through an interference of electro-magnetic and weak amplitudes. We show how future solar neutrino experiments with good angular resolution and low energy threshold, such as Hellaz, can be sensitive to the resulting azimuthal asymmetries in event number, and could therefore provide valuable information on the CP properties and the nature of the neutrinos, provided the solar magnetic field direction is fixed.Comment: 14 pages, 1 figure, eq. (19) corrected. Version to be publishe

Heating-induced bacteriological and biochemical modifications in human donor milk after Holder pasteurization

[Objectives]: The objectives of the present study were to enumerate and characterize the pathogenic potential of the Bacillus population that may survive holder pasteurisation of human milk and to evaluate the nutritional damage of this treatment using the furosine and lactulose indexes. [Materials and Methods]: Milk samples from 21 donors were heated at 62.58C for 30 minutes. Bacterial counts, lactose, glucose, myoinositol, lactulose, and furosine were determined before and after the heat treatment. Some B cereus isolates that survived after pasteurisation were evaluated for toxigenic potential. [Results]: Nonpasteurised milk samples showed bacterial growth in most of the agar media tested. Bacterial survival after pasteurisation was observed in only 3 samples and, in these cases, the microorganisms isolated belonged to the species B cereus. Furosine could not be detected in any of the samples, whereas changes in lactose, glucose, and myoinositol concentrations after holder pasteurisation were not relevant. Lactulose was below the detection limit of the analytical method in nonpasteurised samples, whereas it was found at low levels in 62% of the samples after holder pasteurisation. The lactation period influenced myoinositol content because its concentration was significantly higher in transition milk than in mature or late lactation milk samples. [Conclusions]: Holder pasteurisation led to the destruction of bacteria present initially in donor milk samples, except for some B cereus that did not display a high virulence potential and did not modify significantly the concentration of the compounds analyzed in the present study.The present study was supported by the 110AC0386 (CYTED), CSD2007-00063 (FUN-C-FOOD, Consolider-Ingenio 2010), and AGL2010-15420 projects from the Ministerio de Ciencia e Innovación (Spain), and by projects FIS PS09/00040 (Ministerio de Sanidad y Consumo, Spain) and S2009/AGR-1469 (Comunidad de Madrid, Spain).Peer Reviewe

Filaggrin gene mutations and new SNPs in asthmatic patients: a cross-sectional study in a Spanish population

[EN] Background: Several null-mutations in the FLG gene that produce a decrease or absence of filaggrin in the skin and predispose to atopic dermatitis and ichthyosis vulgaris have been described. The relationship with asthma is less clear and may be due to the influence of atopy in patients with associated asthma. Methods: Four hundred individuals were included, 300 patients diagnosed with asthma divided into two groups according to their phenotype (allergic and non-allergic asthma) and 100 strictly characterized controls. The coding region and flanking regions of the FLG gene were amplified by PCR. We proceeded to the characterization of potential gene variants in that region by RFLP and sequencing and analysed their association with lung function parameters, asthma control and severity, and quality of life. Results: We identified two null-mutations (R501X and 2282del4), seven SNPs previously described in databases and three SNPs that had not been previously described. One of the SNP identified in this study (1741A > T) was more frequently detected in patients with non-allergic asthma, worse FVC, FEV1 and PEF values and a higher treatment step. In addition, lowered spirometric values were observed in the non-allergic group carrying any of the nonsynonymous SNPs. Conclusions: In the association study of genetic variants of the FLG gene in our population the 1741A > T polymorphism seems to be associated with non-allergic asthma

Modulating the Synthesis of Dextran with the Acceptor Reaction Using Native and Encapsulated Dextransucrases

Dextransucrases are glucansucrases with broad applications in the food, cosmetics and pharmaceutical industries. Using sucrose as the glucosyl donor, they synthesize both high molecular weight (HMW) dextrans and potential prebiotic oligosaccharides. The process selectivity can be modulated by varying the reaction conditions. When no other molecule is present in the reaction, only dextrans are synthesized. In the presence of methyl α-D-glucopyranoside, the synthesis of methyl polyglucosides takes place, diminishing the transfer of glucose molecules to form dextran. In this work, the formation of HMW soluble dextran and methyl polyglucosides was studied with dextransucrases from Leuconostoc mesenteroides, strains B-512F and B-1299. The amount of dextran formed with dextransucrase B-512F was reduced up to 4 % with respect to the control in absence of acceptor, using a mass ratio of sucrose:methyl α-D-glucopyranoside of 1:4. The encapsulation in alginate retains the dextran inside the beads, causing a distortion of the biocatalyst and finally releasing the polysaccharides into the reaction medium

LINK-B: study protocol of a retrospective and prospective project for identification and linkage to care of people living with hepatitis B in a large health area of Barcelona

Hepatology; Telemedicine; VirologiaHepatologia; Telemedicina; VirologiaHepatología; Telemedicina; VirologíaIntroduction An estimated 290 million people are living with hepatitis B virus (HBV) worldwide; in Spain, the prevalence of hepatitis B virus surface antigen (HBsAg) is 0.4%. In our setting, many HBsAg-positive individuals are not linked to care, which implies a barrier to receiving treatment and controlling the infection. The main objective of this project is to evaluate the performance of a programme designed to achieve appropriate linkage to specialist care of HBsAg-positive individuals, newly tested or previously tested and lost to follow-up. Methods and analysis This is a retrospective and prospective study in which all HBsAg-positive cases recorded in the microbiology database will be identified. The retrospective phase will include cases detected between 2018 and 2020, and the prospective phase will run from January 2021 to June 2022. The project will be carried out in a tertiary university hospital covering the northern health area of Barcelona with a catchment population of 450 000 inhabitants and 16 affiliated primary care centres. The central laboratory detects approximately 1200 HBsAg-positive individuals every year; therefore, we expect to identify around 4000 patients over the duration of the project. The medical records of HBsAg-positive individuals will be consulted to identify and retrieve those who have not been appropriately linked to care. Candidates will be contacted to offer specialist disease assessment and follow-up. A website will be created to provide HBV-related information to primary care physicians, and a mobile phone application will be available to patients to improve the linkage circuits and ensure follow-up continuity. Ethics and dissemination The Vall d’Hebrón Hospital Ethics Committee (PR(AG)201/2021) and the Spanish Agency of Medicines and Medical Devices approved this study. The findings will be disseminated through peer-reviewed publications and conference presentations. This programme could increase the number of HBsAg-positive individuals properly linked to care and achieve better HBV monitoring, which will have a positive impact on WHO’s viral hepatitis elimination goals.This project is supported by Gilead Sciences through the competitive research 'HBV Treat' (protocol number IN-ES-320-6107)

Denervación renal en el tratamiento de la hipertensión arterial. Posicionamiento conjunto de la SEH-LELHA y la ACI-SEC

Hypertension is the most prevalent cardiovascular risk factor. Despite pharmacological treatment, a high percentage of patients do not achieve an adequate blood pressure control. Renal sympathetic denervation is a minimally invasive intervention for the management of hypertension involving the interruption of the renal artery sympathetic nervous system using a catheter-based approach. The early studies showed promising results, but the controversial results coming from the SYMPLICITY HTN-3 trial sent this technique into oblivion. Over the last 3 years, new clinical trials have appeared including new devices used in different populations, which definitively proves the effectiveness of renal sympathetic denervation. This joint position statement from the Spanish Society of Hypertension-Spanish League for Combating High Blood Pressure (SEH-LELHA), and the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) reviews the evidence available on the efficacy and safety profile of renal sympathetic denervation for the management of hypertension. Based on the results of clinical trials, recommendations have been established on what patients may be eligible for renal sympathetic denervation and under what circumstances

Barriers to linkage to care in hepatitis C patients with substance use disorders and dual diagnoses, despite centralized management

Hepatitis C virus; Dual diagnosis; Substance use disorderVirus de l'Hepatitis C; Diagnòstic dual; Trastorn per consum de substànciesVirus de la Hepatitis C; Diagnóstico dual; Trastorno por consumo de sustanciasBackground: Hepatitis C virus (HCV) management is a challenge in patients with substance use disorder (SUD). This study aimed to describe an HCV screening and linkage to care program in SUD patients, and analyze the characteristics of this population in relation to HCV infection, particularly the impact of psychiatric comorbidities (dual diagnosis). Methods: This study was a prospective clinical cohort study using a collaborative, multidisciplinary model to offer HCV care (screening, diagnosis, and therapy) to individuals with SUD attending a dedicated hospital clinic. The characteristics of the participants, prevalence of HCV infection, percentage who started therapy, and adherence to treatment were compared according to the patients’ consumption characteristics and presence of dual diagnosis. HCV screening, diagnosis, treatment initiation, and sustained virologic response were analyzed. Results: 528 individuals attended the center (November 2018–June 2019) and 401 (76%) accepted screening. In total, 112 (28%) were anti-HCV-positive and 42 (10%) had detectable HCV RNA, but only 20 of the latter started HCV therapy. Among the 253 (63%) patients with a dual diagnosis, there were no differences in HCV infection prevalence versus patients with SUD alone (p = 0.28). Dual diagnosis did not lead to a higher risk of HCV infection or interfere with linkage to care or treatment. Conclusion: This study found a high prevalence of dual diagnosis and HCV infection in SUD patients, but dual diagnosis was not associated with an increased risk of acquiring HCV or more complex access to care. Despite use of a multidisciplinary management approach, considerable barriers to HCV care remain in this population that would need more specific focus.This work was supported by AbbVie