Osteonecrosis of the jaws and bisphosphonates : report of fifteen cases: therapeutic recommendations

Recently there have been reports of osteonecrosis of the jaw (ONJ) in patients with chronic therapy with bisphosphonates (Bps). So far three drugs have been linked: Pamidronate of disodium, Zoledronic acid and Alendronate of sodium. It is due to a non detected side effect in clinical trials before commercialization, and reverberates significantly in the quality of life of these patients. Most of the cases are seen in oncology patients that have received long term concurrent antineoplasic therapy and were treated sporadically with steroids, together with Bps endovenous, for treatment of cancer and its symptoms. Among these cases we find the reported by R.E. Marx (1), S.L. Ruggiero (2) and J. V. Bagán (3). In this report fifteen cases diagnosed, treated and followed up at the author´s surgery department are presented and some suggestions are given in order to reduce the incidence in patients with cancer who are going to receive Bps, as well as in patients with established ONJ being treated with these drugs who may need a surgical intervention

Assessment of Vitamin D Supplementation in People with Intellectual Disability

Vitamin D levels are often lower than recommended among certain groups, and these so-called at risk populations include institutionalised people with intellectual disabilities. The administration of vitamin D supplements does normalize these levels, but they tend to fall again when treatment is discontinued. The objectives of this study were, first, to assess whether the administration of 20,000 IU of cholecalciferol monthly and 60,000 IU quarterly over a year provide similar satisfactory results, and second, to explore whether the results are associated with following variables: sex, antiepileptic medication, being a wheelchair user or able to walk, and being a resident or day care user. The study population was composed of 204 individuals of both sexes cared for in four centres of the same institution. There were no differences between the levels reached with monthly and quarterly administration. The overall results show that, at the end of the test period, total 25(OH)vitamin D levels were <30 nmol/L in 3.5% of participants, 30 to < 50 nmol/L in 34%, 50 to <75 nmol/L in 41% and ≥75 nmol/L in 21.5%. There were significant differences between centres. We did not observe any harmful adverse effects attributable to the treatment. To conclude, we propose the continuous systematic administration of 60,000 IU of cholecalciferol every three months in this at-risk population

Analysis of Physical Demands in Four Tug of War World Indoor Championships (2010-2016)

Background: Tug-of-war (TOW) is one of the oldest sports in current existence and is an internationally played activity that includes professional and amateur sport athletes, played according to the rules laid out by the Tug of War International Federation (TWIF). In this type of competition, the two teams of eight members each pull against one another on a rope. The team that pulls the opposing team towards a centerline for a distance of 4 m in two pulls out of three is considered the winning team in an international competition. To the best of the authors’ knowledge, no previous scientific articles have described data during a follow-up period of Championships in TOW. Therefore, the main aim of this study was to analyze the duration of the matches, differentiating between the first (T1) and second pull (T2) of each match. Methods: The pulls were compared in the qualification point phase and the final phase, as well as in each weight category. In addition, any differences between the statistics for each of the four World Championships studied were analyzed. Finally, the total volume of pulls in each weight category was studied, both in the open club competition and in the national team competition. Data were collected from four World Indoor Championships (2010–2016). A total of 1862 matches were registered (3724 pulls), differentiating the first (T1) and second (T2) pull. The data were expressed as means (M) ± standard deviations (SD). Results: (1) The second pull is shorter than the first: T1 T1 phase1, p T2 phase1, (p < 0.05), (ES = 0.486; small effect); (3) there are statistical differences (p < 0.005) in T1 and T2 at all weights, except for T1 at 500 kg and T2 at 640 kg; (4) the comparison among World Championships does not present significant changes in the duration of the pulls; (5) however, in females, significant differences (p < 0.05) between the 2010 World Championships and the remainder in T1 are observed; (6) the volumes that we should take into account when designing the preparation should be those obtained when 11 teams compete against each other, considering the maximum volume that we could find in the competition. Conclusion: This first aspect of the reality of TOW indoor competitions, specifically the duration of the matches, leads to a better understanding of the demands of the sport and the type of effort required. These ideas may help coaches in the design of training plans, maximizing their specificity and their effectiveness.Funds have been obtained from the project number 257/24

Analysis of Tug of War Competition: A Narrative Complete Review

Tug-of-war (TOW) is an internationally played activity including professional and amateur athletes, defined as early as 4000 years ago (as a rope-less version) in the artwork on Egyptian tomb engravings, and is played as per the rules laid out by TWIF, which has 73 member countries and administrative headquarters in the USA. Typically, two teams of “pullers” participate and apply enormous contra directional forces on the pulling rope. Originally, two types of competition are used: knockout and points. This narrative review describes the scientific state of the art of TOW. To the best of the authors’ knowledge, no previous information has been published on this topic. Anthropometric parameters for competitors are near 83.6, lean body mass 69.4, and body fat 16. The VO2MAX is 55.8 mL/kg/min. In terms of relative strength, the dynamic leg power is 4659.8 N. Endurance TOW elicits minimal muscle damage. Injured strains and sprains comprised over half of all injuries: back (42%), shoulder–upper limb (23%) and knee (17%). Pulling movement in TOW contests can be divided into three phases, namely the “drop”, “hold” and “drive” phases. The maximal pulling force was 1041.6 ± 123.9 N. The percentage of dynamic pulling force in the static maximal pulling force was 75.5 ± 14.4% and the dynamic ranged from 106.4 to 182.5%. There are two gripping styles: indoor and outdoor. The friction characteristics between surface and shoe in TOW is important in determining a suitable shoe for indoor TOW. A waist belt might be a useful piece of equipment for TOW sport. The EMG technique in TOW entails a high degree of dorsal muscle activity during the pulling. The factor of force vanishing was the coordination among athletes. The force vanishing percentage goes from 8.82 ± 5.59 for two contenders to 19.74 ± 2.22 for eight athletes, 6.4% in the sum of two pullers. However, in the drop phase, for female elite TOW team, only the 0.5% of the pulling force was wasted. Future studies are need in order to understand better this historical sport activity.This research received external funding VAGI20IRR

The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study

(1) Background: Healthcare-associated infections (HAIs) after head and neck free-flap reconstruction are a common postoperative complication. Risk factors for HAIs in this context and their consequences have not been adequately described. (2) Methods: Ongoing prospective multicentre study between 02/2019 and 12/2020. Demographic characteristics and outcomes were analysed, focusing on infections. (3) Results: Forty out of 65 patients (61.54%) suffered HAIs (surgical site infection: 52.18%, nosocomial pneumonia: 23.20%, bloodstream infection: 13% and urinary tract infection: 5.80%). Methicillin-resistant Staphylococcus aureus (MRSA) and resistant Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter cloacae were the most frequently implicated. The significant risk factors for infection were: previous radiotherapy (Odds ratio (OR): 5.42; 95% confidence interval (CI), 1.39–21.10), anaemia (OR: 8.00; 95% CI, 0.96–66.95), salvage surgery (eight out of eight patients), tracheostomy (OR: 2.86; 95% CI, 1.01–8.14), surgery duration (OR: 1.01; 95% CI, 1.00–1.02), microvascular reoperation <72 h (eight/eight) and flap loss (eight/eight). The major surgical complications were: a need to reoperate (OR: 6.89; 95% CI, 1.42–33.51), prolonged hospital admission (OR: 1.16; 95% CI, 1.06–1.27) and delay in the initiation of postoperative radiotherapy (OR: 9.07; 95% CI, 1.72–47.67). The sixth month mortality rate in patients with HAIs was 7.69% vs. 0% in patients without HAIs (p = 0.50). (4) Conclusions: HAIs were common after this type of surgery, many of them caused by resistant microorganisms. Some modifiable risk factors were identified. Infections played a role in cancer prognosis by delaying adjuvant therapy

Obliteración del seno frontal mediante abordaje subcraneal con viruta ósea de calota y DBX (Demineralized Bone Matrix). Estudio de regeneración ósea en patología traumática frontal

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 21/09/2012Fac. de MedicinaTRUEunpu

Relato

Trabajo presentado en el Seminario de Sonido, Imagen y Video Digital del Departamento de Producción Multimedial, Facultad de Bellas Artes, UNLP.Facultad de Bellas Arte

Tiroides lingual: un nuevo abordaje quirúrgico

Lingual thyroid is an uncommon congenital disorder of thyroid gland development, resulting in a lack of descend of the gland from the foramen caecum to his normal prelaringeal location. In this paper we present a case of a postmenopausic patient presenting with a big size lingual thyroid deeply located in the base of the tongue, suffering increasing disphagia and respiratory impairment. For tumor resection, we chose a surgical approach combining a cervical submental incision, lingual pull- through and midline glossotomy. We discuss the different image studies recommended for proper diagnosis also reviewing the most common surgical techniques used for treatment, as compared with the approach we have described in this case.El tiroides lingual es una rara anomalía congénita del desarrollo tiroideo resultante de la ausencia de descenso del mismo desde el foramen caecum hasta la localización prelaríngea habitual. Presentamos el caso de una paciente en edad postmenopáusica con diagnóstico anatomopatológico de tiroides lingual de gran tamaño y localización profunda en la base de la lengua que producía disfagia y dificultad respiratoria crecientes. Asimismo, planteamos un nuevo abordaje quirúrgico para la resección combinando cervicotomía media, pull-through lingual y glosotomía media. Se discuten las distintas pruebas complementarias para llegar a su diagnóstico y se revisan las diferentes técnicas quirúrgicas habitualmente empleadas en su tratamiento concluyendo con las ventajas del abordaje empleado en este caso