ABSTRACT
Abstract Introduction: It is uncommon to come across patients with neuromuscular diseases in the daily practice of anesthesia, given the low prevalence of those conditions. Charcot-Marie-Tooth (CMT) disease is the most frequently, caused by an inherited abnormal myelin structure pattern. In view of the low prevalence of this condition (1:25,000), there is little information, derived mostly from case reports, about the use of neuroaxial anesthesia in these patients. Case presentation: Description of a patient with underlying CMT disease compromising lower limb mobility, who comes to the emergency service due to lower limb pain. After being diagnosed with an acetabular fracture, the patient underwent orthopedic surgery under spinal anesthesia, selected based on patient comorbidities, and the immediate postoperative follow-up. Results: The anesthetic and surgical procedures proceeded uneventfully and no neuropathic worsening was observed during the next 24 hours. Conclusion: Uneventful neuroaxial anesthesia is reported in a patient with neuromuscular disease. The case contributes to show the benefits and safety of this form of anesthesia when compared with other options.
Resumen Introducción: En la práctica anestésica diaria es raro enfrentarse a pacientes con patologías neuromusculares, dada la poca pre-valencia de dichas patologías. La más frecuente de ellas es la enfermedad de Charcot-Marie-Tooth, en la cual se hereda un patrón alterado en la estructura de la mielina. Debido a la baja prevalencia de esta patología (1:25000), el uso de anestesia neuroaxial en dichos pacientes no cuenta con mucha información, y mucha de ella proviene de reportes de casos. Presentación del caso: Se describe el caso de un paciente con enfermedad de Charcot-Marie-Tooth, de base, con compromiso de la movilidad en miembros inferiores, y quien asiste a urgencias por dolor en miembro inferior. Tras ser diagnosticado con fractura de acetábulo, fue sometido a cirugía ortopédica bajo anestesia raquídea, indicada a la luz de sus comorbilidades, y el posterior seguimiento inmediato. Resultados: Se realiza el procedimiento anestésico y quirúrgico sin complicaciones, y no se presenta empeoramiento de la neuropatía en las 24 horas posteriores. Conclusiones: Se reporta un caso de anestesia neuroaxial en paciente con enfermedad neuromuscular sin incidencias, que ayuda así a ir mostrando los beneficios de la mencionada anestesia y su seguridad frente a otras opciones.
Subject(s)
Humans , Male , Middle Aged , Charcot-Marie-Tooth Disease , Orthopedic Procedures , Anesthesia, Spinal , Surgical Procedures, Operative , Aftercare , Lower Extremity , Fractures, Bone , Acetabulum , Myelin Sheath , Neuromuscular DiseasesABSTRACT
El objetivo del presente artículo es la revisión de la literatura desde enero 2013 hasta diciembre 2017 con el fi n de encontrar el enfoque actual de la ingeniería de tejidos para regenerar la pulpa dental. Se realizó una revisión bibliográfi ca en diciembre de 2017 en el motor de búsqueda PubMed utilizando los descriptores: dental regeneration, pulp regeneration y dental pulp regeneration. La tendencia de estos últimos cinco años está dirigida mayormente al estudio de las células madre y pocos de estos estudios se han enfocado en las moléculas de señalización. Se concluyó que las DPSC fueron las más utilizadas, los escasos estudios de andamios utilizaron colágeno, a coágulo sanguíneo, plasma rico en plaquetas y una diversidad de moléculas de señalización donde prevalece el uso de fragmentos de dentina en sus diferentes formas; se utilizó un número similar de estudios in vivo e in vitro (AU)
The aim of this paper is the literature review since January 2013 until December 2017 in order to fi nd the current approach of tissue engineering to regenerate dental pulp. A bibliographic review was made on December 2017 in the PubMed search engine using the descriptors: dental regeneration, pulp regeneration and dental pulp regeneration. The trend of the last fi ve years is mainly directed to the study of stem cells and few of these studies have focused on signaling molecules. It was concluded that the DPSC were the most used, scant scaff olding studies used collagen, a blood clot, platelet-rich plasma, and a variety of signaling molecules where the use of dentine fragments in their diff erent forms prevails; a similar number of in vivo and in vitro studies were used (AU)
Subject(s)
Humans , Animals , Regeneration , Tissue Engineering , Dental Pulp , Stem Cells , Biocompatible Materials , In Vitro Techniques , Tissue ScaffoldsABSTRACT
Antecedentes: El estándar dorado para diagnosticar segundos molarescon conducto radicular en C antes del inicio de un tratamiento endodóntico restaurador es la tomografía cone beam. La difi cultad para accedera los servicios tomográfi cos y su baja distribución en los consultorios odontológicos nos han llevado a diseñar una técnica alternativa enradiografías panorámicas nombrada «evidencia del ángulo obtenido¼(EAO). Objetivo: El objetivo de este trabajo fue crear un punto de cortey estimar la precisión diagnóstica del mismo mediante un estudio pilotocuyo resultado será utilizado en una futura investigación de validación de pruebas diagnósticas...
Background: The gold standard to diagnose second molars withC-shaped root canals prior to beginning an endodontic and restorative treatment is cone-beam tomography. Tomographic services are hard to access and have a low distribution in dental clinics this has led usto design an alternative technique in panoramic radiographs named«evidence of the obtained angle¼ (EAO). Objective: The aim of thisstudy was to create a breakpoint and estimate its diagnostic accuracy through a pilot study; its results will be used in a future investigation of validation of diagnostic tests...
Subject(s)
Male , Female , Humans , Dental Pulp Cavity/anatomy & histology , Molar/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Molar/diagnostic imaging , Cone-Beam Computed Tomography , Pilot Projects , Radiography, Panoramic , Data Interpretation, StatisticalABSTRACT
Objective The aim of this study was to demonstrate the immunogenicity and safety of diphtheria, tetanus, pertussis (acellular, component) , poliomyelitis (inactivated) vaccine (adsorbed) and Haemophilus influenzae type b conjugate vaccine (DTaP-IPV//PRP-T) combined vaccine compared with commercially available DTaP (diphtheria, tetanus and pertussis), Haemophilus influenzae type b (Hib), tetanus conjugate and IPV monovalent vaccine. Methods Subjects were randomly divided into three groups, Group A and Group B were DTaP-IPV//PRP-T combined vaccine (PENTAXIMTM) vaccinated at 2,3,4 months of age or 3,4, 5 months of age respectively; Group C was commercially available DTaP. Hib tetanus conjugate (Act-HIBTM) and IPV (IMOVAX PolioTM) vaccines vaccinated at 3,4, 5 months of age. All groups received booster dose at 18 to 20 months of age, with antibody titers tested. Non-inferiority analysis was demonstrated in terms of seroprotection / seroconversion rates between Group A, Group B respectively and Group C. Safety information was collected after each vaccination to assess the safety of investigational vaccines. Results The non-inferiority of DTaP-IPV//PRP-T combined vaccine vaccinated at 2,3,4 or 3,4, 5 months of age versus DTaP, Hib tetanus conjugate and IPV vaccine was demonstrated for all vaccine antigens in both primary and booster phases in terms of seroprotection/seroconversion rates. DTaP-IPV//PRP-T combined vaccine was well tolerated. The rate of solicited/unsoliciated severe adverse reactions was very low and similar to the control vaccines. Conclusion DTaP-IPV//PRP-T combined vaccine was highly immunogenic with good safety profile in Chinese infants, which was comparable to the commercially available control vaccines.
ABSTRACT
This study assessed the booster immune response to a pentavalent combination vaccine containing diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and conjugated-Hib polysaccharide antigens, (DTaP-IPV//PRP-T, Pentaxim, an AcXim family vaccine) at 18-24 months of age. Study subjects received a three-dose primary vaccination at 2, 4 and 6 months with a hexavalent vaccine containing the same antigens plus recombinant hepatitis B surface antigen. Antibody concentrations were measured immediately before and one month after vaccination. Reactogenicity and safety were evaluated from parent reports. Before the booster dose, 92.9% of the 156 children included in this study still had anti-PRP antibody titers > or = 0.15 microg/ml. Seroprotective concentrations of anti-diphtheria, tetanus and poliovirus antibodies were maintained in 97 to 100% of subjects in the interval between primary and booster vaccination. One month after the booster dose, all subjects had seroprotective anti-PRP (> or = 1 microg/ml), diphtheria and tetanus (> or = 0.1 IU/ml) and poliovirus types 1, 2, 3 (> or = 8 1/dil) antibody levels. At least 92.3% of subjects had 4-fold increases in concentrations of anti-pertussis antigens from pre- to post-booster dose. Geometric mean titers (GMTs) increased from 3.8 to 181.2 EU/ml and from 18.0 to 289.7 EU/ml for anti-PT and anti-FHA, respectively. The anti-PRP GMT increased from 1.6 to 58.0 microg/ml. The pentavalent DTaP-IPV//PRP-T vaccine booster was well tolerated and highly immunogenic, following primary vaccination with a hexavalent vaccine.