Síndrome autoimune induzida por adjuvantes (ASIA) sinais e sintomas experienciados por mulheres / Implementation of an intravenous therapy team based on convergent-assistance research / Síndrome autoinmune inducido por adyuvante (ASIA) signos y síntomas experimentados por mujeres

Objetivo: Identificar sinais e sintomas experienciados por mulheres com síndrome autoimune induzida por adjuvantes (ASIA) devido ao uso de prótese mamária e os tratamentos realizados. Método: Estudo de campo de abordagem qualitativa realizado por meio de entrevistas online utilizan-do-se a técnica bola de neve. Incluíram-se 13 participantes. Resultados: A partir da análise dos dados, foram elencadas quatro categorias: conhecimento acerca da síndrome; sinais e sintomas; tratamento; e cuidados e implicações de Enfermagem. Identificaram-se mais de 120 sinais e sintomas, e o explante foi mencionado como tratamento definitivo por todas as entrevistadas. Os sinais e sintomas apresentados pelas participantes vão ao encontro do que é descrito pela literatura. Conclusão: Antes da descoberta da doença, as participantes realizaram tratamento com foco no alívio dos sintomas. Após o diag-nóstico, todas as mulheres procederam com o explante

Objective: To identify signs and symptoms experienced by women with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) due to the use of breast implants and the treatments performed. Method: Field study with a qualitative approach carried out through online interviews using the snowball technique. 13 participants were included. Results: Based on data analysis, four categories were listed: knowledge about the syndrome; signs and symptoms; treatment; and nursing care and implications. Over 120 signs and symptoms were identified, and the explant was mentioned as a defi-nitive treatment by all interviewees. The signs and symptoms presented by the participants are in line with what is described in the literature. Conclusion:Before discovering the disease, the participants underwent treatment focused on symptom relief. After diagnosis, all women proceeded with the explant.Keywords: Autoimmune diseases. Prothesis implantation. Breast implantation. Silicones. Perioperative nursing

Objetivo: Identificar los signos y síntomas experimentados por mujeres con síndrome autoinmune inducido por adyuvantes (ASIA) debido al uso de implantes mamarios y los tratamientos realizados. Método: Estudio de campo con enfoque cualitativo realizado a través de entrevistas en línea utilizando la técnica de bola de nieve. Se incluyeron 13 participantes. Resultados: Con base en el análisis de los datos, se enumeraron cuatro categorías: conocimiento sobre el síndrome; signos y síntomas; tratamiento; y cuidados e implicaciones de enfermería. Se identificaron más de 120 signos y sínto-mas, y todos los entrevistados mencionaron el explante como tratamiento definitivo. Los signos y síntomas presentados por los participantes están en línea con lo descrito en la literatura. Conclusión: Antes de descubrir la enfermedad, los participantes realizaban un tratamiento enfocado en el alivio de los síntomas. Después del diagnóstico, todas las mujeres procedieron al explante

Validez y confiabilidad de un cuestionario sobre satisfacción en usuarios de prótesis dentales totales / Validity and Reliability of a Questionnaire on Treatment Satisfaction among Patients Wearing Complete Dentures / Validade e confiabilidade de um questionário de satisfação em usuários de próteses dentárias totais

Introducción: evaluar la satisfacción con los tratamientos requiere cuestionarios específicos y validados que garanticen una prestación del servicio adecuada y que contribuya al bienestar de las personas. El objetivo fue evaluar la validez y la confiabilidad de la versión colombiana de un cuestionario sobre satis-facción en una población de usuarios de prótesis total. Materiales y métodos: se realizó un estudio de evaluación de tecnología diagnóstica con una población de 226 pacientes, a partir de las características sociodemográficas y los diez ítems del instrumento. Se analizó la consistencia interna, la reproducibilidad prueba-reprueba y los límites de acuerdo de Bland y Altman. Así mismo, se analizaron los componentes y se aplicó el modelo de Rasch. Resultados: participaron 158 (69.91 %) mujeres y la mediana de edad fue de 69 años. Se obtuvieron un alfa de Cronbach de 0.90 y un coeficiente de correlación intraclase de 0.91. Se identificaron dos factores, los diez ítems se ajustaron al modelo de Rasch y no se observó un funcionamiento diferencial del ítem. Conclusiones: la versión colombiana del cuestionario presentó excelente confiabilidad y las medidas obtenidas explicaron el 58.60 % de la varianza.

Introduction: Evaluating treatment satisfaction requires a specific and validated questionnaire that can obtain information about adequate service provision and contribute to people's well-being. The objective of this study was to evaluate the validity and reliability of the Colombian version of a questionnaire on satisfaction among complete denture wearers. Materials and methods: This survey evaluated diagnostic technology used among 226 patients. Information on sociodemographic characteristics was obtained and ten items of the instrument were evaluated. Internal consistency, test-retest reproducibility, and Bland-Altman limits of agreement were analyzed. Component analysis was performed and the Rasch model was used. Results: Median age of the participants was 69 (ric: 63-76) years, and 158 (69.91%) were women. Cronbach's alpha and intraclass correlation coefficients were 0.91 and 0.80, respectively. Two factors were identified, all ten items conformed to the Rasch model and no differential item functioning was observed. Conclusions: The Colombian version of the questionnaire showed excellent reliability, and the proportion of variance explained by the measures was deemed satisfactory (58.60%).

Introdução: a avaliação da satisfação com os tratamentos requer questionários específicos e validados, que garantam uma prestação de serviço adequada e contribuam para o bem-estar das pessoas. O obje-tivo é avaliar a validade e confiabilidade da versão colombiana de um questionário de satisfação em uma população de usuários de próteses dentárias totais. Materiais e métodos: foi realizado um estudo de avaliação de tecnologia diagnóstica com uma população de 226 pacientes. Foram avaliadas as carac-terísticas sociodemográficas e os dez itens do instrumento. A consistência interna, a reprodutibilidade teste-reteste e os limites de concordância foram analisados de acordo com Bland e Altman. Foi reali-zada uma análise de componentes e aplicado o modelo Rasch. Resultados: participaram 158 (69,91%) mulheres, a mediana de idade foi de 69 anos. Obteve-se um alfa de Cronbach de 0,90 e um coeficiente de correlação intraclasse de 0,91. Dois fatores foram identificados, os dez itens se ajustaram ao modelo Rasch e nenhum funcionamento diferencial dos itens foi observado. Conclusões: A versão colombiana do questionário apresentou excelente confiabilidade e as medidas obtidas explicaram 58,60% da variância.

Influence of ceramic primers on microshear bond strength to zirconia

This study aimed to investigate the effect of two ceramic primers on the microshear bond strength (µSBS) of yttria-stabilized zirconia (Y-TZP) to two types of self-adhesive resin cement and one BisGMA-based resin cement. Zirconia specimens were sandblasted with 27-µm aluminum oxide and composite cylinders were cemented with resin cement with or without the prior use of ceramic primers. Nine groups (n=12) were randomly distributed according to the cement (self-adhesive RelyX U200/3M ESPE, self-adhesive Maxcem Elite/Kerr, and BisGMA-based dual-cure RelyX ARC/3M ESPE) and ceramic primer (Z-Primer Plus/Bisco and Porcelain Liner M/Sun Medical Co.). After luting, the specimens were stored in distilled water at 37°C for 24 hours and then submitted to the µSBS test. The data were analyzed with two-way ANOVA followed by the Scheffe post hoc test (p<0.05). There were significant differences between RelyX U200 and other groups. There were also significant differences between the RelyX U200 group without ceramic primer and other groups without ceramic primers (p<0.05). Self-adhesive resin cement (RelyX U200 and MaxCem) presented higher microshear bond strength (6.17 and 2.32 MPa) than the conventional resin cement (RelyX ARC) when a porcelain primer was not used (0.43 MPa). When using Porcelain Liner M, the results of RelyX ARC (2.94 MPa) were equivalent to the results of self-adhesive cement (3.93 and 2.11 MPa). When using Z-Prime Plus, the results of MaxCem (5.36 MPa) were lower than those of RelyX U200 (9.59 MPa) but equivalent to those of RelyX ARC (6.07 MPa). When using the RelyX ARC, the use of both ceramic primers improved bond strength to zirconia. When using self-adhesive resin cement, Z-Prime Plus improved microshear bond strength values. It can be concluded that, after 24 hours, the highest µSBS results were obtained when using Z-Prime Plus and RelyX U200 self-adhesive cement.

Caracterización de pacientes con fractura de cadera, intervenidos con artroplastia / Characterizing Patients with Hip Fracture, Operated with Arthroplasty

Introducción: Las lesiones traumáticas de la cadera ocupan uno de los propósitos más importantes de la cirugía traumatológica. El uso de la artroplastia como regla de oro en el tratamiento quirúrgico de las mismas, es el fundamento del trabajo. Objetivo: Caracterizar los pacientes con diagnóstico de fractura de cadera, intervenidos con artroplastia total y parcial y estudiar la mortalidad, según el tipo de prótesis utilizada. Métodos: Se realizó un estudio descriptivo de corte transversal retrospectivo en 1506 pacientes del Hospital Ortopédico Docente Fructuoso Rodríguez entre 2015 y 2019, portadores de fractura de cadera, y tratados con artroplastia. Se analizaron variables tales como edad, sexo y comorbilidades presentes. Resultados: Se colocaron prótesis totales a 427 pacientes y en 1079 se utilizó la modalidad de prótesis parcial. Predominaron las personas entre 61 y 80 años de edad. El sexo femenino prevaleció en el estudio, con una relación 3:1. Predominó el grupo de pacientes con 1 o 2 enfermedades asociadas. La mortalidad < 30 días resultó el 1,1 por ciento y ≥ 30 días el 9,2 por ciento. Conclusiones: La utilización de prótesis totales dista mucho de la media interpuesta actualmente en el mundo, donde la prótesis total se maneja como herramienta de elección. Las prótesis parciales quedan reservadas para pacientes que tienen una corta expectativa de vida y muy poco validismo(AU)

Introduction: Traumatic hip injuries occupy one of the most important purposes of trauma surgery. The use of arthroplasty as a golden rule in their surgical treatment is the foundation of the work. Objectives: To characterize patients with a diagnosis of hip fracture, who underwent total and partial arthroplasty and to study mortality, according to the type of prosthesis used. Methods: A descriptive retrospective cross-sectional study was carried out in 1506 patients from Fructuoso Rodríguez Orthopedic Teaching Hospital from 2015 to 2019, with hip fracture, and treated with arthroplasty. Variables such as age, sex, and present comorbidities were analyzed. Results: Total prostheses were placed in 427 patients and in 1079 the partial prosthesis modality was used. Persons between 61 and 80 years of age predominated. The female sex prevailed in this study, with a 3: 1 ratio. The group of patients with 1 or 2 associated diseases predominated. Mortality <30 days was 1.1 percent and ≥30 days was 9.2 percent. Conclusions: The use of total prostheses is far from the current average in the world, where the total prosthesis is used as the tool of choice. Partial prostheses are reserved for patients who have short life expectancy and very little validity(AU)

Beneficios de los obturadores quirúrgicos en la rehabilitación bucomaxilofacial. Revisión de la literatura / Benefits of surgical obturators in oral maxillofacial rehabilitation. Review of literature

RESUMEN Introducción: Las fracturas por lesión traumática, la resección quirúrgica de tumores y los defectos congénitos exponen al maxilar a agresiones, y para la rehabilitación están las prótesis obturatrices que recuperan algunas funciones como la deglución y la fonación, así como la estética. Objetivo: Resumir los beneficios del uso de prótesis obturatriz como forma de rehabilitación en los servicios de Prótesis Bucomaxilofacial. Métodos: Estudio de revisión bibliográfica en 25 publicaciones entre 2015-2020 sobre el uso de prótesis obturatriz. Se consultaron y tamizaron 153 documentos de las bases de datos de los sistemas referativos MEDLINE, PubMed y SciELO e indexadas en la Web of Sciences, Scopus, Redalyc y Latindex, con el uso de los descriptores: obturador bucal, prótesis obturatriz, cáncer bucal. Desarrollo: Los obturadores protésicos o palatinos, se indican para sellar los tejidos de la cavidad bucal expuestos de forma quirúrgica o congénita, y constituyen un sustituto fundamental del paladar duro, del hueso alveolar y de los tejidos blandos circundantes. Durante la rehabilitación, el profesional en prótesis bucomaxilofacial realizará nuevas modificaciones, a medida que el lecho quirúrgico madura. La prótesis final contará con dientes similares a una prótesis dental; el paciente la puede extraer y limpiar, además de ocuparse de la higiene del defecto. Conclusiones: Los obturadores protésicos corrigen defectos palatinos o maxilares, con varios diseños y aditamentos a aplicar, lo cual logra recuperar un alto nivel de calidad de vida de los pacientes, pues se separa la cavidad bucal de la nasal o sinusal, con una consecuente rehabilitación dental y oclusal satisfactoria. Palabras clave: obturadores palatinos; prótesis maxilofacial; rehabilitación bucal.

ABSTRACT Introduction: Fractures due to traumatic injury, surgical resection of tumors and congenital defects expose the maxilla to aggressions, and for rehabilitation there are obturator prostheses that recover some functions such as swallowing and phonation, as well as aesthetics. Objective: To summarize the benefits of the use of an obturator prosthesis as a rehabilitation form in Oral Maxillofacial Prosthesis services. Methods: Study of bibliographic review in 64 publications between 1978-2019 on the use of obturator prosthesis. 153 documents from the MEDLINE, PubMed and SciELO reference systems databases were consulted, screened and indexed on the Web of Sciences, Scopus, Redalyc and Latindex, with the use of the following descriptors: oral obturator, obturator prosthesis, oral cancer. Development: Prosthetic or palatal obturators are indicated to seal the surgically or congenitally exposed tissues of the oral cavity, and are a fundamental substitute for the hard palate, alveolar bone and surrounding soft tissues. During rehabilitation, the buccomaxillofacial prosthesis professional will make new modifications as the surgical site matures. The final prosthesis will have teeth similar to a dental prosthesis; the patient can remove and clean it, in addition to taking care of the hygiene of the defect. Conclusions: Prosthetic obturators correct palatal or maxillary defects, with various designs and attachments to be applied, which manages to recover a high level of quality of life for patients, since the oral cavity is separated from the nasal or sinus cavity, with a satisfactory dental and occlusal rehabilitation.

Aortic valve replacement via right anterior mini-thoracotomy: the conventional procedure performed through a smaller incision

Abstract Minimally invasive aortic valve replacement has gained consent due to its good results in terms of minimized surgical trauma, faster rehabilitation, pain control and patient compliance. In our experience, we have tried to replicate the conventional and gold standard approach through a smaller incision. Sparing the right internal thoracic artery, avoiding rib fractures and performing total central cannulation is important to make this procedure minimally invasive from a biological point of view too. In addition, the total central cannulation is pivotal to simplify perfusion and drainage. Moreover, a complete step-by-step procedure optimization and-when possible-the use of sutureless prosthesis help to reduce the cross-clamping and perfusion times. After more than 1000 right anterior thoracotomy (RAT) aortic valve replacements, we have found tips and tricks to make our technique more effective.

Immediate precision of the digital osteotomy template in the digital stackable template: a clinical study / 华西口腔医学杂志

OBJECTIVES@#This study aimed to evaluate the immediate accuracy of the digital osteotomy template in the digital stackable template.@*METHODS@#From November 2018 to January 2020, 4 patients with dentition loss were selected from the Prosthodontics Department, West China Stomatological Hospital. All patients met the conditions for immediate planting and immediate restoration. Owing to the lack of vertical target-restoration space, the implantation plan included intraoperative osteotomy. According to the preoperative cone beam CT (CBCT) data, combined with aesthetic digital smile design (DSD) analysis, virtual wax design, and so on, the ideal bone plane design was performed. According to the virtual osteotomy plane, the virtual implantation plan was designed, and then the digital stackable template assuming osteotomy template, implantation guide, and temporary restoration were made and 3D printed. Osteotomy was performed under the guidance of digital osteotomy template during the operation. The preoperative CBCT and postoperative CBCT of all patients overlapped, the deviation between the actual osteotomy and the ideal osteotomy was calculated, and the angle deviation between the postoperative bone plane and the ideal bone plane was measured.@*RESULTS@#The ave-rage volume deviation between the postoperative design and the ideal one was 492.94 mm³, accounting for 21.21% of the preset osteotomy volume. The average deviation between the postoperative osteotomy and the ideal osteotomy in four patients was 0.024 8 mm. The average angle between the postoperative bone plane and the ideal bone plane was 6.03°.@*CONCLUSIONS@#The displacement deviation of virtual osteotomy design and the actual osteotomy one under the guidance of digital osteotomy template in the digital stackable template are highly consistent with the original design. Thus, this clinical technique is worth popularizing, accurate, and quantifiable.

Canal flare index evaluation for different dog breeds / Avaliação do canal flare index femoral de diferentes raças de cães

ABSTRACT: This study determined the canal flare index (CFI) of four dog breeds using two distinct femoral regions as a reference. Thirty-five radiographs of the hip joints of Golden Retrievers (GRG), German Shepherds (GSG), Labrador Retrievers (LRG), and Rottweilers (RG) of both sexes were used. Seventy experimental units were submitted to CFI calculation. Objective (CFIob) and subjective (CFIsub) values of the CFI of each experimental unit were determined according to the anatomical reference used for the calculation. A significant difference in the CFIob between the Golden Retriever and German Shepherd breeds (1.68 ± 0.16 and 1.49 ± 0.08), and in the CFIsub between Golden Retriever, German Shepherd, and Rottweiler breeds (2.09 ± 0.31, 1.86 ± 0.11, and 1.84 ± 0.18) was reported. The subjective form of measurement showed higher values than the objective form (GRG: 2.09 ± 0.31; GSG: 1.86 ± 0.11; LRG: 2.07 ± 0.12; RG: 1.84 ± 0.18). The CFI values of each breed were similar, suggesting a certain racial pattern. A significant difference in the interobserver assessment for both CFIsub and CFIob, in all races was observed. The CFI analysis identified morphological patterns of the proximal femur in the different races. Results indicated the need for standardization of the anatomical references used to calculate the CFI because there were statistical differences among the measurements among the observers.

RESUMO: Objetivou-se determinar o canal flare index (CFI) de quatro raças específicas de cães, utilizando-se duas regiões femorais distintas como referência. Foram analisadas 35 radiografias de articulações coxofemorais de cães das raças Golden Retriever (GGR), Pastor Alemão (GPA), Labrador Retriever (GLR) e Rottweiler (GR), de ambos os sexos, configurando 70 unidades experimentais submetidas ao cálculo do CFI. Determinaram-se os valores objetivo (CFIob) e subjetivo (CFIsub) do CFI de cada unidade experimental de acordo com a referência anatômica utilizada para o cálculo. Houve diferença significativa do CFIob entre as raças Golden Retriever e Pastor Alemão (1,68 ± 0,16 e 1,49 ± 0,08), e do CFIsub entre as raças Golden Retriever, Pastor Alemão e Rottweiler (2,09 ± 0,31, 1,86 ± 0,11 e 1,84 ± 0,18). A forma subjetiva de mensuração apresentou valores maiores que a forma objetiva (GGR: 2,09 ± 0,31; GPA: 1,86 ± 0,11; GLR: 2,07 ± 0,12; GR: 1,84 ± 0,18). Os valores de CFI de cada raça se apresentaram similares, sugerindo haver determinado padrão racial. Houve diferença significativa na avaliação interobservadores, tanto do CFIsub quanto CFIob, em todas as raças. A análise do CFI identificou padrões morfológicos do fêmur proximal nas diferentes raças. Os resultados indicaram a necessidade de padronização dos referenciais anatômicos utilizados para o cálculo do CFI, uma vez que houve relevância estatística entre as diferentes mensurações entre os observadores.

Resistencia a la tracción diametral in vitro de cinco cementos dentales usados como cementantes de puentes y coronas en prótesis fijas / In vitro diametral tensile strength of five dental cements used as bridge and crown cement in fixed prostheses

RESUMEN Objetivo: El propósito de la investigación fue evaluar la resistencia a la tracción diametral in vitro de cinco cementos dentales: BisCem, Duolink, Ketac Cem, Meron, Allcem, cuatro adhesivos convencionales y un autoadhesivo polimerizado químicamente utilizados como cementantes de puentes y coronas en prótesis fijas. Materiales y métodos: Se prepararon 100 especímenes conformados por cementos: BisCem, Duolink, Ketac Cem, Meron, Allcem, los cuales se dividieron aleatoriamente en 5 grupos de 20 especímenes cada grupo sujetas a fotopolimerización y auto polimerización de 8mm de diámetro y 5mm de alto, con 2mm de distancia aproximadamente de la lámpara para la polimerización, se utilizó un formador de probetas de polietileno de alta densidad estandarizado, el tipo de muestreo es no probabilístico. Se sometieron a los especímenes de cada grupo a la prueba de tracción utilizando una máquina de ensayo universal (zwickiLine by Zwick/Roell), hasta lograr el fracaso del cemento, sometidas a una fuerza continua de 500 kg, con una velocidad de desplazamiento fija de 1 cm/min. Resultados: La resistencia promedio a la tracción diametral de probetas del cemento BisCem fue de 38,75 ± 11,56 MPa, del cemento Duolink fue 64,30 MPa, del cemento Meron 57,14 MPa, del cemento Ketac Cem es de 32,23 MPa, del cemento BisCem (38,753 MPa) y el cemento Ketac Cem (39,233 MPa). El cemento dental Duolink es aquel que presenta mayor resistencia a la tracción diametral de probetas en comparación a Meron (57,137 MPa) que es su similar. La tabulación y el análisis han sido sometidos a los test de Shapiro Wilk, análisis de varianza ANOVA y la prueba de Tuckey los valores de cada muestra se distribuyen normalmente existiendo diferencias significativas entre los grupos estudiados. Conclusiones: Las probetas del cemento de resina adhesiva Duolink evidenció una mayor resistencia a la tracción diametral con mejores valores significativos de resistencia a diferencia de los cementos Ketac Cem, Allcem, Meron y BisCem.

SUMMARY Objetive: The purpose of the research was to evaluate the in vitro diametral tensile strength of five dental cements: BisCem, Duolink, Ketac Cem, Meron, Allcem, four conventional adhesives and a chemically polymerized self-adhesive used as bridge cements and crowns in fixed dentures . Materials and methods : 100 specimens consisting of cements were prepared: BisCem, Duolink, Ketac Cem, Meron, Allcem, which were randomly divided into 5 groups of 20 specimens each group subject to photopolymerization and self-polymerization of 8mm in diameter and 5mm high, with an approximate distance of 2mm from the lamp for polymerization, a standardized high density polyethylene specimen was used, the type of sampling is not probabilistic. The specimens of each group were subjected to tensile testing using a universal testing machine (zwickiLine by Zwick / Roell), until the failure of the cement was achieved, subjected to a continuous force of 500 kg, with a fixed displacement speed of 1 cm / min Results: The average tensile strength of diametral tensile specimens of BisCem cement was 38.75 ± 11.56 MPa, Duolink cement was 64.30 MPa, Meron cement 57.14 MPa, Ketac Cem cement was 32.23 MPa, BisCem cement (38.753 MPa ) and Ketac Cem cement (39,233 MPa). Duolink dental cement is the one with the highest tensile strength of diametral specimens compared to Meron (57,137 MPa), which is similar. The tabulation and the analysis have been submitted to the Shapiro Wilk test, ANOVA analysis of variance and the Tuckey test. The values of each sample are normally distributed with significant differences between the studied groups. Conclusions : Duolink adhesive resin cement specimens showed a higher diametral tensile strength with better significant strength values unlike Ketac Cem, Allcem, Meron and BisCem cements.

Uso de ácido tranexámico en la artroplastía total primaria de rodilla / Use of tranexamic acid in primary total knee arthroplasty

Resumen: Introducción: La reducción de la pérdida sanguínea y de las transfusiones en pacientes operados de artroplastía total de rodilla (ATR) primaria se asocia a un mejor resultado clínico y funcional. El uso de ácido tranexámico (ATX) es uno de los métodos utilizados para disminuir ese sangrado. Material y métodos: Se compararon los resultados en hemoglobina (Hb), hematocrito (Hto), tasa de sangrado y de transfusión, tiempo quirúrgico y dolor entre los grupos A (con ATX) y grupo B (sin ATX) posterior a la ATR. Resultados: Se encontraron diferencias estadísticamente significativas en la disminución del sangrado transquirúrgico y periquirúrgico global, en la disminución de la Hb a las 24 horas, en la tasa de transfusión, en el tiempo quirúrgico y en el dolor a la deambulación a favor del grupo A. Discusión: En México no hay literatura publicada sobre el uso de ATX en pacientes operados de ATR. A pesar del uso cada vez más común del ATX, la mejor dosis y vía de administración sigue siendo un tema controversial. Conclusión: El uso de ATX en el esquema propuesto es un método seguro y eficaz para disminuir la tasa de sangrado y de transfusiones en los pacientes operados de ATR.

Abstract: Background: Reducing blood loss and transfusions in patients operated on primary TKR is associated with a better clinical and functional outcome. The use of Tranexamic Acid (ATX) is one of the methods used to decrease that bleeding. Material and methods: Results in Hb, Hto, rate of bleeding and transfusion, surgical time and pain between groups A (with ATX) and group B (without tranexamic acid) after TKR are compared. Results: Statistically significant differences were found during surgery and perisurgical bleeding, in the decrease of Hb at 24 hours, transfusion rate, surgical time and pain to wandering in favor of group A. Discussion: There are no published studies in Mexico on the use of ATX in patients operated on TKR. We consider its use to be increasingly common, the optimal dose and route of administration remains a controversial topic. Conclusion: The use of ATX in the proposed scheme is safe and effective in reducing the rate of bleeding and transfusions in patients operated on ATR.

Presença de Candida sp na saliva de pacientes usuários de prótese total e próteses parciais removíveis atendidos em uma Faculdade de Odontologia de Goiás / Presence of Candida sp in the saliva of patients with complete dentures and partial removable dentures of a Goiás Dental School

Objetivos ­ À vista disso, conhecendo como a principal condição exógena para que ocorra a proliferação de Candida e introdução de Candidose em cavidade oral é a prótese dentária com tempo de uso de mais de 5 anos, propomos nesse estudo avaliar a quantificação de Candida na saliva pacientes usuários de prótese parcial e total removíveis, correlacionando com idade avançada e o fluxo salivar e fatores que possam agir influenciando sua quantificação. As espécies do gênero Candida são normalmente encontradas na microbiota de pacientes saudáveis, sendo a C. Albicans a mais comum. Já a patogenicidade da espécie só ocorre caso haja condições propicias para o seu desenvolvimento, como comprometimento do sistema imune, hiposalivação e uso incorreto de próteses. As próteses totais, em especial, estão associadas ao aumento de UFC e presença de candidose na cavidade oral. Métodos ­ Foram avaliados 121 indivíduos sendo 31 do grupo controle e 90 usuários de próteses dentárias. Foram realizada uma coleta de saliva de cada paciente no momento da primeira consulta odontológica e os pacientes foram classificados quanto ao fluxo salivar em reduzido, normal e aumentados. A análise microbiológica foi realizada com a mesma saliva utilizada na avaliação do fluxo salivar, sendo estas semeadas e a as colônias de Candida foram quantificadas e os pacientes serão categorizados em negativos, portadores e positivos. Resultados ­ Foi possível uma relação forte no que se refere a diminuição do fluxo salivar associado a idade avançada e em decorrência disto, com a quantidade de UFC de Candida na saliva dos pacientes estudados. Conclusão ­ Posto isso, fica comprovado que os pacientes que utilizam próteses removíveis são os com maior quantidade de UFC, seguidos pelos pacientes que utilizam próteses totais

Objectives ­ In view of this, knowing as the main exogenous condition for the occurrence of Candida proliferation and introduction of Candidosis in oral cavity is the dental prosthesis with time of use of more than 5 years, we propose in this study to carry out a evaluation the quantification of the presence of Candida in saliva in patients using partial and total removable prosthesis, correlating at the found with advanced age and the salivar flow and factors that may influence its quantification. Species of the genus Candida are usually found in the microbiota of healthy patients, with C. Albicans being the most universal. The pathogenicity of the species occurs only if there are propitious conditions to its development, such as impairment of the immune system, hyposalivation and incorrect use of prostheses. Total prostheses, in particular, are associated with increased CFU and the presence of candidosis in the oral cavity. Methods ­ A total of 121 individuals were evaluated, 31 from the control group and 90 users of dental prostheses. Saliva collection was performed from each patient at the time of the first dental appointment and the patients were classified as reduced, normal and increased salivary flow. Microbiological analysis was performed with the same saliva used for salivary flow evaluation. These were sown and Candida colonies were quantified and patients were categorized as negative, carrier and positive. Results ­ It was possible to have a strong relationship regarding the decrease in salivary flow associated with advanced age and, as a result, with the amount of Candida CFU in the saliva of the studied patients. Conclusion ­ Thus, it is proven that patients using removable prostheses are the ones with the highest amount of CFU, followed by patients using total prosthesis

Previsibilidade na Instalação Imediata de Implante Cone Morse pelo Planejamento Digital e Provisionalização Imediata: Relato de Caso / Predictability in Immediate Implant Placement of Morse Taper by Digital Planning and Immediate Provisionalization: Case Report

A instalação imediata de implantes em região estética é uma prática frequente, pois reduzir a remodelação óssea e tecidual. Os implantes com interface cone Morse apresentam resultados biológicos e estéticos satisfatórios a longo prazo, pois apresentam gap reduzido entre implante e componente protético e a interface fica distante do tecido ósseo. Este artigo tem como objetivo relatar a reabilitação estética de um incisivo central superior comprometido através da instalação de um implante cone Morse utilizando a técnica da cirurgia guiada com provisionalização imediata. Paciente com 40 anos de idade, do sexo masculino, apresentava incisivo central superior (#21) com tratamento endodôntico prévio, recessão gengival vestibular, escurecimento coronário e mobilidade. O caso clínico apresentado mostrou que, após 12 meses, resultados precisos e estéticos são possíveis de alcançar com a instalação de implantes em alvéolos pós-extração e instalação de um dente provisório imediato em regiões estéticas.

The immediate placement of implant in fresh sockets in the aesthetic area is a frequent practice as it reduces bone and tissue remodeling. Morse taper implants present satisfactory biological and aesthetic results in the long term, since they present a reduced gap between implant and prosthetic component and this interface is distant from bone. This article aims to report the aesthetic restoration of a compromised central upper incisor with the placement of a Morse taper implant using guided surgery with immediate provision. A 40-year-old male patient had a central upper incisor (#21) with previous endodontic treatment, vestibular gingival recession, coronary browning, and mobility. The clinical case presented showed that, after 12 months, precise and aesthetic results are possible to achieve with the placement of implants in post-extracting alveolus and installation of an immediate provisional tooth in esthetic regions.

Prótese dento-gengival sobre implantes: relato de caso / Dentogengival prosthesis on implant: case report

A perda de tecido ósseo e gengival na região anterior é um desafio para o clínico devido as exigências estéticas do sorriso, essa perda de tecido de sustentação cria uma relação desarmônica entre as coroas clínicas e ameias interdentais. O objetivo deste estudo é relatar o caso clínico de uma reabilitação maxilar anterior através de uma prótese dentogengival sobre implantes (PDGI). O tratamento realizado após o diagnóstico clínico consistiu na realização de moldagens de estudo, fotografias para o planejamento digital (DSD), confecção dos provisórios, abertura dos implantes, escolha dos pilares protéticos, colocação dos provisórios sobre os implantes, remodelação gengival com provisórios, moldagem de trabalho, ajustes e prova da porcelana, parafusamento da prótese sobre implante e preservação do paciente. Essa reabilitação pode ser uma alterativa viável para substituição de tecido gengival e ósseo perdido, quando a regeneração não tiver um prognóstico favorável ou em pacientes que não desejam ou não podem submeter-se a procedimentos regenerativos. Concluímos que a PDGI melhorou de maneira significativa tanto os requisitos estéticos como funcionais do paciente(AU)

The loss of the bone and gingival tissue in the frontal zone is a challenge to the clinician due to the smiling aesthetic requirements. The loss of the teeth sustentation tissue creates an inharmonic relation between the clinical crowns and the interdental niches. The purpose of this study is to report a clinical case of aesthetic rehabilitation of the anterior maxillary through dentogingival prosthesis on implants. The treatment accomplished after the clinical diagnosis consisted in molding study, taking pictures for digital planning (DSD), confection of the provisional ones, opening the dental implant, assorting of the prosthetic abutments, placing the dental abutment on the dental implant, gingival remodeling with provisional ones, molding work, adjusting and testing the porcelain crown, screw driving the prosthesis on the implant and preserving the patient. This rehabilitation may be a viable alternative to replacing both the gingival and bone tissue when regeneration does not have a favorable prognosis, or in patients whom do not wish or cannot undergo regenerative procedures. We conclude that dentogingival prosthesis on implant has significantly improved both the functional and aesthetic requirements of the patient(AU)

A prospective study on the application of 6-mm-long implants in the upper and lower posterior edentulous regions / 中华口腔医学杂志

Objective@#To assess clinical and radiographic outcomes of short implants (length six mm) in the posterior region and early-loading with splinted fixed dental prostheses.@*Methods@#Forty-five patients were recruited at 3 centers and 2-3 implants (diameter 4 mm, length 6 mm) were implanted in each case. Totally, ninty-five implants were placed, using one-stage surgery protocol and loaded with a screw-retained splinted fixed prosthesis 6 weeks later. Clinical and radiographic examinations were performed preoperatively, post-surgery, at loading, and 6, 12 and 24 months after prosthesis placement.@*Results@#Four implants were removed before loading. A total of 36 patients with 76 implants completed the whole treatment and 2 year follow-up according to the research design. No implant was lost after loading, and the 2-year survival rate of the implant was 100%(76/76). In all cases, the response of swelling and pain after operation was mild, and the bone resorption around the implants was not obvious at 6 months [(0.04±0.29) mm], 1 year [(-0.11±0.44) mm], and 2 years [(0.00±0.53) mm] after loading. Bone loss less than 1.00 mm was found only in 26% (18/69) implants after 2 years of loading, and the height of the alveolar bone around 17% (12/69) of the implant increased. During 2-year follow-up, the probing depth of the implants increased by nearly 0.50 mm, but there was no clinical significance (P>0.05).@*Conclusions@#The 2-year results of this study showed that the 6-mm-long implants can be a predictable procedure, especially in situations with limited bone height in posterior edentulous regions.

Reconstrução de sequela facial por prótese interna acrílica / Reconstruction of facial sequela by internal acrylic prothesis

As sequelas faciais decorrentes do trauma representam grande desafio para o cirurgião buco-maxilo-facial e exigem que este tenha em mente o conhecimento anatômico, cirúrgico, do acervo material, bem como do aporte tecnológico que lhe assiste a prática cirúrgica. Frente aos biomateriais utilizados na confecção protética, a resina acrílica aparece como uma possibilidade amplamente vantajosa para o profissional e para o paciente, e, uma vez somada às técnicas de prototipagem, se tornam ainda mais eficientes e eficazes. O presente trabalho objetiva discutir o uso da resina acrílica no tratamento das sequelas faciais após o trauma por meio da apresentação de um caso clínico... (AU)

As the facial sequelae resulting from trauma represent a great challenge for the maxillo-facial surgeon, and require that keep in mind the knowlodge about anatomical, surgical, material assets and the technological support that assists you to surgical practice. In view of the prosthetic biomaterials used in making the acrylic resin appears as a widely advantageous possibility for professional and patient, and once added to the prototyping techniques become more efficient and effective. This paper aims to discuss the use of acrylic resin in the treatment of facial sequelae after trauma by presenting a clinical case... (AU)

Fixed prosthetic treatment for the patient with delayed eruption disorder

Delayed eruption disorders caused by systemic or local conditions are mostly found during childhood and can be treated with orthodontic forced eruption. When the disorder is not found nor treated during childhood, however, orthodontic eruption might become a difficult option while prosthodontic restoration can be considered as an another option. Considerations for the prosthodontic treatment plan include the extent of tooth loss, interdental mesio-distal space and interarch space, and age of the patient. In this case report, oral rehabilitation of the patient with delayed eruption disorder through zirconia partial fixed prostheses for both maxilla and mandible was performed.

Effects of leg length discrepancy on gait: An experimental study / 医用生物力学

Objective To simulate leg length discrepancy by unilateral increase in lower limb of normal person, analyze gait features in the case of leg length discrepancy and its effect on walking gait, so as to provide theoretical proofs for chronical musculoskeletal diseases in lower limb amputees due to leg length discrepency. Methods Leg length discrepancy was simulated by subjects wearing shoes to increase the unilateral height of one leg. The time-space parameters, ground reaction forces and joint angles of the subjects during normal walking gait and leg length discrepancy gait were obtained via the 3D motion capture system and the reaction force platform to make comparative analysis. Results Significant differences were found between leg length discrepancy gait and normal gait in terms of step length, stride time and single supporting period. In the case of leg length discrepancy gait, the ground reaction force of both feet significantly increased at heel-strike phase compared with normal gait, and obvious changes were observed in angles of hip, knee and ankle joints. Conclusions Leg length discrepancy is an important cause leading to gait abnormalities, and maybe a cause of leg joint diseases for trans-tibial amputees wearing prosthesis.

Interrelationship between implant and orthognathic surgery for the rehabilitation of edentulous cleft palate patients: a case report

A 43-year-old woman with a unilateral cleft lip and palate, presenting a totally edentulous maxilla and mandible with marked maxillomandibular discrepancy, attended the Prosthodontics section of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo for treatment. She could not close her mouth and was dissatisfied with her complete dentures. Treatment planning comprised placement of six implants in the maxilla, four in the mandible followed by prostheses installation and orthognathic surgery. The mandibular full arch prosthesis guided the occlusion for orthognathic positioning of the maxilla. The maxillary complete prosthesis was designed to assist the orthognathic surgery with a provisional prosthesis (no metal framework), allowing reverse treatment planning. Maxillary and mandibular realignment was performed. Three months later, a relapse in the position of the maxilla was observed, which was offset with a new maxillary prosthesis. This isa complex interdisciplinary treatment and two-year follow-up is presented and discussed. It should be considered that this type of treatment could also be applied in non-cleft patients.

Feasibility of anticoagulation therapy after mechanical valve replacement in grass-root health institutions / 中华全科医师杂志

Objective To assess the feasibility of anticoagulation therapy after mechanical valve replacement in grass-root health institutions.Methods One hundred and sixty one patients with mechanical valve replacement received anticoagulation therapy with warfarin,including 79 cases receiving the therapy in grass-root health institutions (test group) and 82 cases in the tertiary hospitals (control group).The patients were followed up for 12 months after operation;the rate of anticoagulation efficacy,the anticoagulationrelated complications,and the anticoagulation-related cost were documented and compared between two groups.Results The international normalized ratio (INR) tests were performed for 1 021 times in test group and 717 times were up to anticoagulation standard (70.2 ％,717/1 021),while INR tests in control group were performed for 965 times and 688 times were up to standard (71.3％,688/965);there were no significantly differences in efficacy rate between two groups (P ＞ 0.05).There were no significant differences in rate of bleeding events and thrombosis between two groups [16.5％ (13/79) vs.12.2％ (10/82),6.3％(5/79) vs.4.9％(4/82),respectively,x2 =0.596,P=0.44,x2 =0.161,P=0.69].The anticoagulation-related cost per month and per patient in test group was significantly lower than those in control group [(63.1 ±.12.8) vs.(176.6 ± 16.4) yuan,t =48.716,P ＜0.05].Conclusion Compared with the tertiary hospital,the anticoagulation therapy in grass-root institutions can accomplish the similar clinical outcomes and significantly reduce the medical cost in patients with mechanical valve replacement.

Some implications on tympanoplastic III types surgery / Шинэ санаа Шинэ нээлт

Among world population, 23.4% have different kinds of hearing disorders and 56% are middle ear disorders, 30% are inner ear disorder, 10% are congenital deaf and 4% are congenital mixed outer and middle ear disorder (WHO info, 2006).In 1995, by the German research, 2% of newborn babies were deaf therefore, among children from 1-18, 16% had middle ear disorder and 0.8% had inner ear disorder. In most cases (54%) cause of hear loss and deaf as sound transmitting apparatus. Later in 2010, sound transmitting apparatus related disorder was decreased by 22.4% J.Helms1995 , K.Schwager 2010 . Doctors proved that 62% of sound transmitting apparatus related disorders are middle ear diseases, 16,2% out of the diseases have the defect of malleus, 44,1 % have the defect of incus and discontinuity of incus and stapedius, and 39,7% is totally absent of ossicular chain 120 tympanoplasty III type surgeries were operated in 2011-2013 in Mongolia. Clinical and operative features of the tympanoplasty III type surgeries were prospectively recorded. Aim: To recover sound transmitting related hear loss with titan prosthesis implant. 120 tympanoplasty III type surgeries were operated in 2011-2013 in Mongolia. Clinical and operative features of the tympanoplasty III type surgeries were prospectively recorded. Out of the surgeries, 51 cases (42.5%) were cholesteatoma, 53 cases (44.2%) were granuloma middle ear and 16 cases (13.3%) were adhesive otitis media. The air and bone gap of all patients were above 15-35 dB. HEINZKURZ firm’s TTP-Variac system’s titan prosthesis was used. Titan prosthesis PORP was carried out in 86 cases (71.6%). For 40 (45.5%) out of the 86 cases, size of titan prosthesis PORP 2.25 mm was chosen. Hearing level increased for 72% out of patients by 10-25 dB after the operation. However, for 46 (54.5%) out of the 86 cases, size of titan prosthesis PORP 2.5 mm was chosen. Hearing level increased for 82% out of patients by 10-30 dB after the operation. Titan prosthesis TORP size 4-4.25 mm waschosen for 34 (28.4%) out of 120 cases. Hearing level increased by 10-30 dB for 80% out of patients involved after the operation Out of the surgeries, 51 cases (42.5%) were cholesteatoma, 53 cases (44.2%) were granuloma middleear and 16 cases (13.3%) were adhesive otitis media.Titan prosthesis PORP was carried out in 86 cases (71.6%). For 40 (45.5%) out of the 86 cases, size oftitan prosthesis PORP 2.25 mm was chosen. Hearing level increased for 72% out of patients by 10-25 dB after the operation. However, for 46 (54.5%) out of the 86 cases, size of titan prosthesis PORP 2.5 mm was chosen. Hearing level increased for 82% out of patients by 10-30 dB after the operation. Titan prosthesis TORP size 4-4.25 mm was chosen for 34 (28.4%) out of 120 cases. Hearing level increased by 10-30 dB for 80% out of patients involved after the operation. Implantation of Titanium prosthesis increased hearing capability by 80% dB. We drum cover the cartilage and cartilage film is used to by Canal wall down, Canal wall updone. Hearing level decrease d by patients involved after the operation. Implantation of Titanium prosthesis increased hearing capability by 80% dB. The air transfer of more than35 dB air-bonegapofmorethan15dB we observed defect of hearing bone