[High-risk drug use: epidemiological pattern through hair testing in the forensic context]. / Drogas y consumo de alto riesgo: patrón epidemiológico a partir de análisis de cabello en el contexto forense.

OBJECTIVE: The basic sources of information on drug use are epidemiological surveys, although they have some limitations: their results may be conditioned by the lack of veracity of the responses and the sampling method makes it difficult to detect lowprevalence behaviours in target populations. This study aimed to establish the epidemiological pattern of drug use in the population undergoing drug testing in hair, in the framework of judicial investigations, in order to provide an additional approach to the knowledge of high-risk drug use. METHODS: A cross-sectional study on drug use was conducted on the population subjected to drug testing in hair (N=5,292) in the forensic context. Prevalence of cannabis, cocaine, heroin, ketamine, amphetamine (AP), methamphetamine (MA), 3,4-methylenedioxy- methamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxy-N-ethylamphetamine (MDEA) and methadone uses were obtained. Association between drug use and demographics, and trends of prevalence over the period were analysed using the Pearson Chi-square test. Frequency distribution of drug concentrations in hair was obtained and it was assessed in relation to gender and age using the non-parametric Mann-Whitney U and Kruskal-Wallis H methods. RESULTS: During the period 2013-2015, prevalence of cocaine use was particularly high (49%), rating second among the population studied, after cannabis use (54%). Proportions of heroin, methadone, MDMA and amphetamine use ranged from 10% to 18%. There was a significant increase in prevalence of MDMA, heroin and amphetamine use during the period 2013-2015, as well as a significant decrease in methadone use. The rates of cannabis, cocaine and MDMA use were higher in men, whereas methadone use was higher among women. CONCLUSIONS: Cannabis and cocaine are the most frequently abused drugs among the population undergoing drug testing in hair in the framework of judicial investigations over the three-year period, although the proportions of heroin, MDMA and amphetamine users show an increasing trend. Drug use patterns vary according to age and sex, with a decrease in cannabis and MDMA use and an increase in heroin and methadone use as age increased; cannabis, cocaine and MDMA use are more prevalent among men and methadone use among women.

OBJETIVO: Las encuestas epidemiológicas son las fuentes básicas de información sobre el consumo de drogas, aunque presentan algunas limitaciones en este campo: sus resultados pueden verse condicionados por la falta de veracidad de las respuestas y el método de muestreo dificulta la detección de comportamientos de baja prevalencia en las poblaciones diana. El objetivo de esta investigación fue establecer el patrón epidemiológico del consumo de drogas en la población sometida a análisis de drogas en cabello en el marco de investigaciones judiciales, con el fin de aportar una fuente de información adicional al conocimiento del consumo de drogas de alto riesgo. METODOS: Se realizó un estudio transversal de consumo de drogas en la población sometida a análisis de drogas en cabello en el contexto forense (N=5.292). Se obtuvo la prevalencia de consumo de cannabis, cocaína, heroína, ketamina, anfetamina (AP), metanfetamina (MA), 3,4-metilendioxi-metanfetamina (MDMA), 3,4-metilendioxianfetamina (MDA), 3,4-metilendioxi-N-etilamphetamina (MDEA) y metadona. Se analizó la asociación entre el consumo de drogas y los factores demográficos, así como de sus tendencias, mediante la prueba de Chicuadrado de Pearson. Se obtuvo la distribución de frecuencias de las concentraciones de drogas en cabello y se evaluó en relación con el sexo y la edad, utilizando los métodos no paramétricos U de Mann-Whitney y H de Kruskal-Wallis. RESULTADOS: En el periodo 2013-2015, la prevalencia de consumo de cocaína fue particularmente elevada (49%) en la población estudiada, próxima a la de cannabis (54%). Las tasas de consumo de heroína, metadona, MDMA y anfetamina resultaron entre un 10% y mun 18%. Durante el período estudiado, se registró un aumento significativo del consumo de MDMA, heroína y anfetamina, así como una disminución significativa del consumo de metadona. CONCLUSIONES: Cannabis y cocaína son las drogas de abuso más frecuentes entre la población sometida a análisis de drogas en cabello en el marco de investigaciones judiciales en el periodo estudiado, si bien las proporciones de consumidores de heroína, MDMA y anfetamina muestran una tendencia creciente. Los patrones de consumo varían en función de la edad y del sexo, observándose disminución del consumo de cannabis y MDMA e incremento del consumo de heroína y metadona al aumentar la edad. El consumo de cannabis, cocaína y MDMA resulta más prevalente en hombres y el de metadona en mujeres.

Bisphosphonate-related osteonecrosis. Application of adipose-derived stem cells in an experimental murine model.

BACKGROUND: Bisphosphonate-related osteonecrosis of the jaw is a pathological condition without effective established treatment and preventive strategies. The aim of this study was to analyse the effect of adipose-derived stem cells (ASC) in an experimental murine model of osteonecrosis. MATERIAL AND METHODS: 38 Wistar rats were injected intraperitoneally with zoledronic acid. After treatment, upper jaw molars were extracted. The animals were randomly assigned to one of two groups. In the control group, saline solution was applied over the alveolar sockets after the tooth extractions. In the treatment group, ASCs were applied instead of saline solution. The control and treatment groups were subdivided based on the time of euthanasia. A clinical and histological analysis was performed. RESULTS: The presence of osteonecrosis in alveolar bone was observed in a similar distribution in both groups. In the ASC-treated group, new bone formation was greater than in controls. CONCLUSION: In this study, application of ASCs showed greater new bone formation in an osteonecrosis-like murine model. Previous inhibited post-extraction bone remodelling could be reactivated, and these findings appeared to be secondary to implantation of ASCs.

Drogas y consumo de alto riesgo: patrón epidemiológico a partir de análisis de cabello en el contexto forense / High-risk drug use: epidemiological pattern through hair testing in the forensic context

OBJETIVO: Las encuestas epidemiológicas son las fuentes básicas de información sobre el consumo de drogas, aunque presentan algunas limitaciones en este campo: sus resultados pueden verse condicionados por la falta de veracidad de las respuestas y el método de muestreo dificulta la detección de comportamientos de baja prevalencia en las poblaciones diana. El objetivo de esta investigación fue establecer el patrón epidemiológico del consumo de drogas en la población sometida a análisis de drogas en cabello en el marco de investigaciones judiciales, con el fin de aportar una fuente de información adicional al conocimiento del consumo de drogas de alto riesgo. MÉTODOS: Se realizó un estudio transversal de consumo de drogas en la población sometida a análisis de drogas en cabello en el contexto forense (N=5.292). Se obtuvo la prevalencia de consumo de cannabis, cocaína, heroína, ketamina, anfetamina (AP), metanfetamina (MA), 3,4-metilendioxi-metanfetamina (MDMA), 3,4-metilendioxianfetamina (MDA), 3,4-metilendioxi-N-etilamphetamina (MDEA) y metadona. Se analizó la asociación entre el consumo de drogas y los factores demográficos, así como de sus tendencias, mediante la prueba de Chicuadrado de Pearson. Se obtuvo la distribución de frecuencias de las concentraciones de drogas en cabello y se evaluó en relación con el sexo y la edad, utilizando los métodos no paramétricos U de Mann-Whitney y H de Kruskal-Wallis. RESULTADOS: En el periodo 2013-2015, la prevalencia de consumo de cocaína fue particularmente elevada (49%) en la población estudiada, próxima a la de cannabis (54%). Las tasas de consumo de heroína, metadona, MDMA y anfetamina resultaron entre un 10% y mun 18%. Durante el período estudiado, se registró un aumento significativo del consumo de MDMA, heroína y anfetamina, así como una disminución significativa del consumo de metadona. CONCLUSIONES: Cannabis y cocaína son las drogas de abuso más frecuentes entre la población sometida a análisis de drogas en cabello en el marco de investigaciones judiciales en el periodo estudiado, si bien las proporciones de consumidores de heroína, MDMA y anfetamina muestran una tendencia creciente. Los patrones de consumo varían en función de la edad y del sexo, observándose disminución del consumo de cannabis y MDMA e incremento del consumo de heroína y metadona al aumentar la edad. El consumo de cannabis, cocaína y MDMA resulta más prevalente en hombres y el de metadona en mujeres

OBJECTIVE: The basic sources of information on drug use are epidemiological surveys, although they have some limitations: their results may be conditioned by the lack of veracity of the responses and the sampling method makes it difficult to detect lowprevalence behaviours in target populations. This study aimed to establish the epidemiological pattern of drug use in the population undergoing drug testing in hair, in the framework of judicial investigations, in order to provide an additional approach to the knowledge of high-risk drug use. METHODS: A cross-sectional study on drug use was conducted on the population subjected to drug testing in hair (N=5,292) in the forensic context. Prevalence of cannabis, cocaine, heroin, ketamine, amphetamine (AP), methamphetamine (MA), 3,4-methylenedioxy- methamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxy-N-ethylamphetamine (MDEA) and methadone uses were obtained. Association between drug use and demographics, and trends of prevalence over the period were analysed using the Pearson Chi-square test. Frequency distribution of drug concentrations in hair was obtained and it was assessed in relation to gender and age using the non-parametric Mann-Whitney U and Kruskal-Wallis H methods. RESULTS: During the period 2013-2015, prevalence of cocaine use was particularly high (49%), rating second among the population studied, after cannabis use (54%). Proportions of heroin, methadone, MDMA and amphetamine use ranged from 10% to 18%. There was a significant increase in prevalence of MDMA, heroin and amphetamine use during the period 2013-2015, as well as a significant decrease in methadone use. The rates of cannabis, cocaine and MDMA use were higher in men, whereas methadone use was higher among women. CONCLUSIONS: Cannabis and cocaine are the most frequently abused drugs among the population undergoing drug testing in hair in the framework of judicial investigations over the three-year period, although the proportions of heroin, MDMA and amphetamine users show an increasing trend. Drug use patterns vary according to age and sex, with a decrease in cannabis and MDMA use and an increase in heroin and methadone use as age increased; cannabis, cocaine and MDMA use are more prevalent among men and methadone use among women

Beckwith-Wiedemann Syndrome: Open bite evolution after tongue reduction.

BACKGROUND: Macroglossia causes functional deficits such as airway obstruction, drooling, phonation difficulties, and leads to protrusion of dentoalveolar structures resulting in an anterior open bite and a prognathic mandibular appearance. Macroglossia is present in the majority of patients with Beckwith-Wiedemann syndrome (BWS) and surgical treatment may be indicated. MATERIAL AND METHODS: A retrospective review was conducted including BWS patients who underwent surgical tongue reduction between 2000 and 2015 at the Hospital Universitario La Paz, Madrid. RESULTS: Out of 16 patients with BWS, surgery was performed in 11 cases. Tongue protrusion with open bite was the main indication for surgical treatment. Reduction glossectomy was performed using the keyhole technique. We analysed the relationship between age at surgery and evolution of open bite. Complications were minimal and satisfactory outcomes were observed with a decrease in anterior open bite. CONCLUSIONS: In this study we have observed that surgical treatment in patients with BWS and open bite accompanied by macroglossia seems to provide positive results with a satisfactory outcome in dentoskeletal alterations.

Development of an antioxidant biomaterial by promoting the deglycosylation of rutin to isoquercetin and quercetin.

Quercetin-3-O-rutinoside (rutin), quercetin-3-O-glucoside (isoquercetin) and quercetin have shown antioxidant, cytoprotective, vasoprotective, antiproliferative and antiinflammatory properties. The aim of this work was to determine the conversion of rutin to isoquercetin and quercetin during the production of poly(l-lactic acid) films with potential to deliver these flavonoids toward tissues, pharmaceuticals or food matrices. Three poly(l-lactic acid) formulations with 17.7, 39.6 and 39.1mg/g of rutin were prepared by the extrusion process. Processing temperatures (130-165°C) promoted the deglycosylation of rutin to produce isoquercetin and subsequently quercetin, identified by high performance liquid chromatography coupled to mass spectrometry. The effect of the process on the antioxidant activity of the films was determined by measuring the capacity to scavenge 2,2 diphenyl-1-picrylhydrazyl radicals. The material with the highest proportion of quercetin showed the highest antioxidant activity which could be used to produce delivering devices of the flavonoids to tissues, pharmaceuticals or food matrices.

Polyetheretherketone custom-made implants for craniofacial defects: Report of 14 cases and review of the literature.

BACKGROUND: Craniofacial defects tend to carry functional and esthetic consequences for the patient. The complex shapes in this region make such reconstructions a challenging procedure and the most suitable material to be used remains controversial. METHODS: We report a series of 14 patients whose craniofacial defects were reconstructed using a computer designed PEEK-PSI (Polyetheretherketone- Patient Specific Implant). We analyzed the complications and outcomes of PEEK custom-made implants and compared our results with those of other case series reported in the current literature. RESULTS: Fourteen patients underwent craniofacial reconstruction using a PEEK-PSI. Three cases involved a one-step primary reconstruction and the rest of cases underwent a delayed reconstruction. Two cases (14.3 %) presented infection and only in one case was the implant definitively removed. Esthetic results were considered to be highly satisfactory. CONCLUSION: With CAD-CAM techniques, it is possible to prefabricate an individual implant. The ideal material for reconstructing maxillofacial defects does not exist, but PEEK has demonstrated good outcomes. When autologous bone is not available or, in selected cases with large or complex defects in the maxillofacial area, PEEK is one of the best options to reconstruct these defects. However, further studies are needed to determine the long-term results.

Management of dental-oral procedures in patients with hereditary angioedema due to C1 inhibitor deficiency.

BACKGROUND: Hereditary angioedema due to C1 inhibitor deficiency (HAE-C1-INH) has considerable implications for dental health care providers, since dental procedures may trigger severe and even life-threatening episodes. The aim of the present study was to analyze the efficacy and safety of premedication with attenuated androgens (AAs), plasma-derived human C1 esterase inhibitor concentrate (pdhC1INH), or both to prevent the development of upper airway angioedema after dental-oral procedures in patients with HAE-C1-INH. MATERIAL AND METHODS: All dental-oral procedures performed on patients with HAE-C1-INH who were followed up at La Paz University Hospital, Madrid, Spain were reviewed. Demographic data, maintenance treatment, preprocedure prophylaxis, disease severity, and occurrence of upper airway angioedema were recorded. RESULTS: Twenty-four patients (14 male/10 female; mean age, 42.6 years) underwent 66 procedures. Most procedures were performed on patients with severe HAE-C1-INH (20 procedures) or moderate HAE-C1-INH (26 procedures). Only 9 procedures were performed without short-term prophylaxis. Mild upper airway angioedema developed after 3 procedures performed without short-term prophylaxis in patients with minimal or asymptomatic HAE-C1-INH. A statistically significant association was found between development of mild postprocedure upper airway angioedema and lack of maintenance treatment with AA, lack of increased dose of preprocedure AA, and failure to administer preprocedure pdhC1INH (P = .002, Fisher exact test). CONCLUSIONS: Increased doses of prophylactic AA, administration of pdhC1INH, or both were good options for ambulatory management of dental-oral procedures in patients with HAE-C1-INH. Prophylaxis with pdC1INH or increased doses of AA is advisable before dental-oral procedures, even in patients with low disease severity.

Management of Dental-Oral Procedures in Patients With Hereditary Angioedema due to C1 Inhibitor Deficiency

Antecedentes: El angioedema hereditario por déficit de C1 Inhibidor (AEH-C1-INH) tiene unas importantes implicaciones para los profesionales de la salud bucodental ya que una cirugía dental puede desencadenar episodios de angioedema potencialmente mortales. El objetivo del estudio fue analizar la eficacia y seguridad de los andrógenos atenuados (AAs) y/o del concentrado plasmático de C1 Inhibidor derivado de humanos (pdhC1INH) para prevenir el desarrollo de angioedema de vías respiratorias superiores tras procedimientos odontoestomatológicos en pacientes con AEH-C1-INH. Material y métodos: Se revisaron los procedimientos odontoestomatológicos realizados en el Hospital Universitario La Paz. Se consideraron datos demográfi cos, tratamiento de mantenimiento, profi laxis pre-procedimiento, grado de severidad de la enfermedad y aparición de angioedema faringolaríngeo. Resultados: Veinticuatro pacientes (14H/10M) (edad media: 42,6 años) se sometieron a 66 procedimientos. La mayor parte se realizaron en pacientes con estadio grave (20 procedimientos) o moderado (26 procedimientos) de la enfermedad. Sólo nueve procedimientos se realizaron sin profilaxis de corto plazo (PCP). En tres procedimientos realizados sin PCP se desarrolló angioedema faríngeo leve ocurriendo en pacientes en estadio asintomático o mínimo de la enfermedad. Se encontró una asociación estadísticamente significativa entre desarrollo mínimo de angioedema de vías respiratorias superiores y ausencia de tratamiento de mantenimiento con AA, ausencia de incremento de dosis y no-administración de pdhC1INH preprocedimiento (Test exacto de Fisher: P=.002). Conclusiones: El aumento de dosis preprocedimiento de AA y/o la administración de pdhC1INH son buenas opciones para el manejo ambulatorio de los procedimientos odontoestomatológicos en pacientes con AEH-C1-INH. El tratamiento profiláctico con pdC1INH o el incremento de dosis de AA es recomendable antes de la manipulación dental, incluso en pacientes con estadio bajo en la escala de gravedad de la enfermedad (AU)

Background: Hereditary angioedema due to C1 inhibitor deficiency (HAE-C1-INH) has considerable implications for dental health care providers, since dental procedures may trigger severe and even life-threatening episodes. The aim of the present study was to analyze the efficacy and safety of premedication with attenuated androgens (AAs), plasma-derived human C1 esterase inhibitor concentrate (pdhC1INH), or both to prevent the development of upper airway angioedema after dental-oral procedures in patients with HAE-C1-INH. Material and Methods: All dental-oral procedures performed on patients with HAE-C1-INH who were followed up at La Paz University Hospital, Madrid, Spain were reviewed. Demographic data, maintenance treatment, preprocedure prophylaxis, disease severity, and occurrence of upper airway angioedema were recorded. Results: Twenty-four patients (14 male/10 female; mean age, 42.6 years) underwent 66 procedures. Most procedures were performed on patients with severe HAE-C1-INH (20 procedures) or moderate HAE-C1-INH (26 procedures). Only 9 procedures were performed without short-term prophylaxis. Mild upper airway angioedema developed after 3 procedures performed without short-term prophylaxis in patients with minimal or asymptomatic HAE-C1-INH. A statistically significant association was found between development of mild postprocedure upper airway angioedema and lack of maintenance treatment with AA, lack of increased dose of preprocedure AA, and failure to administer preprocedure pdhC1INH (P=.002, Fisher exact test). Conclusions: Increased doses of prophylactic AA, administration of pdhC1INH, or both were good options for ambulatory management of dental-oral procedures in patients with HAE-C1-INH. Prophylaxis with pdC1INH or increased doses of AA is advisable before dental-oral procedures, even in patients with low disease severity (AU)

[Interpretation of ventilator curves in patients with acute respiratory failure]. / Interpretación de las curvas del respirador en pacientes con insuficiencia respiratoria aguda.

Mechanical ventilation is a therapeutic intervention involving the temporary replacement of ventilatory function with the purpose of improving symptoms in patients with acute respiratory failure. Technological advances have facilitated the development of sophisticated ventilators for viewing and recording the respiratory waveforms, which are a valuable source of information for the clinician. The correct interpretation of these curves is crucial for the correct diagnosis and early detection of anomalies, and for understanding physiological aspects related to mechanical ventilation and patient-ventilator interaction. The present study offers a guide for the interpretation of the airway pressure and flow and volume curves of the ventilator, through the analysis of different clinical scenarios.

Severe odontogenic infections: Epidemiological, microbiologicaland therapeutic factors

Objectives: A retrospective study is made of the odontogenic infections treated in La Paz University Hospital(Madrid, Spain) during 2007 and 2008, with an epidemiological and microbiological analysis of a large group ofpatients.Study Design: A retrospective descriptive study was made, involving the consecutive inclusion of all patients withodontogenic infection requiring admission to our hospital in the period between January 2007 and December2008.Results: A total of 151 patients were included, with a mean age of 40.3 years and a balanced gender distribution.The most frequently affected teeth were those located in the posterior mandibular segments, caries being themain underlying cause. Most isolates comprised mixed flora, particularly viridans streptococci, different speciesof Prevotella, Micromonas micros, and different species of Actinomyces. Susceptibility analysis of the microbialisolates showed a high percentage resistance to clindamycin (42.8% of all isolates), particularly among viridansstreptococci.Conclusions: The use of antibiotics in head and neck infections requires updated protocols based not only on theexisting scientific evidence but also on the epidemiological reality of each center. On the other hand, identificationis required of the surgical factors determining infection and how they influence morbidity associated with thistype of pathology (AU)

Adenoma pleomorfo de lóbulo profundo de parótida. Diagnóstico diferencial de masas en el espacio parafaríngeo / No disponible

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Severe odontogenic infections: epidemiological, microbiological and therapeutic factors.

OBJECTIVES: A retrospective study is made of the odontogenic infections treated in La Paz University Hospital (Madrid, Spain) during 2007 and 2008, with an epidemiological and microbiological analysis of a large group of patients. STUDY DESIGN: A retrospective descriptive study was made, involving the consecutive inclusion of all patients with odontogenic infection requiring admission to our hospital in the period between January 2007 and December 2008. RESULTS: A total of 151 patients were included, with a mean age of 40.3 years and a balanced gender distribution. The most frequently affected teeth were those located in the posterior mandibular segments, caries being the main underlying cause. Most isolates comprised mixed flora, particularly viridans streptococci, different species of Prevotella, Micromonas micros, and different species of Actinomyces. Susceptibility analysis of the microbial isolates showed a high percentage resistance to clindamycin (42.8% of all isolates), particularly among Viridans Streptococci. CONCLUSIONS: The use of antibiotics in head and neck infections requires updated protocols based not only on the existing scientific evidence but also on the epidemiological reality of each center. On the other hand, identification is required of the surgical factors determining infection and how they influence morbidity associated with this type of pathology.

I Conferencia Nacional de Consenso sobre el Injerto Óseo del Seno Maxilar / 1st National Consensus Conference on maxillar sinus bone grafts

Objetivo: El objetivo de la I Conferencia Española de Consenso sobre el Injerto Óseo Sinusal era intentar llegar a puntos de acuerdo sobre las principales controversias de esta técnica, aplicada de forma muy variada y con el empleo de materiales muy diversos, y conseguir plasmar los mismos en un documento resumen consensuado por todos los autores. Material y método: Durante los días 17 y 18 de octubre de 2008 se celebró en Oviedo la citada conferencia, auspiciada por la Sociedad Española de Cirugía Oral y Maxilofacial. En ella se dieron cita un total de 50 ponentes de reconocido prestigio nacional e internacional que repasaron en 6 mesas de trabajo las principales controversias sobre los injertos óseos sinusales. Tras las conferencias de los ponentes, los moderadores establecían las principales conclusiones de cada mesa y se abría un turno de debate donde participaban todos los asistentes. Resultado: Este documento y sus conclusiones emanan de las presentaciones realizadas por los ponentes y de las deliberaciones y acuerdos de cada mesa de trabajo. Ambos han sido aprobados tras varias correcciones por todos los autores antes de ser enviados para su publicación. Además, han obtenido el reconocimiento científico oficial de la Sociedad Española de Cirugía Oral y Maxilofacial y deben servir como base para futuros estudios y reuniones científicas. Conclusiones: El objetivo fundamental cuando se realiza un injerto óseo sinusal es la formación de hueso vital en el seno maxilar, para conseguir la supervivencia a largo plazo de los implantes tras su carga protésica. Para ello, la técnica y la secuencia de tratamiento deben orientarse a conseguir resultados predecibles y estables en el tiempo, aunque esto suponga un mayor tiempo de espera hasta la colocación de la prótesis. La estabilidad inicial del implante es el factor clave para la osteointegración y debe ser el principal criterio para indicar implantes simultáneos o diferidos en el seno maxilar(AU)

Objective: The objectives of the first Spanish Consensus Conference on Sinus Bone Graft were trying to reach agreements points on the major controversies of this technique, and translate them in a summary document. Material and method: During the 17th and 18th of October of 2008 took place in Oviedo (Spain) the Conference, sponsored by the Spanish Society of Oral and Maxillofacial Surgery. There, 50 national and international speakers reviewed in 6 workshops the major controversies of sinus bone grafts. Following the conferences, the moderators proposed the main conclusions of each workshop and opened a round of discussion where all attendees participated. Results: This document and its conclusions emanate from the presentations made by the speakers and the discussions and agreements of each workshop. Both have been approved after several corrections by all authors before being submitted for publication. They have also obtained the official scientific recognition of the Spanish Society of Oral and Maxillofacial Surgery and should serve as a basis for future scientific studies and meetings. Conclusions: The main objective when we perform a sinus bone graft is vital bone formation in the maxillary sinus, to achieve long-term survival of the implants after prosthetic loading. To do this, the technique and sequence of treatment should aim to achieve predictable and stable results over time, although this involves a longer waiting time. The initial implant stability is the key factor for osseointegration and should be the main criterion to indicate simultaneous or delayed implants in the maxillary sinus(AU)

Fístula arteriovenosa postraumática: tratamiento endovascular. Revisión de la literatura y presentación de un caso clínico / Endovascular treatment of a post-traumatic arterio-venous fistula: presentation of a clinical case and literature review

Las fístulas arteriovenosas en la cabeza y el cuello son entidades poco frecuentes. La mayoría es secundaria a heridas penetrantes por arma blanca. Se describe el tratamiento exitoso mediante cirugía endovascular de una fístula postraumática tras una herida penetrante entre la arteria maxilar interna izquierda y la vena yugular externa. A través de este caso clínico y la revisión de la literatura se ilustran las causas, manifestaciones, estudio radiológico y tratamiento de una fístula postraumática entre la arteria maxilar interna y la vena yugular externa. A través de este caso clínico se demuestra la utilidad de los procedimientos endovasculares en el tratamiento de estas complicaciones(AU)

Traumatic arteriovenous fistulas of the head and neck region are uncommon. The majority are due to penetration of blunt injury. We describe a successful endovascular treatment of a posttraumatic fistula between the left maxillary artery and the external jugular vein due to a penetration injury. This case and a review of the literature illustrate the causes, manifestations, image studies and treatment for a posttraumatic fistula between the maxillary artery and the external jugular vein. This case demonstrate the utility of endovascular treatment of head and neck injuries complications(AU)

[Trends in puberal development of school age children living in the Metropolitan Region of Chile]. / Tendencia del desarrollo puberal en escolares de la Región Metropolitana de Chile: Menor edad de presentación, mayor duración y dimorfismo sexual en la estatura.

BACKGROUND: There is a worldwide tendency towards an earlier appearance of puberal development among children, associated with an increase in weight and height. AIM: To study the trends in puberal development in Chilean school age children, between the years 1986 and 2001 and correlate it with weight and height changes. SUBJECTS AND METHODS: In two representative samples of school age children, collected between years 1985 and 1987 (m-1986) and another between years 2000 and 2002 (m-2001), girls between 7 and 15years (958 and 935, respectively) and boys between 9 and 15 years (842 and 870 respectively), were selected. Breast development (B) in females and genital development (G) in males were classified according to Tanner stages. Weight, height, body mass index (BMI) and nutritional status (according to Centers for Disease Control/ National Center for Health Statistics (CDC/NCHS) standards) were assessed. RESULTS: The prevalence of obesity increased four fold between 1986 and 2001. The 2001 generation had a significantly higher degree of puberal development than their counterparts studied in 1986. Compared to m-1986, m-2001 subjects had a lower mean age at puberal development stage two and three, but no differences at puberal stages 4 and 5. BMI of m-2001 subjects was significantly higher than that of m-1986 subjects at all puberal stages. The m-2001 males showed highest stature than m-1986 in all puberal stage, however, in females there is no difference in height between m-2001 and m-1986. CONCLUSIONS: The highest BMI observed in the cohort of 2001, could be facilitating an earlier puberal development and ethnic factors could explain the sexual dimorphism in stature.

Sialoectasia crónica del conducto de Stenon: a propósito de un caso / Chronic sialoectasis of Stenon’s duct: report of a case

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Importance of technical aspects in the beginnings of a pancreas transplantation program.

Pancreas and kidney transplantation is the treatment of choice for patients with type 1 diabetes mellitus and terminal renal insufficiency. Herein we have presented a series of 35 patients transplanted between 2002 and 2009 including periods before and after 2007 divided based on introduction of some technical aspects. In the first phase (learning period) we have noted complications related to pancreatic surgery with a morbidity among 12 of 18 patients (66.6%). In the second period (stabilization period), complications appeared in 6 out of 17 patients (35.2%; P < .028). The reoperation rate was 83.3% in the learning period and 23.5% in the stabilization period (P < .03). Seven transplantectomies were performed in the first period (P < .004). Five patients died, all of them in the learning group (P < .019). Changes in the technical aspects of the procedure were responsible for improved outcomes obtained among pancreas and kidney transplantations.

Tendencia del desarrollo puberal en escolares de la Región Metropolitana de Chile: Menor edad de presentación, mayor duración y dimorfismo sexual en la estatura / Trends in puberal development of school age children living in the Metropolitan Region of Chile

Background: There is a worldwide tendency towards an earlier appearance of puberal development among children, associated with an increase in weight and height. Aim: To study the trends in puberal development in Chilean school age children, between the years 1986 and 2001 and correlate it with weight and height changes. Subjects and Methods: In two representative samples of school age children, collected between years 1985 and 1987 (m-1986) and another between years 2000 and 2002 (m-2001), girls between 7 and 15years (958 and 935, respectively) and boys between 9 and 15 years (842 and 870 respectively), were selected. Breast development (B) in females and genital development (G) in males were classified according to Tanner stages. Weight, height, body mass index (BMI) and nutritional status (according to Centers for Disease Control/ National Center for Health Statistics (CDC/NCHS) standards) were assessed. Results: The prevalence of obesity increased four fold between 1986 and 2001. The 2001 generation had a significantly higher degree of puberal development than their counterparts studied in 1986. Compared to m-1986, m-2001 subjects had a lower mean age at puberal development stage two and three, but no differences at puberal stages 4 and 5. BMI of m-2001 subjects was significantly higher than that of m-1986 subjects at all puberal stages. The m-2001 males showed highest stature than m-1986 in all puberal stage, however, in females there is no difference in height between m-2001 and m-1986. Conclusions: The highest BMI observed in the cohort of 2001, could be facilitating an earlier puberal development and ethnic factors could explain the sexual dimorphism in stature.

Absceso crónico submaseterino secundario a cordal incluido / Chronic submasseter secondary abscess of impacted wisdom tooth

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Linfoma no-hodgkin de alto grado primario mandibular / High level primary mandible non Hodgkin’s lymphoma

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