Maxilla reconstruction with autogenous bone block grafts: computed tomography evaluation and implant survival in a 5-year retrospective study.

This retrospective study was performed to evaluate the bone thickness of the anterior maxillary region after reconstruction with autogenous bone blocks at 6 months and 5 years after surgery using computed tomography (CT) and to determine the implant survival rate. Eleven patients with a horizontal bone deficiency were treated with reconstructive procedures and implant placement. CT measurements were obtained before surgery (T0) and at 6 months (T1) and 5 years (T2) after surgery. The values were analysed statistically (analysis of variance and Tukey's test; P<0.05). Implant survival was evaluated at follow-up. The mean width of the lower region of the ridge (±standard deviation, in millimetres) was 3.8±1.6 at T0, 7.0±1.6 at T1, and 6.5±1.0 at T2; the mean width of the upper region of the ridge was 5.7±2.3 at T0, 8.3±2.2 at T1, and 7.3±1.6 at T2. The mean total thickness of the ridge was 4.7mm at T0, 7.6mm at T1, and 6.9mm at T2; the average increase in horizontal thickness was 2.9mm at T1 and 2.2mm at T2. A statistically significant difference was observed in the mean width of the lower portion at T1 and T2 compared to the width at T0. The implant survival rate was 94.1%. This technique demonstrated high predictability for implant survival, with a reduction in the graft bone during the follow-up period.

Food Safety Hazards and Microbiological Zoonoses in European Meat Imports Detected in Border Inspection in the Period 2008-2013.

Microbiological contaminations and other food safety hazards are omnipresent within the European Union (EU) and a considerable risk for consumers, particularly in imported meat and meat products. The number of rejections at external EU borders has been increasing in recent years. Official authorities in each member state are therefore obliged to notify border rejections of food and animal feed due to a direct or indirect risk to human or animal health. This study explored the trends and temporal and spatial distribution of notifications on food safety hazards between January 2008 and December 2013 with a special emphasis on microbiological zoonoses in meat and meat products including poultry at border checks resulting from the rapid alert system for food and feed (RASFF). Results indicated that border rejection notifications are increasing exponentially, frequently due to Salmonella in poultry and shiga-toxin-producing E. coli in meat and meat products.

Antecedente de hipotiroidismo en pacientes consultantes por lipodistrofia (celulitis) / Hypothyroidism in women who consulted for lipodystrophy (cellulite)

La celulitis es una entidad que afecta a la mayoría de las mujeres. Existen varias teorías sobre su fisiopatología. Sabemos que la hormona tiroidea tiene un efecto a nivel cutáneo, y en nuestro país se ha reportado una mayor prevalencia de hipotiroidismo que en otros países. Objetivo: Comparar la prevalencia de hipotiroidismo en mujeres que consultaron para tratamiento de celulitis y/o flaccidez abdominal en un centro dermatológico de Santiago con la reportada en la literatura. Materiales y métodos: Se realizó un estudio retrospectivo con 122 pacientes evaluadas entre noviembre 2009 y enero 2012. Se excluyeron 25 por no contar con anamnesis completa. Los datos fueron obtenidos de la entrevista inicial, y de la ficha clínica cuando ésta estaba incompleta. Resultados: Se obtuvo una prevalencia de 19 por ciento, valor significativamente mayor (p<0,001)a la reportada en la literatura (6,8 por ciento en Chile y entre 5 por ciento y 10 por ciento en otros países).

Cellulite is an entity that affects most women. There are many theories about its physiopathology. It is known that the thyroid hormone has an effect on the skin, and there are reports of a higher prevalence of hypothyroidism in our country than elsewhere. Objective: Compare the prevalence of hypothyroidism in women who consulted for cellulite and/or abdominal flabbiness in a dermatologic clinic in Santiago, with the data reported in the literature. Materials and methods: We performed a retrospective study with 122 patients who consulted between November 2009 and January 2012, of whom 25 were excluded because of incomplete data. Information was obtained from the initial interview, and, if missing some data, from the clinical records. Results: We found a prevalence of 19 percent, which is significantly higher (p<0,001) than the value reported in the literature (6,8 percent in Chile, and between 5 percent and 10 percent elsewhere).

Dysregulation of calcium homeostasis after severe burn injury in children: possible role of magnesium depletion.

OBJECTIVE: To determine the cause and extent of hypocalcemia observed in children after severe burns. DESIGN: We studied 10 children with burns covering 57% +/- 17% (SD) body surface area, ages 9.6 +/- 4.7 years, who were admitted consecutively during a 6-month period. Diet supplied a minimum of 2.7 gm/m2 of calcium, 0.3 gm/m2 of magnesium, and 2.2 gm/m2 phosphate. Blood specimens were obtained daily for 10 +/- 5 days for the following tests: (1) simultaneous analysis for ionized calcium, magnesium, and intact parathyroid hormone (group A); (2) two of these children, randomly selected, had serial 2-hour determinations on a single day (group B); (3) a modified Ellsworth-Howard test, consisting of a 10-minute infusion of synthetic parathyroid hormone 18 +/- 10 days post-burn and associated changes in urinary cyclic adenosine monophosphate excretion and renal threshold phosphate concentration (group C). Three of these children, when normomagnesemic, also received a standard magnesium infusion to determine magnesium retention (group D). Data were analyzed with chi-square, regression analysis, and non-parametric testing as appropriate. RESULTS: All patients showed sustained hypocalcemia and hypomagnesemia; intact parathyroid hormone response was inappropriately low and response to synthetic parathyroid hormone infusion was blunted. Lowest ionized calcium levels were associated with hypomagnesemia. CONCLUSION: Hypoparathyroidism and blunted renal response to parathyroid hormone suggest that magnesium depletion may contribute to their pathogenesis. Magnesium repletion and monitoring are recommended.

Long-term reduction in bone mass after severe burn injury in children.

OBJECTIVE: Because burn victims are at risk of having bone loss, a cross-sectional study was undertaken to determine whether severe burn injury had acute and long-term effects on bone mass or on the incidence of fractures in children. METHODS: Dual-energy x-ray absorptiometry of the lumbar portion of the spine was performed on 68 children: 16 moderately burned (15% to 36% of total body surface area) and 52 age-matched severely burned (> or = 40% of total body surface area). Twenty-two severely burned children were hospitalized and studied within 8 weeks of their burn, and 30 others were studied approximately 5 years after discharge. In the severely burned group, both hospitalized and discharged, serum and urine were analyzed for calcium, phosphorus, intact parathyroid hormone, osteocalcin, and type I collagen telopeptide. RESULTS: Sixty percent of severely burned patients had age-related z scores for bone density less than -1, and 27% of severely burned patients had age-related z scores for bone density less than -2 (p < 0.005, for each). In the moderately burned group, 31% of patients had z scores less than -1 (p < 0.005 vs normal distribution), but only 6% had z scores less than -2 (p value not significant). There was evidence of increased incidence of fractures after discharge in the severely burned patients. Biochemical studies were compatible with a reduction in bone formation and an increase in resorption initially, and with a long-term persistence of low formation. CONCLUSION: We conclude that acute burn injury leads to profound and long-term bone loss, which may adversely affect peak bone mass accumulation.

Experiencia en el tratamiento del carcinoma de las vías biliares / Experience in the treatment of carcinoma of the biliary tract

Se presenta una serie de 21 enfermos con tumores malignos de las vías biliares extrahepáticos. Se hace un análisis en los procedimientos diagnósticos y de la topografia de las lesiones. Se describen una variedad de operaciones y métodos que tienem como meta el alivio de la hiperbilirrubinemia y sus consecuencias. Se comparan nuestros resultados en relación a mortalidad y sobrevida con las series de autores extranjeros finalizando con una serie de recomendaciones y conclusiones que deben tomarse en cuenta para mejorar el prognóstico

Elevated antibody titers to Epstein-Barr virus and low natural killer cell activity in patients with Chediak-Higashi syndrome.

Four Venezuelan patients with the autosomal recessive Chediak-Higashi syndrome (CHS) were studied. The results confirm the severe reduction in natural killer (NK) cell activity, as previously described and showed also a decline in the activity of cells involved in antibody-dependent cellular cytotoxicity (ADCC). No defect was found in the production of immunoglobulins and of specific antibodies to measles, varicella, herpes simplex, and cytomegalo viruses. Two of the patients had extremely high antibody titers to the Epstein-Barr virus (EBV) specific viral capsid antigen (VCA), to the restricted (R) component of the EBV-induced early antigen complex, and to the EBV-associated nuclear antigen (EBNA). These two patients had enlarged livers, spleens, and lymph nodes indicative of the lymphoproliferative phase. The other two patients were initially negative for all EBV-associated antibodies but seroconverted subsequently and, in the course of a year, also developed high antibody titers to VCA and R. In one of these patients the primary infection was accompanied by moderate signs of infectious mononucleosis (IM) followed after more than 6 months by persistent hepatosplenomegaly. The other patient also developed signs of a lymphoproliferative syndrome with hepatosplenomegaly and jaundice and died 8 months later. Such high anti-R titers are seen frequently in Burkitt's lymphoma, but rarely in other conditions. It is likely that the high antibody titers reflect an increased production of VCA and R due to defective NK and ADCC cell activities so that productively infected B lymphocytes are no longer eliminated before they have synthesized maximal amounts of antigens. The high anti-EBNA titers suggest normal T lymphocyte function. The possibility that the accelerated, lymphoma-like phase of the CHS involves EBV-transformed cells is discussed.

Transient steatorrhea following episodes of mild diarrhea in early infancy.

Fecal fat excretion was studied after a mild episode of diarrhea in eight infants for whom adequate control data were available. Mean age of onset of diarrhea was 28 days. Duration of the episode, defined as the number of days until the infant was again feeding and libitum, averaged 5.1 days. Balance studies were carried out 3 to 13 days later. Mean fecal fat excretion rose from a prediarrhea value of 2.9 +/- 1.4 gm/day to 8.7 +/- 3.1 gm/day following diarrhea (P less than 0.001). Restudy of five infants one month later showed persistent steatorrhea in one. Mild transient steatorrhea may follow mild diarrhea in infancy and should be considered in infants who are slow to gain weight subsequent to an episode of diarrhea.