Treatment of Refractory Ischemic Priapism: A Case Report and Literature Review.

Recurrent priapism is a rare and poorly known entity. It is defined by recurrent episodes of painful erections that last less than four hours. The etiology is similar to that of ischemic priapism. Episodes lasting more than four hours require immediate intervention to prevent penile fibrosis and subsequent erectile dysfunction. A 42-year-old male with no significant chronic-degenerative history was referred to our medical center from his second-level medical unit after a 56-hour history of ischemic priapism with the persistence of tumescence despite medical and surgical treatment. Upon interrogation, the patient reported stuttering (recurrent) episodes of painful erections lasting approximately three to four hours, not associated with sexual activity or arousal, in the past two years, with spontaneous resolution. He denied the use of psychotropics or drugs for erectile dysfunction. As a palliative measure, a left saphenous-cavernous (Grayhack) bypass was performed, with a 90% decrease in tumescence and total resolution of pain during the first 12 hours. There is little information and treatment recommendations for patients with recurrent priapism, and even less for patients who are refractory to conventional medical and surgical treatment. Recurrent or stuttering priapism is a condition with a low incidence and a pathophysiology compatible with low-flow priapism. It is difficult to treat and has a poor prognosis in terms of erectile function. Likewise, it is mostly associated with the use of psychotropic drugs such as cocaine and marijuana, medications for erectile dysfunction such as phosphodiesterase inhibitors, prostaglandin E1 analogues, and hematological malignancies such as sickle cell anemia and multiple myeloma. The aim of this article is to share our experience with a patient refractory to multiple medical and surgical treatments.

How Do We Measure Social Management in Non-profit Organizations? A Scale Design Based on the Once Case.

One of the most important current challenges facing non-profit organizations (henceforth, NPOs) is to demonstrate that resources are being used properly to fulfill their missions. The development of control mechanisms to facilitate the measurement of social goal fulfillment has thus become a priority. In this context, transparency and good governance are configured as essential strategic elements to build trust with different stakeholders. In this work, we show the value provided by management indicators as they have become a necessary tool to confirm that the use of resources, internal processes and decisions within NPOs are carried out with the highest levels of efficiency and excellence. Only in this way can social credibility be achieved. The success of an NPO is inextricably linked to the support of donors, users, public administration and society as a whole. To achieve our research objective, we build a measurement scale based on the case of the Spanish National Organization for the Blind (ONCE), one of the largest Spanish NPOs. Based on ONCE's experience, we propose a management indicator model that covers all social dimensions. The model is empirically validated to standardize the indicators for the ONCE and for serving as a reference for other entities.

Histological differences in the adherence of connective tissue to laser-treated abutments and standard abutments for dental implants. An experimental pilot study in humans

Background: The goal of the current study is to assess the difference in connective tissue adherence to laser microtextured versus machined titanium abutments. Material and Methods: Six patients were selected and each of them received 2 implants, one combined with a laser treated abutment and one with a machined abutment. After three months, the abutments were retrieved together with their surrounding gingival tissue for histological analysis. Qualitative and quantitative evaluation of microscopical images was performed to assess the presence or absence of adherence between the soft tissues and the abutment, and the percentage of soft tissue adhered to the two different surfaces. Results: Intimate adherence between connective tissue and the laser treated abutments, while on machined abutments no adherence was detected. A significant difference was found in the percentage of surface in contact with soft tissue between both implant abutments p=0.03. Conclusions: Within the limitation of the current study, it can be concluded that connective tissues show enhanced adherence to microtextured abutments compared to machined abutments (AU)

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Computer-aided system for morphometric mandibular index computation. (Using dental panoramic radiographs).

OBJECTIVE: We propose and validate a computer-aided system to measure three different mandibular indexes: cortical width, panoramic mandibular index and, mandibular alveolar bone resorption index. STUDY DESIGN: Repeatability and reproducibility of the measurements are analyzed and compared to the manual estimation of the same indexes. RESULTS: The proposed computerized system exhibits superior repeatability and reproducibility rates compared to standard manual methods. Moreover, the time required to perform the measurements using the proposed method is negligible compared to perform the measurements manually. CONCLUSIONS: We have proposed a very user friendly computerized method to measure three different morphometric mandibular indexes. From the results we can conclude that the system provides a practical manner to perform these measurements. It does not require an expert examiner and does not take more than 16 seconds per analysis. Thus, it may be suitable to diagnose osteoporosis using dental panoramic radiographs.

Histomorphological study of the bone regeneration capacity of platelet-richplasma, bone marrow and tricalcium phosphate Experimental study on pigs

Introduction: Bone defects are rather common after oral surgery and may prove difficult to repair. Objective: Weprovide a histomorphological analysis of the bone regenerative capacity of platelet-rich plasma at different concentrationsand the extraction of platelet-rich bone marrow, compared with &bgr;-tricalcium phosphate. Methodology:We performed an experimental study on 8 pigs, in which we performed trepanations of the mandible inorder to place the materials to be studied. Using an electron microscope, we observed the samples obtained andtook a series of photographs in order to analyze the samples through a gray-scale histogram system.Results: Ossification phenomena were present in 96% of the charged defects, regardless of the material used to fillit. Platelet-rich plasma (PRP) and the bone marrow (M) showed an equivalent degree of osteogenesis, 12.3 and 13.4respectively, which is greater in than the control group. The platelet-poor plasma (PPP) shows a capacity similarto the control groups (C), with an average count of 14.03 and 14.12 respectively. Tricalcium phosphate (TP) wasshown to be effective as an ossification inducer, 3.03 times stronger than the control group. Conclusions: Ossificationoccurs in most of the charged defects. PRP and M had the greatest osteogenic capacity but PPP was nomore effective than the control (AU)

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Histomorphological study of the bone regeneration capacity of platelet-rich plasma, bone marrow and tricalcium phosphate: Experimental study on pigs.

INTRODUCTION: Bone defects are rather common after oral surgery and may prove difficult to repair. OBJECTIVE: We provide a histomorphological analysis of the bone regenerative capacity of platelet-rich plasma at different concentrations and the extraction of platelet-rich bone marrow, compared with beta-tricalcium phosphate. METHODOLOGY: We performed an experimental study on 8 pigs, in which we performed trepanations of the mandible in order to place the materials to be studied. Using an electron microscope, we observed the samples obtained and took a series of photographs in order to analyze the samples through a gray-scale histogram system. RESULTS: Ossification phenomena were present in 96% of the charged defects, regardless of the material used to fill it. Platelet-rich plasma (PRP) and the bone marrow (M) showed an equivalent degree of osteogenesis, 12.3 and 13.4 respectively, which is greater in than the control group. The platelet-poor plasma (PPP) shows a capacity similar to the control groups (C), with an average count of 14.03 and 14.12 respectively. Tricalcium phosphate (TP) was shown to be effective as an ossification inducer, 3.03 times stronger than the control group. CONCLUSIONS: Ossification occurs in most of the charged defects. PRP and M had the greatest osteogenic capacity but PPP was no more effective than the control .

[Risk percentiles: a new adapted method for evaluating vascular risk. ERVPA study]. / Percentiles de riesgo: un nuevo método adaptado para la valoración del riesgo vascular. Estudio ERVPA.

BACKGROUND AND OBJECTIVE: Various cardiovascular scoring systems estimating the risk in the Spanish population are currently used. The aim of our study was to create graphs and charts of populational percentiles to assess the total burden of risk of a population and to place each subject individually in the context of their own population setting by using cardiovascular risk charts. SUBJECTS AND METHOD: A cross-sectional study of 514 individuals of both sexes from a general population setting was carried out. Cardiovascular risk was calculated according to the SCORE project equations and charts and graphs of cardiovascular risk were formulated. RESULTS: In primary prevention, 17.11% of men and 22.36% of women aged 20-79 showed a high cardiovascular risk. The percentages vary from 0% in persons of both sexes aged 20-39 to 91.2% of men and 97.9% of women in their 70s. Risk medians range in men from 0.11% (age 20-39) to 8.86% (age 70-79) and in women from 0.02% (age 20-39) to 15.20% (age 70-79). Graphs of cardiovascular risk percentiles were formulated for both sexes; graphs can be used to situate each subject individually in the context of their own population setting and to project the risk to any age. CONCLUSIONS: Nearly a fifth of the population has a high cardiovascular risk. More than 90% of men and women in their 70s have a high cardiovascular risk.

Síndrome de Muir-Torre / Muir-Torre's Syndrome

El síndrome de Muir-Torre es una genodermatosis en la que una o múltiples neoplasias internas están asociadas a adenomas, epiteliomas o carcinomas sebáceos. Presentamos el caso de un paciente varón de 60 años que acude a consulta por varias neoplasias en área facial, entre las cuales figura un adenoma sebáceo y varios queratoacantomas. Tras este hallazgo, en una exploración dirigida a buscar neoplasias internas asociadas, se detectó un adeno-carcinoma de colon. Tiene historia familiar de neoplasias gastrointestinales y ginecológicas. Las lesiones cutáneas pueden ser la primera expresión del síndrome y por tanto deben ser conocidas para detectar tempranamente un proceso neoplásico asociado (AU)

El trauma craneal por accidente del tránsito en terapia de cirugía / Cranial trauma due to traffic accident in surgical therapy

Se estudió la morbilidad y mortalidad del trauma craneoencefálico por accidente del tránsito en 165 pacientes ingresados en la unidad de terapia de cirugía del Hospital Militar "Dr. Carlos J. Finlay" durante el año 1990. Se concluyó que la contusión cerebral y el hematoma subdural son las causas más frecuentes de la alta letalidad. Se plantea que la medición intracraneal es necesaria y que la tomografía axial computadorizada de cráneo debe ser realizada de urgencia, si está disponible, para mejorar el diagnóstico y tratamiento del trauma craneoencefálico

El trauma craneal por accidente del tránsito en terapia de cirugía / Cranial trauma due to traffic accident in surgical therapy

Se estudió la morbilidad y mortalidad del trauma craneoencefálico por accidente del tránsito en 165 pacientes ingresados en la unidad de terapia de cirugía del Hospital Militar "Dr. Carlos J. Finlay" durante el año 1990. Se concluyó que la contusión cerebral y el hematoma subdural son las causas más frecuentes de la alta letalidad. Se plantea que la medición intracraneal es necesaria y que la tomografía axial computadorizada de cráneo debe ser realizada de urgencia, si está disponible, para mejorar el diagnóstico y tratamiento del trauma craneoencefálico