Osteoprotegerin and zoledronate bone effects during orthodontic tooth movement.

OBJECTIVES: To assess the effects of local delivery of recombinant fusion protein osteoprotegerin (OPG-Fc) and bisphosphonate zoledronate on bone and periodontal ligament in a rat tooth movement model. MATERIALS AND METHODS: Maxillary first molars of 36 male Sprague-Dawley rats were displaced mesially using a calibrated spring connected to an anterior mini-screw. Two different drugs were used: a single dose of Zoledronate (16 µg) and a twice-weekly dose of OPG-Fc (5.0 mg/kg) were injected. Tooth movement was measured on scanned plaster casts. Structural and immunohistochemical analysis of the orthodontic-induced changes in bone included receptor activator of nuclear factor ĸ (RANK), Runx, type 1 collagen, matrix metalloproteinases (MMPs) 2 and 9, tissue inhibitors of metalloproteinases (TIMPs) 1 and 2, and vimentin. RESULTS: Both groups showed a reduction in mesial molar displacement. Animals receiving OPG-Fc demonstrated only 52%, 31%, and 21% of the total mesial molar displacement compared to control rats at 7, 14, and 21 days, respectively (*p < 0.001). For rats receiving zoledronate tooth displacement decreased significantly with 52%, 46% and 30%, respectively (*p < 0.001). At 14 and 21 days, OPG-Fc group showed significantly less molar displacement than the zoledronate group (*p < 0.001). RANK, Runx, vimentin, MMP-9 and tissues-inhibitor metalloproteinase 1 immunoreactivity were reduced in zoledronate treated animals and even more in OPG treated animals. CONCLUSION: Local delivery of OPG-Fc or zoledronate inhibits bone resorption and therefore tooth movement. OPG-Fc was more effective than zoledronate in blocking the action of osteoclasts.

Evidencia científica en la indicación de filtro de vena cava inferior: Revisión bibliográfica / Scientific evidence in inferior vena cava filter indication: Bibliographic review

En esta revisión bibliográfica se pretende aplicar la Medicina Basada en la Evidencia a las indicaciones de colocación de filtro de vena cava inferior, y establecer una comparación con las indicaciones clásicas. Asimismo se revisan las indicaciones de los filtros temporales de vena cava, así como sus características, ventajas e inconvenientes. Finalmente se hace una breve mención a la indicación de filtro de vena cava inferior en algunos casos especiales, como son los pacientes politraumatizados y oncológicos (AU)

In this review is intended to implement the Evidence-based indications of a placement of inferior vena cava filter, and a comparisonwith the classic signs. It also reviews the indications of temporary vena cava filters, as well as their characteristics, advantages and disadvantages. Finally a brief mention of the indication of inferior vena cava filter in some special cases, such as cancer patients and polytraumatized (AU)

Patient and normal three-dimensional eye-movement responses to maintained (DC) surface galvanic vestibular stimulation.

HYPOTHESIS: That disease or dysfunction of vestibular end organs in human patients will reduce or eliminate the contribution of the affected end organs to the total eye-movement response to DC surface galvanic vestibular stimulation (GVS). BACKGROUND: It was assumed that DC GVS (at current of 5 mA) stimulates all vestibular end organs, an assumption that is strongly supported by physiological evidence, including the activation of primary vestibular afferent neurons by galvanic stimulation. Previous studies also have described the oculomotor responses to vestibular activation. Stimulation of individual semicircular canals results in eye movements parallel to the plane of the stimulated canal, and stimulation of the utricular macula produces changes in ocular torsional position. It was also assumed that the total three-dimensional eye-movement response to GVS is the sum of the contributions of the oculomotor drive of all the vestibular end organs. If a particular vestibular end organ were to be diseased or dysfunctional, it was reasoned that its contribution to the GVS-induced oculomotor response would be reduced or absent and that patients thus affected would have a systematic difference in their GVS-induced oculomotor response compared with the response of normal healthy individuals. METHODS: Three-dimensional video eye-movement recording was carried out in complete darkness on normal healthy subjects and patients with various types of vestibular dysfunction, as diagnosed by independent vestibular clinical tests. The eye-movement response to long-duration bilateral and unilateral surface GVS was measured. RESULTS: The pattern of horizontal, vertical, and torsional eye velocity and eye position during GVS of patients independently diagnosed with bilateral vestibular dysfunction, unilateral vestibular dysfunction, CHARGE syndrome (semicircular canal hypoplasia), semicircular canal occlusion, or inferior vestibular neuritis differed systematically from the responses of normal healthy subjects in ways that corresponded to the expectations from the conceptual approach of the study. CONCLUSION: The study reports the first data on the differences between the normal response to GVS and those of patients with a number of clinical vestibular conditions including unilateral vestibular loss, canal block, and vestibular neuritis. The GVS-induced eye-movement patterns of patients with vestibular dysfunction are consistent with the reduction or absence of oculomotor contribution from the end organs implicated in their particular disease condition.

Reseccion toracoscopica de una glandula paratiroidea hipersecretante mediastinal / Thoracoscopic resection of mediastinal hypersecretant parathyroid gland

In general experienced hands, the inferior parathyroid glands, localized in the thymus or low extrathymus are the main cause or surgical therapeutic failure. When they could not be approached through cervicotomy, or when they were diagnosed after surgery the sternotomy or the angiographic ablation were chosen as treatment. The limited number of thoracoscopic approach whit good results published so far, moved us to use this method. MATERIAL AND METHOD: Patient of 49 years with a 7 year secondary hiperprathyroidism due to CRI. After a sub total parathyroidectomy with bilateral thimectomy, the patient did not present clinical or laboratory improvement. Through a thoracic centellogram sixth MIBI, NMR and CAT, a tumor in the middle mediastinum was fond. The mediastinal structures have been easily identified through a left thoracoscopic approach. At the level of the aortopulmonary window, a tumoral mass is located and, with a simple dissection, et is easily extracted in bag. The biopsy through freezing confirms the parathyroid etiology of the gland. RESULT: Clinical and laboratory evolution has been favorable, with hospital discharged at the 3 day, and being asymptomatic after two years. CONCLUSION: The hipersecretant parathyroid glands, located in middle mediastinum, that can not be approach through cervicotomy, can be successfully approach through thoracoscopic technique.

Por lo general en manos experimentadas las paratiroides inferiores. de localización tímica o extratímica baja, son la principal causa de fracaso terapéutico quirúrgico. Cuando no son accesibles por cervicotomía o bien se diagnosticaron posteriormente. la esternotomía o la ablación angiográfica eran considerados como los tratamientos de elección. El haberse publicado limitadas experiencias de abordaje toracoscópico con buenos resultados nos motivo al empleo de esta VÍa. Material y método: paciente de 49 años con hiperparatiroidismo secundario por IRC de 7 años de evolución. Luego de una paratiroidectomía sub-total con timectomía bilateral. no presenta mejoría clínica ni de laboratorio. Al ser estudiada con centellograma sesta-MIBI. RMN y TAC torácica es localiza un tumor en mediastino meido. Abordaje toracoscópico izquierdo. identificándose con facilidad las estructuras mediastinales. A nivel de la ventana aortopulmonar se localiza una masa tumoral que con simples maniobras de disección es fácilmente extraída en bolsa. La biopsia por congelación confirma la etiología paratiroidea de la misma. Resultado: Evolución clínica y de laboratorio favorable con alta de sala al 3- día. encontrándose a los dos años asintomático. Conclusión: vemos con entusiasmo el abordaje toracoscópico de glándulas paratiroideas hipersecretantes ubicadas en medias tino medio que no hayan podido ser extraídas por cervicotomía.

Reseccion toracoscopica de una glandula paratiroidea hipersecretante mediastinal / Thoracoscopic resection of mediastinal hypersecretant parathyroid gland

In general experienced hands, the inferior parathyroid glands, localized in the thymus or low extrathymus are the main cause or surgical therapeutic failure. When they could not be approached through cervicotomy, or when they were diagnosed after surgery the sternotomy or the angiographic ablation were chosen as treatment. The limited number of thoracoscopic approach whit good results published so far, moved us to use this method. MATERIAL AND METHOD: Patient of 49 years with a 7 year secondary hiperprathyroidism due to CRI. After a sub total parathyroidectomy with bilateral thimectomy, the patient did not present clinical or laboratory improvement. Through a thoracic centellogram sixth MIBI, NMR and CAT, a tumor in the middle mediastinum was fond. The mediastinal structures have been easily identified through a left thoracoscopic approach. At the level of the aortopulmonary window, a tumoral mass is located and, with a simple dissection, et is easily extracted in bag. The biopsy through freezing confirms the parathyroid etiology of the gland. RESULT: Clinical and laboratory evolution has been favorable, with hospital discharged at the 3 day, and being asymptomatic after two years. CONCLUSION: The hipersecretant parathyroid glands, located in middle mediastinum, that can not be approach through cervicotomy, can be successfully approach through thoracoscopic technique.(AU)

Por lo general en manos experimentadas las paratiroides inferiores. de localización tímica o extratímica baja, son la principal causa de fracaso terapéutico quirúrgico. Cuando no son accesibles por cervicotomía o bien se diagnosticaron posteriormente. la esternotomía o la ablación angiográfica eran considerados como los tratamientos de elección. El haberse publicado limitadas experiencias de abordaje toracoscópico con buenos resultados nos motivo al empleo de esta VIa. Material y método: paciente de 49 años con hiperparatiroidismo secundario por IRC de 7 años de evolución. Luego de una paratiroidectomía sub-total con timectomía bilateral. no presenta mejoría clínica ni de laboratorio. Al ser estudiada con centellograma sesta-MIBI. RMN y TAC torácica es localiza un tumor en mediastino meido. Abordaje toracoscópico izquierdo. identificándose con facilidad las estructuras mediastinales. A nivel de la ventana aortopulmonar se localiza una masa tumoral que con simples maniobras de disección es fácilmente extraída en bolsa. La biopsia por congelación confirma la etiología paratiroidea de la misma. Resultado: Evolución clínica y de laboratorio favorable con alta de sala al 3- día. encontrándose a los dos años asintomático. Conclusión: vemos con entusiasmo el abordaje toracoscópico de glándulas paratiroideas hipersecretantes ubicadas en medias tino medio que no hayan podido ser extraídas por cervicotomía.(AU)

Maintained ocular torsion produced by bilateral and unilateral galvanic (DC) vestibular stimulation in humans.

This study was designed to measure ocular movements evoked by galvanic (DC) stimulation using computerised video-oculography. Long duration (>30 s) galvanic vestibular stimulation at currents of up to 5 mA through large-area surface electrodes over the mastoid processes causes maintained changes in the ocular torsional position of both eyes in healthy human subjects. With the subject seated and the head held firmly, torsion was measured by a computer-based image-processing system (VTM). Torsion was recorded in darkness, with or without a single fixation point. With bilateral stimulation, the upper poles of both eyes always torted away from the side of cathode placement and toward the anode. For unilateral stimulation, torsion was directed away from the cathode or toward the anode. The magnitude of ocular torsion was dependent on current strength: with bilateral stimulation the peak torsion was on average 2.88 degrees for 5-mA current intensity compared with 1.58 degrees for 3 mA. A smaller amplitude of torsion was obtained for unilateral stimulation. The average peak torsion was the same for both eyes for all forms of stimulation. Our findings indicate that low-intensity galvanic stimulation evokes ocular torsion in normal subjects, an effect which is consistent with an action on otolith afferents.

Unilateral vestibular deafferentation produces no long-term effects on human active eye-head coordination.

We tested the hypothesis that the reason some patients compensate well after unilateral vestibular deafferentation (uVD) and others do not could be due to differences in eye-head coordination or in blink characteristics during natural, active head movements. Patients with well-compensated uVDs do not report distressing postural unsteadiness or an aversive sensation of apparent motion of a visual scene (oscillopsia) or "visual confusion" upon rapid head rotation as do those patients with poorly compensated uVDs. It has been suggested that well-compensated subjects eliminate the subjective sensations associated with retinal slip, which must occur as a result of an inadequate vestibuloocular reflex (VOR), either by restricting head movement to the lesioned side or by blinking during head turns. To test this, subjects stood at the curbside of a busy road with a 180 degrees view of regular, fast-moving traffic, which they scanned in preparation of crossing the road, and their eye and head movements and blinks were measured in this natural situation. Both normals and uVDs generated similar ranges of head position, head velocity and gaze magnitude, and all subjects performed a blink during the gaze saccade. Contrary to the hypothesis, no systematic differences were found between normals and either group of uVDs.

[Evaluation of the efficacy of haloperidol decanoate in the treatment of chronic psychotic hospital patients]. / Evaluación de la eficacia del haloperidol decanoato en el tratamiento de pacientes psicóticas crónicas hospitalizadas.

The purpose of our experience was to determine the efficacy of haloperidol decanoate during the treatment of chronic psychotic in-patients. So we included, in an open study, 30 patients hospitalized in the Esquirol and Magnan Departments of the National Hospital of Mental Health "Dr. Braulio A. Moyano". As a result of this study, we have observed that to the already known properties of this drug, it may be added, because of its new depot formulation, the following advantages: a) it replaces effectively the daily intake of neuroleptics; b) it allows the reduction of the dose of oral neuroleptics as well as the number of drugs combination; c) it diminishes the incidence of extrapyramidal symptoms, allowing the reduction of the dose or the interruption of antiparkinsonian drugs; d) it facilitates the nurse's labor; e) it allows the physician to be sure of the fulfillment of his prescription.

Evaluación de la eficacia del haloperidol decanoato en el tratamiento de pacientes psicóticas crónicas hospitalizadas. / [Evaluation of the efficacy of haloperidol decanoate in the treatment of chronic psychotic hospital patients]

The purpose of our experience was to determine the efficacy of haloperidol decanoate during the treatment of chronic psychotic in-patients. So we included, in an open study, 30 patients hospitalized in the Esquirol and Magnan Departments of the National Hospital of Mental Health [quot ]Dr. Braulio A. Moyano[quot ]. As a result of this study, we have observed that to the already known properties of this drug, it may be added, because of its new depot formulation, the following advantages: a) it replaces effectively the daily intake of neuroleptics; b) it allows the reduction of the dose of oral neuroleptics as well as the number of drugs combination; c) it diminishes the incidence of extrapyramidal symptoms, allowing the reduction of the dose or the interruption of antiparkinsonian drugs; d) it facilitates the nurses labor; e) it allows the physician to be sure of the fulfillment of his prescription.