Craniofacial trauma: Experience in private hospital care during the pandemic provoked by SARS-CoV-2.

BACKGROUND: The onset of the SARS-Cov-2 pandemic brought with it important changes in the hospital care for all diseases. According to the international literature, since the beginning of the pandemic there has been an impact in the incidence, etiology, and severity of head trauma, all these changes as a direct consequence of lockdown. OBJECTIVE: In this article we analyzed the characteristics of craniofacial trauma in patients admitted to a private hospital in Mexico City during the SARS-CoV-2 pandemic. METHOD: Medical records from patients admitted in Medica Sur between March 2020 and June 2021. In this study, incidence, etiology, severity of the injuries and the SARS-CoV-2 PCR result performed upon admission were analyzed. RESULTS: Although there is no study in Mexico like ours, the results were similar to those reported by other hospital centers worldwide, presenting a greater number of cases classified as mild craniofacial trauma, in addition to finding that the main age group affected were older adults. CONCLUSIONS: The reported information in our study provides a general view of craniofacial trauma characteristics during SARS-CoV-2 pandemic.

INTRODUCCIÓN: El inicio de la pandemia provocada por SARS-CoV-2 trajo consigo importantes cambios en los cuidados hospitalarios para todas las enfermedades. De acuerdo con la literatura internacional, desde el comienzo, y a consecuencia del aislamiento, ha existido un impacto en la incidencia, la etiología y la gravedad del trauma craneomaxilofacial. OBJETIVO: Estudiar las características del trauma craneofacial en los pacientes ingresados a un hospital privado en la Ciudad de México durante la pandemia por SARS-CoV-2. MÉTODO: Se revisaron los expedientes clínicos de los pacientes ingresados a Médica Sur, entre marzo de 2020 y junio de 2021. Se analizaron la incidencia, la etiología, la gravedad de las lesiones y el resultado de la prueba de reacción en cadena de la polimerasa para SARS-CoV-2 que se realizó durante la atención hospitalaria. RESULTADOS: En México no existe un estudio semejante al nuestro, pero los resultados fueron similares a los reportados por otros centros hospitalarios en el mundo, presentando un mayor número de casos clasificados como traumatismo craneofacial leve, además de encontrar que el principal grupo de edad afectado fueron los adultos mayores. CONCLUSIONES: La información reportada en nuestro estudio brinda un panorama general sobre las características del trauma craneofacial durante la pandemia por SARS-CoV-2.

Ceguera legal unilateral y liposucción. Revisión de la literatura y reporte del primer caso en México, octavo en el mundo / Liposuction and unilateral legal blindness. Literature review and first case report in Mexico, eight in the world

Presentamos el caso de una paciente de 32 años que desarrolló ceguera legal posterior a liposucción y mamoplastia de aumento, evolucionando con anemia transitoria y disminución progresiva de la agudeza visual del ojo izquierdo (20/200). A pesar de la corrección de la anemia y la mejoría del estado general, continuó durante 2 meses con sintomatología ocular. Se estableció diagnóstico de neuropatía óptica isquémica anterior no arterítica (NOIA) de acuerdo con los hallazgos oftalmológicos. Revisamos las publicaciones previas para neuritis óptica isquémica anterior después de liposucción y las recomendaciones para prevenir dicha patología

We present the case of a 32-year-old woman who developed legal blindness posterior to liposuction and augmentation mammoplasty, with postoperative anemia and decreased vision of the left eye (20/200). Despite the correction of the anemia and improvement of the general status, the patient continued with vision loss for 2 months. According to ophthalmologic studies we could establish the diagnosis of non-arteritic ischemic optic neuropathy (NAION). We review the previous reports in the literature for anterior ischemic optic neuritis after liposuction and the recommendations to prevent this complicatio

Perfusion Bioreactor Culture of Bone Marrow Stromal Cells Enhances Cranial Defect Regeneration.

BACKGROUND: Cell-seeded biomaterial scaffolds have been proposed as a future option for reconstruction of bone tissue. The ability to generate larger, functional volumes of bone has been a challenge that may be addressed through the use of perfusion bioreactors. In this study, the authors investigated use of a tubular perfusion bioreactor system for the growth and differentiation of bone marrow stromal (mesenchymal stem) cells seeded onto fibrin, a highly angiogenic biomaterial. METHODS: Cells were encapsulated within fibrin beads and cultured either within a tubular perfusion bioreactor system or statically for up to 14 days. Scaffolds were analyzed for osteogenic differentiation. A rodent cranial defect model (8-mm diameter) was used to assess the bone regeneration of scaffolds cultured in the bioreactor, statically, or used immediately after formation. Immunohistochemistry was used to visualize CD31 vessel density. Micro-computed tomographic imaging was used to visualize mineral formation within the defect volume. RESULTS: Tubular perfusion bioreactor system-cultured samples showed significantly greater osteodifferentiation, indicated by an increase in VEGF expression and mineral deposition, compared with statically cultured samples. Increased expression of OPN, RUNX2, VEGF, and CD90 was seen over time in both culture methods. After implantation, bioreactor samples exhibited greater bone formation and vessel density compared with all other groups. Analysis of micro-computed tomographic images showed full union formation through the greatest diameter of the defect in all bioreactor samples and the highest levels of mineralized volume after 8 weeks. CONCLUSION: Mesenchymal stem cells encapsulated in fibrin beads and cultured in the tubular perfusion bioreactor system resulted in increased vascularization and mineralized tissue formation in vivo relative to static culture.

Serum ghrelin and obestatin levels in HIV-infected patients: Effect of 36 weeks of antiretroviral treatment / Niveles séricos de Ghrelina y Obestatina en pacientes infectados con VIH: efecto de 36 semanas de tratamiento antirretroviral

Introduction: Patients with HIV+ often present lipid disturbances. The role of ghrelin and obestatin in these lipid disturbances is not clear. The effect of antiretroviral (ART) drugs on those molecules is also unknown. This study measured ghrelin and obestatin levels, as well as metabolic markers, in patients with HIV+ before and after 36 weeks of ART. Material and methods: Twenty HIV-positive, ART-naïve patients who started a scheme consisting of tenofovir/emtricitabine+lopinavir/ritonavir were enrolled. Plasma samples were collected before and after 36 weeks of treatment. Serum ghrelin and obestatin levels were quantitated by ELISA; glucose, cholesterol, and triglyceride levels were measured by colorimetric and enzymatic methods, and cardiovascular risk was calculated by the atherogenic index of plasma (AIP). Results: All patients completed 36 weeks of ART. Total cholesterol (p<0.001), LDL-C (p=0.019), HDL-C (p=0.003), VLDL-C (p=0.002), and triglyceride levels (p=0.021) significantly increased after treatment. AIP revealed increased cardiovascular risk at baseline, which remained high after treatment. There was a statistically significant increase in obestatin level in the unpaired and paired analyses, while ghrelin levels only showed a trend to increase. Changes in ghrelin and obestatin levels positively correlated, but no correlation was seen with any metabolic parameter. Conclusion: After 36 weeks of ART, patients showed an altered lipid profile, but there were no significant changes in cardiovascular risk. Ghrelin and obestatin levels increased after 36 weeks of ART, but the increase was only significant for obestatin. Changes in ghrelin and obestatin positively correlate

Introducción: Los pacientes con VIH+ frecuentemente presentan alteraciones del perfil lípidico. El papel de ghrelina y obestatina en estas complicaciones no está claro. El efecto del tratamiento antirretroviral (TAR) en dichas moléculas es desconocido. Este estudio determinó los niveles de ghrelina y obestatina, así como los parámetros metabólicos en pacientes VIH+ antes y después de 36 semanas del TAR. Material y métodos: Participaron 20 pacientes VIH+, vírgenes a TAR, que iniciaron con un esquema de tenofovir/emtricitabina + lopinavir/ritonavir. Se tomaron muestras de plasma antes y después de 36 semanas de tratamiento. Los niveles séricos de ghrelina y obestatina fueron cuantificados por ELISA, los parámetros bioquímicos fueron determinados por métodos colorimétricos, se evaluó el riesgo cardiovascular por medio del índice aterogénico del plasma (AIP). Resultados: Los pacientes completaron 36 semanas del TAR. Los niveles de colesterol total (p<0,001), c-LDL (p=0,019), c-HDL (p=0,003), c-VLDL (p=0,002) y triglicéridos (p=0,021) mostraron un incremento estadísticamente significativo posterior al tratamiento. El AIP reveló un riesgo cardiovascular alto. Los niveles de obestatina se incrementaron significativamente en el análisis pareado y no pareado; y ghrelina solo mostró tendencia al incremento. Los cambios en ghrelina y obestatina correlacionaron positivamente, sin embargo no correlacionaron con los parámetros metabólicos. Conclusión: Los pacientes VIH+ mostraron un perfil lipídico alterado después de 36 semanas del TAR. Los niveles de ghrelina y obestatina se incrementaron tras 36 semanas del TAR. El riesgo cardiovascular es persistente. Los cambios en ghrelina y obestatina mostraron una correlación positiva

Serum ghrelin and obestatin levels in HIV-infected patients: Effect of 36 weeks of antiretroviral treatment.

INTRODUCTION: Patients with HIV+ often present lipid disturbances. The role of ghrelin and obestatin in these lipid disturbances is not clear. The effect of antiretroviral (ART) drugs on those molecules is also unknown. This study measured ghrelin and obestatin levels, as well as metabolic markers, in patients with HIV+ before and after 36 weeks of ART. MATERIAL AND METHODS: Twenty HIV-positive, ART-naïve patients who started a scheme consisting of tenofovir/emtricitabine+lopinavir/ritonavir were enrolled. Plasma samples were collected before and after 36 weeks of treatment. Serum ghrelin and obestatin levels were quantitated by ELISA; glucose, cholesterol, and triglyceride levels were measured by colorimetric and enzymatic methods, and cardiovascular risk was calculated by the atherogenic index of plasma (AIP). RESULTS: All patients completed 36 weeks of ART. Total cholesterol (p<0.001), LDL-C (p=0.019), HDL-C (p=0.003), VLDL-C (p=0.002), and triglyceride levels (p=0.021) significantly increased after treatment. AIP revealed increased cardiovascular risk at baseline, which remained high after treatment. There was a statistically significant increase in obestatin level in the unpaired and paired analyses, while ghrelin levels only showed a trend to increase. Changes in ghrelin and obestatin levels positively correlated, but no correlation was seen with any metabolic parameter. CONCLUSION: After 36 weeks of ART, patients showed an altered lipid profile, but there were no significant changes in cardiovascular risk. Ghrelin and obestatin levels increased after 36 weeks of ART, but the increase was only significant for obestatin. Changes in ghrelin and obestatin positively correlate.