RESUMO
OBJECTIVE: We evaluated the safety of REPLICA, a CAD/CAM-designed patient-specific titanium mandible, in patients with mandibular defects not suitable for reconstruction with traditional techniques. PATIENTS AND METHODS: We performed a cohort study with a composite primary outcome assigned at the end of a 1-year follow-up. The outcome was assigned in the presence of all the following: 1) absence of intraoral or skin extrusion of REPLICA; 2) decrease or cessation of oral pain; 3) stability or increase in mouth opening; 4) resumption of oral feeding without the need of nasogastric tube; 5) absence of fracture at multidetector computer tomography (MDCT); 6) absence of displacement (MDCT); 7) absence of screw loosening (MDCT). The secondary outcome was the patient-reported QOL at 6 months of follow-up as detected by the EORTC QLQ-C30 and QLQ-H&N35 questionnaires. RESULTS: Between March 2012 and June 2017, 18 consecutive patients, with a median (IQR) age of 67 (65;74) underwent reconstruction of mandibular defects with REPLICA at our Unit. The primary outcome was reached by 14 of the 18 patients. QOL data were available for 15 patients at the 6-month follow-up, showing a good profile of general and disease-specific QOL. CONCLUSION: REPLICA offered a safe solution at 1-year for the treatment of mandibular defects not suitable for reconstruction with traditional techniques, and was associated with subjective well-being and satisfaction. Further studies are needed to assess the full range of indications of REPLICA.
Assuntos
Desenho Assistido por Computador , Mandíbula , Reconstrução Mandibular/métodos , Desenho de Prótese/métodos , Titânio , Idoso , Estudos de Coortes , Contraindicações de Procedimentos , Ingestão de Alimentos , Feminino , Humanos , Masculino , Fraturas Mandibulares/diagnóstico por imagem , Fraturas Mandibulares/cirurgia , Reconstrução Mandibular/efeitos adversos , Doenças da Boca/terapia , Manejo da Dor , Satisfação do Paciente , Qualidade de Vida , Cirurgia Assistida por Computador/métodos , Fatores de TempoRESUMO
El estudio "Persistencia de lesión cervical premaligna posterior a LEEP en el Hospital San Juan de Dios", investigó la persistencia de lesión cervical en pacientes sometidas a LEEP basándose en el compromiso de márgenes, así como la relación de algunos factores de riesgo como lo es el HPV. Se determinó la persistencia en pacientes sometidas a LEEP en el Servicio de Ginecología del Hospital San Juan de Dios en el período del 1 de enero al 31 de diciembre del 2005. El estudio se realizó basado en la información recaudada de los expedientes clínicos de las pacientes con patología cervical, controladas en el Servicio de Colposcopía en consulta externa de dicho hospital.
