RESUMEN
INTRODUCTION: Hypopituitarism is associated with higher prevalence of cardiovascular risk factors and premature death. Furthermore, some clinical and therapeutic features of hypopituitarism have been associated with a worse prognosis. OBJECTIVE: We reviewed, retrospectively, a large series of adult patients with hypopituitarism using stringent epidemiological criteria. Prevalence, association with cardiovascular risk factors, mortality and survival have been analysed. DESIGN AND METHODS: Two hundred and nine adult hypopituitary patients (56·9% females) from a population of 405 218 inhabitants, followed for 10 years. RESULTS: Prevalence of hypopituitarism at the end of the study was 37·5 cases/100 000 inhabitants. Incidence of hypopituitarism was 2·07 cases/100 000 inhabitants and year. Thirty-two patients died during the period of the study. Standardized mortality rate (SMR) was 8·05, higher in males (8·92 vs 7·34) and in younger patients (84·93 vs 5·26). Diagnosis of acromegaly (P = 0·033), previous radiotherapy (P = 0·02), higher BMI (P = 0·04), diabetes mellitus (P = 0·03) and cancer (P < 0·0001) were associated with mortality. A lower survival was associated with older age at diagnosis, nontumoural causes, previous radiotherapy, diabetes mellitus with poor metabolic control and malignant disease. CONCLUSIONS: Prevalence of hypopituitarism was 37·5 cases/100 000 inhabitants, and annual incidence was 2·07 cases/100 000 inhabitants. SMR was 8 times higher in hypopituitarism than in general population and was also higher in males and younger patients. Reduced survival was significantly related to cancer, nontumoural causes of hypopituitarism, older age at diagnosis, previous radiotherapy and diabetes mellitus with poor metabolic control.
Asunto(s)
Hipopituitarismo/epidemiología , Hipopituitarismo/patología , Adolescente , Insuficiencia Suprarrenal , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Hormona Folículo Estimulante , Hormona del Crecimiento , Humanos , Hipopituitarismo/etiología , Hipopituitarismo/mortalidad , Hipotiroidismo , Hormona Luteinizante , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , España/epidemiología , Adulto JovenRESUMEN
The etiologic factors associated with crestal bone loss have not been comprehensively clarified. Several theories exist as to the reason for the observed changes in crestal bone height following implant restoration. In the 1990s, the wide-diameter implants were commercially introduced. Initially, the implants were restored with standard-diameter abutments because of lack of matching prosthetic components. Long-term radiographic follow-up of these 'platform-switched' restored wide-diameter dental implants has demonstrated a smaller-than-expected vertical change in the crestal bone height around these implants that is typically observed around implants restored conventionally with prosthetic components of matching diameters. The aim of this randomised controlled study was to assess radiographically marginal bone level alterations in implants restored according to the platform-switching concept compared with traditionally restored implants. Fifty-four subjects to participate in this randomised controlled study were selected. Two groups were assigned at random: control group (56 implants were restored with standard matching-diameter abutments) and test group (58 implants were restored with medialised abutments). X-ray explorations were taken for peri-implant bone level at the minute the last cementing of the prosthesis and at 1-year follow-up. NHI Image was used to digitally process and manipulate the radiographic images and perform the measurements. Mean of bone loss with platform-switching implants was -0·01 mm, and the mean of bone loss with standard platform implant was 0·42 mm. Outcomes of this study indicated that the platform-switching design could preserve the crestal bone levels to 1-year follow-up. There was a statistically significant difference in marginal bone loss.
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Proceso Alveolar/diagnóstico por imagen , Diseño de Implante Dental-Pilar , Implantes Dentales de Diente Único , Adulto , Anciano , Pérdida de Hueso Alveolar/diagnóstico por imagen , Densidad Ósea/fisiología , Cementación , Cefalometría/métodos , Pilares Dentales , Femenino , Estudios de Seguimiento , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Persona de Mediana Edad , Radiografía de Mordida Lateral/métodos , Método Simple CiegoRESUMEN
The aim of this report is two-fold. First it analyses the precision of a modification of the parallel technique that can be used in those cases with anatomical limitations. Second, it checks the influence of the reference points' definition of objects to be measured by using both the original and the modified radiographic techniques. 2 intraoral radiographs were taken of 28 implants with 2 different methods: a standard paralleling technique and a modified technique that used a smaller film and a silicone spacer to ensure parallelism. Measurements of peri-implant bone levels and implant width were made in triplicate on digitized film radiographs. The results of the peri-implant bone levels were that with the parallel method the mean was 0.44 mm and the precision was 0.43 mm, and with the modified method the mean was 0.73 mm and the precision was 0.66 mm. In addition to the correct localization of the point of reference in this study, the precision with the parallel method was 0.08 mm and with the modified method was 0.13 mm. Although it was greater with the gold standard technique than with the modified technique, precision was very high for both methods and accurate enough for clinical use.
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Pérdida de Hueso Alveolar/diagnóstico por imagen , Proceso Alveolar/diagnóstico por imagen , Implantes Dentales , Radiografía Dental/métodos , Adulto , Anciano , Análisis de Varianza , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Radiografía Dental/instrumentación , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Adulto JovenRESUMEN
The acute effects of microwave exposure from the Global System for Mobile Communication (GSM) were studied in rats, using 900MHz radiation at an intensity similar to mobile phone emissions. Acute subconvulsive doses of picrotoxin were then administered to the rats and an experimental model of seizure-proneness was created from the data. Seventy-two adult male Sprague-Dawley rats underwent immunochemical testing of relevant anatomical areas to measure induction of the c-fos neuronal marker after 90min and 24h, and of the glial fibrillary acidic protein (GFAP) 72h after acute exposure to a 900MHz electromagnetic field (EMF). The experimental set-up facilitated measurement of absorbed power, from which the average specific absorption rate was calculated using the finite-difference time-domain (FDTD) 2h after exposure to EMF radiation at 1.45W/kg in picrotoxin-treated rats and 1.38W/kg in untreated rats. Ninety minutes after radiation high levels of c-fos expression were recorded in the neocortex and paleocortex along with low hippocampus activation in picrotoxin treated animals. Most brain areas, except the limbic cortical region, showed important increases in neuronal activation 24h after picrotoxin and radiation. Three days after picrotoxin treatment, radiation effects were still apparent in the neocortex, dentate gyrus and CA3, but a significant decrease in activity was noted in the piriform and entorhinal cortex. During this time, glial reactivity increased with every seizure in irradiated, picrotoxin-treated brain regions. Our results reveal that c-fos and glial markers were triggered by the combined stress of non-thermal irradiation and the toxic effect of picrotoxin on cerebral tissues.