RESUMEN
INTRODUCTION: Gingival recession is an unsightly condition due to root exposure. It can lead to dental hypersensitivity, root caries, and tooth loss. OBJECTIVE: To determine the influence of different clinical and periodontal parameters on the severity of gingival recession evaluated at four periods: initial, 6, 12, and 18 months of follow-up. MATERIAL AND METHODS: Forty patients with gingival recession were included in the study. Sociodemographic data, systemic diseases, harmful habits, dental hygiene habits, parafunctional habits, and orthodontic treatment were collected. Periodontal status (plaque index, gingival bleeding index, attached gingiva loss, pocket probing depth, and attachment loss) was also measured. RESULTS: None of the clinical parameters studied influenced the number of teeth with gingival recession. Smokers showed a higher number of teeth with attached gingiva loss (p=0.03). A direct relationship between the severity of gingival recession and plaque index (p=0.02) or 4-6 mm attachment loss (p=0.04) was observed. At six months of follow-up, gingival index was the only parameter that influenced the severity of gingival recession (p=0.01).
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Recesión Gingival/diagnóstico , Adolescente , Adulto , Anciano , Índice de Placa Dental , Femenino , Recesión Gingival/etiología , Humanos , Masculino , Persona de Mediana Edad , Índice Periodontal , Valor Predictivo de las Pruebas , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Adulto JovenRESUMEN
El Isocromosoma 18q es una aberración cromosómica de estructura poco frecuente, en la cual ocurre una división anormal de las cromátidas hermanas, generando afectación de los cromosomas. En este trabajo se describe el caso de un paciente de 4 meses de edad que presenta retraso pondoestatural y rasgos dismórficos, lo que se corresponden con el síndrome Edwards ocasionado por Isocromosoma 18q. Se postula sobre la posible patogenia y el efecto de dosis génica como causantes del fenotipo. El diagnóstico se realiza por el fenotipo del paciente y los estudios cromosómicos de linfocitos en sangre periférica. Se ilustra la importancia del interrogatorio y el diagnóstico preciso para el correcto asesoramiento genético del caso (AU)
Isochromosome 18q chromosomal aberration is an unusual structure, in which case an abnormal division of sister chromatids, generating involvement of chromosomes. This paper describes the case of a 4-month-old has delayed pondoestatural and dimorphic traits, which are consistent with Edwards syndrome caused by Isochromosome 18q. We hypothesize on the possible pathogenesis and gene dose effect in causing the phenotype. Diagnosis is made by the patient's phenotype and chromosome studies of peripheral blood lymphocytes. It illustrates the importance of questioning and accurate diagnosis for proper genetic counseling of the case.
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IsocromosomasRESUMEN
Objetivos: El propósito del estudio determinar las características clínico epidemiológicas de los pacientes con TEC en menores de 18 años atendidos en 2 hopitales de referencia de Lima. menores de 18 años atendidos en 2 hospitales de referencia de Lima. Métodos: Se realizó un estudio descriptivo retrospectivo de 2506 pacientes hospitalizados en 2 centros de neurocirugía pediátrica: El Instituto Nacional de Salud del Niño y el Hospital de Emergencias Pediátricas, durante los años 1998 al 2002. Se revisaron las historias clínicas y se agruparon los datos según variables epidemiológicas así como las características de lospacientes con TEC grave. Resultados: Se encontró un predominio del sexo masculino (61 por ciento), el grupo etáreo más afectado fue el de 1-4 años (48 por ciento) y la caída (45 por ciento) fue una de las causas más frecuentes. El síntoma mas común fue el vómito (61.7 por ciento) y el signo más frecuente el cefalohematoma (23.3 por ciento). La TAC cerebral se realizó en el 69 por ciento de los pacientes y en el 44 por ciento de éstos se encontró alguna lesión craneal o intracraneal, siendo los diagnósticos más frecuentes fractura de bóveda (30.5 por ciento), edema cerebral (14.9 por ciento) y hematoma epidural (12.1 por ciento). El hematoma epidural de la convexidad requirió cirugía en el 61 por ciento y el de fosa posterior en el 81 por ciento. El hematoma subdural agudo fue raro (0.08 po rciento). La mortalidad en el TEC grave fue mucho mayor (13 porciento) siendo el accidente detránsito la causa más común (42 por ciento) y la contusión cerebral (58.3 por ciento) la lesión más asociada a mortalidad. Conclusiones: El TEC en el paciente pediátrico tiene características clínicas y epidemiológicas particulares que lo diferencian del adulto, características que deben ser tomadas en cuenta para la implementación de un adecuado plan de atención en emergencia, mejora del sistema de referencia y de medidas preventivo promocionales con la finalidad de ...
Objective: The intention of the study was to determine the clinical and epidemiological characteristics of the patients with TCE in minors of 18 years attended in 2 hospitals of reference of Lima. Methods: There was realized a descriptive retrospective study of 2506 patients hospitalized in 2 centers of paediatric neurosurgery: The Health National Institute of the Child and the Hospital of Paediatric Emergencies, during the year 1998 to 2002. The charts were checked and the information was grouped according to epidemiological variables as well as the characteristics of the patients with serious TCE. Result: It was found a predominance of the masculine sex (61 per cent), the age group more affected was that of 1-4 years (48 per cent) andthe fall (45 per cent) was one of the most frequent reasons. The symptom mas common was the vomit (61.7 per cent) and the sign was the cefalohematoma (23.3 per cent). The CT scan was done in 69 per cent of the patients and in 44 per cent of these it was found some craneal or intracraneal injury, being the most frequent diagnoses fractures of vault (30.5 per cent), cerebral edema (14.9 per cent) and epidural haematoma (12.1 per cent). Epidural haematoma of the convexity needed surgery in 61 per cent and that of posterior pit in 81 per cent. Acute subdural Haematoma was rare (0.08 percent). The mortality in the serious TCE was very high (13 per cent) being the accident of traffic the most common reason (42 per cent) and the cerebral contusion (58.3 per cent) the injury most associated with mortality. Conclusions: The TCE in the paediatric patient has special characteristic clinical and epidemiological that separate it from the adult, characteristics that must be taken in bill for the implementation of a suitable plan of attention in emergency, improvement of the reference system and of promotional preventive measurements with the purpose of decrese the morbidity and mortality.
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Masculino , Femenino , Humanos , Lactante , Preescolar , Niño , Adolescente , Fracturas Craneales , Hematoma Epidural Craneal , Traumatismos Craneocerebrales , Traumatismos Craneocerebrales/epidemiología , Epidemiología Descriptiva , Estudios Epidemiológicos , Estudios RetrospectivosRESUMEN
PURPOSE: To evaluate the response of advanced squamous cell head and neck carcinoma to a combination of induction chemotherapy and radiotherapy. METHODS: We present long-term results of a phase II trial of Induction Chemotherapy with UFT 200 mg/m(2) p.o. days 1 to 21, Vinorelbine 25 mg/m(2) i.v. days 1 and 8 and Cisplatin 100 mg/m(2) i.v. day 1 (UFTVP) each 21 days for 4 courses, followed by Radiotherapy concomitant with UFT 100 mg/m(2) p.o. daily and Carboplatin AUC = 0.5 i.v. weekly (RT/UFTJ) in patients (pts) with Non-Resectable Locally Advanced (Stage IV-B) Squamous Cell Head and Neck Carcinoma (IV-B-SCHNC). Primary endpoint was Complete Response to induction UFTVP and secondary endpoints were Disease Free Status Rate after locoregional treatment and long-term Overall Survival. Between 1994 and 1997, 32 pts were included. RESULTS: Complete Response to Induction UFTVP was 59% (95% CI: 48%-70%). Main toxicity of UFTVP was G 3,4 neutropenia (94% of pts; 25% developed febrile neutropenia and 1 of this pts dead). After Induction Chemotherapy with UFTVP, 30 pts received radiotherapy and 25 of them received concomitant Carboplatin and UFT (RT/UFTJ): main toxicity was mucositis (G3-4: 72%) and one patient died during RT/UFTJ because pneumonia. Twenty-five pts (78%) were alive and disease free at the end of the whole treatment. Actuarial 5 year Overall survival is 32%. CONCLUSION: Although toxicity is important, this approach has interesting activity and deserves further investigation.
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Antineoplásicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carboplatino/uso terapéutico , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/terapia , Cisplatino/uso terapéutico , Neoplasias de Cabeza y Cuello/radioterapia , Neoplasias de Cabeza y Cuello/terapia , Trasplante de Células Madre de Sangre Periférica , Vinblastina/análogos & derivados , Adulto , Anciano , Antineoplásicos/efectos adversos , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Terapia Combinada , Femenino , Fiebre/inducido químicamente , Neoplasias de Cabeza y Cuello/mortalidad , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neutropenia/inducido químicamente , Pronóstico , Tasa de Supervivencia , Tegafur/uso terapéutico , Factores de Tiempo , Uracilo/uso terapéutico , Vinblastina/uso terapéutico , VinorelbinaRESUMEN
INTRODUCTION: Testicular tumors are frequent in young adults, coinciding with incorporation to military service. The present study evaluates the tumor characteristics, time course and results obtained with the treatments used in our center for this type of neoplasms. MATERIAL AND METHODS: A retrospective longitudinal study was conducted in a cohort of 98 patients with an average age of 28.6 years, subjected to orchiectomy for testicular tumors in our center between 1979 and 2004. Data were collected relating to patient age, tumor characteristics, the outcome of treatment, and the course of the disease. RESULTS: The right testicle was affected in 61% (with significant differences versus the left side). The most common histological type corresponded to non-seminomatous germ cell tumors (NSGCTs) (65.3%), followed by pure seminomas (27.6%) and non-germinal cell tumors (NGCs) (7.1%). NSGCT was diagnosed at a significantly younger average age (23.2 years) than the other two tumor types. Stage I was the most frequent presentation (58%). Seminomas presented in stage I significantly more often (80%) than the others tumors. The data collected over the 25-year study period showed no significant variations in tumor characteristics. The log-rank test showed a significant difference in terms of patient survival according to the tumor cell line (p = 0.000) and stage (p = 0.000), except between stages I and II, where no significant differences were observed in terms of survival. CONCLUSIONS: Non-seminomatous germ cell tumors (NSGCTs) are the most frequent testicular tumors in young adults. Most neoplasms are diagnosed in early stages, the prognosis being better in the case of seminomas and tumor stages I and II.
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Neoplasias Testiculares , Adulto , Hospitales Militares , Humanos , Masculino , Estudios Retrospectivos , España , Neoplasias Testiculares/mortalidad , Neoplasias Testiculares/patología , Neoplasias Testiculares/terapia , Resultado del TratamientoRESUMEN
In this study, the authors prospectively followed one-hundred thirthy patients undergoing surgery in order to investigate the influence of age, surgery time, surgical room temperature, major surgery, blood transfusion, gender, and anesthetic method in the occurrence of mild intraoperative hypothermia (MIH). Sixty-one patients (47 percent) were female and 69 (53 percent) were male, and patient's mean age was 42 ñ 20 years. Fifty-three patients(41 percent) developed MIH. Fifty-two (40 percent) underwent major surgery, 65 (50 percent) patients were scored as ASA I (American Society Anesthesia) 52 (40 percent), ASA II and 13 (10 percent), ASA III or IV. Sixty-four (49.2 percent) received balanced general anesthesia, 22 (17 percent), spinal lumbar anesthesia, 20 (15.3 percent), epidural lumbar anesthesia and 24 (18.5 percent), miscellaneous anesthesia. Thirteen (10 percent) received blood transfusion, mean surgery time was 83 ñ 59 min and meand surgical room temperature was 22.9 ñ 1.2ºC. Regression logistic with elimination method was employed to determine the impact of all variables over development of MIH. Only major surgery (Odds Ratio 2.8) and blood transfusion (Odds Ratio 6.7) were identified as risk factors for MIH