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BACKGROUND: Dental autotransplantation (DAT) is defined as the replacement or direct transfer of an impacted, semi-impacted or erupted tooth to a donor site, either to a post-extraction socket or to a surgically created socket within the same individual. The use of new technological advances, such as 3-D dental models based on computer-aided design, among others, have been reported to improve the success rate of DAT. Therefore, we aimed to perform a systematic review to explore the possible benefits that the use of these innovative techniques can provide when applied to DAT. MATERIAL AND METHODS: The literature search was conducted in PubMed, Scopus, and Web of Science databases following the PRISMA guidelines. The research question was: "Are computerized technological advancements a useful tool for improving the success of third molar autotransplantation technique? RESULTS: The initial literature search identified 195 articles, of which only 11 were included for qualitative analysis. All studies used 3D dental models based on computer-aided design data. Surgical guides and stereolithographic models were used by 4 and 1 study respectively. A total of 91 transplanted teeth were evaluated, out of which only 88 were considered within the parameters of clinical success (96.7%). Only 7 out of the 11 articles reported the specific autotransplanted tooth, being mandibular third molars the most prevalent autotransplanted teeth. CONCLUSIONS: Although the application of new technologies for DAT increases the success rate of this technique, further primary studies are still needed to address long-term teeth survival rates and complications. The cost and availability to implement the integration of these techniques to DAT may be a variable to consider, as this can be a limitation for some patients or for low-income countries.
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Dente Serotino , Dente Impactado , Humanos , Autoenxertos , Dente Molar , Dente Serotino/transplante , Transplante AutólogoRESUMO
The current paradigm of star formation through accretion disks, and magnetohydrodynamically driven gas ejections, predicts the development of collimated outflows, rather than expansion without any preferential direction. We present radio continuum observations of the massive protostar W75N(B)-VLA 2, showing that it is a thermal, collimated ionized wind and that it has evolved in 18 years from a compact source into an elongated one. This is consistent with the evolution of the associated expanding water-vapor maser shell, which changed from a nearly circular morphology, tracing an almost isotropic outflow, to an elliptical one outlining collimated motions. We model this behavior in terms of an episodic, short-lived, originally isotropic ionized wind whose morphology evolves as it moves within a toroidal density stratification.
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OBJECTIVE: To identify factors that influence refusing to donating blood. MATERIAL AND METHODS: Prospective case and control study. Hospitalized patients' relatives were interviewed with a questionnaire to evaluate their knowledge of blood and personal attitudes toward blood donation. Cases were all relatives who did not donate blood and controls who did. RESULTS: A total of 121 individuals was studied, 30 cases and 91 controls. Age of the cases was 32.3 +/- 8.1 years and controls was 28.8 +/- 7.9 years (p = 0.04). Risk factors were female sex (OR = 6.3; 95%CI 2.4 to 17.1), being married (OR = 3.7 95%CI 1.3 to 10.5). No differences were present between the two groups in level of knowledge concerning blood. The average of positive attitudes toward blood donation was greater among relatives who donated blood (cases 5.9 +/- 1.6; controls 6.4 +/- 1.2; P = 0.049). Among the attitudes that influence refusing to donate blood were fear of getting dizzy at the sight of blood (OR = 5.2, 95%CI 1.3-21.4), fear of donating blood (OR = 2.2, 95%C, 0.8-6.0), and getting nervous at the sight of blood (OR = 4.1, 95%CI% 1.5-10.9). CONCLUSIONS: Among patient's relatives who donate blood positive personal attitudes toward blood donation have more weight than knowledge on the subject.
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Doadores de Sangue/estatística & dados numéricos , Família , Adulto , Estudos de Casos e Controles , Feminino , Hospitais Pediátricos , Humanos , Masculino , México , Estudos ProspectivosRESUMO
In most centers only selected patients with high risk thyroid nodules undergo thyroid surgery, and fine needle aspiration biopsy (FNA) is used to select patients for surgical treatment. The aim of the present study was to evaluate the impact of FNA on the management of thyroid nodules at our institution. A total of 872 patients who underwent FNA over a period of 7 years were retrospectively analyzed. There were 66 men and 806 women with a mean age of 40 +/- 15 years. Altogether 549 patients presented with a thyroid nodule and 323 with multinodular disease. The sensitivity and specificity of FNA were 90.0% and 99.8%, respectively. The positive and negative predictive values were 98% and 99%, respectively, and the accuracy was 99%. Our results are in agreement with those of other reports establishing that FNA of the thyroid is safe, reliable, and effective for differentiating benign from malignant nodules.
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Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/cirurgia , Tireoidectomia , Resultado do TratamentoRESUMO
The objective of this study was to identify the tendency of acute leukemia among children in Mexico City from 1982 to 1991. A hospital survey was performed. Medical records of children under 15 years of age with a diagnosis of acute leukemia were reviewed. The cases were chosen from hospitals which provide medical attention to children with cancer in Mexico City. The annual incidence rate (AIR) was calculated in general, by sex, age groups (under 1 year of age, from 1 to 4 years, 5 to 9 years and 10 to 14 years) and standardized with the world population. The trend was evaluated with Spearman's correlation method. Acute lymphoblastic leukemia showed a significantly increasing trend during the study period. The AIR was 7.75 (per million) in 1982 and 22.19 (per million) in 1991. For age groups a tendency to increase was observed in females of age group 1 to 4 years and in males of age group 10 to 14 years. Acute non-lymphoblastic leukemia did not display a specific trend. In conclusion, acute lymphoblastic leukemia shows a tendency to increase in the children of Mexico City.
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Leucemia Mieloide Aguda/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , México/epidemiologia , Estudos RetrospectivosRESUMO
This report describes the process used to develop locally appropriate educational materials and to implement the education component of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. The process is broken into five stages: formative research, developing recommendations for behavior change, development of educational messages, development and production of educational materials, and distribution of the materials. Appropriate terminology and taxonomies for dengue were obtained from open in-depth interviews; baseline data from a knowledge, beliefs, and practices questionnaire served to confirm this information. A larval survey of house lots was carried out to identify the Ae. aegypti larval production sites found on individual house lots. This enabled the program to target the most important larval habitats. Community groups were organized to work on the development of messages and production of the educational materials to be used. The education intervention was successful in stimulating changes in both knowledge and behavior, which were measured in the evaluations of the intervention. To be successful, community-based strategies must be flexible and adapted to the local setting because of ecologic, cultural, and social differences between localities.
PIP: Aedes aegypti mosquito is a vector of yellow fever and dengue hemorrhagic fever. It was eradicated that seventeen different Latin American countries during the 1950s and 1960s, but has reappeared in almost all of these countries as a result of laxness in monitoring ports and border crossings for potential importations of eggs and adult mosquitoes. This paper describes the process used to develop locally appropriate educational materials and implement the education component of a community-based Ae. aegypti control program in Merida, Yucatan, Mexico, over the period June 1989 to December 1990. Merida is the capital of Yucatan and harbors a population of approximately 700,000. Dengue was epidemic in 1979 and 1984, and its transmission is now endemic in the city. The process consisted of the following five stages formative research, developing recommendations for behavior change, development of educational methods, development and production of educational materials, and distribution of the materials. Terminology and taxonomies for dengue were obtained from open, in-depth interviews, while baseline data were gathered via a knowledge, beliefs, and practices questionnaire. A larval study of house lots was then carried out to identify the Ae. aegypti larval production sites found on individual house lots, thus enabling the program to target the most important larval habitats. Community groups were organized to work on message development and production of educational materials to be used in the program. The education intervention proved overall to be successful in stimulating changes in knowledge and behavior measured in the evaluations of the intervention. Finally, the authors hold that community-based strategies must be flexible and adapted to varied ecological, cultural, and social differences between localities in order to be successful.
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Aedes , Dengue/prevenção & controle , Educação em Saúde , Insetos Vetores , Controle de Mosquitos/métodos , Animais , Dengue/epidemiologia , Surtos de Doenças , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , México/epidemiologia , Eliminação de Resíduos , Pesquisa , Materiais de Ensino , ÁguaRESUMO
OBJECTIVE: The aim of this study was to analyze the efficacy in prophylaxis during biliary tract and gallbladder surgery with amoxicillin/clavulanate and to compare it with the combination of cephalothin and clindamycin. DESIGN: A randomized nonblinded clinical trial with a blind independent observer. PLACE: Tertiary-care center. PATIENTS: Forty-two patients were included. All had undergone biliary tract and/or gallbladder surgery. They were divided in two groups: 22 in group A (cephalothin and clindamycin), and 20 in group B (amoxicillin/clavulanate). INTERVENTIONS: Patients from group A were intravenously treated with three doses of cephalothin (2 g at anesthetic induction and two additional doses of 1 g at six-hour intervals), and three of clindamycin (600 mg every six hours). Patients from group B received three doses of amoxicillin/clavulanate (1000/200 mg IV, one during the induction of the anesthesia followed by two more at six-hour intervals). RESULTS: In group A six wound infections were recorded, one of them with secondary bacteremia. In group B we did not record any infection (Fisher p < 0.01). One case of phlebitis was recorded in each group. CONCLUSIONS: Our results indicate that amoxicillin/clavulanate is useful in the prophylaxis of gallbladder and biliary tract surgery, and more effective than the combination of cephalothin and clindamycin.
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Colecistectomia , Quimioterapia Combinada/uso terapêutico , Pré-Medicação , Infecção da Ferida Cirúrgica/prevenção & controle , Adulto , Idoso , Amoxicilina/administração & dosagem , Amoxicilina/uso terapêutico , Ductos Biliares/cirurgia , Cefalotina/administração & dosagem , Cefalotina/uso terapêutico , Ácido Clavulânico , Ácidos Clavulânicos/administração & dosagem , Ácidos Clavulânicos/uso terapêutico , Clindamicina/administração & dosagem , Clindamicina/uso terapêutico , Quimioterapia Combinada/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Resultado do TratamentoRESUMO
INTRODUCTION: Leukemia is the most frequent neoplasia in children; in our country it is the main cause of medical attention in children with cancer. The are different risk factors associated with the development of this kind of cancer. OBJECTIVE: To identify which of the already known factors described in the literature associated with the development of leukemia are most frequent in the pediatric population of Mexico City. MATERIAL AND METHODS: A protective case-control study was carried out using prevalent and incident cases. In two third level hospitals of Mexico City, a total of 81 children who had been diagnosed as suffering from different kind of leukemia, confirmed by biopsy of bone marrow, were select and studied. The control were 154 children from two different sources: 77 of them came from the same hospital where the cases received medical care, the selection criteria was not to have any kind of neoplasia; and 77 came from the same community where those diagnosed children cases lived, the selection criteria for this group was that they were healthy children. Both cases and community controls were visited at home and interview to complete precoded questionnaire with the different variables of the study. The information from the hospital controls was obtained during the time they stayed in the hospital. Odds ratio (OR's) for the different associations were calculated, as well as its confidence intervals at 95% (IC) accord to Cornfield and unconditioned logistic regression was carried out to control confounding variables. RESULTS: OR greater than 1 was found in those with familiar cancer background 1.93 (1.2-3.63); the mother being exposed to X-ray during pregnancy 1.89 (0.84-4.22); previous abortions before the child with leukemia was born 2.44 (1-06-5.68); being born from full term birth 2.42 (0.47-16.65); being born with weight greater that 3500 g 2.21 (1.04-4.33); being exposed to fertilizers 4.73 (1.04-24.14) and insecticides 1.93 (1.05-3.56). OR smaller than 1 was found in those who have been in a hospital because of an infectious disease during the first year of life 0.57 (0.17-1.74); to have suffered from chicken pox 0.59 (0.32-1.08). No association to parent's age or job was found. Multivariated analysis shows that the exposure to insecticide is the most important risk factor associated with the development of leukemia in children. CONCLUSIONS: We obtained positive associations to different risk factors described in the literature, having found that exposure to fertilizers is the most important risk factor and finding no association with the parent's occupation. This leads to the need of carrying out further studies to investigate, in more detail, the occupation of the father to confirm whether or not this is a risk factor.
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Leucemia/etiologia , Estudos de Casos e Controles , Pré-Escolar , Humanos , Lactente , Razão de Chances , Pais , Fatores de RiscoRESUMO
Early EKG changes may contribute to predict the site of coronary artery occlusion during acute inferior myocardial infarction (MI). Its interpretation is relevant to therapeutic clinical decisions. We have prospectively evaluated early EKG changes of 40 consecutive patients with acute inferior MI and correlated them with the site and location of the coronary artery culprit lesion. Proximal right coronary artery occlusion was characterized by negative ST-T wave changes in leads D1 and aVL and ST segment elevation in leads D3 > D2. However the most distinctive EKG pattern of proximal right coronary artery occlusion was ST segment elevation with positive T wave in V4R (specificity 96%, predictive value 89%, p < 0.001). Distal right coronary artery occlusion was characterized by a positive T wave without ST segment elevation in V4R. Finally circumflex coronary artery occlusion was defined by a positive R/S > 1 relationship in V1, ST segment elevation in V5 and V6. Again lead V4R with flat or negative ST-T wave morphology had the highest predictive value for circumflex coronary artery occlusion (100%). Thus early EKG changes may contribute to precise the site and location of coronary artery occlusion and may help to implement clinical therapeutic strategies in patient with inferior MI. Right precordial leads are most useful in the EKG interpretation of inferior MI.
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Eletrocardiografia , Infarto do Miocárdio/diagnóstico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
This report describes the results of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. Baseline surveys concerning knowledge, beliefs, and practices of 577 women and a larval survey of 616 house lots were carried out in October 1989. Following development of a public health communication intervention from this data, the program was implemented in six communities. Evaluation used an untreated control group design with pretest and two post-tests, one at completion and one six months later. Significant changes in knowledge and behavior were seen in the treatment group in both post-tests. Women in the intervention group were able to identify the Ae. aegypti mosquito, the larval production sites of the mosquito, and appropriate control methods. A behavior change proxy was measured by examining changes in the Breteau (number of positive containers/100 houses surveyed) and container indices. The Breteau index remained the same in the intervention group while it increased significantly in the comparison group. Changes were also seen with respect to individual containers. This project demonstrated that a community-based communication program aimed at larval production site elimination or control can be effective in changing behavior and reducing larval production sites.
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Aedes , Dengue/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Insetos Vetores , Controle de Mosquitos/métodos , Adulto , Animais , Dengue/psicologia , Dengue/transmissão , Escolaridade , Feminino , Habitação , Humanos , Entrevistas como Assunto , Larva , México , Pessoa de Meia-Idade , Controle de Mosquitos/normas , Educação de Pacientes como Assunto , Fatores Socioeconômicos , Inquéritos e Questionários , População UrbanaRESUMO
Blood and its products are valuable therapeutic resources for the pediatrician who care for newborns with severe illnesses. The use of blood and its products requires for the hospital personnel working at neonatal care units to be precise and up to date on the indications and complications of total blood, the globular package, albumin, plasma, the concentration of granulocytes, platelets and immunoglobulins for intravenous use. This review gathers, on the one hand, accumulated experiences by the members of the Commission of Blood and its Products from the Pediatric Hospital of the National Medical Center and on the other hand, a selection of the more important concepts which have been judged so by the authors and expressed in the current medical literature.
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Transfusão de Sangue , Doenças do Recém-Nascido/terapia , Transfusão de Eritrócitos , Granulócitos/transplante , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Recém-Nascido , Plasma , Transfusão de Plaquetas , Albumina Sérica/administração & dosagem , Albumina Sérica/efeitos adversos , Reação TransfusionalRESUMO
The clinical-pathological characteristics of 11 patients with intestinal nodular lymphoid hyperplasia (INLH) are described. Five fulfilled the criteria for Herman's syndrome and presented all or several of the following alterations: dysgammaglobulinemia, recurrent respiratory tract infections, sinusitis, pneumonia and giardiasis; of the remaining six cases, in five gammaglobulin levels were not quantified and in one they were normal. All the patients in this group suffered from recurrent pharyngotonsillitis, and Giardia lamblia was isolated in four. In both groups the INLH occurred in young patients with an average age of 21 years. Eight of the 11 were men. The most frequent symptoms included diarrhea, steatorrhea and weight loss. Radiologically, INLH usually was a finding affecting the jejunum and/or the ileum. Prominent lymph nodes in mucosa and submucosa were documented histologically in all cases, and a large decrease or absence of plasma cells in the lamina propria was seen in 7 of the 11. In spite of the diversity in the treatment schemes instituted, symptoms persisted for months or years after diagnosis. In two cases (one with dysgammaglobulinemia and one without) associated intestinal lymphoma existed. Other associated diseases included non-deforming joint arthritis, erythema nodosum, and intestinal infection by E. coli and Entamoeba histolytica.
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Intestino Delgado/patologia , Adolescente , Adulto , Feminino , Humanos , Hiperplasia/complicações , Hiperplasia/patologia , Enteropatias/complicações , Enteropatias/patologia , Tecido Linfoide/patologia , MasculinoRESUMO
The best results of the therapeutic immunosuppression in a plastic anemia have been obtained with antilymphocyte globulin (ALG). Considering this, 14 patients with this disease, 9 females and 5 males, from 8 to 60 years of age, were given ALG (40 mg/K/day/4 days) and corticosteroids. Fifty one percent of them, older than 30 years of age, showed partial or minimal remissions of the disorder. According to this result ALG administration together with bone-marrow transplantation in younger patients may offer effective treatment for a generally fatal disease to a greater number of patients.