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ABSTRACT: Mandibular reconstruction is a challenging procedure, especially in cancer patients with defects that are greater than 6 cm. Free vascularized fibular flap is the gold standard treatment in these cases since it allows three-dimensional restoration of the lost segments after ablative surgery in addition to providing the possibility of a subsequent implant-supported rehabilitation improving the functional and aesthetic outcomes of the surgery.To obtain accurate results, preoperative planning must be done with detail. Approaches for the preoperative planning include both the conventional analog planning and the virtual planning that are valid alternatives in meeting the trans-surgical requirements.This study makes a comparative analysis of 2 clinical cases with a diagnosis of squamous cell carcinoma that were reconstructed using a vascularized fibular free flap. The first case was planned using the conventional analog method whereas the second case was planned using the virtual planning approach.The impact of virtual planning and conventional analog planning on preoperative planning time, ischemia period, and total surgical time is analyzed according to the experience obtained in the cases presented. In addition, the authors described the technique used for each planning method along with a literature review in which the results are contrasted and discussed.
Assuntos
Retalhos de Tecido Biológico , Reconstrução Mandibular , Transplante Ósseo , Estética Dentária , Fíbula/cirurgia , Humanos , Mandíbula/cirurgia , Reconstrução Mandibular/métodos , Duração da CirurgiaRESUMO
BACKGROUND: Staphylococcus aureus is one of most prevalent pathogens in the world associated with a high mortality rate and a rapid development of resistance to antibiotics. Despite its pathogenicity, epidemiological monitoring in Mexico is scarce. AIM: To analyze the local molecular epidemiology and determine the clonal origin of methicillin-resistant (MR) strains isolated from patients admitted to Hospital "Dr. Ignacio Morones Prieto". METHODS: A cross-sectional prospective study was carried out from July to December 2016. The characterization of the strains was carried out by Spa genotyping, frequency of specific virulence genes by PCR and antibiogram. RESULTS: The prevalence of MRSA was 25.7%, highlighting the presence of the Spa type t895 in 76% of the resistant strains and a similar pattern of susceptibility to antibiotics. CONCLUSION: The results of this study indicate that the regional prevalence of MRSA has not changed in the last 10 years and provide valuable information on the clonal origin and the virulence factors of the strains of S. aureus isolated in the region.
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Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Antibacterianos/farmacologia , Estudos Transversais , Genótipo , Humanos , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/genética , México/epidemiologia , Testes de Sensibilidade Microbiana , Prevalência , Estudos Prospectivos , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Fatores de Virulência/genéticaRESUMO
Resumen Introducción: Staphylococcus aureus es uno de los patógenos con mayor prevalencia en el mundo, asociado a una alta tasa de mortalidad y un rápido desarrollo de resistencia a los antimicrobianos. A pesar de su patogenicidad, su seguimiento epidemiológico en México es escaso. Objetivo: Analizar la epidemiología molecular local y determinar el origen clonal de cepas resistentes a meticilina (RM) aisladas de pacientes internados en el Hospital Central "Dr. Ignacio Morones Prieto". Métodos: Se llevó a cabo un estudio prospectivo de corte transversal, de julio a diciembre de 2016. La caracterización de las cepas se realizó mediante genotipificación Spa, la determinación por RPC punto final de la frecuencia de genes de virulencia específicos y su antibiograma. Resultados: A partir de estos datos, se obtuvo que la prevalencia de S. aureus RM fue de 25,7%, destacando la presencia del tipo Spa t895 en 76% de las cepas resistentes y un patrón similar de susceptibilidad a antimicrobianos. Conclusión: Los resultados de este estudio indican que la prevalencia regional de SARM no se ha modificado en los últimos 10 años y proporcionan información valiosa del origen clonal y los factores de virulencia de las cepas de S. aureus aisladas en la región.
Abstract Background: Staphylococcus aureus is one of most prevalent pathogens in the world associated with a high mortality rate and a rapid development of resistance to antibiotics. Despite its pathogenicity, epidemiological monitoring in Mexico is scarce. Aim: To analyze the local molecular epidemiology and determine the clonal origin of methicillin-resistant (MR) strains isolated from patients admitted to Hospital "Dr. Ignacio Morones Prieto". Methods: A cross-sectional prospective study was carried out from July to December 2016. The characterization of the strains was carried out by Spa genotyping, frequency of specific virulence genes by PCR and antibiogram. Results: The prevalence of MRSA was 25.7%, highlighting the presence of the Spa type t895 in 76% of the resistant strains and a similar pattern of susceptibility to antibiotics. Conclusion: The results of this study indicate that the regional prevalence of MRSA has not changed in the last 10 years and provide valuable information on the clonal origin and the virulence factors of the strains of S. aureus isolated in the region.
Assuntos
Humanos , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/genética , Testes de Sensibilidade Microbiana , Prevalência , Estudos Transversais , Estudos Prospectivos , Fatores de Virulência/genética , Genótipo , México/epidemiologia , Antibacterianos/farmacologiaRESUMO
The study was inspired by the chemical surface analysis of a pigmented ceramic sample of a clinical case, which was submitted to a surface study, by means of a chemical chromatographic and electronic microscope. We also performed an "in-vitro" quali-quantitative experiment with 200 ceramic surfaces made of lithium disilicate and feldspar. Which were divided into different surface variables. We also executed mathematical calculations in order to calculate the Delta-E-1976 indicator, which determines the difference of color in ceramic surfaces. In this sense, we analyzed the values obtained with standardized polarized photographs, before and after submerging them into different pigmentation containers for 20 days. These values were compared with visual tests. We performed the mathematical analysis by using the SPSS-22 statistical package.
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Contenido: v.1 2.-Clasificacion de los vehiculos de carga, analisis de los puentes construidos en Bolivia, metodologia y determinacion de las solicitaciones maximas en puentes, metodologia y determinacion de las cargas en los camiones tipo frecuentes en Bolivia, conclusiones y recomendaciones. v.2 Anexos.