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Martin-Granizo R, González LV, López JP, de la Sen O. Needle Therapy: A Minimally Invasive Therapeutic Concept as Part of Temporomandibular Single-Portal Arthroscopy. J Oral Maxillofac Surg 2024; 82:519-524. [PMID: 38387855 DOI: 10.1016/j.joms.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024]
Abstract
The transition from a single portal to a double portal can be complex, necessitating time and training to minimize complications that rely on the operator's skill. Needle therapy is a simple method for treating symptoms that has several benefits. Consequently, this innovative strategy aims to introduce an intermediate technique that enables surgeons to perform therapeutic procedures during single-port arthroscopy.
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Affiliation(s)
- Rafael Martin-Granizo
- Professor, Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain
| | - Luis Vicente González
- Professor, Oral and Maxillofacial Service, Hospital Universitario La Samaritana, Bogotá, Colombia; Professor, Department of Oral Research, School of Dentistry, Institución Universitaria de Colegios de Colombia UNICOC, Bogotá DC, Colombia
| | - Juan Pablo López
- Professor, Oral and Maxillofacial Surgery Service, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia; Professor, Oral and Maxillofacial Surgery Program, Universidad El Bosque, Bogotá, Colombia.
| | - Oscar de la Sen
- Professor, Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain
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López JP, Orjuela MP, Díaz-Baez D, González LV. Comparison of the TMJ arthroscopy discopexy techniques: A systematic review and meta-analysis. J Craniomaxillofac Surg 2024:S1010-5182(24)00142-2. [PMID: 38631972 DOI: 10.1016/j.jcms.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/12/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
This article aims to analyze which of the main arthroscopic discopexy techniques has the best results and if there are differences between the techniques for both pain and maxillary intercuspid opening. A systematic review and meta-analysis was performed according to the PRISMA statement. An electronic search was performed with no publication date restriction in PubMed, Ovid and Embase. The PICO criteria: (P) Patients: With temporomandibular internal disorders with discopexy indication. (I) Intervention: Temporomandibular joint arthroscopic discopexy. (C) Comparison: Arthroscopic discopexy among different techniques classified as non-rigid, semi-rigid and rigid. (O) Outcomes: Impact in clinical conditions such as pain and maximum mouth opening. The inclusion criteria were Patients with temporomandibular internal disorders with discopexy indication performed with different techniques classified as non-rigid, semi-rigid and rigid. The outcomes evaluated were pain and maximum mouth opening. Case series, cohort studies, quasi-experimental studies, and randomized clinical trials with at least 3 months of follow-up were included. The exclusion criteria considered were patients with related concomitant surgeries, patients with associated neoplastic disease or connective tissue disease. A total of 1515 joints where 1400 discopexies were performed including 849 females and 204 males. The most common diagnostic was Wilkes stage III in 257 joints. For pain and oral opening, the semi-rigid technique shows the best results median (MD) 4.84 (CI 2.52-7.16; p = 0.001, I2:100%), MD -2.78 (CI -4.34, -1.21; p = 0.001, I2:99%), respectively. The rigid technique has the greatest probability for complications MD 0.14 CI 95% (0.00, -0.28). Although the semi-rigid technique showed better results, there is no statistically significant difference. However, due to the heterogeneity of the studies, the results should be interpreted with caution.
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Affiliation(s)
- Juan Pablo López
- Oral and Maxillofacial Surgeon, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia; Universidad El Bosque, Unidad de Investigación en Epidemiología Clínica Oral UNIECLO, Bogotá DC, Colombia.
| | - María Paula Orjuela
- Oral and Maxillofacial Surgery Surgeon, Universidad El Bosque, Bogotá DC, Colombia
| | - David Díaz-Baez
- Unit of Basic Oral Investigation (UIBO), Facultad de Odontología, Universidad El Bosque, Bogotá DC, Colombia
| | - Luis Vicente González
- Oral and Maxillofacial Surgeon, Hospital Universitario La Samaritana, Bogotá DC, Colombia; Department of Oral Research, School of Dentistry, Institución Universitaria de Colegios de Colombia UNICOC, Colombia
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López JP, Orjuela MP, González LV, Peraza-Labrador AJ, Díaz-Baez D. Comparison of the Clinical Effectiveness of Intra-Articular Injection with Different Substances After TMJ Arthroscopy: A Systematic Review and Meta-Analysis. J Maxillofac Oral Surg 2024; 23:261-270. [PMID: 38601255 PMCID: PMC11001798 DOI: 10.1007/s12663-023-02047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 10/22/2023] [Indexed: 04/12/2024] Open
Abstract
Objective This systematic review aims to describe the clinical outcomes after TMJ arthroscopy followed by intra articular infiltration with different substances. Materials and Methods A literature search was carried out, the variables were Arthroscopy with different substances, pain and maximal mouth opening. The inclusion criteria were articles that reported infiltration of different substances after arthroscopy. Case series, observational studies, and randomized clinical trials were included. Exclusion criteria were studies that included arthrocentesis, animal studies, connective tissue disease, patients with previous surgeries. Results Of the 5 studies finally included, the population studied were 346 subjects, of which 315 were female. The mean age was 34.7 (16-77). Regarding diagnoses, Wilkes III and Wilkes IV were taken into account. The most commonly used substance was sodium hyaluronate/hyaluronic acid in 4 of the 5 studies. Conclusion Multiple substances have been infiltrated within the temporomandibular joint, with sodium hyaluronate/hyaluronic acid being the most studied. However, the benefit of substances like ATM artroscopia adyuvantes has not been clearly established. It is recommended in future studies that the substances and results be evaluated in the same way to obtain more homogeneous studies.
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Affiliation(s)
- Juan Pablo López
- Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Universidad El Bosque, Bogotá, Colombia
| | | | - Luis Vicente González
- Hospital Universitario La Samaritana, Bogotá, Colombia
- Department of Oral Research, School of Dentistry, Institución Universitaria de Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Alberto Jose Peraza-Labrador
- Centro de Odontología Integral, Acarigua, Portuguesa Venezuela
- Department of Diagnosis Sciences, Texas A&M University College of Dentistry, Dallas, TX USA
| | - David Díaz-Baez
- Unit of Basic Oral Investigation (UIBO) Facultad de odontología, Universidad El Bosque, Bogotá, Colombia
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Orozco-Fernández M, Mejía JP, López JP, Vanegas M, Orostegui-Hernández V. Acellular Dermal Matrix, Osseoplastic Flap, and Transnasal Endoscopic Approach for Frontal Mucocele. J Craniofac Surg 2023; 34:e796-e799. [PMID: 37643071 DOI: 10.1097/scs.0000000000009684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 06/25/2023] [Indexed: 08/31/2023] Open
Abstract
PURPOUSE The primary objective of this study is to suggest the use of acellular dermal matrix through an osteoplastic flap and transnasal endoscopic treatment for the management of frontal mucoceles. The secondary objective is to propose the characteristics to choose this approach. METHODS A retrospective cohort study was carried out on patients with frontal mucoceles of different etiologies where an osteoplastic flap was made to address the sinus and subsequently obliterated with acellular dermal matrix. RESULTS A cohort of 11 patients were included in the study, 6 (67%) were female and 5 (56%) were male, with a mean age of 56 years (range 35-71). The majority of patients (73%) with a history of trauma and all the patients were treated with frontal osteoplastic flap and obliteration with acellular dermal matrix. No evidence of recurrence in a follow-up period with a mean of 18 months and a low rate of complications. CONCLUSIONS The frontal osteoplastic flap and obliteration with acellular dermal matrix is a simple and safe technique to perform with low morbidity. Also, an orbital reconstruction can be performed simultaneously.
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Affiliation(s)
- Martin Orozco-Fernández
- Department of Oral and Maxilofacial Surgery, Hospital Universitario Clínica Colombia
- Oral and Maxilofacial Surgery Program, Universidad El Bosque
| | - Juan Pablo Mejía
- Department of Oral and Maxilofacial Surgery Hospital Universitario Clínica Colombia
| | - Juan Pablo López
- Department of Oral and Maxillofacial Surgery, Universidad El Bosque
- Oral and Maxillofacial Surgery, Fundación Santa Fe de Bogota
| | - Marcela Vanegas
- Department of Otorhinolaryngology, Hospital Universitario Clínica Colombia
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Gonzalez LV, López JP, Orjuela MP, Mejía M, Gallo-Orjuela DM, Granizo López RM. Diagnosis and management of temporomandibular joint synovial chondromatosis: A systematic review. J Craniomaxillofac Surg 2023; 51:551-559. [PMID: 37562984 DOI: 10.1016/j.jcms.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 02/26/2023] [Accepted: 07/30/2023] [Indexed: 08/12/2023] Open
Abstract
The aim of this study was to systematically review the diagnosis and management of temporomandibular joint synovial chondromatosis (TMJ-SC). Using a systematic study design based on the PRISMA guideline, the researchers implemented and analyzed a cohort of relevant publications indexed by PubMed, Embase, Medline, and LILACS between January 1990 and December 2022. The outcomes of interest were demographics of the primary studies, and Clinical, radiological, and therapeutic data associated with TMJ-SC. The study samples included 8 studies presenting 121 TMJ-SC cases (73.6% female; 100% unilateral; 53.7% left-sided; mean age, 43.3 ± SD 5,80 [range, 21-81]. Non-specific symptoms were mostly reported, including TMJ pain, noise and local inflammation, and/or malocclusion. Radiographically, loose bodies, masses with low-signal foci, and calcification were common charateristics. Until now, there has been no internationally accepted consensus on diagnosis and management of TMJ-SC. Arthroscopic surgery should be performed on masses confined to the superior TMJ space, while open arthroplasty is indicated in cases with the extra-articular extension. A combination of both treatment methods may be necessary, when the lesion locates extending beyond the medial groove of the condyle.
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Affiliation(s)
- Luis Vicente Gonzalez
- Oral and Maxillofacial Surgeon, Hospital Universitario La Samaritana. Bogotá, Colombia
| | - Juan Pablo López
- Oral and Maxillofacial Service, Hospital Universitario Fundación Santa Fe de Bogotá Colombia; Oral and Maxillofacial Surgery Program, Universidad El Bosque, Bogotá, Colombia.
| | - María Paula Orjuela
- Oral and Maxillofacial Surgery Program, Universidad El Bosque, Bogotá, Colombia
| | - Manuel Mejía
- Biomedical Engineer, Escuela Colombiana de Carreras Industriales, Bogotá, Colombia
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Martinez JDC, Tellez N, Gonzalez LV, López JP, Rodríguez-Sáenz Á, Orjuela MP, Torres I. Correlation Between Demographic Variables and Complications in Nonsyndromic Craniosynostosis. J Craniofac Surg 2023; 34:e341-e344. [PMID: 36503966 DOI: 10.1097/scs.0000000000009123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This retrospective cross-sectional, observational study aims to determine the correlation between demographic variables and nonsyndromic craniosynostosis. METHODS A cross-sectional study was carried out. The inclusion criteria were nonsyndromic craniosynostosis and the exclusion criteria were patients who did not have complete records. RESULTS The sample included 49 patients and mainly women. Patients with more than 4 days in the intensive care unit were related with more complications. Intracranial Hypertension was seen predominantly in patients between 6 and 8 months P =0007. CONCLUSION Some variables can modificate complications risk but future studies are needed to further investigate the influence of such variables on craniofacial care.
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Affiliation(s)
- Jose Del Carmen Martinez
- Pediatric and Craniomaxillofacial Surgery Service Hospital for Children and Adolescents of Morelense
| | - Nicolas Tellez
- Pediatric and Craniomaxillofacial Surgery Service Hospital for Children and Adolescents of Morelense
| | - Luis Vicente Gonzalez
- La Samaritana University Hospital
- Department of Oral Research, School of Dentistry, University Institution of Colleges of Colombia
| | - Juan Pablo López
- Fundación Santa Fe de Bogotá
- Oral and Maxillofacial Surgery program, El Bosque University
| | | | | | - Ivan Torres
- Pediatric and Craniomaxillofacial Surgery Service Hospital for Children and Adolescents of Morelense
- Craniomaxillofacial Surgery Service Hospital Regional de la Orinoquia, Colombia
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Gonzalez LV, López JP, Torres I, Martin-Granizo López R. External Jugular Thrombosis: A Previously Unreported Complication of Temporomandibular Joint Arthroscopy. J Oral Maxillofac Surg 2023:S0278-2391(23)00346-4. [PMID: 37127149 DOI: 10.1016/j.joms.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/27/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
Temporomandibular joint intra-articular disorders are commonly managed using arthroscopic-assisted procedures. Arthroscopic procedures are minimally invasive, generally successful, and report a low frequency of complications. Vascular complications are particularly uncommon. This case report summarizes the diagnosis and management of jugular vein thrombosis following temporomandibular joint arthroscopy.
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Affiliation(s)
- Luis Vicente Gonzalez
- Oral and Maxillofacial Surgeon, Hospital Universitario La Samaritana, Bogotá, Colombia, Department of Oral Research, School of Dentistry, Institución Universitaria de Colegios de Colombia UNICOC
| | - Juan Pablo López
- Oral and Maxillofacial Service, Hospital Universitario Fundación Santa Fe de Bogotá, Oral and Maxillofacial Surgery program, Universidad El Bosque, Bogotá, Colombia.
| | - Ivan Torres
- Pediatric and Craniomaxillofacial Surgery Service Hospital del Niño y el AdolecenteMorelense, Cuernavaca México, Craniomaxillofacial Surgery Service Hospital Regional de la Orinoquia, Colombia
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Barreto D, López JP. Idiopathic Unilateral Intracranial Condylar Dislocation: A Case Report. J Oral Maxillofac Surg 2023:S0278-2391(23)00326-9. [PMID: 37084761 DOI: 10.1016/j.joms.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/02/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
Intracranial condylar dislocation to the middle fossa is rare, as it is not reported often. Known cases have an etiology, identified as erosion of the glenoid cavity from joint prostheses and/or traumatic events. As such, this case aims to offer a predisposing reason for the idiopathic condylar dislocation to the middle cranial fossa with nonfunctional limitations.
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Fandiño K, Gómez-Delgado A, López JP. Open Reduction of Condylar Fracture Through a Modified Endaural Approach. J Maxillofac Oral Surg 2022; 21:936-938. [PMID: 36274878 PMCID: PMC9474740 DOI: 10.1007/s12663-022-01746-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/03/2022] [Indexed: 10/17/2022] Open
Abstract
Throughout history, several authors have extensively modified approaches to temporomandibular joint surgery to improve access, improve aesthetics, and decrease the risk of nerve damage. In this report, we propose the reduction of a medial condylar fracture through the modified endaural approach, being a safe approach for the facial nerve, effective, aesthetic, and simple to perform.
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Affiliation(s)
- Karen Fandiño
- Hospital Universitario Clinica San Rafael, Bogotá, Colombia
| | - Andrés Gómez-Delgado
- Hospital San Juan de Dios and Hospital UNIBE, San José, Costa Rica
- Universidad El Bosque, Bogotá, Colombia
| | - Juan Pablo López
- Universidad El Bosque, Calle 129#7d-47, Bogotá, Colombia
- Fundación Santa Fe de Bogota, Bogotá, Colombia
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Pauwels A, Lozano C, López JP. The Facial Nerve Injury After Temporomandibular Joint Surgery after Endaural Approach with Sharp Dissection. J Maxillofac Oral Surg 2022; 21:957-960. [PMID: 36274887 PMCID: PMC9474780 DOI: 10.1007/s12663-021-01570-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/10/2021] [Indexed: 11/24/2022] Open
Abstract
Several authors have extensively modified approaches to temporomandibular joint surgery throughout history to improve access, improve aesthetics, and decrease the risk of nerve damage. However, This is why this retrospective cross-sectional is carried out to show the rate of facial nerve injury after the endaural approach with sharp dissection for the temporomandibular joint with a low rate of facial nerve paresis our case series.
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Affiliation(s)
- Andrés Pauwels
- DDS, Oral and Maxillofacial Surgeon, Professor Universidad El Bosque, Department Head, Oral Health Service, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Oral Health Service, Hospital Universitario Fundación Santa Fe de Bogotá, 110111 Bogotá, Colombia
| | - Constanza Lozano
- Oral Health Service, Hospital Universitario Fundación Santa Fe de Bogotá, 110111 Bogotá, Colombia
- DDS, Oral and Maxillofacial Surgeon,Professor Universidad El Bosque, Chief of the Division Oral and Maxillofacial Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Juan Pablo López
- DDS, Oral & Maxillofacial Dental Research,Hospital Universitario Fundación Santa Fe de Bogotá. Resident of Oral and Maxillofacial Program, Universidad El Bosque, Hospital Universitario Fundación Santa Fe de Bogotá, 110111 Bogotá, Colombia
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González LV, López JP, Díaz-Báez D, Martin-Granizo López R. Intraoperative complications in temporomandibular joint arthroscopy: A retrospective observational analysis of 899 arthroscopies. J Craniomaxillofac Surg 2022; 50:651-656. [PMID: 35842375 DOI: 10.1016/j.jcms.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/05/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
This study aims to describe intraoperative complications in temporomandibular joint arthroscopy in patients with Wilkes stage II, III y IV. An analytic observational retrospective study. Inclusion criteria were patients who had no improvement with conservative treatment diagnosed as Wilkes II stage to Wilkes stage IV, and no previous TMJ surgery. Exclusion criteria were disc perforation observed by arthroscopy. Data collected from 458 patients (899 arthroscopies). Of this population, 772 (85.8%) arthroscopies correspond to women, and 127 men (14.1%). Of the sample evaluated, 368 (40.9%) were arthroscopic without discopexy, and 531 (59%) were arthroscopic with discopexy using resorbable pins. In total, 330 complications (36.7%) were found, of which 293 (32.5%) were implicated with iatrogenic damage to the anatomy, and 36 (4%) were associated with some instrument failure. Of this total number of complications, 191 (51.9%) of 386 corresponded to the arthroscopy without discopexy group and 138 (25.9%) of 531 corresponded to the arthroscopy with discopexy group. These study data suggest that the main complications were irrigation fluid extravasation (p = 0.000), and intra-articular bleeding (p = 0.001) followed by pin problems (p = 0.001) in cases of arthroscopies with discopexy. Within the limitations of the study it seems that the learning curve has an important influence on the occurrence of complications. At the beginning of the learning curve, complications are more related to anatomy. Afterwards, the rate of complications decreases but they are more related to the instruments used in advanced techniques. Therefore, proper training and a wide learning curve can reduce the risk of complications and if any occur, more timely management could be given.
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Affiliation(s)
- Luis Vicente González
- Oral and Maxillofacial Surgeon, Hospital Universitario La Samaritana, Bogotá, Colombia; Department of Oral Research, Institución Universitaria Colegios de Colombia, Bogotá, Colombia
| | - Juan Pablo López
- Oral and Maxillofacial Service, Hospital Universitario Fundación Santa Fe de Bogotá, Colombia; Oral and Maxillofacial Surgery Program, Universidad El Bosque, Bogotá, Colombia.
| | - David Díaz-Báez
- Unit of Basic Oral Investigation (UIBO), Facultad de Odontología, Universidad El Bosque, Bogotá, Colombia
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Gonzalez LV, Cote A, López JP, Gómez-Delgado A. Endoscopic Approach for Insertion of Custom-Designed Facial Implants. J Craniofac Surg 2021; 32:e520-e522. [PMID: 33290338 DOI: 10.1097/scs.0000000000007314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT The objective of this article is to describe the combination of virtual planning used to produce a custom-made facial implant, along with the minimally invasive endoscopic approach used to place it, for the reconstruction of the frontal bone. This management reduces the sequelae that occur with the traditional incisions while restoring the proper contour of facial surfaces at the same time.
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Affiliation(s)
- Luis Vicente Gonzalez
- Hospital Universitario La Samaritana; Department of Oral Research, Institución Universitaria Colegios de Colombia
| | - Adriana Cote
- Universidad El Bosque.,Oral Health Service, Hospital Universitario Santa Fe de Bogotá, Bogotá, Colombia
| | - Juan Pablo López
- Oral Health Service, Hospital Universitario Santa Fe de Bogotá, Bogotá, Colombia
| | - Andrés Gómez-Delgado
- Hospital San Juan de Dios and Hospital UNIBE, San José, Costa Rica; Oral and Maxillofacial Surgery Residency Program, Universidad El Bosque, Bogotá, Colombia
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González LV, López JP, Díaz-Báez D, Orjuela MP, Chavez M. Clinical outcomes of operative arthroscopy and temporomandibular medical infiltration with platelet-rich fibrin in upper and lower articular space. J Craniomaxillofac Surg 2021; 49:1162-1168. [PMID: 34384651 DOI: 10.1016/j.jcms.2021.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022] Open
Abstract
This study aims to describe the short-term therapeutic results of patients treated with operative arthroscopy and medical infiltration with platelet-rich fibrin in upper and lower articular space. The study design is descriptive observational with retrospective case series of patients with Wilkes II and III. These patients were managed with operative arthroscopy viscosupplementation with platelet-rich fibrin (PRF) and were followed up for up to 8 months to evaluate their response to treatment. 17 patients were included in the study. In the pre-surgical assessment (T1) mean VAS was 7.1 and MID was 22.2 mm. Eight months later (T4) a relevant improvement in both mentioned variables MID 38.2 ± 4.1 and VAS 1.1 ± 0.2 was observed. Regarding the reduction of pain, a significant improvement in symptoms were found, this being 84.6% ± 3.5% and in mandibular mobility satisfactory results were also obtained, improving in 41.7% ± 20.9%. Within the limitations of the study temporomandibular joint arthroscopy and medical infiltration platelet-rich fibrin viscosupplementation is a procedure of limited invasiveness that shows promising results.
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Affiliation(s)
| | - Juan Pablo López
- Universidad El Bosque, Bogotá, Colombia; Hospital Universitario Santa Fe de Bogotá, Bogotá, Colombia.
| | - David Díaz-Báez
- Universidad El Bosque, Bogotá, Colombia; Unit of Basic Oral Investigation (UIBO), Facultad de Odontología, Universidad El Bosque, Bogotá, Colombia
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González LV, López JP, Valencia-Muñoz C, Arango A. Virtual Navigation Endoscopically Integrated Into Orbital Trauma. J Craniofac Surg 2021; 32:2851-2853. [PMID: 34231507 DOI: 10.1097/scs.0000000000007814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Orbital reconstruction has traditionally been accomplished utilizing different techniques developed for this purpose and has been modified and improved throughout the years. However, there is a high rate of complications associated with eye globe positioning and/or migration of implants, which has created the need to continue to improve these techniques to decrease the frequency of complications. On the other hand, techniques that involve an endoscopic approach and technologies that use virtual surgical planning and three-dimensional model impressions are being used more often to decrease complication rates and seek better surgical outcomes. Combining these 2 methods results in endoscopically integrated virtual surgical navigation. When used for orbital reconstruction, it can be a great alternative and can be useful to decrease the risk of complications associated with this procedure. Therefore, this technical note aims to describe the integration of these 2 techniques into the same instrument to demonstrate the synergy of their benefits when used together.
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Affiliation(s)
- Luis Vicente González
- Hospital Universitario La Samaritana, Cundinamarca, Colombia Universidad El Bosque Oral Health Service, Hospital Universitario Santa Fe de Bogotá, Bogotá, Colombia Universidad Politécnica de Cataluña, Barcelona, Spain Assistant professor, Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery UT Health San Antonio, TX
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González LV, López JP, Díaz-Báez D, Gómez-Delgado A. Correlation between MRI-diagnosed joint effusion and demographic, clinical, imaging, and arthroscopic findings of the temporomandibular joint. J Craniomaxillofac Surg 2021; 49:1169-1174. [PMID: 34246539 DOI: 10.1016/j.jcms.2021.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 06/04/2021] [Accepted: 06/30/2021] [Indexed: 10/20/2022] Open
Abstract
Our study aimed to evaluate the diagnostic accuracy of MRI in cases of joint effusion and documented its relationship with clinical and arthroscopic findings. A cross-sectional study was carried out, using the following selection criteria: clinical, radiological, and MRI-based diagnosis of joint pathology; joint pain; and indication for minimally invasive management with arthroscopy. Arthroscopic analysis, included synovitis, adhesions, chondromalacia, and disc perforations. These variables were recorded and compared with MRI findings of effusion. Data were analyzed using chi-square and Fisher's exact tests. In total, 44 temporomandibular joints were studied, of which 38 corresponded to women; 21 cases were diagnosed as Wilkes IV-V, with effusion found in all of them. The presence of effusion was significantly related to synovitis (p = 0.031) and adherences (p = 0.042). Pain was significantly related to the presence of effusion (p = 0.002), Wilkes advanced stages (p = 0.006), synovitis (p = 0.031), and adherences (p = 0.004). Regarding maximum mouth opening, there was no significant correlation with the variables studied, aside from gender and Wilkes classification. There was a significant correlation between the presence of joint effusion detected by MRI and clinical and arthroscopic findings. This suggests that effusion diagnosed by magnetic resonance has a significant value. Therefore, an adequate presurgical examination should be considered before submitting the patient to an invasive diagnostic procedure.
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Affiliation(s)
- Luis Vicente González
- Oral and Maxillofacial Surgeon, Hospital Universitario La Samaritana, Bogotá, Colombia
| | - Juan Pablo López
- Oral and Maxillofacial Service, Hospital Universitario Fundación Santa Fe de Bogotá, Colombia; Oral and Maxillofacial Surgery Resident, Universidad El Bosque, Bogotá, Colombia.
| | - David Díaz-Báez
- Unit of Basic Oral Investigation (UIBO), Facultad de Odontología, Universidad El Bosque, Bogotá, Colombia
| | - Andrés Gómez-Delgado
- Oral and Maxillofacial Surgeon, Hospital San Juan de Dios and Hospital UNIBE, San José, Costa Rica; Oral and Maxillofacial Surgery Residency Program, Universidad El Bosque, Bogotá, Colombia
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Oporto JI, Zúñiga P, Ossandón D, Zanolli M, Pérez V, López JP, Stetcher X, Rodríguez A, Puentes Á, Rustom S, Lobos J. Intra-arterial chemotherapy for retinoblastoma treatment in Chile: Experience and results 2013-2020. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:288-292. [PMID: 34092282 DOI: 10.1016/j.oftale.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/06/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To establish the success rate of salvage intra-arterial chemotherapy (IAC), defined as the percentage of eyes that achieved tumoral remission and avoided enucleation. The second objective was the clinical characterization, catheterization results, and associated local and systemic complications. METHODS Retrospective, interventional case series of 29 patients (35 eyes) with persistent or recurrent retinoblastoma. RESULTS A total of 73 salvage IAC procedures with topotecan and melphalan were carried out. Success rate was 77% at a mean follow-up of 41.4 months. All patients with only one remaining eye avoided enucleation (10 cases). Catheterization was successful in 98.6% of cases. The types of catheterizations were as follows: 71.2% supraselective ophthalmic artery, 12.3% occlusion pump assisted supraselective ophthalmic artery, 16.4% selective external carotid with retrograde flow. 14% of patients suffered local adverse effects: 1 (2.8%) transitory ptosis, 1 (2.8%) transitory oculomotor nerve palsy, 2 (5.7%) aseptic cellulitis and 1 (2.8%) periorbitary pigmentation. 4.1% (3 cases) suffered neutropenia due to medullar chemosuppression. There were no cases of severe anemia or thrombocytopenia. There were no cerebral ischemic events or mortality associated to the procedure. CONCLUSION IAC with melphalan and topotecan is a safe and effective treatment option for persistent or recurrent retinoblastoma, able to reduce enucleation rates.
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Affiliation(s)
- J I Oporto
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - P Zúñiga
- Clínica Alemana de Santiago-Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - D Ossandón
- Clínica Alemana de Santiago-Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile; Hospital de San Juan de Dios, Santiago, Chile.
| | - M Zanolli
- Clínica Alemana de Santiago-Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - V Pérez
- Clínica Alemana de Santiago-Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile; Hospital de San Juan de Dios, Santiago, Chile
| | - J P López
- Clínica Alemana de Santiago-Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - X Stetcher
- Clínica Alemana de Santiago-Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - A Rodríguez
- Hospital de San Juan de Dios, Santiago, Chile
| | - Á Puentes
- Hospital de San Juan de Dios, Santiago, Chile
| | - S Rustom
- Hospital de San Juan de Dios, Santiago, Chile
| | - J Lobos
- Hospital de San Juan de Dios, Santiago, Chile
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Fernández-Olarte H, Gómez-Delgado A, López JP, Castro-Núñez J. The Use of Inferior Meatal Antrostomy to Decrease Sinusitis with the Placement of Zygomatic Implants. Int J Oral Maxillofac Implants 2021; 36:126-130. [PMID: 33600533 DOI: 10.11607/jomi.8507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To present a case series treated by inferior meatal antrostomy as a prophylactic maneuver after the placement of zygomatic implants to decrease the risk of sinusitis. MATERIALS AND METHODS All patients undergoing zygomatic implant placement using the lower meatal antrostomy protocol between June 2011 and March 2019 at the Department of Oral and Maxillofacial Surgery, Universidad El Bosque, were included. Patients were evaluated after 12 months of the procedure using clinical and radiologic criteria described by Kuriyama and Reiskin. RESULTS Forty-eight patients were included, in whom 184 implants were placed. Complications were as follows: paresthesia (6.2%), orosinusal fistula (4.1%), skin infection (2.1%), and loss of the implant (1.6%). There were no cases of sinusitis. CONCLUSION This study provides evidence that the technique is effective and should be considered because of its simplicity. The inferior meatal antrostomy has been proven to be a simple, effective, and reliable technique to decrease the risk of sinusitis associated with the placement of zygomatic implants.
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18
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López JP, Barriga MM, Lecea D, Parada C, Stephens G. Ophthalmology examination during well-child visits in primary care health centres: Knowledge and difficulties experienced by health workers. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:26-31. [PMID: 33067032 DOI: 10.1016/j.oftal.2020.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The red reflex examination (RRE) and visual acuity testing (VA) is a mandatory part of the examination during the well-child visits (WCV) in primary health care centres of the public system of health in Chile. The eye examination is aimed at the early detection of severe eye diseases in children, such as retinoblastoma, congenital cataracts, and amblyopia. The knowledge and difficulties experienced by health workers in primary care health centres for evaluating the red reflex during WCV in Chile is unknown. MATERIAL AND METHODS A survey was performed in primary community health centres of XXX Santiago de Chile. RESULTS The WCV were mainly performed by physicians (45.2%) and nurses (35.8%). Only 34% of health workers performed the red reflex test, and 42.3% checked VA during the WCV. The main reasons for not doing it include the lack of direct ophthalmoscopes and VA charts (55.2% and 43.9%, respectively) at their centres, and not having the knowledge or skills (29.3% and 22%, respectively) to properly perform these clinical tests. CONCLUSION In this series, the eye examination of children attending WCV was unfrequently performed. A better implementation of the health centres and training of the health workers are needed in order to improve the access and quality of the paediatric eye examination in primary health care institutions in Chile.
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Affiliation(s)
- J P López
- Clínica Alemana de Santiago-Universidad del Desarrollo, Santiago, Chile.
| | - M M Barriga
- Facultad de Medicina, Universidad del Desarrollo-Clínica Alemana, Santiago, Chile
| | - D Lecea
- Facultad de Medicina, Universidad del Desarrollo-Clínica Alemana, Santiago, Chile
| | - C Parada
- Facultad de Medicina, Universidad del Desarrollo-Clínica Alemana, Santiago, Chile
| | - G Stephens
- Departamento de Gestión de Redes, SSMS, Santiago, Chile
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Zanolli M, Oporto JI, Verdaguer JI, López JP, Zacharías S, Romero P, Ossandón D, Denk O, Acuña O, López JM, Stevenson R, Álamos B, Iturriaga H. Genetic testing for inherited ocular conditions in a developing country. Ophthalmic Genet 2020; 41:36-40. [DOI: 10.1080/13816810.2020.1734944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Mario Zanolli
- Clínica Alemana de Santiago- Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
- Departamento de oftalmología, Hospital de niños Roberto del Río, Santiago, Chile
| | - Joaquín I. Oporto
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan I. Verdaguer
- Fundación Oftalmológica Los Andes, Universidad de los Andes, Santiago, Chile
| | - Juan Pablo López
- Clínica Alemana de Santiago- Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Sergio Zacharías
- Fundación Oftalmológica Los Andes, Universidad de los Andes, Santiago, Chile
| | - Pablo Romero
- Clínica Alemana de Santiago- Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Diego Ossandón
- Clínica Alemana de Santiago- Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
- Departamento de oftalmología, Hospital de niños Roberto del Río, Santiago, Chile
| | - Oliver Denk
- Clínica Alemana de Santiago- Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Olga Acuña
- Fundación Oftalmológica Los Andes, Universidad de los Andes, Santiago, Chile
| | - José Manuel López
- Fundación Oftalmológica Los Andes, Universidad de los Andes, Santiago, Chile
| | | | | | - Hernán Iturriaga
- Fundación Oftalmológica Los Andes, Universidad de los Andes, Santiago, Chile
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20
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Henao-Díaz F, Arrroyo S, Cárdenas-Posada G, Fernández M, López JP, Martínez DC, Mendoza JS, Mondragón-Botero A, León O, Pulido-Herrera KL, Rodríguez-Cerón N, Madriñán S. Caracterización biológica en la zona de transición bosque-páramo del Complejo de Páramos Chingaza, Colombia. Biota Colombiana 2019. [DOI: 10.21068/c2019.v20n01a10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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21
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Ossandón D, Zanolli M, López JP, Benavides F, Pérez V, Repetto GM. Molecular diagnosis in patients with retinoblastoma: Report of a series of cases. ACTA ACUST UNITED AC 2016; 91:379-84. [PMID: 27021801 DOI: 10.1016/j.oftal.2016.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 02/17/2016] [Accepted: 02/18/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To report the benefits of genetic diagnosis in patients with retinoblastoma. METHOD Observational study. Patients with retinoblastoma and their families were included. Demographic and clinical data were recorded. Blood and tumour samples were obtained. Next generation sequencing was performed on the samples. When deletion 13 q syndrome was suspected, cytogenetics microarray was performed (Cytoscan® HD, Affymetrix, Santa Clara, CA, USA), with a high density chip of 1.9 million of non-polymorphic probes and 750 thousand SNP probes. RESULTS Of the 7 cases were analysed 4 were male. The mean age at diagnosis was 21 months (range 5-36). Three cases had bilateral retinoblastoma, and 4 unilateral. None had family history. In all patients, blood was analysed, and a study was performed on the tissue from 2 unilateral enucleated tumours, in which 6 mutations were identified, all de novo. Just one was novel (c.164delC; case 1). One case of unilateral tumour revealed blood mosaicism, showing that his condition was inheritable, and that there is a high risk of developing retinoblastoma in the unaffected eye. The patient also has an increased risk of presenting with other primary tumours. CONCLUSION Molecular diagnosis of RB1 in patients with retinoblastoma impacts on the decision process, costs, treatment, and prognosis of patients, as well as their families.
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MESH Headings
- Child, Preschool
- Chile
- Chromosome Deletion
- Chromosome Disorders/diagnosis
- Chromosome Disorders/genetics
- Chromosomes, Human, Pair 13/genetics
- DNA Mutational Analysis
- DNA, Neoplasm/blood
- DNA, Neoplasm/genetics
- DNA, Neoplasm/isolation & purification
- Eye Neoplasms/blood
- Eye Neoplasms/chemistry
- Eye Neoplasms/diagnosis
- Eye Neoplasms/genetics
- Female
- Genes, Retinoblastoma
- Humans
- Infant
- Male
- Mosaicism
- Mutation
- Neoplasms, Multiple Primary/blood
- Neoplasms, Multiple Primary/chemistry
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/genetics
- Oligonucleotide Array Sequence Analysis
- Polymorphism, Single Nucleotide
- Retinoblastoma/blood
- Retinoblastoma/chemistry
- Retinoblastoma/diagnosis
- Retinoblastoma/genetics
- Retinoblastoma Binding Proteins/genetics
- Sequence Analysis, DNA/methods
- Ubiquitin-Protein Ligases/genetics
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Affiliation(s)
- D Ossandón
- Departamento de Oftalmología, Hospital San Juan de Dios, Santiago, Chile; Departamento de Oftalmología, Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - M Zanolli
- Departamento de Oftalmología, Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile.
| | - J P López
- Departamento de Oftalmología, Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - F Benavides
- Centro de Genética y Genómica, Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - V Pérez
- Departamento de Oncología Pediátrica (Programa PINDA), Hospital San Juan de Dios, Santiago, Chile
| | - G M Repetto
- Centro de Genética y Genómica, Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
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22
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Ossandón D, Zanolli M, López JP, Stevenson R, Agurto R, Cartes C. [Telemedicine correlation in retinopathy of prematurity between experts and non-expert observers]. Arch Soc Esp Oftalmol 2015; 90:9-13. [PMID: 25443208 DOI: 10.1016/j.oftal.2014.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 06/24/2014] [Accepted: 06/30/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To study the correlation between expert and non-expert observers in the reporting images for the diagnosis of retinopathy of prematurity (ROP) in a telemedicine setting. METHODS A cross-sectional, multicenter study, consisting of 25 sets of images of patients screened for ROP. They were evaluated by two experts in ROP and 1 non-expert and classified according to telemedicine classification, zone, stage, plus disease and Ells referral criteria. The telemedicine classification was: no ROP, mild ROP, type 2 ROP, or ROP that requires treatment. Ells referral criteria is defined as the presence at least one of the following: ROP in zone I, Stage 3 in zone I or II, or plus+ For statistical analysis, SPSS 16.0 was used. For correlation, Kappa value was performed. RESULTS There was a high correlation between observers for the assessment of ROP stage (0.75; 0.54-0.88) plus disease (0.85; 0.71-0.92), and Ells criteria (0.89; 0.83-1.0). However, inter-observer values were low for zone (0.41; 0.27-0.54) and telemedicine classification (0.43; 0.33-0.6). CONCLUSIONS When evaluating telemedicine images by examiners with different levels of expertise in ROP, the Ells criteria gave the best correlation. In addition, stage of disease and plus disease have good correlation among observers. In contrast, the correlation between observers was low for zone and telemedicine classification.
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Affiliation(s)
- D Ossandón
- Equipo Multicéntrico Retinopatía del Prematuro, Hospital de Niños Roberto del Río, Santiago, Chile
| | - M Zanolli
- Equipo Multicéntrico Retinopatía del Prematuro, Hospital de Niños Roberto del Río, Santiago, Chile.
| | - J P López
- Equipo Multicéntrico Retinopatía del Prematuro, Hospital de Niños Roberto del Río, Santiago, Chile
| | - R Stevenson
- Equipo Multicéntrico Retinopatía del Prematuro, Hospital de Niños Roberto del Río, Santiago, Chile
| | - R Agurto
- Equipo Multicéntrico Retinopatía del Prematuro, Hospital de Niños Roberto del Río, Santiago, Chile
| | - C Cartes
- Fundación Oftalmológica Los Andes, Santiago, Chile
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Torrella F, López JP, Banks CJ. Survival of indicators of bacterial and viral contamination in wastewater subjected to low temperatures and freezing: application to cold climate waste stabilisation ponds. Water Sci Technol 2003; 48:105-112. [PMID: 14510200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The survival of bacterial and viral pollution indicators and Salmonella in urban wastewaters under freezing conditions (-14 degrees C for up to 60 days) is reported. Presumptive, total and faecal coliforms (PC, TC, FC), salmonellae and coliphages were tested. The dynamics of somatic coliphage (E. coli C) and F-pili specific coliphage inactivation were compared at 4 degrees C and 25 degrees C over various run times. On freezing of the wastewater, it was found that PC, TC and FC showed a first rapid phase (days) of inactivation followed by a slower second phase (up to 4 weeks) and then stabilisation at between 1-10% of the initial population size, depending on the wastewater sample used. Salmonella spp. were detectable in 0.1 ml of raw wastewater and were still detected up to 2 days after freezing but none were detected in 100 ml samples after 4, 42 and 60 days, although microbiologically similar but antigenically different forms were found. Viral indicators of pollution showed a slow but constant decrease in viability during the first month but then stabilised at between 10-20% survivors (10% in somatic E. coli C phages, 15.8% in somatic Salmonella phages and 17.9% in F-pili specific coliphages). Using electron microscopy, no difference in susceptibility to freezing could be detected with respect to morphological phage types, which were either small icosahedral particles or complex tailed phages. The study of viral indicators at 4 degrees C versus 25 degrees C showed a higher survival of the various coliphages over time at 4 degrees C. F-pili specific leviviridae were particularly susceptible to the antiviral factors at 25 degrees C and no viable units per ml were detected after one month at that temperature, whereas somatic coliphages were detected in higher numbers after this period, especially at 4 degrees C.
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Affiliation(s)
- F Torrella
- Dept. of Genetic and Microbiology, Faculty of Biology, University of Murcia, 30100 Murcia, Spain.
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Abstract
The present multicentre study was undertaken to assess the prevalence of nocturnal hypoglycaemia and its determining factors in 117 diabetic children and adolescents, aged 2-18 years and diabetes duration > 1 year in Spain. Each child made 3 measurements of blood glucose (BG) at home at night (between 0000 h and 0600 h) on nine separate nights. A hypoglycaemic event occurred in 12-14% of children in any one night. This is lower than rates for nocturnal hypoglycaemia reported in literature, perhaps because of relatively late mealtimes and different meal content, in Spanish children. Children aged < 7 years were at higher risk of nocturnal hypoglycaemia than older children (p < 0.05). Mean HbA1c from the year before the study and mean HbA1c measured during the closest time to the study were significantly lower in those with nocturnal hypoglycaemia (p < 0.0001). Blood glucose concentrations 2 h before hypoglycaemia did not predict nocturnal hypoglycaemia. The occurrence of low or very low blood glucose concentrations before breakfast was related to a higher risk for nocturnal hypoglycaemia (chi 2 22.97; p < 0.001). No previous symptoms were detectable in 89% of cases.
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Affiliation(s)
- M J López
- Paediatric Endocrinology Hospital Clinico Universitario of Valencia and Valladolid, Spain
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Abstract
A study of 16 patients who underwent intralbugineous testicular implants during the practice of orchiectomy is presented. In 14 cases of prostatic carcinoma, after bilateral subcapsular orchiectomy intralbugineous prostheses were implanted and in 2 other cases of testicular torsion unilateral prosthesis was implanted. With this new, easily executed technique the size, mobility and testicular sensibility are maintained.
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Affiliation(s)
- R G Aguilera
- Department of Urology, Sagrada Familia Clinic, Barcelona, Spain
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Abstract
A study of ureteral blockage by Candida in a patient suffering from urinary derivation is presented. It has been favourably resolved by medical treatment and nephrostomy. The increasing medical importance of urinary infections by fungi, especially in weak patients and catheter carriers, makes it important to employ more aggressive treatment. Regarding urinary derivation and Candida infection, in the case of urinary blockage the possibility must be considered that blockage may be due to fungi, since it can be successfully treated medically without the need of surgery.
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