La cuantificacion de la expresion genica en celulas vivas mediante mecanismos no invasivos, posee una gran importancia para la Biomedicina y la Medicina Clinica dado que estan aumentado exponencialmente la identificacion de genes implicados en patologia humana. A pesar del incremento en la precision de las herramientas de que disponemos para evaluar la expresion genica in vitro, no existe un avance paralelo para evaluarla in vivo. La espectroscopia Raman permite obtener informacion sobre las caracteristicas quimicas y estructurales de las muestras en base a las caracteristicas de la radiacion dispersada inelasticamente por las mismas en respuesta a un haz incidente. La espectroscopia de Raman esta siendo utilizada experimentalmente en diversos campos de la Biomedicina incluyendo la discriminacion de celulas tumorales. En este trabajo proponemos sentar las bases para utilizarla en la identificacion de las diferencias que provoca en celulas vivas la expresion de un detenninado gen. La sobrexpresion de la proteina verde fluorescente (GFP) en celulas de la linea HEK293FT, conduce a la aparicion de picos detectables mediante espectroscopia Raman de infrarrojo cercano.
El tratamiento que ha demostrado mayor eficacia en los pacientes con síndrome de apneas-hipopneas del sueño (SAHS) es la presión positiva continua de la vía aérea (CPAP).Los mayores inconvenientes son la incomodidad y
El tratamiento que ha demostrado mayor eficacia en los pacientes con síndrome de apneas-hipopneas del sueño (SAHS) es la presión positiva continua de la vía aérea (CPAP). Los mayores inconvenientes son la incomodidad y la sensación de claustrofobia, que en algunos pacientes provoca rechazo o intolerancia. Una alternativa son los dispositivos de avance mandibular (DAM), que insertados en las arcadas dentarias producen el avance de la mandíbula y de la lengua, aumentando el volumen de la vía aérea. Presentar nuestra experiencia en el tratamiento del SAHS mediante dispositivos de avance mandibular tipo Herbst. Estudio de seguimiento prospectivo desde junio de 2006 hasta enero de 2009 de 7 pacientes del Área Hospitalaria Virgen Macarena con SAHS que rechazan el tratamiento con CPAP y a los que se ofrece tratamiento con DAM. Las variables analizadas son: índice de apneas-hipopneas por hora, índice de desaturaciones por hora, intensidad subjetiva del ronquido y el test de somnolencia de Epworth, antes del tratamiento y al menos 6 meses después desde el inicio de su uso. Utilizamos el test de Wilcoxon para detectar diferencias estadísticas significativas (p<0,05). Se observó una reducción estadísticamente significativa del índice de apneahipopneas por hora (p<0,018) y del índice de desaturaciones por hora (p<0,018), así como una reducción no significativa del ronquido y de la somnolencia. El uso de DAM tipo Herbst en pacientes afectos de SAHS que rechazan el uso de la CPAP podría ser útil, mejorando clínica y funcionalmente su situación. The most effective treatment in patients with sleep apnea-hypopnea syndrome (SAHS) is CPAP (continuous positive airway pressure). The main drawback of CPAP is the discomfort and claustrophobic sensation that it causes, which elicits rejection or intolerance by some patients. A non-surgical alternative to CPAP is the mandibular advancement device (MAD), which consists of a plastic splint inserted between the dental arches to shift the jaw and tongue forward and thus increase airway volume. Report our experience with the treatment of SAHS using the Herbst mandibular advancement device. A prospective follow-up study was carried out from June 2006 until January 2009 at the Virgen Macarena University Hospital with 7 patients with SAHS who refused treatment with CPAP and were treated with the mandibular advancement device. The outcome variables analyzed were: apnea-hypopnea disruptions per hour index, desaturations per hour index, subjective intensity of snoring, and the Epworth Sleepiness Scale. Variables were evaluated pre-treatment and at least once 6 months after initiation MAD use. The Wilcoxon test for paired samples was used to detect statistically significant differences (p<0.05). A statistically significant reduction in the hourly indices of apnea-hypopnea disruptions (p<0.018) and desaturations (p<0.018) was observed, as well as a statistically nonsignificant reduction in snoring and sleepiness. Use of the Herbst mandibular advancement device in patients with obstructive sleep apnea syndrome who refuse CPAP may be helpful as it improves the clinical and functional parameters of the condition.
Conocer la calidad y grado de cumplimentación de la información recogida en las altas hospitalarias (IAH) del Servicio de Cirugía Oral y Maxilofacial de nuestro hospital. Estudio descriptivo transversal de 152 altas hospitalarias. Incluye un total de 35 ítems agrupados. Para la evaluación del IAH valoramos la ausencia y el déficit de información. El criterio de adecuación se fijó por consenso en la cumplimentación del 90% de los ítems de forma correcta. Con el fin de conocer la fiabilidad de los resultados obtenidos se realizó la evaluación por dos revisores de forma independiente y en caso de discordancia se tomó la decisión por consenso tras revisar la historia clínica. El 53,94% de los IAH disponen del 90% de los ítems completos y correctos del modelo de alta de nuestro Servicio. El 10,74% presentan alguna ausencia y el 65,79% de IAH presentan algún déficit de información. Se observa una variabilidad importante en la cumplimentación según el tipo de ítem analizado. Nuestro trabajo valora la calidad de un modelo específico de IAH con ítems previamente seleccionados, considerados útiles y adecuados para reflejar de forma completa, exacta y precisa el proceso asistencial que recibe el paciente y detecta que los ítems: teléfono, residente, fechas de consulta, biopsia y de informe de biopsia, cirugía mayor ambulatoria e intervención urgente deben mejorarse. To determine the quality and compliance to the information contained in the hospital discharge registry (HDR) issued by the Department of Oral and Maxillofacial Surgery in our hospital. A cross-sectional descriptive study was conducted to evaluate 152 HDR reports. These reports included a total of 35 items. We observed that there was a lack of information and some mistakes when filling the HDR boxes. Suitability criteria were set up by consensus as the completion of 90% of the items examined. To evaluate the reliability of the results, an assessment was performed by two reviewers independently, and in case of disagreement the decision was made by consensus after reviewing the medical record. Only 53.94% of the HDR had 90% of the items completed appropriately; 10.74% had some items missing when filling in the form, and 65.79% lacked some information. Depending on the type of item there was a significant variation in the completion of the form. In the present work, we assess the quality of a specific hospital discharge form in our hospital, with items previously selected as useful and appropriate to reflect a complete, accurate and precise view of the care process of the patient, and improvements were needed in items such as, telephone, home address, date of consultation, biopsy report and the date it was performed, ambulatory surgery and emergency response.
To evaluate the effectiveness and complications related to the use of a partially absorbable mesh for the reconstruction of orbital floor fractures. This is a retrospective review of 34 consecutive patients who suffered orbital trauma from August 2007 to March 2013 treated with a partially absorbable mesh for orbital reconstruction. Data collected included gender, age, nationality, cause of injury, date of admission, date of surgery, date of discharge, type of fracture, signs and symptoms such as diplopia, enophthalmos, and sensory disturbance related to the infraorbital nerve, complications before and after surgery, and follow-ups at 1 week, 1 month, 6 months, and after 1 year.Since January 2007, 34 patients were treated in our department with orbital fractures: 28 males (82.4%) and 6 females (17.6%). The mean age was 31 years (minimum 14, maximum 45). The main causes of trauma were road traffic accidents (20 patients, 58.8%), followed by work-related accidents (9 patients, 26.5%), aggressions (3 patients, 8.8%), and sports (2 patients, 6%). Posttraumatic Diplopia was present in 20 patients (58.8%), and enophthalmos was in 9 (26.5%). The incidence of postoperative diplopia was present in 8 patients (23.5%), which decreased to 1 (2.9%) after one year. Paresthesia due to trauma was first noticed in 8 patients (20.6%) and completely disappeared after 12 months. Post surgical enophthalmos was noticed in 3 patients (7.5%). There was one case of migration of the mesh and one case of adherence in the lower lid. Both required surgery and resolved completely. Time from trauma to surgery was on average 5.5 days (min 0, max 27, SD 5.15), and the number of days before discharge was 3.5 days (min 1, max 16, SD 2.61).This study describes the results of the first series of orbital floor reconstructions with a partially absorbable mesh (Monofilament polypropylene fibre and monofilament poliglecaprone-25) to date. Although there are a wide variety of materials for treatment, we believe it is a suitable option with an acceptable rate of complications.
Juvenile granulosa cell tumour (JGCT) is a rare tumour arising from the ovarian sex cord stroma (SCST) and comprising about 5 percent of all granulosa cell tumours. To our knowledge, a cervical metastasis has not been described before. We report a case of a 19-year-old female who had a left supraclavicular mass with a previous history of a JGCT in 2010 and an abdominal recurrence in 2011 followed by radiotherapy and chemotherapy after surgery. JGCT generally affects young women, can be hormonally active, and has malignant potential. The diagnosis is made by histopathology after surgical removal, although it should be suspected when there is a large adnexal tumour along with hyperestrogenism signs. Regional lymph nodes metastases are rare let alone extra-abdominal ones.
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