General health & psychological distress in children with temporomandibular disorder.

INTRODUCTION: Temporomandibular disorders (TMD) are an heterogeneous group of disorders affecting temporomandibular joints (TMJ), masticatory muscles, or both. The aim of this study is to evaluate the relationship between general health and psychological distress variables and the clinical diagnosis of TMD in children between 8 - 13 years old. Moreover, it will be underlined the different perception of psychological distress existing between patients and their parents. MATERIALS AND METHODS: Patients were divided in two groups: the "case group", which includes patients with TMD, and the "control group", which included patients asymptomatic for TMD. The "case group" is composed by 29 patients, while the "control group" is composed by 22 patients. The patients were asked to fill in a questionnaire called Child Health Questionnaire (CHQ), to evaluate general health and psychological condition and, eventually, the presence of symptoms of stress, anxiety and/or depression. The CHQ is 87 - item questionnaire developed in USA specifically for children. RESULT: As widely reported during the present work, the link between TMD and psychological distress is existing and quite strong, because of lack of number of patients many aspects worth of attentions have not been analyzed as they deserved. CONCLUSION: That's way the conclusion must lead to the proposal of going on with the present study following, possibly, some aspects of research as an increase of the number of patients involved in the study; Individuate possible elements, internal and external, that could strongly influence differences between patient's results and parent's results, etc.

Identificación de tipos rotacionales y categorías auxológicas como herramienta diagnóstica en la predicción del potencial de crecimiento mandibular / Identification of rotational types and auxological categories as diagnostic tool in the prediction of mandibular growth potential

En la población joven venezolana las maloclusiones representan un importante problema de salud bucal. Resulta útil la aplicación de métodos diagnósticos cefalométricos como el propuesto por Petrovic que permitan identificar el potencial de crecimiento mandibular del paciente como un instrumento para seleccionar la modalidad de tratamiento. El propósito de esta investigación fue identificar los grupos rotacionales y las categorías auxológicas en pacientes venezolanos, de ambos géneros, entre 7 y 10 años, que acudieron a la Facultad de Odontología de la UCV, durante el periodo 2006-2010. Se aplicó el método cefalométrico de Petrovic para la identificación del tipo rotacional y categoría auxológica en las radiografías cefálicas laterales de pacientes sin tratamiento ortopédico ni ortodóncico previo. El tipo rotacional más frecuente fue el P1N, seguido por R2D, R1N y P2D; en ambos géneros el tipo rotacional P1N fue el más frecuente, sin embargo en el género femenino, también se observaron los tipos P2D, R2D y R1N. El grupo rotacional más frecuente fue P1NOB y en segundo lugar R1NOB. Los grupos rotacionales P1NOB y R1NOB fueron los más frecuentes en las niñas y P1NOB en los niños. La determinación del tipo rotacional y la categoría auxológica es una herramienta diagnóstica importante para orientar el plan de tratamiento más acorde según el potencial de crecimiento del paciente...

In the young venezuelan population, malocclusions are an important oral health problem. It is useful the application of cephalometric diagnostic methods as the proposed by Petrovic that allows to identify the mandibular growth potential of the patient as a tool to select the appropriate treatment modality. The aim of this study was to identify the rotational auxologic groups and categories in Venezuelan patients for both genders, age between 7 and 10 years, who had been attended in the Faculty of Dentistry of the Universidad Central of Venezuela, during the period 2006-2010. Was applied Petrovic cephalometric method for identifying the rotational type and auxologic category in the cephalic lateral radiographs of patients without previous orthodontic or orthopedic treatment. The most frequent rotational type was P1N, followed by R2D, R1N and P2D; in both genders P1N rotational type was the most common, however in the female gender, P2D, and R2D and R1N types were also observed. The most frequent rotational group was P1NOB and secondly R1NOB. R1NOB and P1NOB were rotational groups most frequent in girls and in boys was P1NOB. The determination of the rotational type and auxologic category is important to guide the treatment plan according to the patient's growth potential...

Tratamiento multidisciplinario de pacientes edéntulo con síndrome de Apert: reporte de un caso clínico / Multidisciplinary treatment of edentulous patients Apert syndrome: report of a case

Durante el abordaje terapéutico odontológico de los pacientes parcialmente edéntulos, resulta indispensable la obtención de una adecuada estabilidad esquelética, una buena dimensión vertical y una adecuada rehabilitación protésica; a tal fin, es necesaria una programación terapéutica así como la cooperación de las distintas especialidades odontológicas: prótesis, ortodoncia y cirugía. El presente artículo resume la programación y principales fases terapéuticas durante el abordaje de una paciente parcialmente edéntula, diagnosticada con Síndrome de Apert, quien fue sometida a un tratamiento ortodóntico-quirúrgico, además de realizársele una rehabilitación protésica con adecuada dimensión vertical, logrando un equilibrio neuromuscular y una estabilidad oclusal y esqueletal a largo plazo

A case of Apert´s Syndrome is reported as a contribution of better understanding of this disease. A literature review is done concluding that this disease has an important genetic component and belongs to those ones that present craneofacial deformities. The most important characteristics of this syndrome are the associated craneofacial and limb deformities. It´s treatment requires a team aproach with participation of diverses specialities of dentists, in order to give the patient a better treatment from the functional, esthetic and social standpoint

Individualización del tratamiento ortodontico. Importancia de los tipos rotacionales y las categorias auxologicas

El objetivo del presente trabajo consiste en proporcionar herramientas diagnósticas útiles para la individualización terapéutica de cada paciente según sus características individuales de crecimiento y desarrollo cráneo facial. Se describen diversos tipos rotacionales mandibulares así como las categorías auxológicas propuestas por Petrovic, Lavergne y Stutzmann como indicadores del potencial de crecimiento y la modalidad que permite su identificación a través del análisis cefalométrico. En el presente trabajo se evaluaron 800 pacientes que acudieron al servicio de Ortodoncia de la Universidad Católica Sacro Cuore (Roma) a quienes se les determinó el tipo rotacional y la categoría auxológica de crecimiento según Petrovic.

The aim of the authors is to furnish of the indication useful to guideline for orthodontics treatment. We describe rotational type and auxology categories Petrovic's, Lavergne and Stutzmann as indication of growth potential and the modality to identify with cephalometric studies.

Consideraciones estructurales y biológicas en la oseointegración. Revisión de la literatura

Los implantes dentales oseointegrados, ofrecen a los pacientes la posibilidad de usar prótesis estéticas y funcionalmente adecuadas. El objetivo de la terapia implanto protésica es lograr una anquilosis funcional entre hueso e implante, a fin de lograr estabilidad ante las tensiones mecánicas generadas durante la carga protésica. En la presente revisión destacamos aspectos estructurales y biológicos relacionados con los tejidos que rodean al implante.

Dental implants and their prosthetic counterparts provide a stable foundation for a tooth replacement and the solution for patient satisfaction. The aim of dental implant therapy is the osseointegration, the implant can be successfully fused into bone, but in all cases, what must be addressed is the functional aspect of the final implant restoration. This study examined the structural and functional connection between the living bone and the implant.

Regeneración osea guiada GBR: revisión de la literatura / Guide bone regeneration GBR: revew of the literature

La regeneración ósea guiada (Guided Bone Regeneration- GBR) actualmente es considerada una terapia de gran importancia en Implantología, para promover la regeneración de hueso en defectos óseos maxilares; la finalidad es crear un lecho adecuado para el posicionamiento de Implantes. La GBR se basa en el uso de membranas reabsorbibles y no reabsorbibles en combinación con biomateriales de relleno como hueso autólogo, homólogo, heterólogo o materiales aloplásticos con funciones de barrera mecánica, tendientes a excluir de la zona de reparación células epiteliales y conjuntivas, permitiendo la invasión de células osteoprogenitoras

Guide Bone Regeneration has been used widely in implantology for enhancing bone healing to optimize implant placements in the maxillary. The GBR is a technique that uses resorbable and non-resorbable membranes in combination with other filling biomaterials as autologous, homologous or heterologous bone graft, or aloplastic materials as mechanic barriers that prohibit the migration of connective and epithelial cells, enabling the osteogenic cells invasion in bone defects

Indicaciones y efectos terapeuticos del activador de andresen: reporte de un caso / Indications and therapeutic effects andresen activator: a case report

En el tratamiento de las maloclusiones clase II por retrognatismo mandibular se han utilizado gran número de aparatos funcionales. El presente trabajo resume las principales características e indicaciones de uno de los Aparatos Funcionales más utilizado en Europa: el Activador de Andresen. Este estudio reporta un caso de una maloclusión Clase II División 1 tratado exitosamente con el Activador de Andresen

Authors have reviewed the principal characteristics of the most utilized functional dispositive in orthodontic in Europe: Andresen Activator. Factors like construction of the appliance, state of growth, direction of growth and necessity of cooperation determine the success of all functional appliances, inclusive the Andresen Activator. The aim of this study was to examine a case with Class II Division 1 malocclusion, which was treated with the Andresen Activator

Hipomovilidad mandibular crónica asintomática asociada a proceso inflamatorio relacionado con inclusión de terceros molares / Symptomatic chronic mandibular hypomobility associated with third molar impaction-related inflammatory process

En el presente trabajo se analiza un caso clínico de reducción de la apertura bucal con diagnóstico presuntivos de anquilosis temporomandibular; se discutirán las diversas teorías etiopatogénicas de hipomovilidad mandibular, confrontando los datos anamnésicos, clínicos y radiológicos

Tension-Free vaginal tape: analysis of outcomes and complications in 404 stress incontinent women.

The aim of this prospective multicenter study was to evaluate the safety and efficacy of tension-free vaginal tape (TVT) for the surgical treatment of female stress incontinence. Four hundred and four women underwent the TVT procedure. Their mean age was 57 years (range 31-83). The median follow-up time was 21 months (range 12-35). The subjective and objective cure rates were 92% and 90%, respectively. Another 4% of the women were significantly improved by the procedure. Intra- and postoperative complications were few and included uneventful bladder perforations (6%), retropubic bleeding requiring surgery (0.5%), voiding difficulties (4%) in the postoperative course, and one obturator nerve injury. We conclude that the TVT procedure is associated with a high cure rate and a low morbidity.

Significance of lymph node sampling in epithelial carcinoma of the ovary.

From 1979 to 1984, 127 patients operated on for ovarian cancer underwent pelvic, para-aortic, or pelvic and para-aortic lymph node sampling. Forty-seven patients proved to be stage I(14 IA and 33 IC), 14 were stage II(3 IIA, 8 IIB, and 3 IIC), 58 were stage III (7 IIIA, 13 IIIB, and 38 IIIC), and 8 were stage IV. Positive lymph nodes were found in 4.2% of patients at stage I, 35.7% at stage II, 41.3% at stage III, and 87.5% at stage IV. With regard to grading, positive lymph nodes were found in 4.4% of G1, in 21.6% of G2, and in 49.1% of G3. A significant increase in survival (P = 0.04) was found for patients classified as stage IIIC only according to lymph node involvement compared to patients in peritoneal stage IIIC with positive lymph nodes (3-year survival: 46% vs 12%). A small increase in survival was observed for N- patients compared to N+ patients, at both stage III and IV, even with same residual tumor size, but the difference is not statistically significant. All other things being equal, because the prevalence of lymph node positivity depends closely on the number of lymph nodes removed and examined (OR = 3.9 for >10 lymph nodes removed compared to 1-5 lymph nodes removed), lymph node sampling does not seem to be a reliable method for evaluating the retroperitoneal status. With regard to the therapeutic role of systematic lymphadenectomy, few data in literature are available and, most important, are not derived from experimental studies. Probably, only randomized studies with a large number of patients will provide useful answers.

Antiemetic efficacy of granisetron in patients with gynecological malignancies.

The efficacy and tolerability of granisetron in the management of acute and delayed emesis was compared with that of a multiple antiemetic drug combination regimen, including metoclopramide, dexamethasone, lorazepam and orphenadrine. The trial was a randomized, cross-over study involving 111 patients with gynecological cancers undergoing chemotherapy with cisplatin. Granisetron was significantly more effective than the combination regimen during the first 24 h after chemotherapy; complete response, rates were 67 and 48%, respectively (p = 0.002). There was a significant reduction in the effectiveness of the combination during the second treatment cycle, compared with the first. In contrast, the efficacy of granisetron did not differ between the two cycles. The response rate during the 6 days after chemotherapy was 40.8% in both groups. At the end of the study, 55% of patients preferred granisetron and 23% preferred the combination (p < 0.001). Granisetron was well tolerated. The principal adverse event was headache, which was reported in 7% of patients. The results of this study confirm that granisetron is effective in the treatment of cisplatin-induced nausea and vomiting during the 24 h after chemotherapy.

[Surgical treatment of acute pancreatitis using the open abdomen technique]. / Trattamento chirurgico della pancreatite acuta necrotica con la tecnica dell' addome aperto.

There is as yet no agreement about a conservative surgical strategy in the therapy of acute necrotizing pancreatitis. This report describes our experience with "open packing" laparostomy. This procedure is only performed when renal and pulmonary insufficiency is proceeding, despite optimal conservative treatment. Since 1986 twenty-two patients were treated in this manner. Three compartments are established: an upper compartment (stomach, liver, spleen covered by the omentum majus, which is dissected from the colon transversum); a lower compartment (small bowel covered by the left colon) and the mid compartment that permanently opens the bursa omentalis and the left retrocolic space. Initially a careful necrosectomy is performed, followed by a tamponade. At the intensive care unit changing of the tamponade and lavage of the bursa omentalis was done every day. So far three patients (13.6%) have died pursuing this therapeutic regimen.

Carboplatin (JM 8), adriamycin and cyclophosphamide (JAC) in advanced ovarian carcinoma: a pilot study.

Eleven untreated patients with advanced ovarian cancer were studied for tolerance and response to combination treatment with fixed doses of adriamycin (45 mg/m2) and cyclophosphamide (600 mg/m2) + escalating doses of carboplatin. At the first dose level of carboplatin (200 mg/m2), toxicity was acceptable. With carboplatin at 300 mg/m2, severe hematologic toxicity was observed. The dose-limiting toxicity was leukopenia. Although carboplatin was administered without any hydration, no patient experienced renal toxicity. Eight objective responses were observed in 9 clinically evaluable patients. At second look surgery, 3 complete responses and 4 partial responses were documented. Polychemotherapy with JAC (carboplatin, 200 mg/m2, adriamycin, 45 mg/m2, and cyclophosphamide, 600 mg/m2) is administrable with acceptable toxicity.

The place of pelvic exenteration in surgical management of advanced and recurrent pelvic tumors.

A series of 28 exenterations for advanced pelvic tumours is presented. The operative mortality (within 90 days) was 17.8%. The actuarial survival (expressed as a two-year disease-free interval) was 35.7%, and better in cases with negative lymph nodes. The types of urinary and bowel diversions adopted are discussed in terms of longer survival.

Cisplatin and cyclophosphamide in early epithelial ovarian carcinoma.

Toxicity and efficacy of adjuvant cisplatin-based chemotherapy were assessed in 41 patients with FIGO stage I-II ovarian carcinoma. Chemotherapy consisted of cisplatin 50 mg/m2 and cyclophosphamide 600 mg/m2 administered on a one-day schedule q 28 d for six courses. Inclusion criteria were based on appropriate staging procedures and absence of macroscopic disease after primary surgery; patients with stage IAi G1-G2 or with borderline tumors were excluded from the study. Second look laparotomy was performed 2 months after termination of chemotherapy. At 60 months the actuarial survival is 77.5%. Recurrences were observed in 8 patients; in 1 case relapse was diagnosed at second look laparotomy. Toxicity was acceptable with only 1 treatment drop-out due to reversible neurotoxicity. Our results demonstrate that short-term chemotherapy including cisplatin is a safe and effective regimen and is suitable for administration on a outpatient basis. In our experience second-look laparotomy has limited value for early detection of relapses.