Early diagnosis and aggressive surgical resection matters to cure rhinocerebral mucormycosis: Six case reports.

Rhino-cerebral mucormycosis (RM) is a rare and opportunistic fungal infection observed in immune-compromised patients and metabolic imbalances such as Diabetes Mellitus. RM rapidly infiltrates blood vessels, leading to vascular thrombosis, subsequent tissue necrosis, and high mortality rates (23.6-60%). Due to its fast advancement, RM is a life-threatening condition requiring accurate clinical decisions by the medical and surgical teams. Based on the report of six cases, we emphasize the need for an early diagnosis and starting antifungal pharmacological therapy at the slightest suspicion of RM. Moreover, the restitution of metabolic balance and aggressive surgical debridement are vital steps to control RM, reducing the possibility of fatal outcomes.

Distracción osteogénica del tercio medio facial. Reporte de dos casos clínicos / Distraction osteogenesis of the midface. Two clinical cases report

La corrección quirúrgica de grandes asimetrías faciales son un desafío para el equipo quirúrgico. En dichos casos, los resultados de la corrección utilizando técnicas quirúrgicas convencionales son limitados, lo que hace necesario la utilización de otras herramientas terapéuticas. La distracción ósea (DO) es una de ellas, pues permite el estiramiento controlado del callo óseo previamente creado mediante osteotomías. La DO permite realizar cambios en el posicionamiento óseo de gran envergadura, favoreciendo el crecimiento óseo como mecanismo de acción. El objetivo de este artículo es describir los resultados quirúrgicos de DO intraoral del tercio medio facial utilizado en dos pacientes con severas asimetrías faciales asociadas a malformaciones de origen genético. Se relata el diagnóstico, la planificación, las herramientas tecnológicas utilizadas, técnica quirúrgica y los resultados obtenidos.

Surgical correction of major facial asymmetries is a challenge for the surgical team. In such cases, treatment results from conventional surgical techniques are limited, which requires using other therapeutic tools. Bone distraction is one of them, as it allows controlled stretching of the bone callus previously developed through osteotomies. Distraction osteogenesis allows making changes in large bone positioning, favoring bone growth as an action mechanism. This article aims to describe the surgical results of intraoral distraction osteogenesis of the midface used in two patients with severe facial asymmetries related to congenital malformations. Diagnosis, planning, technological tools, surgical techniques, and results obtained are explained.

Artritis séptica de la articulación temporomandibular como complicación de una celulitis facial: reporte de un caso / Septic arthritis of the temporomandibular joint after complication of facial cellulitis: case report

La infección del cóndilo mandibular, artritis séptica, es una enfermedad caracterizada por dolor, fiebre, edema y disminución funcional de la articulación temporomandibular. Predomina en hombres adultos y su etiología incluye distintos factores: enfermedades sistémicas, autoinmunes, trauma local y diseminación de infecciones en la región de cabeza y cuello. Se presenta un caso clínico de artritis séptica en articulación temporomandibular como complicación de una celulitis facial infecciosa. El tratamiento consistió en antibioterapia y artrocentesis seriadas con el objetivo de realizar un aseo intraarticular, acompañado de la movilización temprana de la articulación, idealmente con el apoyo de un equipo de kinesiología. Además, son muy importantes los controles periódicos y de larga data para poder obtener un mejor resultado clínico en el paciente, controlar en el largo plazo, minimizando los riesgos de presentar disminución en la dinámica mandibular y/o anquilosis de la articulación.

Mandibular condyle infection, septic arthritis, is a disease characterized by pain, fever, edema, and functional decrease of the temporomandibular joint. It predominates in adult men and its etiology includes different factors: systemic diseases, autoimmune diseases, local trauma and spread of infections in the head and neck region. A clinical case of septic arthritis in the temporomandibular joint as a complication of infectious facial cellulitis is presented. Treatment consisted of antibiotic therapy and serial arthrocentesis with the aim of performing an intra-articular cleaning, accompanied by early mobilization of the joint, ideally with the support of a kinesiology team. In addition, long-term and periodic controls are very important in order to obtain a better clinical result in the patient, control in the long term, minimizing the risks of presenting a decrease in mandibular dynamics and / or ankylosis of the joint.

Linfoma de Burkitt asociado a Virus de la Inmunodeficiencia Humana. Reporte de un caso clínico / Burkitt lymphoma associated with Human Immunodeficiency Virus. A clinical case report

RESUMEN: El linfoma de Burkitt es un linfoma de células B maduras altamente agresivo, de baja incidencia. Según la Organización Mundial de la Salud presenta tres variantes: endémico, esporádico y asociado al Virus de la Inmunodeficiencia Humana. Este último representa el 30-40% de los linfomas no Hodgkin en pacientes seropositivos para virus de la inmunodeficiencia humana. El tratamiento con quimioterapia en combinación a terapia antirretroviral de gran actividad da muy buenos resultados. Se reporta caso de paciente seropositivo para virus de la inmunodeficiencia humana con linfoma de Burkitt en la cavidad oral, tratado con la terapia anteriormente mencionada.

ABSTRACT: Burkitt lymphoma is a highly aggressive mature B-cell lymphoma with a low incidence. According to the World Health Organization, it has three variants: endemic, sporadic and associated with Human Immunodeficiency Virus (HIV). The last one represents 30-40% of non-Hodgkin's lymphomas in HIV seropositive patients. Treatment with chemotherapy in combination with highly active antiretroviral therapy gives very good results. Here is the case report of a HIV seropositive patient who developed Burkitt lymphoma in the oral cavity and received this treatment.

Compromiso de seno cavernoso como presentación de cáncer anaplásico de tiroides / Cavernous sinus involvement as presentation of anaplastic thyroid cancer

Anaplastic thyroid cancer is an uncommon malignant tumor, usually fatal, primarily affecting older adults and doesn't have effective systemic therapy. The median survival is less than 6 months from diagnosis. Brain metastases are low frequency and reach 18 percent. We present the case of a patient with papillary carcinoma of the thyroid who takes an aggressive form, becoming anaplastic carcinoma, with involvement of the central nervous system (CNS) manifested by paralysis of the cranial nerve IV, which is rare clinical condition.

Cáncer diferenciado de tiroides en tiroides lingual, presentación de un caso / Differentiated thyroid cancer in the lingual thyroid, presentation of a case

The lingual thyroid carcinoma is very uncommon neoplasia with an incidence of less than 1 percent. The papillary variant is the most frequent. Cervical MRI helps differentiate muscle from thyroid tissue. The definitive diagnosis is given by histology. Management is similar to that of orthotopic thyroid cancer. We present the case of a 23-year-old woman with hypothyroidism undergoing treatment with dysphagia and sensation of pharyngeal foreign body and malodorous oral bleeding. Nasopharyngoscopy showed a rounded mass at the base of the tongue; the biopsy was compatible with thyroid neoplasia. Image study with ultrasound confirms empty thyroid bed with presence of lingual ectopic thyroid. The team of surgeons performed surgery with Trotter Technique, they removed a tumor of 4 centimeters of diameter. The definitive biopsy concludes minimally invasive follicular carcinoma. The treatment was completed with 100 mCi of radioiodine. Systemic screening at 7 days was negative, as the post-operative thyroglobulin (Tg)

Prevention of liver ischemia reperfusion injury by a combined thyroid hormone and fish oil protocol.

Several preconditioning strategies are used to prevent ischemia-reperfusion (IR) liver injury, a deleterious condition associated with tissue resection, transplantation or trauma. Although thyroid hormone (T3) administration exerts significant protection against liver IR injury in the rat, its clinical application is controversial due to possible adverse effects. Considering that prevention of liver IR injury has also been achieved by n-3 polyunsaturated fatty acid (n-3 PUFA) supplementation to rats, we studied the effect of n-3 PUFA dietary supplementation plus a lower dose of T3 against IR injury. Male Sprague-Dawley rats receiving fish oil (300 mg/kg) for 3 days followed by a single intraperitoneal dose of 0.05 mg T3/kg were subjected to 1 h of ischemia followed by 20 h of reperfusion. Parameters of liver injury (serum transaminases, histology) and oxidative stress (liver contents of GSH and oxidized proteins) were correlated with fatty acid composition, NF-κB activity, and tumor necrosis factor-α (TNF-α) and haptoglobin expression. IR significantly modified liver histology; enhanced serum transaminases, TNF-α response or liver oxidative stress; and decreased liver NF-κB activity and haptoglobin expression. Although IR injury was not prevented by either n-3 PUFA supplementation or T3 administration, substantial decrease in liver injury and oxidative stress was achieved by the combined protocol, which also led to increased liver n-3 PUFA content and decreased n-6/n-3 PUFA ratios, with recovery of NF-κB activity and TNF-α and haptoglobin expression. Prevention of liver IR injury achieved by a combined protocol of T3 and n-3 PUFA supplementation may represent a novel noninvasive preconditioning strategy with potential clinical application.