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BACKGROUND: Population-based linked datasets are vital to generate catchment area and population health research. The novel Cancer Information & Population Health Resource (CIPHR) links statewide cancer registry data, public and private insurance claims, and provider- and area-level data, representing more than 80% of North Carolina's large, diverse population of individuals diagnosed with cancer. This scoping review of articles that used CIPHR data characterizes the breadth of research generated and identifies further opportunities for population-based health research. METHODS: Articles published January 2012 - August 2023 were categorized by cancer site and outcomes examined across the care continuum. Statistically significant associations between patient-, provider-, and system/policy-level factors and outcomes were summarized. RESULTS: Among 51 articles, 42 reported results across 23 unique cancer sites and 13 aggregated across multiple sites. The most common outcomes examined were treatment initiation and/or adherence (n = 14), mortality/survival (n = 9), and health care resource utilization (n = 9). Few articles focused on cancer recurrence (n = 1) or distance to care (n = 1) as outcomes. Many articles discussed racial, ethnic, geographic, and socioeconomic inequities in care. CONCLUSIONS: These findings demonstrate the value of robust, longitudinal, linked, population-based databases to facilitate catchment area and population health research aimed at elucidating cancer risk factors, outcomes, care delivery trends, and inequities that warrant intervention and policy attention. Lessons learned from years of analytics using CIPHR highlight opportunities to explore less-frequently studied cancers and outcomes, motivate equity-focused interventions, and inform development of similar resources.
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Purpose The increasing use of computed tomography (CT) imaging has led to the detection of more ground-glass nodules (GGNs) and subsolid nodules (SSNs), which may be malignant and require a biopsy for proper diagnosis. Approximately 75% of persistent GGNs can be attributed to adenocarcinoma in situ or minimally invasive adenocarcinoma. A CT-guided biopsy has been proven to be a reliable procedure with high diagnostic performance. However, the diagnostic accuracy and safety of a CT-guided biopsy for GGNs and SSNs with solid components ≤6 mm are still uncertain. The aim of this study is to assess the diagnostic accuracy of a CT-guided core needle biopsy (CNB) for GGN and SSNs with solid components ≤6 mm. Methods This is a retrospective study of patients who underwent CT-guided CNB for the evaluation of GGNs and SSNs with solid components ≤6 mm between February 2020 and January 2023. Biopsy findings were compared to the final diagnosis determined by definite histopathologic examination and clinical course. Results A total of 22 patients were enrolled, with a median age of 74 years (IQR: 68-81). A total of 22 nodules were assessed, comprising 15 (68.2%) SSNs with a solid component measuring ≤6 mm and seven (31.8%) pure GGNs. The histopathological examination revealed that 12 (54.5%) were diagnosed as malignant, nine (40.9%) as benign, and one (4.5%) as non-diagnostic. The overall diagnostic accuracy and sensitivity for malignancy were 86.36% and 85.7%, respectively. Conclusion A CT-guided CNB for GGNs and SSNs with solid components measuring ≤6 mm appears to have a high diagnostic accuracy.
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INTRODUCTION: The widespread use of computed tomography as a screening tool for early lung cancer has increased detection of pulmonary lesions. It is common to encounter patients with more than one peripheral pulmonary nodule (PPN) of uncertain etiology. Shape-sensing robotic-assisted bronchoscopy (ssRAB) emerges as a potential alternative to biopsy multiple PPN, in addition to mediastinal staging in single anesthetic procedure. METHODS: This is a single-center, retrospective review of 22 patients who underwent ssRAB for evaluation of two or more PPN, between November 2021 and April 2023 at Mayo Clinic, FL, USA. RESULTS: A total of 46 PPNs were biopsied in 22 patients. All lesions were ≤2 cm with a median minimum and maximum cross-sectional lesion size of 1.40 cm and 1.05 cm, respectively. Diagnostic yield was 86.9% (n = 40), and target reach was 91.3% (n = 42). Most lesions were in the upper lobes, a solid pattern was found in 78.3% (n = 36), bronchus sign was present in 82.6% of cases (n = 38), 54.4% (n = 25) were malignant nodules, and 32.6% (n = 15) were benign. Fourteen patients had at least one malignant lesion out of two or more nodules sampled, and 10 patients had a malignant diagnosis for all sampled lesions. The complication rate was 9% (n = 2) with one case of bleeding and one of pneumothorax. CONCLUSION: This study is, to our knowledge, the first to assess the use and safety of ssRAB for diagnosis of multiple PPN in a single anesthetic event. This procedure will mainly impact management decisions and subsequently shorten the time from diagnosis to treatment.
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Broncoscopia , Neoplasias Pulmonares , Nódulos Pulmonares Múltiplos , Procedimentos Cirúrgicos Robóticos , Humanos , Broncoscopia/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Procedimentos Cirúrgicos Robóticos/métodos , Nódulos Pulmonares Múltiplos/patologia , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/diagnóstico , Nódulos Pulmonares Múltiplos/cirurgia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Tomografia Computadorizada por Raios X , AdultoRESUMO
BACKGROUND: The American Indian (AI) population in North Carolina has limited access to the Indian Health Service. Consequently, cancer burden and disparities may differ from national estimates. We describe the AI cancer population and examine AI-White disparities in cancer incidence and mortality. METHODS: We identified cancer cases diagnosed among adult AI and White populations between 2014 and 2018 from the North Carolina Central Cancer Registry. We estimated incidence and mortality rate ratios (IRR and MRR) by race. In addition, between the AI and White populations, we estimated the ratio of relative frequency differences [RRF, with 95% confidence limits (CL)] of clinical and sociodemographic characteristics. Finally, we evaluated the geographic distribution of incident diagnoses among AI populations. RESULTS: Our analytic sample included 2,161 AI and 204,613 White individuals with cancer. Compared with the White population, the AI population was more likely to live in rural areas (48% vs. 25%; RRF, 1.89; 95% CL, 1.81-1.97) and to have Medicaid (18% vs. 7%; RRF, 2.49; 95% CL, 2.27-2.71). Among the AI population, the highest age-standardized incidence rates were female breast, followed by prostate and lung and bronchus. Liver cancer incidence was significantly higher among the AI population than White population (IRR, 1.27; 95% CL, 1.01-1.59). AI patients had higher mortality rates for prostate (MRR, 1.72; CL, 1.09-2.70), stomach (MRR, 1.82; 95% CL, 1.15-2.86), and liver (MRR, 1.70; 95% CL, 1.25-2.33) cancers compared with White patients. CONCLUSIONS: To reduce prostate, stomach, and liver cancer disparities among AI populations in North Carolina, multi-modal interventions targeting risk factors and increasing screening and treatment are needed. IMPACT: This study identifies cancer disparities that can inform targeted interventions to improve outcomes among AI populations in North Carolina.
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Neoplasias , Humanos , Masculino , Neoplasias/epidemiologia , Neoplasias/etnologia , Neoplasias/mortalidade , North Carolina/epidemiologia , Feminino , Pessoa de Meia-Idade , Idoso , Incidência , Adulto , Sistema de Registros/estatística & dados numéricos , Indígena Americano ou Nativo do Alasca/estatística & dados numéricos , Adulto Jovem , População Branca/estatística & dados numéricosRESUMO
INTRODUCTION: Lung cancer remains the leading cause of cancer death worldwide. Subsolid nodules (SSN), including ground-glass nodules (GGNs) and part-solid nodules (PSNs), are slow-growing but have a higher risk for malignancy. Therefore, timely diagnosis is imperative. Shape-sensing robotic-assisted bronchoscopy (ssRAB) has emerged as reliable diagnostic procedure, but data on SSN and how ssRAB compares to other diagnostic interventions such as CT-guided transthoracic biopsy (CTTB) are scarce. In this study, we compared diagnostic yield of ssRAB versus CTTB for evaluating SSN. METHODS: A retrospective study of consecutive patients who underwent either ssRAB or CTTB for evaluating GGN and PSN with a solid component less than 6 mm from February 2020 to April 2023 at Mayo Clinic Florida and Rochester. Clinicodemographic information, nodule characteristics, diagnostic yield, and complications were compared between ssRAB and CTTB. RESULTS: A total of 66 nodules from 65 patients were evaluated: 37 PSN and 29 GGN. Median size of PSN solid component was 5 mm (IQR: 4.5, 6). Patients were divided into two groups: 27 in the ssRAB group and 38 in the CTTB group. Diagnostic yield was 85.7% for ssRAB and 89.5% for CTTB (p = 0.646). Sensitivity for malignancy was similar between ssRAB and CTTB (86.4% vs. 88.5%; p = 0.828), with no statistical difference. Complications were more frequent in CTTB with no significant difference (8 vs. 2; p = 0.135). CONCLUSION: Diagnostic yield for SSN was similarly high for ssRAB and CTTB, with ssRAB presenting less complications and allowing mediastinal staging within the same procedure.
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Broncoscopia , Biópsia Guiada por Imagem , Neoplasias Pulmonares , Nódulos Pulmonares Múltiplos , Procedimentos Cirúrgicos Robóticos , Tomografia Computadorizada por Raios X , Humanos , Feminino , Masculino , Estudos Retrospectivos , Pessoa de Meia-Idade , Broncoscopia/métodos , Idoso , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Biópsia Guiada por Imagem/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Nódulos Pulmonares Múltiplos/patologia , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/diagnóstico , Nódulo Pulmonar Solitário/patologia , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/diagnósticoRESUMO
INTRODUCTION: The use of cryobiopsy in conjunction with robotic assisted bronchoscopy is on the rise due to the safety and increased diagnostic yield of cryobiopsy. The incorporation of 3D fluoroscopy in the procedure improves the workflow and helps confirm the accuracy of sampling of peripheral pulmonary nodules. METHODS: We describe an observational series of 12 patients comprising 14 nodules where cryobiopsy was performed during shape-sensing robot-assisted bronchoscopy cryobiopsy under general anesthesia. 3D fluoroscopy was used to confirm accurate placement of the cryoprobe. All these patients underwent a second spin with the 3D fluoroscopy either to sample a second lesion intraoperatively or to investigate suspected pneumothorax. RESULTS: The development of a pneumatocele was noted after cryobiopsy in each of the cases. The majority of these were in the upper lobe with the median size of a sampled nodule being 14 mm. The majority of patients were asymptomatic with 1 patient developing mild hemoptysis and 4 patients developing chest tightness or dyspnea. None of the patients required an intervention for the pneumatocele. CONCLUSION: The development of pneumatoceles appears to be a fairly frequent and benign occurrence following cryobiopsy, likely due to increased tissue destruction. The increased use of intraoperative 3D fluoroscopy is likely to highlight changes to the pulmonary parenchyma that were previously not known. The occurrence of pneumatoceles does not appear to adversely impact the safety or tolerability profile of cryobiopsy.
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Broncoscopia , Criocirurgia , Procedimentos Cirúrgicos Robóticos , Humanos , Broncoscopia/métodos , Broncoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Feminino , Idoso , Fluoroscopia , Procedimentos Cirúrgicos Robóticos/métodos , Criocirurgia/métodos , Criocirurgia/efeitos adversos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/diagnóstico , Biópsia/métodos , Biópsia/efeitos adversos , Biópsia/instrumentação , Cistos/patologia , Cistos/diagnóstico , AdultoRESUMO
This study aimed to determine the type of drugs reported as suspected of causing severe supraventricular arrhythmias from the Spanish Human Pharmacovigilance System database. A total of 1053 reports were analysed, of which 526 (50%) were on men and 516 (49%) were on women. The most affected age group was the over-65s, with 593 reports (56%). Of the 1613 drugs, those belonging to the cardiovascular system (ATC Group C) were the most numerous (414 reports, 26%), with digoxin being the most frequent drug (49 reports, 12%). Other common groups were antiinfectives for systemic use (ATC Group J; 306 reports, 19%), antineoplastic and immunomodulating agents (ATC Group L; 198 reports, 12%), and nervous system drugs (ATC Group N; 185 reports, 11%). The most common supraventricular arrhythmia was atrial fibrillation (561 reports, 51%). Regarding outcomes, 730 (66%) patients recovered, 76 (7%) did not recover, 25 (3%) recovered but with sequelae, and 23 (2%) resulted in death. This study revealed that certain drugs have reported to be associated more frequently to supraventricular arrhythmias as serious adverse reactions, especially in the older population. Proper clinical management and effective strategies to ensure medication appropriateness should always be considered to improve patient safety when prescribing drugs.
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BACKGROUND: Ground-glass pulmonary nodules (GGNs) are most commonly sampled by percutaneous transthoracic biopsy. Diagnostic yield for ground-glass nodules using robotic-assisted bronchoscopy has been scarcely described, with a reported yield of 70.6%. OBJECTIVES: The aim of this study is to assess diagnostic yield for GGNs using shape-sensing robotic-assisted bronchoscopy (ssRAB). METHOD: A retrospective study of patients who underwent ssRAB for evaluation of GGNs, from September 2021 to April 2023. Primary outcome was diagnostic yield of ssRAB for GGNs, secondary outcomes were sensitivity for malignancy, and complications that required admission or intervention. RESULTS: A total of 23 nodules were biopsied from 22 patients. Median age was 71 years (IQR 66-81), 63.6% were female, and 40.9% had a previous history of cancer. Forty-three percent of nodules were in the right upper lobes, and the median lesion size was 1.8 × 1.21. Twelve were subsolid nodules (SSNs), and 11 were pure GGNs. Overall diagnostic yield was 87%, with a sensitivity for malignancy of 88.9%. Adenocarcinoma was the most common malignancy diagnosed (70%). No procedure-related complications were reported. CONCLUSION: The use of ssRAB shows a high diagnostic yield for diagnosing GGN and SSN with less than 6 mm solid component with a low risk for complications.
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Neoplasias Pulmonares , Procedimentos Cirúrgicos Robóticos , Nódulo Pulmonar Solitário , Humanos , Feminino , Idoso , Masculino , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Estudos Retrospectivos , Broncoscopia , Tomografia Computadorizada por Raios X , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/patologiaRESUMO
El herpes zóster es el cuadro clínico constituido por las manifestaciones dermatológicas (erupción vesiculosa) y neurológica (dolor). Es la expresión de la recurrencia del virus varicela-zóster latente en los ganglios sensitivos, su aparición se favorece por el envejecimiento y la inmunosupresión con una prevalencia que se estima en un 20 %. Se describe los pasos clínicos para la confección de una prótesis ocular en el mejoramiento estético a un paciente con defecto ocular en ojo izquierdo provocado por herpes zoster. Se trata de un paciente masculino de piel blanca de 50 años de edad, que acudió a la consulta de prótesis del Policlínico Universitario Julio Antonio Mella de la provincia Camagüey remitido del Servicio de Oculoplastia del Hospital Universitario Manuel Ascunce Domenech con diagnóstico de defecto ocular izquierdo por evisceración como consecuencias de infección por herpes zoster y antecedente de inmunodepresión. El paciente expuso que la pérdida ocular fue por las complicaciones que se fueron sucediendo en la medida que se agravó su cuadro clínico. Además, refirió que presentaba dolor en la zona y que le irradiaba a la cabeza y que le preocupaba su estética. Se determinó la elaboración de una prótesis ocular acrílica para mejorar el aspecto estético, lo cual permitió que el paciente mejorara su autoestima y calidad de vida(AU)
Herpes zoster is the clinical picture constituted by dermatological (vesicular rash) and neurological (pain) manifestations. It is the expression of the recurrence of the latent varicella-zoster virus in the sensitive ganglia, its appearance is favored by aging and immunosuppression with a prevalence estimated at 20%. We describe the clinical steps for the fabrication of an ocular prosthesis for the aesthetic improvement of a patient with ocular defect in the left eye caused by herpes zoster. This is a 50-year-old male patient with white skin, who came to the prosthesis consultation of the Julio Antonio Mella University Polyclinic in Camagüey province, referred from the Oculoplasty Service of the Manuel Ascunce Domenech University Hospital with a diagnosis of left ocular defect due to evisceration as a consequence of herpes zoster infection and a history of immunosuppression. The patient explained that the ocular loss was due to the complications that occurred as his clinical condition worsened. In addition, he reported that he had pain in the area that radiated to the head and that he was concerned about his esthetics. It was decided to make an acrylic ocular prosthesis to improve the esthetic aspect, which allowed the patient to improve his self-esteem and quality of life(AU)
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HumanosRESUMO
La denominación de carcinomas de cabeza y cuello o tracto aerodigestivo superior, supone un agrupamiento de neoplasias que comparten elementos comunes como etiología, epidemiología, histología, evolución clínica, procedimientos diagnósticos, enfoques terapéuticos y medidas de seguimiento. El objetivo del presente trabajo es identificar la evidencia científica respecto al tratamiento multidisciplinario del paciente con cáncer de cabeza y cuello y el rol que desempeña el protesista. Para ello, se realizó una búsqueda de literatura disponible en las bases de datos electrónicas PubMed, Medline, Cochrane, Hinari y SciELO. Se encontró que el tratamiento de estas lesiones malignas requiere de un equipo conformado por diferentes especialistas, como otorrinolaringólogo, cirujano de cabeza y cuello, cirujano maxilofacial, odontólogo oncológico, protesista, psiquiatra y psicólogo, nutricionista y rehabilitador, para optimizar el tratamiento de estos pacientes mediante la decisión colectiva.
The designation of carcinomas of head and neck or high aero-digestive tract, supposes a grouping of neoplasia that share common elements like etiology, epidemiology, histology, clinical evolution, diagnostic procedures, therapeutic approaches and follow-up measures. The aim of this paper is to identify the scientific evidence regarding the multidisciplinary treatment of the patient with cancer of head and neck and the role played by the prosthodontist. To this end a literature search was conducted in the electronic databases PubMed, Medline, Cochrane, Hinari and SciELO. It was found that the treatment of these malignant lesions requires a team consisting of different specialists, such as otolaryngologist, head and neck surgeon, maxillofacial surgeon, oncologic dentist, prosthodontist, psychiatrist and psychologist, nutritionist and rehabilitator, to optimize the treatment of these patients through a collective decision.
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Introducción: Los principios en que se sustenta el proceso revolucionario cubano y su Sistema Nacional de Salud, es tratar de dar solución a las necesidades de la población y Cuba dentro de sus limitaciones de desarrollo, ha producido cambios en las condiciones de salud, a través de su política estatal. Objetivo: Describir la evolución histórica de la prótesis bucomaxilofacial en la provincia Camagüey. Métodos: Se realizó una revisión de la de literatura, para recopilar los datos de la historia de la prótesis bucomaxilofacial. Se ejecutó una búsqueda de la literatura en las bases de datos Pubmed, Medline, Cochrane, SciELO, Hinari y prensa escrita donde se expusieran las evidencias disponibles sobre los antecedentes de prótesis bucomaxilofacial en Cuba y en la provincia Camagüey. Resultados: En Cuba la prótesis maxilofacial antes del triunfo revolucionario prácticamente no se realizaba. El 14 de junio de 1999 se crea la Red Asistencial Nacional de Rehabilitación de la Cara y Prótesis Bucomaxilofacial y en el año 2001 el Programa de Rehabilitación de la Cara y Prótesis Bucomaxilofacial, con una cobertura para todos los pacientes del país con esta necesidad de atención. En Camagüey con la creación en abril de 1975 de la consulta multidisciplinaria de Estomatología se inició la atención a los pacientes con defectos bucomaxilofacial. Esto permitió rehabilitar en esos momentos a estos enfermos con los recursos disponibles. Conclusiones: El análisis y las valoraciones realizadas determinaron que la prótesis en la provincia Camagüey ha tenido un gran desarrollo tanto asistencial como docente e investigativo, aunque no se cuenta con un servicio dedicado a la prótesis bucomaxilofacial, se han realizados labores de rehabilitación a pacientes con estos defectos, que le han permitido recuperar la estética, el estado psíquico funcional con alto grado de aceptación y satisfacción y el logro de su reincorporación a la vida social.
Introduction: The principles on which the Cuban revolutionary process and its National Health System are based, is to try to provide a solution to the needs of the population, and Cuba within its development limitations, has produced changes in health conditions, through of its state policy. Objective: To describe the historical evolution of the bucomaxillofacial prosthesis in Camagüey. Methods: A review of the literature was carried out to collect the data on the history of the bucomaxillofacial prosthesis. A search of the literature was carried out in the Pubmed, Medline, Cochrane, SciELO, Hinari and written press databases where the available evidence on the history of oral-maxillofacial prostheses in Cuba and in the Camagüey province was exposed. Results : In Cuba, before the revolutionary triumph, maxillofacial prostheses were practically not performed. On June 14, 1999, the National Assistance Network for the Rehabilitation of the Face and Bucomaxillofacial Prosthesis was created, and in 2001 the Program for the Rehabilitation of the Face and Bucomaxillofacial Prosthesis, with coverage for all patients in the country with this need for care. In Camagüey, with the creation in April 1975 of the multidisciplinary Dentistry consultation, care began for patients with oral-maxillofacial defects. This made it possible to rehabilitate these patients at that time with the resources available. Conclusions: The analysis and the evaluations carried out determined that the prosthesis in Camagüey province has had a great development in terms of care, teaching and research, although there is no service dedicated to oral and maxillofacial prostheses, rehabilitation work has been carried out on patients with these defects, which have allowed them to recover their aesthetics, their functional mental state with a high degree of acceptance and satisfaction, and the achievement of their reincorporation into social life.
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Introducción: Todos los órganos y sistemas del cuerpo humano envejecen. No todos al mismo ritmo, pero ninguno está exento de las modificaciones que conlleva el paso del tiempo y el sistema estomatognático, no es la excepción. Modificaciones extraorales e intraorales hacen que se tengan unas condiciones, necesidades y susceptibilidades diferentes en esta etapa de la vida. Objetivo: Identificar la influencia del envejecimiento sobre las estructuras bucodental en el adulto mayor. Métodos: Se realizó una búsqueda electrónica de la literatura con los motores de búsqueda en las bases de datos: PubMed, Medline, Cochrane, Hinari y SciELO. Para búsqueda de la información se utilizaron las palabras clave atención estomatológica, adulto mayor, envejecimiento, lesiones bucales, enfermedades bucales, lesiones premalignas, cáncer bucal; todas fueron combinadas. Resultados: El envejecimiento de la cavidad bucal es una de las pocas características que unifica y define a todos los seres humanos. Durante el mismo se observan diversos cambios y modificaciones extraorales e intraorales y hacen que se tengan nuevas condiciones en los tejidos orales y periorales en diferentes etapas de la vida; como su impacto en estructuras como los dientes, periodonto, articulación temporomandibular, las glándulas salivales, piel, músculos, edentulismo, mucosa oral, lengua y hueso. Conclusiones: El envejecimiento es un fenómeno silencioso y preocupante que va socavando a los adultos mayores con el decursar del tiempo con un efecto significativo en las estructuras bucales que afecta el bienestar y la satisfacción con la vida de los individuos.
Introduction: All organs and the human body systems age. No all at the same rhythm, but no one is exempt of the modifications that it entails the passage of time and the stomatognathic system, it is not the exception. Extraoral and intraoral modifications make them have some conditions, needs and different susceptibilities in this stage of life. Objective: To identify the influence of aging on the oral and dental structures in the older adult. Methods: An electronic search of literature was carried out in the electronic data bases with the help of search engines: PubMed, Medline, Cochrane, Hinari y SciELO. Key words were used to search for information such as: dentistry attention, older adult, aging, oral injuries, oral diseases, injuries premalignant, oral cancer; all of them were combined for the search. Results: The aging of the oral cavity is one of the uncharacteristic that unifies and defines all the human beings. During the same, various extraoral and intraoral changes and modifications are observed and cause new conditions to be had in the oral and perioral tissues at different stages of life; as its impact on structures such as teeth, periodontium, temporomandibular joint, salivary glands, skin, muscles, edentulism, oral mucosa, tongue and bone. Conclusions: The aging is a silent and worrisome phenomenon that keeps on weakening the senior citizens with the passage of time with a significant effect in the oral structures that affects the well-being and the satisfaction with life of the individuals.
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Introducción: El ojo es un órgano esencial para la relación con el entorno y para el desarrollo del ser humano, es fundamental poseer una adecuada salud visual. Objetivo: Describir la confección de una prótesis ocular para el mejoramiento estético en un paciente con tisis bulbi en ojo derecho. Caso clínico: Paciente masculino, de raza blanca, de 59 años de edad que llega a la consulta de Prótesis del Policlínico Universitario Julio Antonio Mella de la provincia Camagüey remitido de Servicios de Oftalmología con diagnóstico de tisis bulbi del ojo derecho. Al interrogatorio plantea que cuando niño, jugando con su hermano recibió un golpe en el ojo, por el cual fue tratado en el servicio de Oftalmología del Hospital Pediátrico Eduardo Agramonte Piña de la ciudad de Camagüey. Tuvo una pérdida visual progresiva que finalizó en ceguera y cambio de coloración del ojo. Refiere que nunca ha tenido dolor, pero le preocupa su estética. Conclusiones: El tratamiento protésico de la tisis del globo ocular, es una situación desafiante para el equipo rehabilitador, dada las características de este defecto. Con la utilización de este tipo de prótesis oculares en la rehabilitación del paciente, se logró mejorar su estética, lo que condujo a la recuperación física, psíquica y social.
Introduction: The eye is an essential organ for the relationship with the environment, and for the development of the human being it is essential to have adequate visual health. Objective: To describe the preparation of an ocular prosthesis for aesthetic improvement in a patient with phthisis bulbi in the right eye. Clinical case: A 59-year-old white male patient who arrived at the prosthesis clinic of the Julio Antonio Mella University Polyclinic in the province of Camagüey, referred from Ophthalmology Services with a diagnosis of phthisis bulbi of the right eye. Upon interrogation, he states that when he was a child, playing with his brother, he received a blow to the eye, for which he was treated at the ophthalmology service of the Eduardo Agramonte Piña Pediatric Hospital in the city of Camagüey. He had progressive visual loss that ended in blindness and eye color change. He says that he has never had pain, but he is concerned about his aesthetics. Conclusions: The prosthetic treatment of ocular globe phthisis is a challenging situation for the rehabilitation team, given the characteristics of this ocular defect. With the use of this type of ocular prosthesis in the patient's rehabilitation, it was possible to improve their aesthetics, which led to physical, mental and social recovery.
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Introducción: Estudios previos han demostrado diferencias en la percepción de asimetrías dentales y faciales entre profesionales de la odontología y personas no expertas. Sin embargo, la literatura sobre las diferencias en la percepción de las asimetrías del mentón es limitada. Objetivo: Comparar la percepción estética de las asimetrías del mentón entre ortodoncistas, odontólogos especialistas, estudiantes y pacientes de la Facultad de Odontología de la Universidad Central del Ecuador. Métodos: Estudio observacional, analítico y transversal. El universo estuvo conformado por 36 ortodoncistas, 77 odontólogos especialistas, 96 estudiantes y 2580 pacientes de esta Facultad. El tamaño de la muestra fue de 30 participantes para cada grupo. Se modificó digitalmente la posición transversal del mentón de 0° a 6° en las fotografías de dos sujetos (hombre-mujer) ecuatorianos. La evaluación se realizó por medio de una escala visual análoga. Resultados: Las fotografías de asimetrías del mentón con 0° de desviación fueron calificadas como muy estéticas y las asimetrías con 6° fueron poco estéticas para los cuatro grupos. Los ortodoncistas, odontólogos especialistas y estudiantes consideraron como límite estético los 2° de desviación del mentón para la fotografía del sujeto femenino y masculino. Los límites estéticos fueron los 2° de desviación para el sujeto femenino y 3° para el sujeto masculino. Se encontraron diferencias significativas entre los grupos de evaluadores y las fotografías (p < 0,05). Conclusiones: Los ortodoncistas percibieron la estética facial cercana a la norma de la asimetría del mentón, que tiene un papel importante en la percepción de la estética facial(AU)
Introduction: Previous studies have shown differences in the perception of dental and facial asymmetries between dental professionals and non-experts. However, the literature on differences in the perception of chin asymmetries is limited. Objective: Compare the aesthetic perception of chin asymmetries among orthodontists, specialist dentists, students and patients of the Faculty of Dentistry of the Central University of Ecuador. Methods: Observational, analytical and cross-sectional study. The universe was made up of 36 orthodontists, 77 specialist dentists, 96 students and 2580 patients from this Faculty. The sample size was 30 participants for each group. The transverse position of the chin was digitally modified from 0° to 6° in the photographs of two Ecuadorian subjects (male-female). The evaluation was carried out by means of an analogous visual scale. Results: The photographs of asymmetries of the chin with 0° of deviation were qualified as very aesthetic and the asymmetries with 6° were unsightly for the four groups. Orthodontists, specialist dentists and students considered as an aesthetic limit the 2nd deviation of the chin for the photography of the female and male subject. The aesthetic limits were 2° of deviation for the female subject and 3° for the male subject. Significant differences were found between the groups of evaluators and the photographs (p < 0.05). Conclusions: Orthodontists perceived facial aesthetics close to the norm of chin asymmetry, which has an important role in the perception of facial aesthetics(AU)
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Humanos , Percepção , Literatura de Revisão como Assunto , Estudo ObservacionalRESUMO
Currently, there is a limited number of treatment options available for patients with symptomatic leiomyomas, and surgical removal is by far the most frequent procedure. Previous studies found that GnRH agonists and antagonists acting through GnRH receptors led to cell death and decreased extracellular synthesis in cultured leiomyoma cells. In this study, we encapsulated the GnRH antagonist ganirelix in PLGA microspheres contained in an alginate scaffold that also supports a leiomyoma ex vivo tissue explant. Microspheres maintained ganirelix concentration stably during six days of culture, inducing significant cell death in 50-55% of tumor cells. Although no changes were observed in the expression of extracellular matrix genes, a decreased expression of the Nuclear Factor of Activated T cells 5, a transcription factor involved in osmotic stress and tumor size. Interestingly, all tumors analyzed experienced apoptosis independently of the original driver mutation. These data indicate that local therapy of ganirelix would induce tumor reduction in a wide range of uterine leiomyomas.
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Leiomioma , Neoplasias Uterinas , Humanos , Feminino , Preparações de Ação Retardada , Leiomioma/metabolismo , Hormônio Liberador de Gonadotropina/farmacologia , Antagonistas de Hormônios/farmacologia , Antagonistas de Hormônios/uso terapêutico , Neoplasias Uterinas/patologiaRESUMO
Organ culture allows for the understanding of normal and tumor cell biology, and tissues generally remain viable for 5-7 days. Strikingly, we determined that myometrial and MED12 mutant leiomyoma cells repopulated cell-depleted tissue slices after 20 days of culture. Using immunofluorescence and quantitative PCR of stem cell and undifferentiated cell markers, we observed clusters of CD49b+ cells in tumor slices. CD49b+ cells, however, were sparsely detected in the myometrial slices. Almost all LM cells strongly expressed Ki67, while only a few myometrial cells were stained for this proliferation marker. The CD73 marker was expressed only in tumor cells, whereas the mesenchymal stem cell receptor KIT was detected only in normal cells. HMGA2 and CD24 showed broader expression patterns and higher signal intensity in leiomyoma than in myometrial cells. In this study, we propose that activating CD49b+ stem cells in myometrium leads to asymmetrical division, giving rise to transit-amplifying KIT+ cells that differentiate to smooth muscle cells. On the contrary, activated leiomyoma CD49b+ cells symmetrically divide to form clusters of stem cells that divide and differentiate to smooth muscle cells without losing proliferation ability. In conclusion, normal and mutant stem cells can proliferate and differentiate in long-term organ culture, constituting a helpful platform for novel therapeutic discovery.
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BACKGROUND: Carotid body tumor (CBT) is a rare neoplasm that has been increasingly studied during the last decades; nevertheless, it continues to be a topic of controversy. This review aims to provide an update on the general features of CBT and particularly review different treatment strategies and primary outcomes. METHODS: Data for this literature review were identified by PubMed, Scopus, and Medline. 93 articles from the initial search were included, as well as 28 relevant studies utilizing the snowballing method; totaling 121 articles about CBT. RESULTS: Main features such as anatomy, embryology, genetics, clinical presentation, and diagnosis of CBT are presented, followed by evidence of different treatment strategies such as radiotherapy, preoperative embolization, vascular resection, and vascular reconstruction. Main complications are also discussed. CONCLUSION: This review summarizes the most critical aspects regarding CBT. Future studies should compare different treatments to attain the best surgical results with lower morbidity rates.
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Tumor do Corpo Carotídeo , Embolização Terapêutica , Tumor do Corpo Carotídeo/cirurgia , Embolização Terapêutica/métodos , Humanos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
El bruxismo es una disfunción neuromuscular considerada hoy día una parafunción, ya sea consciente (bruxismo en vigilia) o inconsciente (bruxismo del sueño). Debido al posible daño que puede ocasionar en las estructuras del aparato estomatognático, el tratamiento precoz resulta muy importante, de ahí la necesidad de un diagnóstico temprano para aplicar medidas preventivas y curativas. Teniendo en cuenta lo anterior, se realizó el presente estudio con el objetivo de fundamentar diferentes aspectos concernientes al tema en cuestión.
Bruxism is a neuromuscular dysfunction considered a parafunction nowadays, either conscious (awake bruxism) or unconscious (sleep bruxism). The early treatment is very important due to the possible damage that can cause in the structures of the stomatognathic system, hence the necessity of an early diagnosis to apply preventive and healing measures. Taking into acount the above-mentioned, the present study was carried out aimed at supporting different aspects concerning the topic in question.
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Bruxismo , Transtornos da Articulação TemporomandibularRESUMO
Introducción: La prótesis bucomaxilofacial constituye la rehabilitación morfofuncional por medios artificiales de las estructuras intrabucales y peribucales en los defectos oculares, orbitales, nasales, auriculares, maxilares, mandibulares, craneales y complejos; con la conservación de modo armónico de las estructuras remanentes ya sean duros o blandos. Objetivo: Caracterizar los pacientes rehabilitados por defectos oculares en el Policlínico Universitario Julio Antonio Mella. Métodos: Se realizó un estudio observacional, descriptivo y transversal desde enero de 2015 a febrero de 2022 en pacientes rehabilitados por defectos oculares en el departamento de Prótesis Estomatológica del Policlínico Universitario Julio Antonio Mella de la ciudad de Camagüey. Se estudiaron 53 pacientes que acudieron en el período de la investigación remitidos del Hospital Universitario Manuel Ascunce Domenech y del Hospital Pediátrico Provincial Docente Eduardo Agramante Piña de la provincia Camagüey. Resultados: Con relación a los pacientes con rehabilitados según edad, sexo y factores etiológicos prevaleció el grupo 35 a 59 años, así como el sexo masculino y el traumatismo ocular. Se constató que la experiencia protésica satisfactoria primó en los periodos evaluados y con respecto a los pacientes rehabilitados según los factores relacionados con la estética, se comprobó que los valores más favorables fueron para el color de la esclera y la apertura palpebral. Conclusiones: Predominó el sexo masculino junto con el grupo de edad de 35 59 años. La causa más frecuente de pérdida ocular fue la traumática. Hubo un alto índice de experiencia satisfactoria con el uso de las prótesis y los factores que determinaron la estética fueron favorables.
Introduction: The bucomaxilofacial prosthesis constitutes the morpho-functional rehabilitation for artificial means of the intraoral and peribucales structures in the ocular defects, orbital, nasal, aural, maxillary, mandibular, cranial and complex; with the harmonic conservation of mode of the remanent structures either be hard or soft. Objetive: To characterize the patients rehabilitated for ocular defects at the Julio Antonio Mella University Polyclinic. Methods: An observational, descriptive and transversal study was carried out from January, 2015 to February, 2022 in patients rehabilitated by ocular defects in the department Dentistry Prosthesis of the Julio Antonio Mella University Polyclinic of the city of Camagüey. 53 patients constituted the universe that attended in the period of the investigation remitted of the Manuel Ascunce Domenech University Hospital and from the Eduardo Agramontes Piña Provincial Pediatric Hospital in the province Camagüey. Results: With respect to the rehabilitated patients according to age, sex and etiologic factors prevailed the group 35 to 59 years, as well as the masculine sex and the ocular traumatism. It was verified that the prosthetic satisfactory experience had priority in the evaluated periods and regarding the patients rehabilitated according to the factors related with esthetics, it was verified that the most favorable values were for the color of the esclera and the palpebral opening. Conclusions: The masculine patients predominated along with the age rank of 35-59 years. The most frequent cause of ocular loose was the traumatic one. There was a tall index of satisfactory experience with the use of the prosthesis and the factors that determined the esthetics were favorable.