Transport distraction osteogenesis for closing full-thickness calvarial defects in sheep.

OBJECTIVE: To prove the hypothesis that transport distraction osteogenesis can be applied to the skull to close critical-size calvarial defects. DESIGN: A sheep model was developed to investigate this hypothesis. In four sheep, bilateral parietal bone windows were created and adjacent osteotomies performed. On the tested side, an adjacent bone segment was transported into the defect. The contralateral side was left untreated as a control. MAIN OUTCOME MEASURES: After completion of the distraction and consolidation period, a computed tomography study was performed, and the animals were sacrificed. The newly formed bone was examined macroscopically and histologically. RESULTS: A successful closure of the defect with transport distraction was achieved in all of the animals. The control side healed spontaneously in one (younger) sheep but did not heal in the other three animals. The closure of the bony defect with transport distraction was evident macroscopically as well as on the computerized tomography. Microscopic examination showed new healthy bone formation on the treated side. CONCLUSION: We conclude that transport distraction is an effective tool in closing full-thickness calvarial defects in adult sheep. Further investigation is needed before applying this promising technique in humans.

¿Qué, como y cuánto de la psicoeducación del paciente bipolar en Chile / ¿What, how and how many of the psychoeducation in the bipolar patient in Chile?

Today it is accepted that psycho education is essential for the adequate treatment of bipolar disorder. The combination of modern pharmacology with psycho education has been demonstrated to be determinants in the evolution of these patients. This article includes a brief look into the most important studies dealing with psycho education in bipolar patients and its goal is to show a wide angle view on “what, how and how much” is done in psycho education in the most prominent psychiatric centers in the country. Finally, there are some suggestions for the improvement of such activities.

Hoy se acepta que la psicoeducación es una herramienta esencial para el manejo adecuado del trastorno bipolar. La combinación de farmacología moderna con técnicas de psicoeducación, han demostrado ser determinantes en la evolución de estos pacientes. Este artículo incluye una breve reseña de los trabajos más importantes sobre psicoeducación en el paciente bipolar y pretende mostrar una panorámica acerca del “qué, cómo y cuánto” se hace en psicoeducación en los centros psiquiátricos más importantes del país. Finalmente, se proponen algunas sugerencias para mejorar esta actividad.

Silver-sulfadiazine eschar pigmentation mimics invasive wound infection: a case report.

A 3-year-old girl with 52% TBSA scalds, mostly partial thickness, was treated topically with 5% mafenide acetate solution and 1% silver sulfadiazine cream. All blood cultures and wound swabs were negative for the first 5 days. On day 6 gram-negative bacteria and yeast forms were isolated from her wounds. High fever and leukocytosis were present and the child was treated with intravenous ampicillin and gentamicin according to sensitivity bacteriogram. The bacteria were identified as Pseudomonas aeruginosa and the yeast was Candida tropicalis. On day 7, Escherichia coli was identified in blood cultures and intravenous cefixime was added. Amphotericin B was added on day 9 when blood cultures grew Candida tropicalis and Burkholderia cepacia. On day 13 dark pigmentation foci developed on some areas of partial-thickness burns in the back, resembling invasive wound infection. White blood cell count was 14,300 cells/mm3, and her body temperature reached 39.7 degrees C. Cultures from the pigmented areas were negative, and biopsies revealed deposits of silver. Most of the areas healed uneventfully, and only about 8% TBSA needed grafting, including some of the pigmented areas. No residual pigmentation remained on discharge.

Screening for tumour suppressor p16(CDKN2A) germline mutations in Israeli melanoma families.

Approximately ten percent of patients with malignant melanoma have family histories of the disease, suggesting a genetic predisposition. Germline mutations in tumour suppressor p16 gene have been implicated as disease causing mutations in some of the melanoma families. The frequency of families with p16 germline mutations among melanoma prone families varies from eight to fifty percent. The range of the variability is influenced apparently by the number of melanoma affected individuals within the family, as well as by other, yet unidentified factors. Ethnic background is known to determine both the frequency and the nature of germline alterations. Recently, specific mutations in tumour suppressor genes involved in breast cancer and in colon cancer were found at elevated frequency among Ashkenazi Jews. This report describes results of a screening for p16 germline alterations in a collection of Israeli melanoma families. We have analyzed genomic DNA from thirty one Ashkenazi and non-Ashkenazi Jewish melanoma families, as well as from thirty melanoma patients without an apparent family history of the disease. The entire coding region of the p16 gene was screened by single strand conformation polymorphism analysis and direct DNA sequencing. We have detected a number of carriers with the Ala148 Thr polymorphism at the end of the second exon and several instances of 500(G=>C) substitution at the 3' untranslated portion of the gene.