ABSTRACT
Introducción: Las deficiencias hormonales pueden afectar el complejo craneofacial durante el crecimiento y desarrollo esque- lético. Objetivo: Determinar si existía evidencia científica acerca de la asociación entre el tratamiento hormonal y el crecimiento craneofacial en personas con deficiencia hormonal entre los 10 y 18 años de edad evaluados cefalométricamente. Materiales y método: Revisión sistemática de la literatura en Pubmed, Google acadé - mico, Lilacs, Embase, ScienceDirect, sin límite de año de publicación. Se incluye - ron ensayos clínicos, estudios de casos y controles, cohorte, revisiones sistemáticas y meta-análisis. Se hizo lectura ciega e in - dependiente por parte de 2 investigadores, de los resúmenes y los artículos completos. Resultados: De 1085 artículos encontra - dos se excluyeron 1074 por no cumplir criterios de inclusión. Luego de la lectura completa se excluyeron 5 por ser estudios transversales y uno porque no se tuvo ac- ceso a él, quedando un total de 6 artículos incluidos. Estas investigaciones reportaron que los pacientes tratados con terapias de sustitución hormonal presentaron cambios favorables en las estructuras craneofaciales, especialmente la longitud total mandibular, longitud de la rama y cuerpo mandibular; también presentaron mejoría del perfil fa - cial, relaciones intermaxilares y estructuras óseas corporales. Conclusiones: A pesar de la heteroge - neidad de los estudios,se encontró queel tratamiento temprano de sustitución hor - monal, independientemente de la dosis y siempre y cuando sea a largo plazo, acelera el desarrollo de estructuras craneofaciales, principalmente de la mandíbula, hasta lo - grar los patrones esqueléticos establecidos genéticamente. Se requieren estudios que evalúen el efecto de la terapia de sustitución hormonal en pacientes sin compromisos sistémicos adicionales.
Background: Hormone deficiency could affect craniofacial complex during esque- letal growth and development. Objective: Determine whether there is scientific evidence of the association bet - ween hormonal treatment and craniofacial growth measured by cephalometry films, in subjects of 10 to 18 years with hormonal treatment. Materials and Methods: A systematic re- view. For the articles published in PubMed, Google Scholar, Lilacs, Embase and Scien - ce Direct databases, without restriction of publication year was performed. Clinical trials, case control studies, cohort, syste - matic reviews and meta analysis studies were included. Reading of the abstracts and the complete articles were made by two researchers. Results: Among 1085 articles found, 1074 were excluded because did not meet the inclusion criteria. After complete reading of the articles, five were excluded because they were cross-sectional studies and one was not recovered in the full text. In total, 6 articles were included. These studies report that patients who were treated with hormo - ne substitution therapy showed favorable changes in their craniofacial structures, especially in mandibular total length, ramus length and mandibular body length. These positive changes led to an improvement in profile, inter-maxillary relations, and other osseous body structures. Conclusions: Despite the heterogeneity of the studies it was found that early replace - ment with hormone treatment, regardless of the dose and long-term treatment, ac - celerates the development of craniofacial structures, mainly the mandible, to reach the skeletal patterns genetically established. Studies are required to evaluate replace hormone treatment in patients without additional systemic compromises.
Subject(s)
Dentistry , Growth and Development , Hormone Replacement Therapy , Review , Association , Cephalometry , Craniofacial Abnormalities , Databases, Bibliographic , Endocrine Disruptors , Mandible , Radiography, DentalABSTRACT
PURPOSE: There are few data on the impact of immediate and differing surgical interventions on circulating tumor cells (CTCs), nor their compartmentalization or localization in different anatomic vascular sites. PATIENTS AND METHODS: CTCs from consecutive patients with colorectal liver metastases were quantified before and immediately after open surgery, laparoscopic resection, open radiofrequency ablation (RFA), or percutaneous RFA. For individuals undergoing open surgery, either hepatic resections or open RFA, CTCs were examined in both systemic and portal circulation by measuring CTCs in samples derived from the peripheral vein, an artery, the hepatic portal vein, and the hepatic vein. RESULTS: A total of 29 consecutive patients with colorectal liver metastases with a median age of 55 years (range, 30 to 88 years) were included. CTCs were localized to the hepatic portosystemic macrocirculation with significantly greater numbers than in the systemic vasculature. Surgical procedures led to a statistically significant fall in CTCs at multiple sites measured. Conversely, RFA, either open or percutaneous, was associated with a significant increase in CTCs. CONCLUSION: Surgical resection of metastases, but not RFA, immediately decreases CTC levels. In patients with colorectal liver metastases, CTCs appear localized to the hepatic (and pulmonary) macrocirculations. This may explain why metastases in sites other than the liver and lungs are infrequently observed in cancer.
