Impacto de la prostatectomía radical en los resultados urodinámicos de pacientes con cáncer de próstata tratados con radioterapia de intensidad modulada / Impact of a radical prostatectomy on the urodynamic results of prostate cancer patients treated with intensity modulated radiation therapy

Introducción y objetivos Evaluar el efecto de la prostatectomía radical y la edad en los resultados urodinámicos antes y después de la radioterapia de intensidad modulada administrada a pacientes con cáncer de próstata. Materiales y métodos La muestra incluyó a 40 pacientes con cáncer de próstata, 22 de los cuales habían sido sometidos a prostatectomía radical. Se midieron y compararon los parámetros urodinámicos antes y después de una media de 4,2 meses de radioterapia. La radioterapia externa se administró mediante técnicas de terapia de arco volumétrico modulado y de radioterapia de intensidad modulada. Resultados No se vieron cambios significativos en los parámetros de uroflujometría. En el caso de la cistomanometría los datos no mostraron un aumento de la incontinencia urinaria de esfuerzo secundaria, pero sí un incremento del 7% en la incontinencia urinaria de urgencia. Hubo cambios estadísticamente significativos en la reducción de la capacidad vesical, con un deseo miccional fuerte, con urgencia miccional y también en la presión del detrusor con un deseo miccional normal. Además, el estudio de presión/flujo reveló una reducción estadísticamente significativa del volumen de orina residual. Conclusiones El efecto de la prostatectomía y la edad varía según la evolución del estudio urodinámico. Hubo una reducción significativa del volumen de orina residual, así como de la presión del detrusor, con un deseo miccional normal en los pacientes sin prostatectomía y en aquellos menores de 75 años. Además de un aumento en la incontinencia de urgencia, también se produjo un empeoramiento significativo del resultado urodinámico de llenado vesical y una disminución de la capacidad vesical cistomanométrica, con un deseo miccional fuerte y urgencia miccional. Ninguno de estos factores se vio afectado por la edad o la prostatectomía (AU)

Introduction and objectives To evaluate the effect of radical prostatectomy and age on urodynamics before and after intensity-modulated radiation therapy administered to prostate cancer patients. Materials and methods The sample consisted of 40 prostate cancer patients, 22 of whom had undergone a radical prostatectomy. Urodynamic parameters before and after an average of 4.2 months of radiotherapy were measured and compared. External radiotherapy was administered via Volumetric Modulated Arc Therapy (VMAT), Intensity Modulated Radiation Therapy (IMRT) techniques. Results Uroflowmetry presented no significant parameters. In the case of Cystomanometry, the data did not show an increase in secondary stress urinary incontinence, although there is 7 percent increase in urge urinary incontinence. There were statistically significant changes in reduced bladder capacity with a strong desire to void, with an urge to void and also in the detrusor pressure with a normal desire to void. Furthermore, pressure/flow analysis revealed a statistically significant reduction of residual urine volume. Conclusions The effect of prostatectomy and age varies according to the evolution of urodynamics. There was a significant reduction in terms of residual urine volume and detrusor pressure with a normal desire to void in patients without a prostatectomy and in those under 75 years old. In addition to an increase in urge incontinence, there was also a significant worsening of the bladder filling urodynamics and a decrease in the cystomanometric bladder capacity with a strong desire and an urge to void. None of these were modified by age or prostatectomy (AU)

Impact of a radical prostatectomy on the urodynamic results of prostate cancer patients treated with intensity modulated radiation therapy.

INTRODUCTION AND OBJECTIVES: To evaluate the effect of radical prostatectomy and age on urodynamics before and after intensity-modulated radiation therapy administered to prostate cancer patients. MATERIALS AND METHODS: The sample consisted of 40 prostate cancer patients, 22 of whom had undergone a radical prostatectomy. Urodynamic parameters before and after an average of 4.2 months of radiotherapy were measured and compared. External radiotherapy was administered via Volumetric Modulated Arc Therapy (VMAT), Intensity Modulated Radiation Therapy (IMRT) techniques. RESULTS: Uroflowmetry presented no significant parameters. In the case of Cystomanometry, the data did not show an increase in secondary stress urinary incontinence, although there is 7 percent increase in urge urinary incontinence. There were statistically significant changes in reduced bladder capacity with a strong desire to void, with an urge to void and also in the detrusor pressure with a normal desire to void. Furthermore, pressure/flow analysis revealed a statistically significant reduction of residual urine volume. CONCLUSIONS: The effect of prostatectomy and age varies according to the evolution of urodynamics. There was a significant reduction in terms of residual urine volume and detrusor pressure with a normal desire to void in patients without a prostatectomy and in those under 75 years old. In addition to an increase in urge incontinence, there was also a significant worsening of the bladder filling urodynamics and a decrease in the cystomanometric bladder capacity with a strong desire and an urge to void. None of these were modified by age or prostatectomy.

The Role of Occlusal Factors in the Presence of Noncarious Cervical Lesions in Young People: A Case-Control Study.

OBJECTIVE:: The aim of this retrospective case-control study was to evaluate the influence of different occlusal characteristics and self-referred bruxism in the presence of noncarious cervical lesions (NCCLs). METHODS AND MATERIALS:: The participants were 280 students (140 cases and 140 controls), with an average age of 24.5 years, from six schools of dentistry in Spain. Clinical examination was carried out to record the NCCLs and the static and dynamic occlusal characteristics. The side of mastication and bruxism was collected by questionnaire. Data variables were analyzed by means of univariate and multivariate logistic regression. Odds ratios and the respective 95% confidence intervals were calculated ( p<0.05). RESULTS:: The presence of NCCLs was significantly more likely in subjects with protrusive interferences (odds ratio [OR]=1.82); with lateral interferences, especially on the nonworking side (OR= 1.77); or who were self-reported bruxists (OR=1.72). In the multivariate analysis, protrusive interferences, bruxism, age, and the presence of attrition were risk factors for the development of NCCLs. These factors resulted in a model with an area under the receiver-operating characteristic curve of 0.667 and a positive predictive value of 61.43%. CONCLUSIONS:: There was no significant relationship between most occlusal factors and the presence of NCCLs. Only bruxism, protrusive interferences, age, and occlusal wear were risk factors. The predictive model was not sufficiently explanatory. Occlusal factors alone do not appear to be sufficient to explain the presence of NCCLs.

Effect of occlusal splint and transcutaneous electric nerve stimulation on the signs and symptoms of temporomandibular disorders in patients with bruxism.

A crossed-design experimental study has been made involving simple blind paired data and random assignment to treatment, with the aim of evaluating the action of an occlusal splint with transcutaneous electric nerve stimulation (TENS) upon the manifestations of temporomandibular disorders (TMD) in patients with bruxism. The prevalence of TMD in the 24 patients with bruxism was 62.5%%; the corresponding severity, as determined by the pantographic reproducibility index (PRI), was mild (mean value: 20.71). Clicking and pain in the lateral pterygoid muscle were the most frequent clinical manifestations. The occlusal splint and TENS did not significantly improve the signs and symptoms of TMD in these patients with bruxism.

Caracterización de una población bruxista y evaluación de la terapéutica mediante análisis cluster / Characterization of a bruxist population and therapeutical evaluation by means of a cluster analysis

El efecto de la férula oclusal y el TENS ha sido estudiado en una muestra de 24 pacientes bruxistas (apretadores y rechinadores) que fueron diagnosticados por medio de un cuestionario y anamnesis. Se estudiaron diferentes variables tanto cualitativas como cuantitativas, atendiendo a aspectos psicológicos, de oclusión tanto estática como dinámica, actualidad electromiográfica e índices electromiográficos en músculos posturales y elevadores y presencia de desarreglos internos de la articulación temporomandibular. El método estadístico utilizado fue el análisis cluster. Los resultados no mostraron claramente una discriminación entre grupos tanto entre apretadores y rechinadores como entre los dos tipos de tratamiento...

DMFT, dmft and treatment requirements of schoolchildren in Asturias, Spain.

An epidemiological survey was carried out in 1992 to study the dental health status of schoolchildren aged 6, 9 and 12 in Asturias, Spain. It focused on the caries prevalence, dmtf, DMFT, restoration indices and dental treatment needs of this population. A representative sample of 1839 subjects, randomly selected and proportionally assigned by age group (6, 9 and 12) with the classroom as the sample unit, was examined. Analysis of the data showed that in 6-year-old children the caries prevalence in primary teeth was 45.8%. The mean caries indices were 2.10 dmft and 0.25 DMFT. At 9 years old the prevalence of caries in primary teeth was 62.8% and in the permanent teeth 49.1%. The mean level of caries was 2.38 dmft and 1.50 DMFT. At 12 years old the caries prevalence in permanent teeth was 71% and in first molars 64.2%. The mean caries experienced was 3.30 DMFT. In all groups the D-component constituted the major part of the caries index. The results for girls were higher than for boys in almost all age groups. Surface fillings were the treatment most required in all age groups.

Patrón de masticación en las clases III de angle / Masticatory pattern in Angle class III patients

Se seleccionó una muestra de 12 pacientes (cuatro hombres y ocho mujeres) con edad promedio de 17.6 años, los cuales tenían diagnóstico de clase III de Angle y mordida cruzada posterior.- Los resultados mostraron que el 75 por ciento de los pacientes desplazaban la mandíbula hacia el lado de trabajo. El 66 por ciento de la muestra en masticación izquierda y el 75 por ciento en masticación derecha tenían desplazamiento condilar hacia el lado de no trabajo. No se encontró relación entre el desplazamiento del cóndilo con la situación de la mordida cruzada ni con la severidad de la misma...

DMFT and treatment needs in adult population of Oviedo, Spain.

An epidemiological survey was carried out in 1992 researching dental caries and treatment needs in an adult population in Oviedo, Spain. A representative sample of 261 subjects, randomly obtained and stratified by age, was examined. Results show a dental decay prevalence of 99.6%; 12.5 DMFT index with 2.9, 7.5 and 2.1 mean values for D, M and F components. Women and the lower social class showed the highest DMFT index. Treatment needs reach a mean value of 12.1 teeth per person. Pontics are the most needed treatment, the mean value increases with age while the differences among age groups and social classes are statistically significant. The next most needed dental treatment is filling of one surface which decreases with age, is the same for men and women and higher among the middle social class; the differences are statistically significant among the social classes.

Fabrication of an implant radiologic-surgical stent for the partially edentulous patient.

This article describes a technique for fabrication of an implant radiologic-surgical stent, made of thermocurable clear resin, for the partially edentulous patient. Dual-curing composite resin is mixed with colored chalk powder and incorporated into the stent to provide contrast during computerized tomographic bone evaluation and to serve as an easily visible guide during fixture placement.

Determination of the horizontal movement of the working-side condyle during lateral movements of the mandible using computed tomography.

The purpose of this study was to evaluate the horizontal movement of the working-side condyle during lateral movements of the mandible using computed tomography. The results showed that the working-side condyle moves in an outward and forward direction from the position of maximum intercuspation. The average movement is less than 1 mm.

[Microscopic innervation of the skin and annexes of the labium oris]. / Inervación microscópica de la piel y anexos del labium oris.

It is studied the skin and annexes innervation of cat and Wistar rat lips with argentic impregnation and acetylcholinesterase technique. It is made evident the existence of a subepithelial plexus from where some nervous fibers leave ending in the epithelial deep stratums and nervous fibers that finish in dermis thickness forming complex ramifications and different type I and II of SETO morphotypes of nervous receptors. They aren't found typical Merckel, Meissner o Paccini mechano-receivers. The nervous terminations in the transition skin-mucous zone are like the ones found in the rest of skin epidermis. Some intraepithelial fibers have been described at level of sudoriferous and sebaceus glands and sensitive corpuscles in connexion with pilous follicles.

[Evaluation of endodontic treatment with modified Walkhoff technique in teeth with necrotic pulp and/or periapical lesions]. / Evaluación del tratamiento endodóntico con la técnica de Walkhoff modificada, en dientes con pulpa necrótica y/o lesiones periapicales.

A treatment has been carried out in a total of 112 dental cases with necrotic pulp and/or periapical lesions using yodoformic paste. The technique employed was that of a conventional endodontic therapy of the root and ductal filling, using yodoformic paste and gutta-percha. The clinical and radiological follow up checks, three, six and twelve months after treatment, show improvement in the periapical lesions, with bone regrowth and complete disappearance of the radio-lucity within a variable time span, depending on the gravity of the damage, but never greater than twelve months. The immediate post-operative well being and absence of complications in the majority of cases also be highlighted.

[Effects of met-enkephalin on the testis. III. Histoenzymatic study]. / Efectos de la met-encefalina sobre el testículo. III. Estudio histoenzimológico.

We studied the testis of Wistar rats weighing 280-300 gms. following the administration of a single, acute intracardiac dose of methionine-enkephalin (100 microliters of 50% met-enkephalin solution), or a chronic intramuscular dose (50 microliters of 40% met-enkephalin solution). Rats were sacrificed at 15, 30 and 60 minutes following acute injection. Those on chronic treatment were injected once daily for 10 or 20 days. For the study, we utilized 105 male Wistar rats; 30 comprised the control group, and 75 comprised the study group. The following staining methods were used: 1) succinate dehydrogenase, 2) lactate dehydrogenase, 3) ATPase, 4) acid phosphatase, 5) alkaline phosphatase. We observed marked histoenzymological changes in the rat testis. Particularly noteworthy was a marked change in the energy pathways consisting of a decreased activity of aerobic pathways (decreased SDH activity), increased anaerobic activity (increased LDH activity), and consequently, decreased cellular energy stores (decreased ATPase activity). Similarly, changes were observed in other nonspecific enzymes that led to a fall in acid phosphatase activity and a rise in alkaline phosphatase activity.

[Microscopic innervation of the spermatic ducts and the testis. III: Tubuli seminiferi recti, rete testis and ductuli efferentes testis]. / Inervación microscópica de las vías espermáticas y testículo. III: Tubuli seminiferi recti, rete testis y ductuli efferentes testis.

The cholinesterase activity and ultrastructural characteristics of the nerves in tubuli seminiferi recti, rete testis and ductuli efferentes testis have been studied in Wistar rats. The tubuli seminiferi recti and rete testis are innervated by a dense network which has varicosities containing different types of synaptic vesicles. The nerve fibres are located between the smooth muscle cells and the fibroblasts, and under the epithelial basement membrane. Inside the ductuli efferentes testis, the nerves form perivascular, subepithelial and muscle plexuses. According to the positive reaction for cholinesterase as well as the characteristics of the synaptic vesicles, these structure have at least a double adrenergic-cholinergic innervation. Our results demonstrate that the nervous fibres in ductuli efferentes testis are more abundant than in tubuli seminiferi recti and rete testis. The role of the vegetative nervous system in the initial segments of the spermatic pathways is discussed.