Comparación Placas de Titanio vs. Placas Reabsorbibles en Fracturas de Orbita: Revisión de literatura / Comparison of Titanium Plates vs. Resorbable Plates in Orbital Fractures: Literature Review

RESUMEN Introducción: Los tratamientos para fracturas de órbita se basan en la corrección del defecto de las lesiones orbitarias de tipo blow in y blow out (o de estallido), mediante diversas placas y mallas biocompatibles con el organismo, dándose una cicatrización de primera generación evitando un callo óseo y una fijación más rígida. Para el diagnóstico de este tipo de lesiones tenemos inflamación periorbitaria, enoftalmos, diplopía, equimosis, hemorragia subconjuntival. Existen diversos materiales reconstructivos siendo estos compuestos por distintas materias primas, como son los aloplásticos y autógenos; donde encontramos varios tipos como placas de titanio y las placas reabsorbibles siendo estas las más comunes y usadas actualmente, por su bajo estímulo a reabsorciones óseas y evitando efectos secundarios a largo plazo. Estas placas presentan diversos grados de ductilidad y resistencia. Se informó sobre varias complicaciones según el tipo de placas como es la cicatrización, las cirugías postquirúrgicas en caso de placas de titanio, etc. El objetivo de esta revisión es la evaluación de la eficacia las placas reabsorbibles versus placas de titanio en fracturas de órbita. Materiales y métodos: La investigación es de carácter documental, descriptivo y no experimental. En el cual se emplea una metodología de identificación e inclusión de artículos científicos tipo prisma. Resultados y conclusiones: Se verificaron las ventajas y desventajas tanto de las placas reabsorbibles como las de titanio siendo estas similares en la biocompatibilidad con el organismo humano, así como también varias diferencias como el soporte, fuerzas, resistencia de estas, concluyendo que es debatible el material ideal para tratar fracturas de órbita. Se seleccionaron artículos tomando en cuenta el título y objetivos; considerando estudios comparativos, revisiones sistemáticas, revisiones de literatura, los cuales comprendían criterios con respecto a fracturas de órbita y tratamientos quirúrgicos. La búsqueda arrojó 55 artículos en PubMed, 65 en Google, 4 en Scielo y 29 en Science direct, de los cuales se excluyeron libros, monografías, estudios experimentales, dando como resultado 21 artículos para el desarrollo de esta revisión bibliográfica. Y que fueron leídos y analizados en su totalidad, estudiando los objetivos, metodología y conclusión de cada uno de ellos para la posterior comparación.

ABSTRACT Introduction: Treatments for orbit fractures are based on the correction of the defect of blow in and blow out orbital injuries, by means of various plates and meshes biocompatible with the organism, giving a first-generation healing avoiding a bony callus and a more rigid fixation. For the diagnosis of this type of lesions we have periorbital inflammation, enophthalmos, diplopia, ecchymosis, subconjunctival hemorrhage. There are several reconstructive materials being these composed of different raw materials, such as alloplastic and autogenous, where we find several types such as titanium plates and resorbable plates being these the most common and currently used, for its low stimulus to bone resorption and avoiding long-term side effects. These plates have different degrees of ductility and resistance. Several complications have been reported depending on the type of plates, such as scarring, post-surgical surgeries in the case of titanium plates, etc. The objective of this review is to evaluate the efficacy of resorbable versus titanium plates in orbital fractures. Materials and methods: This research are a documentary, descriptive and non-experimental nature. A prism-type methodology of identification and inclusion of scientific articles was used. Results and conclusions: The advantages and disadvantages of both resorbable and titanium plates were verified, being these similar in biocompatibility with the human organism, as well as several differences such as support, forces, resistance of the same, concluding that it is debatable. The ideal material to treat orbital fractures. Articles were selected considering the title and objectives; considering comparative studies, systematic reviews, literature reviews, which included criteria regarding orbital fractures and surgical treatments. The search yielded 55 articles in PubMed, 65 in Google, 4 in Scielo and 29 in Science direct, from which books, monographs, experimental studies were excluded, resulting in 21 articles for the development of this bibliographic review. The 21 articles were read and analyzed in their entirety, studying the objectives, methodology and conclusion of each one of them for subsequent comparison.

Test-Retest and Interreader Reproducibility of Semiautomated Atlas-Based Analysis of Diffusion Tensor Imaging Data in Acute Cervical Spine Trauma in Adult Patients.

BACKGROUND AND PURPOSE: DTI is a tool for microstructural spinal cord injury evaluation. This study evaluated the reproducibility of a semiautomated segmentation algorithm of spinal cord DTI. MATERIALS AND METHODS: Forty-two consecutive patients undergoing acute trauma cervical spine MR imaging underwent 2 axial DTI scans in addition to their clinical scan. The datasets were put through a semiautomated probabilistic segmentation algorithm that selected white matter, gray matter, and 24 individual white matter tracts. Regional and white matter tract volume, fractional anisotropy, and mean diffusivity values were calculated. Two readers performed the nonautomated steps to evaluate interreader reproducibility. The coefficient of variation and intraclass correlation coefficient were used to assess test-retest and interreader reproducibility. RESULTS: Of 42 patients, 30 had useable data. Test-retest reproducibility of fractional anisotropy was high for white matter as a whole (coefficient of variation, 3.8%; intraclass correlation coefficient, 0.93). Test-retest coefficient-of-variation ranged from 8.0%-18.2% and intraclass correlation coefficients from 0.47-0.80 across individual white matter tracts. Mean diffusivity metrics also had high test-retest reproducibility (white matter: coefficient-of-variation, 5.6%; intraclass correlation coefficient, 0.86) with coefficients of variation from 11.6%-18.3% and intraclass correlation coefficients from 0.57-0.74 across individual tracts, with better agreement for larger tracts. The coefficients of variation of fractional anisotropy and mean diffusivity both had significant negative relationships with white matter volume (26%-27% decrease for each doubling of white matter volume, P < .01). CONCLUSIONS: DTI spinal cord segmentation is reproducible in the setting of acute spine trauma, specifically for larger white matter tracts and total white or gray matter.

A randomized trial of ciprofloxacin versus cefixime for treatment of gonorrhea after rapid emergence of gonococcal ciprofloxacin resistance in The Philippines.

From 1994 through 1996-1997, high-level ciprofloxacin resistance (minimum inhibitory concentration [MIC], > or = 4.0 microg/mL) increased from 9% to 49% of gonococcal isolates recovered from consecutive female sex workers in Cebu and Manila, The Philippines (P < .01). During 1996-1997, 105 female sex workers with gonorrhea were prospectively randomized to receive treatment with oral ciprofloxacin, 500 mg, or cefixime, 400 mg, and followed for test of cure. Neisseria gonorrhoeae was reisolated within 28 days after treatment from 1 (3.8%) of 26 women given cefixime versus 24 (32.3%) of 72 women given ciprofloxacin (P < .01). Treatment failure (reisolation of pretreatment auxotype/serovar) occurred in 14 (46.7%) of 30 women infected with strains with MICs of ciprofloxacin > or = 4.0 microg/mL versus 1 (3.6%) of 28 infected by strains with MICs < 4.0 microg/mL (P < .01). High-level, clinically significant gonococcal resistance to ciprofloxacin has rapidly emerged in The Philippines, and spread of fluoroquinolone resistance through commercial sex poses a threat to control of gonorrhea and prevention of human immunodeficiency virus infection and the acquired immunodeficiency syndrome.

Hearing loss and otitis media in velo-cardio-facial syndrome.

There is an increased prevalence of otitis media and associated hearing loss in patients with isolated cleft or submucous cleft palates, palatal abnormalities which are well known components of velo-cardio-facial syndrome (VCFS). The records of 166 VCFS patients were reviewed for the purpose of documenting the prevalence of middle ear disease and associated conductive hearing loss in patients with VCFS. Patients were divided according to age, type of palatal abnormality and presence or absence of chromosomal deletion using fluorescence hybridization test. Results indicated that the prevalence of middle ear disease in patients with VCFS was 47% and the prevalence of hearing loss was 44%, the majority of which was conductive and due to middle ear disease (74%) and 11% of which was sensorineural. There was no statistical difference between groups using the chi2-test with regard to age, type of palatal abnormality and presence of chromosomal deletion. The prevalence of conductive hearing loss secondary to middle ear disease in VCFS is comparable to the prevalence found in isolated cases of cleft palate.

[Abnormalities of sex chromosomes and relationship with reproduction disorders]. / Alteraciones de los sexocromosomas y su relación con los trastornos de la reproducción.

One third of the reproductive failure with genetic aetiology are explained by chromosomal rearrangements; the purpose of the study was to find the frequency of sex chromosome anomalies in Mexican population with amenorrhea, sterility or infertility at the National Institute of Perinatology. We realized cytogenetic studies at the Genetics' laboratory in blood samples from 1st january 1984 to 31st December 1995, with the next indications: amenorrhea, sterility, infertility and history of congenital defects that suggest chromosomal anomalies and correlated with the clinical findings. From 3,201 cytogenetic studies we performed in peripheral blood samples, we detected: 61 patients with anomalies of the sex chromosomes predominantly mosaics. We found sex chromosome rearrangements in 1.5% of the patients studied, so it's important to consider this aetiology in the study of infertility and sterility.

The effect of antiglaucoma drugs on rabbit aqueous humor proteins determined by gel electrophoresis.

Previous studies indicate that there may be differences in the protein composition of the aqueous humor in normal and glaucomatous human eyes. These differences in protein composition and concentration may be due to the topical antiglaucoma medications used to treat glaucoma. These differences should be distinguished from any possible protein composition changes due to glaucoma. In order to study the effects of topical antiglaucoma medications on aqueous humor protein composition, we analyzed the aqueous humor of rabbit eyes topically treated with various antiglaucoma medications (timolol, pilocarpine, and dipivefrin). One eye of each rabbit was treated with the experimental drug, and the fellow eye was treated with saline solution (control). Thirty-six aqueous humor samples from 18 rabbits were obtained after 24 hours and 36 samples were obtained from 18 additional rabbits after 7 days of topical drug treatment. The protein composition of the aqueous humor samples was analyzed by sodium dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Significant protein differences in aqueous humor samples were found between the eyes treated with timolol and the control eyes, whereas no significant differences were found between the eyes treated with pilocarpine or dipivefrin and the controls. These protein differences ranged from 14,000 to 18,000 daltons in molecular weight.

Tau immunoreactivity associated with aluminum maltolate-induced neurofibrillary degeneration in rabbits.

Intracisternal administration of aluminum maltolate to rabbits produces a marked argyrophilic neurofibrillary degeneration (NFD) which is also immunoreactive for both phosphorylated and non-phosphorylated microtubule associated protein tau. Using tissue fixation in PBF, the monoclonal antibodies Tau-2 and AT8 stain the NFD. Dephosphorylation markedly reduces the positivity of AT8. Using PLP-fixed tissue, monoclonal antibody Tau-1 also immunostains aluminum-induced NFD.

Quantitative evaluation of Al maltolate-induced neurodegeneration with subsequent Al removal by desferrioxamine treatment.

The intracisternal administration of aluminum maltolate to New Zealand white rabbits produces a reproducible neurofibrillary degeneration which is significantly reversed by desferrioxamine treatment. Quantitative analysis of brain and spinal cord tissue demonstrates that the aluminum deposition is higher close to the injection site than at locations further removed from the point of administration. Most importantly, treatment with desferrioxamine removes most of the aluminum from the brain and spinal cord, even from the sites of highest concentration. The ability to manipulate this system in the formation and degradation of NFD and in removal of aluminum may shed light on mechanisms of NFD formation and have implications for therapeutic advances in the treatment of certain human neurodegenerative diseases.

The quantitative measurement of spasticity: effect of cutaneous electrical stimulation.

The goal of this research was to determine if cutaneous electrotherapy would temporarily reduce muscle spasticity. Five traumatically brain injured (TBI) and five spinal cord injured (SCI) subjects, all with clinically evident spasticity, received surface electrical stimulation over the tibialis anterior muscle. Using the Spasticity Measurement System, stiffness around the ankle was measured before, immediately after, and 24 hours after treatment. With stimulation, ipsilateral ankle viscoelastic stiffness immediately decreased in 9 of 10 subjects and remained significantly depressed for up to 24 hours. Contralateral ankle spasticity did not significantly change. Using the same subjects under sham conditions, no significant decrements in spasticity occurred. In a subjective survey, only SCI participants reported functionally evident spasticity reductions. Also within this subgroup, efficacy of treatment was directly proportional to the severity of pre-stimulation clonus. We conclude that (1) cutaneous electrotherapy transiently decreases both TBI and SCI related spasticity and (2) pre-stimulation clonus may function as a clinical indicator of SCI patients most likely to benefit from this process.

The effects of malnutrition on the motor, perceptual, and cognitive functions of Filipino children.

The motor, perceptual, and cognitive abilities of 99 Filipino children, aged 4-6 years with a documented history of malnutrition from a nutritionally depressed area of Manila were determined using the Revised Manila Motor-Perceptual Screening Test. They were classified into four groups of: (1) normal; (2) acutely malnourished; (3) stunted but not malnourished; and (4) chronically malnourished using the Waterlow classification. Thirty-one normal children of comparable ages and background from a nationwide pool were similarly tested and served as the control group. Motor (p = 0.001) and perceptual skill (p less than 0.03 to less than 0.001) scores were significantly lower than in their normal counterparts, especially in the chronically malnourished children. Cognitive abilities were not evidently affected by malnutrition.