RESUMO
OBJECTIVES: Bloodstream infections (BSI) are an important cause of mortality, although they show heterogeneity depending on patients and aetiological factors. Comprehensive and specific mortality scores for BSI are scarce. The objective of this study was to develop a mortality predictive score in BSI based on a multicentre prospective cohort. METHODS: A prospective cohort including consecutive adults with bacteraemia recruited between October 2016 and March 2017 in 26 Spanish hospitals was randomly divided into a derivation cohort (DC) and a validation cohort (VC). The outcome was all-cause 30-day mortality. Predictors were assessed the day of blood culture growth. A logistic regression model and score were developed in the DC for mortality predictors; the model was applied to the VC. RESULTS: Overall, 4102 patients formed the DC and 2009 the VC. Mortality was 11.8% in the DC and 12.34% in the CV; the patients and aetiological features were similar for both cohorts. The mortality predictors selected in the final multivariate model in the DC were age, cancer, liver cirrhosis, fatal McCabe underlying condition, polymicrobial bacteraemia, high-risk aetiologies, high-risk source of infection, recent use of broad-spectrum antibiotics, stupor or coma, mean blood pressure <70â mmHg and PaO2/FiO2â≤â300 or equivalent. Mortality in the DC was <2% for ≤2 points, 6%-14% for 3-7 points, 26%-45% for 8-12 points and ≥60% for ≥13 points. The predictive score had areas under the receiving operating curves of 0.81 (95% CI 0.79-0.83) in the DC and 0.80 (0.78-0.83) in the VC. CONCLUSIONS: A 30â day mortality predictive score in BSI with good discrimination ability was developed and internally validated.
Assuntos
Bacteriemia , Humanos , Estudos Prospectivos , Masculino , Feminino , Bacteriemia/mortalidade , Bacteriemia/microbiologia , Idoso , Pessoa de Meia-Idade , Espanha/epidemiologia , Idoso de 80 Anos ou mais , Adulto , Fatores de Risco , Prognóstico , Modelos LogísticosRESUMO
Background: Rapidly progressive osteoarthritis of the hip (RPOH) is a rare syndrome that involves the femoral head and acetabulum. Methods: We analyzed the incidence of RPOH in 2022. The inclusion criteria included a clinical history of pain for 1-6 months and a decrease in joint space of > 2 mm within one year or a decrease in joint space by 50% in that time accompanied by femoral and/or acetabular bone destruction. Exclusion: There are no other destructive arthropathies and no evolutionary radiological image sequence. Results: There were 15 patients, 16 hips, an incidence around 3.17%, a 1:1 laterality ratio, and 1 bilateral affected. The mean average age is 77.35 years. The male/female ratio is 1:2. The average BMI is 31.2. The time of the onset of the symptoms to the patient's diagnosis is 5 months. The functionally modified Harris scale (MHS) had an average score of 30 points. They had surgery hip arthroplasty with a cementless cup in all cases, a revision cup in one of them, and a double mobility cup in the other, with the stem cemented three times. There were no post-surgical complications. Functionally was achieved at 3 months. The average MHS is 70 at 12 months. The average MHS is 85. Conclusions: RPOH is an idiopathic entity characterized by great clinical involvement and rapid radiological evolution. It is most common in women around 77 years of age. The bone quality requires surgical alternatives to implants, and it has good functional recovery post-surgery.
RESUMO
La tabla de diagnóstico Multifunction system representa una herramienta para el correcto uso de la aparatologíabio funcional utilizada en el protocolo de tratamiento dela estimulo terapia programada. Su empleo consiste principalmente en el correcto diagnóstico del paciente, en el que se incluyen problemas funcionales, la respiracion, la deglución y el patrón masticatorio. Después de esto, debe seleccionarse en dicha tabla el tipo de aparato que debe usarse para su tratamiento (AU)
Diagnostic table of Multifunction system represents a tool for the proper use of the biofunctional appliances used in the treatment protocol of the programmed stimulotherapy. Its use is mainly in the correct diagnosis of the patient, which includes functional problems, breathing, swallowing and masticatory pattern; After this, must be located in this table the type of appliance to be use for treatment (AU)
Assuntos
Humanos , Aparelhos Ortodônticos Funcionais , Diagnóstico Bucal/métodosRESUMO
El uso de elementos prefabricados (plano de mordida antibruxistay relajante muscular) se presenta como una forma de tratamiento sencilla y cómoda para la corrección de la mordida profunda anterior en dentición mixta (AU)
The use of prefabricated elements (bite plane (anti-bruxist) and muscle relaxant) represents and easy and confortable way of treatment of the anterior deep bite in mixed dentition (AU)
Assuntos
Humanos , Má Oclusão/reabilitação , Aparelhos Ativadores , Aparelhos OrtodônticosRESUMO
En el artículo precedente, se analizaron las posibilidades terapéuticas de la ortodoncia lingual en conjunto con microimplantes, en casos tratados con extracciones. En el presente, se estudian la biomecánica utilizada por los autores en los casos sin extracciones y en la corrección de las maloclusiones verticales.
Assuntos
Fenômenos Biomecânicos , Implantes Dentários , Mordida Aberta , Aparelhos Ortodônticos , Braquetes OrtodônticosRESUMO
En el artículo precedente, se analizaron las posibilidades terapéuticas de la ortodoncia lingual en conjunto con microimplantes, en casos tratados con extracciones. En el presente, se estudian la biomecánica utilizada por los autores en los casos sin extracciones y en la corrección de las maloclusiones verticales.(AU)
Assuntos
Implantes Dentários , Mordida AbertaRESUMO
En el artículo precedente, se analizaron las posibilidades terapéuticas de la ortodoncia lingual en conjunto con microimplantes, en casos tratados con extracciones. En el presente, se estudian la biomecánica utilizada por los autores en los casos sin extracciones y en la corrección de las maloclusiones verticales.(AU)
Assuntos
Implantes Dentários , Fenômenos Biomecânicos , Braquetes Ortodônticos , Mordida Aberta , Aparelhos OrtodônticosRESUMO
En este artículo se describen los protocolos biomecánicos para el tratamiento de casos con extracciones con brackets linguales y microimplantes en casos de máximo anclaje, mínimo anclaje, con extracciones simétricas y unilaterales.
Assuntos
Fenômenos Biomecânicos , Implantes Dentários , Procedimentos de Ancoragem Ortodôntica , Ortodontia Corretiva , Extração DentáriaRESUMO
En este artículo se describen los protocolos biomecánicos para el tratamiento de casos con extracciones con brackets linguales y microimplantes en casos de máximo anclaje, mínimo anclaje, con extracciones simétricas y unilaterales.(AU)
Assuntos
Implantes Dentários , Ortodontia CorretivaRESUMO
La respiración oral desarrolla unas características oro faciales que pueden ser prevenidas por medio de la reeducación funcional de esta respiración. El obturador bucal MFS ha sido utilizado en una muestra de 48 pacientes, mostrando que se reduce el grado de incompetencia labial de estos pacientes (AU)
Oral respiration develops certain orofacial characteristics that can be prevented by means of functional re-education of breathing. The MFS buccal obturator was used in a selection of 48 patients, demonstrating that the degree of labial incompetence in these patients was reduced (AU)
Assuntos
Humanos , Respiração Bucal/reabilitação , Respiração Bucal/fisiopatologia , Lábio/fisiopatologiaRESUMO
La reeducación funcional es un pilar base dentro de la filosofía MFS de tratamiento. El control de la función labial mejora la incompetencia labial y por tanto, la deglución atípica. El estimulador labial MFS es estudiado en este trabajo, encontrándose una mejora en la incompetencia labial y la longitud del labio superior (AU)
Functional re-education is a mainstay of the MFS treatment philosophy. Lip function control improves labial incompetence and therefore atypical deglution. The MFS labial stimulator is studied in this task, finding an improvement in the labial incompetence and the length of the upper lip (AU)
Assuntos
Humanos , Respiração Bucal/fisiopatologia , Respiração Bucal/reabilitação , Lábio/fisiopatologia , Índice de Gravidade de DoençaRESUMO
El bruxismo es una patología que afecta a numerosos pacientes, complicándose especialmente en los casos de potente musculatura(braquifaciales, con intensa sobremordida). Puede ser cuantificada utilizando elementos como el Bite-strip. En este trabajo se evalúa el aparato antibruxista MFS encontrándose una mejora tanto a nivel subjetivo como en el número de eventos bruxistas medidos con el Bite-strip (AU)
Bruxism is a pathology that affects numerous patients, complicating particularly in the cases of powerful musculature (brachyfacial, with intense overbite). In this task we evaluate the MFS antibruxist device finding an improvement both at a subjective level and in the number of bruxist events measured with the Bite-strip (AU)
Assuntos
Humanos , Reabilitação Bucal/instrumentação , Músculos Faciais/fisiopatologia , Bruxismo/fisiopatologia , Bruxismo/terapiaRESUMO
El conocimiento de la acción de los estímulos, la estimuloterapia programada, el diagnostico de la matriz funcional y su codificación, nos ayudará a la normalización del llamado triunvirato funcional. En el presente trabajo, se establece un nuevo protocolo de tratamiento, utilizando los diferentes elementos prefabricados MFS, y la combinación entre ellos para conseguir un resultado óptimo para lograr así la reeducación temprana de las funciones orales como un programa de prevención en ortodoncia (AU)
The understanding of the action of the stimulants, programmed stimulation therapy, the diagnosis of the functional matrix and its codification will help us in the normalization of the so called functional triumvirate. In this task a new treatment protocol is established, using the various prefabricated MFS devices and their combination to obtain optimum results and so achieve the early re-education of oral functions and a prevention programme in orthodontics (AU)