Redefining our protocol of the orthognathic surgery-first approach after 10 years of experience.

The objective of this study was to update and redefine some concepts of the surgery-first (SF) approach, regarding its indications and contraindications, virtual planning work-up, surgical tips, and postoperative orthodontic benefits, after 10 years of experience. A retrospective analysis was made of orthognathic surgical procedures following the SF protocol between January 2010 and December 2019 to review inclusion and exclusion criteria, diagnostic workflow, surgical tips, and postoperative outcomes. A total of 148 SF procedures were performed during this period, which corresponded to only 9.2% of the total orthognathic surgeries performed, which means that we have broadened the exclusion criteria instead of reducing them. Surgical tips include interdental corticotomies solely in cases of anterior crowding and leaving the intermaxillary fixation miniscrews in place postoperatively for orthodontic skeletal anchorage. The mean duration of postoperative orthodontic treatment was reduced in comparison to conventional surgery (36.8 vs 87.5 weeks). The overall degree of satisfaction was high not only for the patients, but also for the orthodontists and surgeon. SF is especially indicated for patients who desire an immediate aesthetic result, with short-term orthodontics, or for treatment of sleep-related breathing disorders, if they meet the established criteria.

Valores de referencia de recorrido articular y fuerza isométrica cervical en una población adulta sana: factores asociados / Referenced values of articular range of motion and cervical isometric strength in a healthy adult population: associated factors

Introducción: Determinar valores de referencia de recorrido articular (RA) y fuerza isométrica cervical en población sana y valorar la influencia de variables como sexo, edad, medidas antropométricas y actividad física. Material y métodos: Muestra: 80 individuos sanos. Protocolo: el equipo Multi Cervical Unit (MCU) registra RA y fuerza isométrica cervical ángulo-específico y coeficiente de variación. Estos datos se comparan con valores de la American Medical Association y de fuerza de base de datos del equipo. Se registra también perímetro cervical, índice de masa corporal y actividad física. Resultados: Los valores RA obtenidos son cercanos a los valores de la American Medical Association. En esta serie los valores de fuerza son menores que los del MCU. En el análisis de la influencia del sexo en el RA no existen diferencias significativas y en la fuerza comprobamos una fuerte asociación estadística .La influencia de la edad en el RA solo es significativa en hombres. Conclusiones: En los valores de RA no hallamos diferencias significativas entre ambos sexos por lo que no es necesario hacer una diferenciación género-específica. La asociación entre valores de fuerza isométrica cervical y sexo es fuertemente significativa. Se comprueba la relación entre la actividad deportiva y el incremento de la fuerza a nivel cervical (AU)

Introduction: This study aimed to determine the reference values for range of motion (ROM)and cervical isometric strength in a healthy population control group and to assess the influence on it variables such as gender, age, anthropometrical measures and physical activity. Methods and background: Data: Sample: 80 healthy persons. Protocol: The Multi-Cervical Unit (MCU) records ROM and cervical isometric strength specific angle and coefficient of variation. These data were then compared with the American Medical Association values and values obtained by the Multi Cervical Unit (MCU) database. Body mass index, cervical circumference and physical activity were also recorded. Results: The ROM values obtained are close to the American Medical Association values. The force values found in our series are below those of the MCU. No significant difference were found regarding the influence of gender on ROM. A strong statistical association was observed in regards to strength. Influence of age on ROM is only significant in men. Conclusions: Significant differences in the ROM values were not found between both genders. Therefore, it is not necessary to use specific gender differentiation. The association between gender and isometric cervical spine strength is highly significant. The relationship between physical activity and an increase of the cervical strength has been verified (AU)

Characterization of the G91del CRYBA1/3-crystallin protein: a cause of human inherited cataract.

Congenital cataract is a leading cause of visual disability in children. Inherited isolated (non-syndromic) cataract represents a significant proportion of cases and the identification of genes responsible for inherited cataract will lead to a better understanding of the mechanism of cataract formation at the molecular level both in congenital and age-related cataract. Crystallins are abundantly expressed in the developing human lens and represent excellent candidate genes for inherited cataract. A genome-wide search of a five-generation family with autosomal dominant lamellar cataract demonstrated linkage to the 17p12-q11 region. Screening of the CRYBA1/3 gene showed a 3 bp deletion, which resulted in a G91del mutation within the tyrosine corner, that co-segregated with disease and was not found in 96 normal controls. In order to understand the molecular basis of cataract formation, the mutant protein was expressed in vitro and its unfolding and refolding characteristics assessed using far-UV circular dichroism spectroscopy. Defective folding and a reduction in solubility were found. As the wild-type protein did not refold into the native conformation following unfolding, a corresponding CRYBB2 mutant was genetically engineered and its refolding characteristics analysed and compared with wild-type CRYBB2. Its biophysical properties support the hypothesis that removal of the glycine residue from the tyrosine corner impairs the folding and solubility of beta-crystallin proteins. This study represents the first comprehensive description of the biophysical consequences of a mutant beta-crystallin protein that is associated with human inherited cataract.

[Serum adenosine deaminase in human immunodeficiency virus infection. Its relationship with CD4+ lymphocytes and beta 2-microglobulin]. / Adenosina desaminasa sérica en la infección por el virus de la inmunodeficiencia humana. Su relación con los linfocitos CD4+ y la beta 2-microglobulina.

BACKGROUND: The activity of the deaminase adenosine enzyme (ADA) has principally been related with the functionalism and replication of the T lymphocytes. Its serum behavior and possible clinical use in infection by the human immunodeficiency virus type 1 (HIV-1) was studied. METHODS: A multicenter study in which the serum values of ADA were examined and compared with those of two reference markers (CD4+ lymphocytes and beta 2-microglobulin) in 35 presumably healthy donors used as controls, in 60 intravenous drug users (IVDU) seronegative for HIV-1, in 69 HIV-1 asymptomatic seropositive intravenous drug users (HIV-1+) and in 48 patients with AIDS. RESULTS: The serum values of ADA were as follows: control group 10.9 +/- 4.2 U/I; IVDU group 17.6 +/- 7.4 U/I; asymptomatic HIV-1+ group 32.7 +/- 10.2 U/I, AIDS group 46.2 +/- 18.2 U/I. Differences between the different groups were statistically significant in themselves and in relation to the control group. A negative correlation was observed (r = 0.47, p < 0.01) with the number of CD4+ lymphocytes and a positive correlation was found with respect to beta 2-microglobulin (r = 0.76, p < 0.001). The values of serum ADA activity in patients with AIDS and tuberculosis (47.4 +/- 17.2 U/I) were not significantly higher (p < 0.05) to those of patients with AIDS without this second infection (45.9 +/- 19.3 U/I). CONCLUSIONS: Serum deaminase adenosine may be a useful evolutive marker for human immunodeficiency virus type 1 given that its activity increases significantly in infected patients in agreement with the grade of immunodeficiency and its values correlate well with those of reference markers (CD4+ lymphocytes and beta 2-microglobulin).

[Use of DNA amplification to diagnose cytomegalovirus in HIV seropositive patients]. / Utilidad de la amplificación de DNA para diagnosticar citomegalovirus en la población seropositiva para el virus de la inmunodeficiencia humana.

BACKGROUND: Cytomegalovirus (CMV) infection is common among HIV seropositive patients, being difficult to diagnose because it requires cell cultures not available in all hospitals. DNA amplification is being applied for diagnosis of infectious diseases with an increase in sensitivity and specificity with respect to previous laboratory methods. METHODS: Polymerase chain reaction (PCR) has been used in comparison with culture isolation, early antigen detection to diagnose CMV infection in 22 HIV infected patients, that suffered from symptoms compatible with CMV infection at the present time, and in other 5 patients suffering from Kaposi sarcoma. PCR was done with primer for CMV IE genomic region. The amplified sequences were detected after hybridization with a gamma-P-32 labelled probe, followed by electrophoresis in a 5% polyacrylamide gel and autoradiography. RESULTS: The PCR allows to detect CMV genome in cases in which other tests are negatives, in blood as well as in urine, included those patients suffering only from febrile symptoms or with other associated pathogen. CONCLUSIONS: PCR is a sensitive method to detect CMV, although it does not establish the responsibility of CMV in HIV infected patients.

[The activation of the complement system in various connective tissue diseases]. / La activación del sistema del complemento en algunas conectivopatías

A knowledge of the complement system in patients with collagen diseases is of interest as it may serve to indicate the existence of activity or non-activity in these diseases. We have studied the existence or non-existence of the activity of the complement system through evaluation of the levels of C3, as well as the implicated mechanism of the classical or alternate pathways through the measure of C'4 and C'3 proactivator components. Quantitation of complement components was obtained by electroimmunodiffusion, employing specific antiserum. From the results obtained, we observed that the complement activity in patients with SLE, the classic pathway was affected more (7 patients of the 24 studied), than the alternate pathway (3 patients). However, in those patients affected by sclerodermia, there seems to be an equal incidence of the activation of complement through both pathways (2 patients with activation through each way). Also of interest is the existence of a patient with SLE and another affected by sclerodermia in which a selective reduction of C'3 was observed. This observation suggests the possible existence of a selective destruction, perhaps mediated through a factor type such as the nephritic factor. However, there may exist other patients of whom we have already commented on, with a parallel reduction in the three components which suggests a change in the synthesis or in the simultaneous activation in both of the pathways. When realizing the comparative studies of the state in which the immunoglobulins (IgG, IgA and IgM) and complement components are to be found, the conclusion is that there is no significative correlation between the two. This is particularly interesting as it assumes the necessity of knowing the state of the complement and not only of the immunoglobulin, in order to know the state of activity in which the process is.