Restauraciones cerámicas en molares jóvenes con endodoncia / Ceramics restorations in young molars with endodontic

Objetivo: Efectuar restauraciones cerámicas Cerec (feldespática y de dióxido de circonio) en molares jóvenes con endodoncia, para prevenir complicaciones en el aparato estomatognático por la pérdida de estos dientes. Material y métodos: Se describe la confección de restauraciones cerámicas a nivel de la zona molar mandibular derecha de un paciente del género femenino de 18 años de edad, a quien se le realizó radiografía periapical, por presentar dolor espontáneo en el lado derecho mandibular. Se diagnosticó una pulpitis irreversible en el primer y segundo molar que fue tratada en odónticamente. Las restauraciones cerámicas de ambos molares fueron confeccionadas con los sistemas CAD/CAM Cerec y evaluadas clínicamente a los 6 y 12 meses, de acuerdo a los criterios establecidos por el Servicio de Salud Pública de los Estados Unidos (USPHS).Resultados: La evaluación clínica evidenció que las estructuras de cerámica feldespática y de dióxido de circonio ofrecen en el lapso evaluado, adecuada forma anatómica, adaptación marginal, estabilidad en el color, ausencia de caries recidiva a nivel de dientes del sector posterior con tratamiento endodóntico y aceptación del paciente (AU)

Material and methods: It describes the making of ceramic restorations in the right mandibular molar area to a female patient of 18 years old, to whom it was made a periapical radiography, for presenting spontaneous pain on the mandibular right side. It was diagnosed as an irreversible pulpitis at the first and second molar, that were treated endodontically. The ceramic restorations of both molars were made with the Cerec CAD/CA Msystem and were examined after 6 and 12 months in accordance with the US Public Health Service (USPHS)criteria at baseline. Results: The clinical evaluation showed that the structures of feldspathic ceramic and zirconium dioxide in the offer period evaluated presented, proper anatomical shape, marginal adaptation, color stability, absence of recurrence cavities in the posterior teeth with endodontic treatment and acceptance of the patient (AU)

[Myocardial revascularization surgery without extracorporeal circulation]. / Cirugía de revascularización miocárdica sin circulación extracorpórea.

The number of patients who need coronary artery surgery growth every year. Most of these surgical operations are with extracorporeal circulation (ECC). Recently in our hospital this surgery is realized without ECC in selected patients. Some studies shows that this surgery is an alternative in the treatment of coronary artery disease, especially for aged patients with associated disease and in Jehovah's witness faith. A coronary artery diameter at the anastomotic site of 2 mm or greater and satisfactory hemodynamics with the cardiac manipulation are needed to realize this surgery. Given these limitations this technique has proved useful in selected patients requiring revascularization of the left anterior descending, circumflex or right coronary artery (not for grafting the posterior descending branch). The need of mechanical ventilation, days at ICU, blood required, morbidity and mortality, in our experience as in other studies, were fewer than surgery with CEC.

[Barotrauma in newborns. Study of 81 cases at a neonatal intensive care unit of a province]. / Barotrauma en recién nacidos. Estudio de 81 casos en una Unidad de Cuidados Intensivos Neonatales de provincia.

We present 81 patients with diagnosis of air leaks in a Neonatal Intensive Care Unit (NICU). During 6 and a half year period. Air leaks were present in a 7.3% of overall admissions and in 18% in those whom received mechanical ventilation. We observed pneumothorax in all the patients, accompanied by pneumomediastinum in 12% and with interstitial emphysema in 7%. Other forms of air leak were present only rarely. Eighty percent of our patients were managed with intrapleural drainage. Almost 40% of events happened after resuscitation of tracheal aspiration management. The concomitant disease most often seen was respiratory distress syndrome (RDS) during it's convalescent period. Most of them had been previously placed in mechanical ventilation. We had a very high death rate, most significant in the group with weight less than 2,500 g in which 80% died. An analysis between our findings and those in literature was made.

[Analysis of the costs and complications of different procedures for the administration of intravenous liquids]. / Análisis de costos y complicaciones de diferentes procedimientos para administración de líquidos intravenosos.

With the purpose of finding the most economical method to administer intravenous fluids, we studied 3 groups of children with different pathologies: 50 cases with peripheral intravenous lines (PIL), 50 with venesection (VD) and 50 with percutaneous silastic catheter (PC). To facilitate the cost-expense analysis, each procedure was standardized to a "PIL unit". We found that PIL is the less expensive when IV fluids are administered for over periods of less than 5 days; even though we had an index failure of 24%. The PC has a low cost easy to place and with the advantage that can be established centrally for the measurement of central venous pressure, administration of hypertonic solutions or total parenteral nutrition. Preserving the vascular lumen when it is withdrawn, and resulting as an ideal method when administering fluids for for more than 5 days. VD must be left as a last resource, given its cost and because generally this ruins permanently the vein employed. Complications observed in the 3 procedures were similar to those reported by other authors and there were no mayor complications observed in this study.

[Evaluation of central parenteral alimentation in critically ill newborn infants at a provincial pediatric hospital]. / Evaluación de la alimentación parenteral central en recién nacidos críticamente enfermos en un hospital infantil de provincia.

A revision was made on files of newborns whom received total parenteral nutrition (TPN) in the neonatal intensive care unit of the Hospital Infantil de Tamaulipas during a two and a half years period. We try to correlate dosage and caloric intake with weight gain, survival and complications. We reviewed the principal indications that motivated the use of total parenteral nutrition. The average period of administration was 15 days and caloric intake average 75 cal. There was significance in weight gain in newborns older than 35 weeks (14.6 g/kg/day) compared with younger than 34 weeks (9.2 g/kg/day) (p less than 0.001). There was no relation between days and dosage in both groups. Only one case showed cholestatic jaundice. Hyperglycemia was present statistically more frequent in the group lesser gestational age. There were no important electrolytic disturbances. Necrotizing enterocolitis was present more frequent in the older group. Some comments are made in relation to sepsis and a discussion of possible causes that do no permit a better assimilation of nutrients in these babies.

[Diagnostic problems in neonatal hypocalcemia]. / Problemas de diagnóstico en hipocalcemia neonatal.

Fifteen newborns were studied in the neonatal ICU of the Infantile Hospital of Tamaulipas in whom ICH, neural infection, tetanus, HIE++ and electrolyte disturbances were ruled out, with clinical data highly suggestive of hypocalcemia. Determination of both QTc and QoTc intervals by ECG and measurement of levels of total serum calcium and calcium in CSF and calculation of ionic calcium by means of the McLean Hastings nomogram were made in each patient. Calcium gluconate was administered IV as a therapeutic test. Presence and disappearance of clinical manifestations were correlated with laboratory tests during the suspicious period, 8 and 24 hours after treatment was begun. There was no correlation between clinical features and QTc or QoTc, nor between total serum, CSF or ionic calculated calcium. We conclude that the diagnosis of hypocalcemia in centers that do not have the specific electrode for direct Ca +/- measurement, should be sustained basically when after IV administration of Ca, symptomatology disappears and that the real usefulness of laboratory determination of total C, of ionic calcium, of QTc and QoTc is very limited.