Findings from the experience with the punch technique for auditory osseointegrated implants: A retrospective single center comparative study / Resultados de la experiencia con la técnica de perforación para implantes auditivos osteointegrados: estudio comparativo retrospectivo de nuestro centro hospitalario

Objective: To compare the punch technique and linear incision with soft tissue reduction for the placement of auditory osseointegrated implants (AOI) and analyze results of osseointegration obtained with the punch technique as measured with the Implant Stability Quotient (ISQ). Methods: Case review of 34 patients who received auditory osseointegrated implants between January 2010 and July 2015 and were divided into two groups according to the surgical technique: 18 with the punch technique (PT) and 16 with the linear incision technique (LI). Minimum follow-up was four months (mean: 24 months; range 4-64 months). Included in the analysis were patient profiles and records of the demographic data, surgical indications, surgical technique, implant placement, surgical time, intraoperative complications, as well as postsurgical complications (Holgers classification) and implant stability quotients (ISQ). Results: Use of larger abutments was significantly greater in the PT group (PT, 10 mm; LI, 6 mm, p < 0.001). The PT technique resulted in a shorter procedure than the LI (PT, 20 min; LI, 45 min, p < 0.001). Holgers classification scores identified significantly fewer skin complications one week after surgery for the PT group; however, only small differences were seen between the two groups at the one- and three-month control visits. Conclusions: As shown for our cohort, the punch technique for surgical placement of AOI is faster and presents fewer immediate postoperative complications when compared to the linear incision technique. The clinical application of the ISQ is a useful, easy method to demonstrate the status of osseointegration and, thus, the stability of the device (AU)

Objetivo: Comparar la técnica de perforación con la de incisión lineal con reducción de tejidos blandos en la colocación de implantes osteointegrados y analizar los resultados de la osteointegración obtenidos con la técnica de perforación (PT) medidos con el coeficiente de estabilidad del implante (Implant Stability Quotient [ISQ]). Métodos: Treinta y cuatro pacientes recibieron implantes osteointegrados entre enero 2010 y julio 2015, dividiéndolos en 2 grupos: 18 con PT y 16 con técnica de incisión lineal (LI). El seguimiento mínimo fue de 4 meses (media: 24 meses; rango 4-64 meses). Analizamos los perfiles de los pacientes, datos demográficos, indicaciones quirúrgicas, técnica quirúrgica, colocación del implante, tiempo de cirugía, complicaciones intraoperatorias y postoperatorias (clasificación de Holgers) y el ISQ. Resultados: El uso de pilares más largos fue significativamente mayor en el grupo PT (PT: 10mm; LI: 6mm, p < 0,001). La PT fue más corta que la LI (PT: 20 min; LI: 45 min, p < 0,001). La clasificación Holgers identificó menos complicaciones cutáneas a la semana poscirugía en el grupo PT de forma significativa; de hecho, solo se apreciaron pequeñas diferencias entre los 2 grupos en las visitas al mes y los 3 meses. Conclusiones: Como se muestra en nuestro estudio, la PT para la colocación de implantes osteointegrados es más rápida y presenta menos complicaciones cutáneas postoperatorias inmediatas cuando se compara con la técnica LI. La aplicación clínica del ISQ es útil y fácil para objetivar la osteointegración y así la estabilidad del implante (AU)

Findings from the experience with the punch technique for auditory osseointegrated implants: A retrospective single center comparative study.

OBJECTIVE: To compare the punch technique and linear incision with soft tissue reduction for the placement of auditory osseointegrated implants (AOI) and analyze results of osseointegration obtained with the punch technique as measured with the Implant Stability Quotient (ISQ). METHODS: Case review of 34 patients who received auditory osseointegrated implants between January 2010 and July 2015 and were divided into two groups according to the surgical technique: 18 with the punch technique (PT) and 16 with the linear incision technique (LI). Minimum follow-up was four months (mean: 24 months; range 4-64 months). Included in the analysis were patient profiles and records of the demographic data, surgical indications, surgical technique, implant placement, surgical time, intraoperative complications, as well as postsurgical complications (Holgers classification) and implant stability quotients (ISQ). RESULTS: Use of larger abutments was significantly greater in the PT group (PT, 10mm; LI, 6mm, p<0.001). The PT technique resulted in a shorter procedure than the LI (PT, 20min; LI, 45min, p<0.001). Holgers classification scores identified significantly fewer skin complications one week after surgery for the PT group; however, only small differences were seen between the two groups at the one- and three-month control visits. CONCLUSIONS: As shown for our cohort, the punch technique for surgical placement of AOI is faster and presents fewer immediate postoperative complications when compared to the linear incision technique. The clinical application of the ISQ is a useful, easy method to demonstrate the status of osseointegration and, thus, the stability of the device.

Surveillance or Engagement: Children's Conflicts During Health Maintenance Visits.

OBJECTIVE: School-aged health maintenance visits seek to prevent or intervene early with health issues of lifelong importance. Little is known about what children expect to happen in these visits or how they experience them, factors related to their engagement as active collaborators in care. METHODS: Thirty children (53% Latino, 27% African-American, and 20% white) ages 7 to 11 years were video recorded during a health maintenance visit and then interviewed while reviewing the videos. Interview transcripts were analyzed for understanding the purpose of the visit, feelings of comfort and discomfort, and decisions about how much to participate. RESULTS: Children expected doctors to be helpful, caring, and a source of important information. They anticipated visits to include immunizations, a physical examination, and praise for accomplishments, but could be surprised by questions about behavior, family function, and lifestyle. During visits, feelings varied from warmth toward providers to embarrassment, wariness, irritation, and boredom. Even when bored or irritated, children hesitated to interrupt parent-provider conversations or correct perceived provider misunderstandings, not wanting to be seen as inappropriate or rude. When asked questions they considered off topic, likely to reveal sensitive information, or that could lead to changes in their lifestyle, some were silent or answered evasively. Some said they would have spoken more freely without their parent present but valued parental support and wanted parents to make important decisions. CONCLUSIONS: School-aged children's limited knowledge of what to expect in health maintenance visits, uncertainty about conversational norms with adults, and desire to assert control over their lives compete with their desire to access expert advice and form bonds with providers. Engaging children in health maintenance visits might require more relationship-building and education about the visit's goals.

Beneficial rhizobacteria from rice rhizosphere confers high protection against biotic and abiotic stress inducing systemic resistance in rice seedlings.

The present study reports a screening for PGPR in a highly selective environment, the rhizosphere of rice plants, in southwestern of Spain. Among the 900 isolates, only 38% were positive for at least one of the biochemical activities to detect putative PGPR. The best 80 isolates were selected and identified by 16S rRNA partial sequencing. Among these, 13 strains were selected for growth promotion assays. Only one strain (BaC1-38) was able to significantly increase height, while nine strains significantly inhibited it. Five strains significantly increased dry weight, and only BaC1-21 significantly decreased it. Based on significant modifications in growth, three bacteria (BaC1-13, BaC1-21 and BaC1-38) were tested for systemic induction of resistance against stress challenge (salt and Xanthomonas campestris infection). Protection against salt stress and pathogen infection was similar; BaC1-38 protected by 80%, BaC1-13 by 50% and BaC1-21 only by 20%. Toxicity of salt stress to the plants was evaluated by photosynthetic efficiency of seedlings. Fv/Fm only decreased significantly in plants inoculated with BaC1-13. ΦPSII also decreased significantly in plants inoculated with BaC1-21, but increased significantly with BaC1-38. NPQ decreased significantly in plants inoculated with BaC1-21. The two strains able to induce systemic resistance against Xanthomonas campestris seem to work by different pathways. BaC1-13 primed enzymes related with the detoxification of reactive oxygen species (ROS). However, BaC1-38 primed pathogenesis-related proteins (PRs), and this pathway was more effective, both improved chlorophyll index confirming the priming state of the plant.

Pseudomonas fluorescens N21.4 metabolites enhance secondary metabolism isoflavones in soybean (Glycine max) calli cultures.

Phytopharmaceuticals are plant secondary metabolites that are strongly inducible and especially sensitive to biotic changes. Plant cell cultures are a good alternative to obtain secondary metabolites, in case effective stimulation can be achieved. In this study, metabolic elicitors from two rhizobacteria able to enhance isoflavone content in soybean seedlings were tested on three different soybean calli cell lines. Results show that metabolic elicitors from Chryseobacterium balustinum Aur9 were not effective. However, there are at least two different metabolic elicitors from Pseudomonas fluorescens N21.4, one under 10 kDa and another over 10 kDa, that trigger isoflavone metabolism in the three cell lines with different isoflavone content. Elicitors from N21.4 achieved total isoflavone increases up to 29.7% (0.205 mg/g), 64.5% (0.487 mg/g), and 23.4% (0.726 mg/g) in the low-, intermediate-, and high-yield lines, respectively. Therefore, these elicitors have a great potential to enhance isoflavone production in cell cultures for development of functional ingredients.

Estudio de anomalías congénitas del pie

Objetivos. Caracterizar clínicamente a las anomalías congénitas del pie, y sus factores predisponentes, tratamiento y evolución de los pacientes que las padecen. Método: Se realizó un estudio prospectivo, descriptivo y aplicado de las malformaciones congénitas de los pies atendidos en nuestra consulta durante el período comprendido entre el mes de julio del 2004 y mayo del 2006. El universo estuvo constituido por 195 niños pertenecientes a un grupo poblacinonal menor de 15 años, los cuales presentaron malformaciones congénitas de los pies. Resultados: No hubo predominio del sexo, la captación predominante fue en tiempo normal, lo que representó el 40,5 por ciento, las malformaciones fueron generalmente bilaterales para un 75,4 por ciento, presentando en el caso de las unilaterales predominio en el pie derecho para un 16.9 por ciento. Necesitó estudios radiográficos el 63,5 por ciento. El riesgo relativo mediante el cálculo de odds ratio mostró fuerza de asociación de 13.22 para los antecedentes familiares y de 7.41 para los factores ambientales, las deformidades asociadas más frecuentes para un 26.1 y la complicación predominante fue la recidiva con un 7.7 por ciento, así como fueron evaluados de buenos resultados en el tratamiento el 89,7 por ciento de los casos...(AU)