Herida facial por mordedura canina en un anciano / Facial wound due to canine bite in an old man

Se presenta el caso clínico de un anciano de 73 años de edad, que fue asistido en el Cuerpo de Guardia del Hospital General Docente Enrique Cabrera Cossío de La Habana por haber sido mordido en el rostro, en la región supraciliar derecha, por un perro, que le causó una herida avulsiva, con pérdida considerable de tejidos blandos, abundante sangrado y dolor. Luego de efectuar antisepsia del área y profilaxis con antibióticos, se practicó rápidamente el procedimiento quirúrgico, que consistió en desbridamiento de la herida y reconstrucción del defecto a través de plastia primaria con técnica de colgajos locales de avance y rotación, lo que permitió una evolución favorable, tanto estética como funcional, en el paciente.

The case report of a 73 years old man is presented. He was assisted in the Emergency Service of Enrique Cabrera Cossío Teaching General Hospital in Havana city, due to a dog bite in his face, in the right supraciliary region, that caused him a lacerated wound, with considerable loss of soft tissues, abundant bleeding and pain. After making antisepsis of the area and prevention with antibiotics, the surgical procedure was quickly practiced that consisted on debridement of the wound and reconstruction of the defect through primary plasty with technique of advance and rotation local flaps, that allowed a favorable clinical course in the patient, both cosmetic and functional.

Central retinal vein occlusion in a patient using the antipsychotic drug olanzapine: a case report.

BACKGROUND: We report our findings in a patient who developed central retinal vein occlusion (CRVO) and was a chronic user of olanzapine, an antipsychotic medication. CASE PRESENTATION: A 50-year-old Caucasian man, non-smoker, was referred to our clinic with the chief complaint of floater appearance in his left eye for the past 3 days. His past medical history indicated that he had been taking antipsychotic drugs (olanzapine) for about 3 years, with no other systemic disease or risk factors for CRVO. In the examination, his best-corrected visual acuity (BCVA) was 0.7 in the left eye. The fundus showed signs of nonischemic CRVO with subhyaloid hemorrhage and intraretinal hemorrhage in the posterior pole and superior and inferior retina, without macular edema, confirmed by optical coherence tomography (OCT). We ruled out other probable differential diagnoses and risk factors which lead to CRVO through a complete physical exam and blood analysis (complete blood count, glucose, urea, creatinine, lipid profile, erythrocyte sedimentation rate, C-reactive protein, prothrombin time, partial thromboplastin time, Bleeding time (BT), fibrinogen level, proteins, antiphospholipid antibodies, homocysteine blood level, antithrombin III, protein C and S, factor V Leiden, prothrombin mutation, angiotensin-converting enzyme level, other autoantibodies, and human leukocyte antigen [HLA]-B51). Finally, we confirmed the probable side effect of olanzapine in CRVO, which has not been previously reported. A possible pro-thrombogenic mechanism of olanzapine at the molecular level is an affinity for 5-HT2Aserotonin receptors. Blocking these receptors results in increased platelet aggregation and increased blood coagulability. CONCLUSIONS: These results indicate that CRVO can be a complication of chronic use of antipsychotic medications such as olanzapine, as shown for the first time in our case report. Clinicians should question patients who develop a sudden CRVO whether they are using antipsychotic medications such as olanzapine.

Peripheral vascular disease - a new vascular disease associated with normal tension glaucoma: a case report.

INTRODUCTION: Normal-tension glaucoma is known as a multifactorial optic neuropathy. A number of lines of evidence suggested that vascular factors played a significant role in the development of normal-tension glaucoma. The mechanisms underlying the abnormal ocular blood flow in normal-tension glaucoma are still not clear. Peripheral vascular disease seems to be associated with glaucoma populations independent of other cardiovascular risk factors. We found this presentation, for the first time, to our knowledge, as another probable vascular abnormality related to our patient with normal-tension glaucoma, although it is necessary to confirm its pathological effect in future studies. CASE PRESENTATION: Our patient was a 48-year-old Spanish man without any personal and family history of interest except for circulatory problems of the lower limbs with repetitive ulcers at the frontal and lateral aspects of his legs. His chief complaint was vision loss when he came to consult us. In exploration, his best corrected visual acuity was 20/20 in both eyes; initial intraocular pressure in the right eye was 14-16 mmHg and in the left eye was 16-18 mmHg, with a mild sclerosis of the lens in slit-lamp examination. No inflammation or pigmented lesion was detected in the anterior chamber. Open angle confirmed by Goldman four quadrants gonioscopy. Funduscopic examination revealed a vertical cup disc ratio of 0.6 in the right eye and 0.8 in the left eye. The patient's neuroretinal rim was normal in the right eye, and superior thinning in the left eye was determined. Examination of the patient's visual field showed inferior mild probable nasal scotoma in the right eye and an inferior deep arcuate scotoma defect in the left eye. His optical coherence tomography examination revealed thinning of the peripapillary nerve fiber layer thickness in the left eye and superior loss of macular retinal ganglion cells in the left eye. Normal intraocular pressure values were measured on the intraocular pressure curve without treatment (maximum value, 18-20 mmHg), discarding higher intraocular pressures measured out of office. Ultrasonic pachymetry measured 515/520 µm, and normal intraocular pressure measured with a PASCAL tonometer ruled out probable corneal biomechanical underestimations. The patient's polysomnography study was normal and excluded sleep apnea syndrome. The patient's serial mean blood pressure was normal, especially in the lower limbs (mean value, 125/70 mmHg), ruling out the possibility of systemic hypotension. Thyroidal and coagulation abnormalities, autoimmune disease, and inflammatory disease were excluded. Normal immunologic study and normal vascular biopsy were observed, as well as normal brain magnetic resonance imaging and a normal carotid vascular study. The primary diagnosis was moderate medium peripheral arterial disease in the lower limbs, which was confirmed by echography after ruling out other probable vascular abnormalities related to normal-tension glaucoma. CONCLUSION: After ruling out other systemic diseases and vascular abnormalities related to normal-tension glaucoma, we found peripheral arterial disease as a probable vascular abnormality related to normal-tension glaucoma in our patient. To our knowledge, this is the first time such a case has been reported. Thus, further research is needed to determine the relevance of these results to the general population.

The Forbidden Region Self-Organizing Map Neural Network.

Self-organizing maps (SOMs) are aimed to learn a representation of the input distribution which faithfully describes the topological relations among the clusters of the distribution. For some data sets and applications, it is known beforehand that some regions of the input space cannot contain any samples. Those are known as forbidden regions. In these cases, any prototype which lies in a forbidden region is meaningless. However, previous self-organizing models do not address this problem. In this paper, we propose a new SOM model which is guaranteed to keep all prototypes out of a set of prespecified forbidden regions. Experimental results are reported, which show that our proposal outperforms the SOM both in terms of vector quantization error and quality of the learned topological maps.

Quiste dentígero en tercer molar mandibular en posición invertida / Dentigerous cyst in an inverted mandibular third molar

Introducción: la erupción es un proceso complejo y, debido a esto pueden aparecer fallas en él. Objetivo: presentar un caso clínico de un quiste dentígero en un tercer molar mandibular invertido. Caso clínico: paciente masculino de 36 años de edad, quien refiere haber asistido a una clínica estomatológica por molestias en la región mandibular derecha y que al realizársele una ortopantomografía, se detecta la presencia del 48 retenido, por lo que es remitido. Al examen físico bucal se detecta ausencia clínica del 48 con expansión de la tabla vertibular en la zona. Al observarse la ortopantomografía se aprecia en la zona de molares derechos reabsorción radicular en el 47, con 48 en posición invertida y una imagen radiolúcida de límites bien definidos en relación con la corona del 48. Se realiza, bajo anestesia local, la exéresis del 47, 48 y la lesión responsable de la imagen radiolúcida mandibular mediante curetaje. Se indica el estudio histopatológico de la lesión, que indica la presencia de un quiste dentígero. El paciente mostró buena evolución posoperatoria. Conclusiones: lo inusual de la presencia de un quiste dentígero, como complicación de la retención dentaria, en un tercer molar mandibular invertido, permitió valerse de los beneficios de estudios imaginológicos digitales y del método clínico para crear un plan de tratamiento que desencadenó en la exéresis exitosa, sin complicaciones transoperatorias, de los dientes y la lesión asociada(AU)

Introduction: tooth eruption is a complex process and due to this complexity flaws may appear in it. Objective: present a clinical case of a dentigerous cyst in an inverted mandibular third molar. Clinical case: a male 36-year-old patient reports having visited a dental clinic for discomfort in the right mandibular region. Orthopantomography was indicated which revealed that tooth 48 was retained; the patient was therefore referred. Clinical oral examination detected the absence of tooth 48 and an expanded vestibular table in the area. The orthopantomograph showed root resorption of tooth 47 in the area of the right molars, with 48 in an inverted position and a radiolucent image of clear-cut boundaries in relation to the crown of 48. Exeresis of 47 and 48 was performed under local anesthesia, and the lesion responsible for the mandibular radiolucent image was removed by curettage. Histopathological examination of the lesion was indicated, revealing the presence of a dentigerous cyst. Postoperative evolution was satisfactory. Conclusions: the infrequent presence of a dentigerous cyst as a complication of dental retention in an inverted mandibular third molar prompted the use of the benefits offered by digital imaging studies and the clinical method to develop a treatment plan leading to successful exeresis of the teeth involved and the associated lesion, without any perioperative complications(AU)

How can functional annotations be derived from profiles of phenotypic annotations?

BACKGROUND: Loss-of-function phenotypes are widely used to infer gene function using the principle that similar phenotypes are indicative of similar functions. However, converting phenotypic to functional annotations requires careful interpretation of phenotypic descriptions and assessment of phenotypic similarity. Understanding how functions and phenotypes are linked will be crucial for the development of methods for the automatic conversion of gene loss-of-function phenotypes to gene functional annotations. RESULTS: We explored the relation between cellular phenotypes from RNAi-based screens in human cells and gene annotations of cellular functions as provided by the Gene Ontology (GO). Comparing different similarity measures, we found that information content-based measures of phenotypic similarity were the best at capturing gene functional similarity. However, phenotypic similarities did not map to the Gene Ontology organization of gene function but to functions defined as groups of GO terms with shared gene annotations. CONCLUSIONS: Our observations have implications for the use and interpretation of phenotypic similarities as a proxy for gene functions both in RNAi screen data analysis and curation and in the prediction of disease genes.

Grid topologies for the self-organizing map.

The original Self-Organizing Feature Map (SOFM) has been extended in many ways to suit different goals and application domains. However, the topologies of the map lattice that we can found in literature are nearly always square or, more rarely, hexagonal. In this paper we study alternative grid topologies, which are derived from the geometrical theory of tessellations. Experimental results are presented for unsupervised clustering, color image segmentation and classification tasks, which show that the differences among the topologies are statistically significant in most cases, and that the optimal topology depends on the problem at hand. A theoretical interpretation of these results is also developed.