Changes in Volume and Bone Density of Calvarial Grafts After Two Years of Orbital Reconstruction.

One of the greatest challenges in orbital reconstruction is to obtain adequate orbital volume and globe projection after traumatic injury. Autologous bone graft has been considered the gold standard for orbital floor reconstruction, but the harvesting yields many possible complications, such as donor site morbidity. Bone resorption is a frequent problem that can lead to insufficient volume after graft placement. There is a theoretically lower resorption rate of skull bone grafts, even though the exact amount is not known yet. This study is the first to evaluate bone volume and density changes of calvarial split bone grafts after orbital floor reconstruction with a 2-year follow-up. Bone volume and density of calvarial split grafts were determined using computed tomography scans and the software program RadiAnt Dicom Viewer in a total of 10 patients with orbital floor fracture reconstruction. Computed tomography scans taken immediately after surgery (T0) and after a postoperative period of 2 years (T1) were evaluated. The authors found a mean bone volume reduction of 34.25% after 2 years. Bone density was still high after 2 years (over 850 HU), with a mean reduction of 8%. Based on these findings, calvarial split bone grafts represent the ideal reconstruction material for orbital floor fractures.

Zoonotic Cryptosporidium meleagridis in urban invasive monk parakeets.

Zoonotic Cryptosporidium meleagridis was identified in invasive monk parakeets (Myiopsitta monachus) from Santiago metropolis in Chile. Oocysts were isolated from nestlings' faeces, and a fragment of 18S ribosomal RNA gene was amplified and sequenced. This finding emphasizes the importance of permanent pathogen monitoring in synanthropic species with wide global distribution.

Seropositividad a Chlamydophila psittaci en cotorras argentinas (Myiopsitta monachus) invasoras de la ciudad de Santiago de Chile

Introducción: Chlamydophila psittaci es una bacteria zoonótica e intracelular estricta, que provoca la psitacosis humana y su principal hospedero son las aves psitácidas. La cotorra argentina es un ave psitácida nativa de Sudamérica y actualmente considerada una especie invasora en 19 países, incluyendo Chile. Objetivo: Determinar positividad contra C. psittaci en muestras de suero y torulados de cotorras argentinas de vida libre capturadas en la Región Metropolitana de Chile. Métodos: Se analizaron 95 muestras de suero de pichones e individuos adultos de cotorras argentinas, a través de una prueba de ELISA indirecto utilizando un kit comercial. Posteriormente, se analizaron 40 tórulas nasotraqueales y cloacales de individuos adultos a través de una RPC en tiempo real específica para C. psittaci. Resultados: Se detectaron anticuerpos en muestras de suero de cinco individuos adultos de cotorras argentinas (n = 68), mientras que ninguno de los pichones analizados fue seropositivo (n = 27). Todas las muestras analizadas a través de RPC en tiempo real fueron negativas. Conclusión: Estos resultados demuestran por primera vez en Chile la exposición a C. psittaci en cotorras argentinas de vida libre, lo cual puede representar un riesgo importante para la transmisión de este patógeno a poblaciones humanas y animales.

Background: Chlamydophila psittaci is a zoonotic obligate intracellular bacterium that causes the human psittacosis, and its main host are psittacine birds. The monk parakeet is a psittacine bird native to South America, currently being considered an invasive species in 19 countries, including Chile. Aim: To determine positivity to C. psittaci in serum samples and swabs from free-ranging monk parakeets captured in the Metropolitan Region of Chile. Methods: Ninety-five serum samples from nestling chicks and adult monk parakeets were tested using an indirect ELISA test kit. Cloacal and nasotracheal swabs from 40 adult parakeets were further analyzed by C. psittaci-specific real-time PCR. Results: We found antibody titers in sera of five adult monk parakeets (n = 68) while none of the nestlings were seropositive (n = 27). All samples tested with real-time PCR were negative. Conclusions: Our results demónstrate for the first time in Chile the exposure to C. psittaci in free-ranging monk parakeets which may represent a significant risk of pathogen transmission to human and animal populations.

Molecular characterization of Infectious Bursal Disease Virus isolated in Chile reveals several mutations in VP2 coding region and a reassortment in its genome.

Infectious Bursal Disease (IBD) is a well-described disease in young chickens. It is caused by the Infectious Bursal Disease Virus (IBDV), which has a bi-segmented, double-strand RNA genome. The absence of a lipidic envelope makes IBDV highly resistant to environmental conditions. Consequently, it is widely reported around the world. Fourteen samples retrieved from chickens exhibiting apparent alterations of the bursa of Fabricius between 2017 and 2021 were included in the study. These samples were passaged into embryonated eggs and the presence of IBD was confirmed through RT-PCR. The PCR products were sequenced and analyzed to characterize the Chilean IBDV isolates for comparison with GenBank sequences, including vaccines sequences currently used in Chile.Phylogenetic analysis classified the Chilean sequences as A1B1, except the sample 15002_CL_2021 which was classified as A2B1. On the other hand, all Chilean viruses were grouped as B1, based on viral segment B. Estimated evolutionary divergence between different genogroups supports these clustering. Moreover, samples 13936_CL_2017, 14038_CL_2017, 14083_CL_2017, 14145_CL_2018, 14431_CL_2019, and 14459_CL_2019 showed high similitude with the D78 and ViBursa CE vaccines (both currently used in Chile). Viruses 14010_CL_2018, 14040_CL_2017, 14514_CL_2019 and 14019_CL_2017 exhibited patterns that do not exactly fit either vaccine. Finally, viruses 15,041 N-_CL_2021, 15,041 N+_CL_2021, and 15004_CL_2021 showed even more differences regarding both vaccines.This is the first study in Chile to analyze the genetic sequences of IBDV isolates. The different assessments conducted as part of the study suggest a close relationship with vaccines currently in use. Interestingly, one of the viruses exhibited a reassortment in its genome segments, which could confer new characteristics to the virus. However, new approaches would be required to establish the origin of the isolated viruses, as well as how the recombination is changing its virulence or morbidity.

Litter Management Strategies and Their Impact on the Environmental and Respiratory Microbiome Might Influence Health in Poultry.

Aerial and respiratory tract-associated bacterial diversity has been scarcely studied in broiler production systems. This study examined the relationship between the environmental air and birds' respiratory microbiome, considering a longitudinal sampling. Total viable bacteria and coliforms in the air were quantified, and the 16S rRNA gene was sequenced from tracheal and air samples obtained through a novelty protocol. Air results showed a decrease in coliforms over time. However, at week 3, we reported an increase in coliforms (from 143 to 474 CFUc/m3) associated with litter management. Additionally, 16S rRNA gene results indicated a distinctive air microbial community, associated primarily with Bacillota phylum particularly of the Bacilli class (>58%), under all conditions. Tracheal results indicated a predominance of Escherichia coli/Shigella at the beginning of the productive cycle, shifting toward the middle and end of the cycle to Gallibacterium. However, at week 3, the dominance of Escherichia coli/Shigella (>99.5%) associated with litter aeration by tumbling stood out. Tracheal and air samples displayed a statistically different community structure, but shared differentially abundant features through time: Enterococcus, Gallibacterium, and Romboutsia ilealis. These results indicate the impact of production management protocols on the birds' respiratory system that should be considered a breakpoint in poultry farm health.

Efficacy of Multivalent, Cochleate-Based Vaccine against Salmonella Infantis, S. Enteritidis and S. Typhimurium in Laying Hens.

Salmonella enterica is an important foodborne pathogen. Commercial poultry are the main reservoirs of Salmonella enterica, leading to the contamination of food and outbreaks in humans. The vaccination of chickens is one of the most important strategies to reduce the number of Salmonella in poultry farms. Unfortunately, commercial vaccines have not been fully effective in controlling the spread and do not contain all the Salmonella serovars that circulate on farms. In this study, we evaluate a new, cochleate-based, trivalent injectable vaccine against S. Enteritidis, S. Typhimurium and S. Infantis, describing the vaccine security, capacity to induce specific anti-Salmonella serovar IgY and the gene expression of immune markers related to CD4 and CD8 T-cell-mediated immunity. Efficacy was evaluated through oral challenges performed separately for each Salmonella serotype. The efficacy and safety of the trivalent vaccine was proven under controlled conditions. The vaccine has no local or systemic reactions or adverse effects on poultry performance related to the vaccine. The vaccine provided significantly increased serum IgY titer levels, significantly reduced Salmonella CFU/g present in the cecum and an increased CD4+/CD8+ ratio in vaccinated animals when challenged with S. Infantis, S. Enteritidis and S. Typhimurium. These results indicate that this new trivalent vaccine does not generate adverse effects in poultry and produces an increase in neutralizing antibodies against the three Salmonella serovars.

Encapsulation of Cochleates Derived from Salmonella Infantis with Biopolymers to Develop a Potential Oral Poultry Vaccine.

The aim of this study was to develop and characterize Salmonellaenterica serovar Infantis (S. Infantis) cochleates protected by encapsulation technology as a potential vaccine and to determine its safety in pullets. Cochleates were encapsulated by two technologies, spray drying and ionotropic gelation at different concentrations (0-15% v/v), and were characterized by physicochemical properties, protein content and Fourier Transform Infrared Spectroscopy (FTIR). The cochleates were white liquid suspensions with tubular shapes and a protein content of 1.0-2.1 mg/mL. After encapsulation by spray drying, microparticles ranged in size from 10.4-16.9 µm, were spherical in shape, and the protein content was 0.7-1.8 mg/g. After encapsulation by ionotropic gelation, beads ranged in size from 1620-1950 µm and were spherical in shape with a protein content of 1.0-2.5 mg/g. FTIR analysis indicated that both encapsulation processes were efficient. The cochleates encapsulated by ionotropic gelation were then tested for safety in pullets. No ill effect on the health of animals was observed upon physical or postmortem examination. In conclusion, this study was the first step in developing a potential oral S. Infantis vaccine safe for poultry using a novel cochleate encapsulation technology. Future studies are needed to determine the effectiveness of the vaccine.

Determination of five antimicrobial families in droppings of therapeutically treated broiler chicken by high-performance liquid chromatography-tandem mass spectrometry.

Antimicrobials are currently used in poultry for disease treatment. However, their excretion in bird feces may contaminate the environment. Considering this, the objective of this work was to quantify antimicrobials residues concentrations in therapeutically treated broiler chicken droppings throughout the post-treatment period. For this aim a multiresidue method using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was validated. Forty-eight male broiler chickens were distributed and treated with commercial formulations of 5 different antimicrobials. Results showed that oxytetracycline and 4-epi-oxytetracycline, presented the highest concentrations during all sampling period, detecting concentrations of 1471.41 µg kg-1 at the last sampling point (day 22 post-treatment). Florfenicol, tylosin, enrofloxacin, and ciprofloxacin were eliminated and detected in treated chicken droppings until d 18 post-treatment. Sulfachloropyridazine decrease gradually during post-treatment period until day 30. Results demonstrate that studied antimicrobials in treated chicken droppings were eliminated for prolonged periods, therefore becoming a significant route of residues dissemination into the environment.

Detection of Antimicrobial Residues in Poultry Litter: Monitoring a Risk through a Selective and Sensitive HPLC-MS/MS Method.

Tetracyclines, sulphonamides, and quinolones are families of antimicrobials (AMs) widely used in the poultry industry and can excrete up to 90% of AMs administrated, which accumulate in poultry litter. Worryingly, poultry litter is widely used as an agriculture fertilizer, contributing to the spread AMs residues in the environment. The aim of this research was to develop a method that could simultaneously identify and quantify three AMs families in poultry litter by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Samples of AMs free poultry litter were used to validate the method according to 657/2002/EC and VICH GL49. Results indicate that limit of detection (LOD) ranged from 8.95 to 20.86 µg kg-1, while limits of quantitation (LOQ) values were between 26.85 and 62.58 µg kg-1 of tetracycline, 4-epi-tetracycline, oxytetracycline, 4-epi-oxytetracycline, enrofloxacin, ciprofloxacin, flumequine, sulfachloropyridazine, and sulfadiazine. Recoveries obtained ranged from 93 to 108%. The analysis of field samples obtained from seven commercial poultry flocks confirmed the adequacy of the method since it detected means concentrations ranging from 20 to 10,364 µg kg-1. This provides us an accurate and reliable tool to monitor AMs residues in poultry litter and control its use as agricultural fertilizer.

First record of Ornithonyssus bursa (Berlese, 1888) (Mesostigmata: Macronyssidae) parasitizing invasive monk parakeets in Santiago, Chile.

Myiopsitta monachus is an invasive psittacine with wide distribution due to the pet trade. Its large communal nests and synanthropic nature contribute to its successful colonization of cities, from where it seems to be expanding in range and numbers. This is relevant with regard to pathogens that invasive species may harbor, especially when host populations thrive. We aimed to identify an abundant mite found in invasive monk parakeet chicks that had been collected in Santiago during 2017 and 2018. Through morphological and molecular identification of the 18S ribosomal RNA gene, we confirmed the presence of Ornithonyssus bursa. This was the first report of this mite in Chile. This mite is common in native and invasive monk parakeet populations and may affect other birds, including domestic fowl. Further, this mite bites people and can be a potential vector of pathogens such as bacteria or viruses. We conclude that this parasite was likely introduced with the parakeet and discuss possible ecological, health and economic consequences of this new potential pest.

Assesing Intraoperative Virtual Navigation on My Craniofacial Surgery Fellowship for Orbital Fractures Repair: Is it Useful?

ABSTRACT: Orbital fractures pose specific challenge in its surgical management. One of the greatest challenges is to obtain satisfactory restoration of normal orbital volume and globe projection following traumatic injury, due to the inability of the surgeon to gain adequate visibility and to verify proper implant position and placement during the operation. Surgical navigation is a very helpful tool when dealing with the reconstruction of such orbital fractures. During the training of the craniofacial fellowship learning to recognize the orbital floor boundaries is essential for the correct implant placement for reconstruction, their identification is a critical step, which may be assisted by intraoperative virtual navigation. Six patients were surgically treated for orbital floor fracture with intraoperative virtual navigation. The clinical evaluation showed no complications such as enophtalmos, exophtalmos or dystopia in all the patients 2 months post operatively and a correct implant/graft position.During surgery, navigation provides exact determination of transverse, cranio-caudal and postero-anterior dimensions within the orbit and precise control of the position of implants/bone grafts.This tool aids consistently on the craniofacial surgery fellow's formation, as it facilitates the identification of the bony floor boundaries and verifies the correct placement of the implants/bone grafts. It is routinely use could help to avoid implants/bone grafts misplacement not only for craniofacial surgeon's fellow, but for all the orbital surgeons.

First record of Ornithonyssus bursa (Berlese, 1888) (Mesostigmata: Macronyssidae) parasitizing invasive monk parakeets in Santiago, Chile / Primeiro registro de Ornithonyssus bursa (Berlese, 1888) (Mesostigmata: Macronyssidae) parasitando caturritas invasoras em Santiago, Chile

Abstract Myiopsitta monachus is an invasive psittacine with wide distribution due to the pet trade. Its large communal nests and synanthropic nature contribute to its successful colonization of cities, from where it seems to be expanding in range and numbers. This is relevant with regard to pathogens that invasive species may harbor, especially when host populations thrive. We aimed to identify an abundant mite found in invasive monk parakeet chicks that had been collected in Santiago during 2017 and 2018. Through morphological and molecular identification of the 18S ribosomal RNA gene, we confirmed the presence of Ornithonyssus bursa. This was the first report of this mite in Chile. This mite is common in native and invasive monk parakeet populations and may affect other birds, including domestic fowl. Further, this mite bites people and can be a potential vector of pathogens such as bacteria or viruses. We conclude that this parasite was likely introduced with the parakeet and discuss possible ecological, health and economic consequences of this new potential pest.

Resumo Myiopsitta monachus é um psitacídeo invasor amplamente distribuído devido ao tráfico de animais selvagens. Os grandes ninhos comunitários construídos e sua condição de espécies sinantrópicas contribuem para a colonização bem-sucedida das cidades, onde parece estar expandindo sua distribuição e número de indivíduos. Isso é relevante, quando se trata de patógenos que os invasores podem abrigar, especialmente quando as populações hospedeiras prosperam. O objetivo deste trabalho foi identificar um ácaro abundante, encontrado em filhotes de periquitos-monge introduzidos em Santiago, Chile, coletados durante 2017 e 2018. Por meio da identificação morfológica e molecular do gene do RNA ribossômico 18S, foi confirmada a presença de Ornithonyssus bursa, sendo o primeiro registro para o Chile. Esse ácaro é comum em populações nativas e introduzidas de periquitos-monge e pode afetar outras aves, incluindo aves domésticas. Além disso, esse ácaro pode picar pessoas e pode ser um potencial vetor de patógenos, como bactérias ou vírus. Conclui-se que esse parasita provavelmente foi introduzido com o periquito e foram discutidas as possíveis consequências ecológicas de saúde e econômicas dessa nova praga em potencial.

Live Attenuated Infectious Bronchitis Virus Vaccines in Poultry: Modifying Local Viral Populations Dynamics.

Infectious bronchitis virus (IBV) remains one of the most important diseases impacting poultry today. Its high adaptive capacity, attributable to the high mutation rate associated with its ssRNA(+), is one of its more important features. While biosecurity procedures and barriers have been shown to be preponderant factors in minimizing the impact of infectious bronchitis (IB), the environment and procedures associated with intensive poultry systems greatly influence the viral population dynamics. High-density poultry flocks facilitate recombination between different viruses, and even with live attenuated vaccines, which can change the dominant circulating field strains. Furthermore, the remaining issue of reversion to virulence gives rise to significant problems when vaccinal strains are introduced in places where their pathogenic variants have not been reported. Under specific conditions, live attenuated vaccines could also change the frequency of circulating viruses and enable replacement between different field strains. In summary, under a comprehensive approach, while vaccination is one of the most essential tools for controlling IB, the veterinarians, farmers, and official services role in its usage is central to minimizing alteration in a malleable viral population. Otherwise, vaccination is ultimately counterproductive.

Manejo de secuencia de Pierre Robin con distracción externa mandibular y palatoplastia de incisiones mínimas / Managment of Pierre Robin Sequence with external mandibular distraction and palatoplasty of minimal incisions

Antecedentes. La secuencia de Pierre Robin es una patología poco frecuente y entendida en la literatura latinoamericana . La incidencia en el mundo es variable y en Latinoamerica no existen cifras exactas. La etiopatogenia es poco clara y aminorar y manejar las complicaciones respiratorias constituyen un objetivo primordial en el tratamiento de estos pacientes. El objetivo de este artículo es presentar el manejo del Pierre Robin en nuestro Servicio desde un punto de vista íntegro presentando un caso ejemplo. Presentación de caso. Masculino de 9 meses con diagnóstico de Pierre Robin, quien fue tratado con distractores mandibulares y retiro de los mismos tres meses después, con una excelente evolución posoperatoria. Posterior a esto, se realizó una palatoplastia sin complicaciones, con excelentes resultados respiratorios a los 6 meses de seguimiento. Conclusiones. El manejo del síndrome de Pierre Robin es un desafío para el cirujano plástico, con muchas opciones quirúrgicas disponibles, pero la distracción mandibular es actualmente la técnica que tiene mejores resultados confirmados para los parámetros respiratorios a largo plazo.

Background. Pierre Robin's sequence is a rare pathology. The incidence in the world is variable and in Latin America is unknown. The etiopathogenesis is unclear and respiratory complications are a challenge for surgical treatment. The objective of this article is to present the management of Pierre Robin from an integrative point of view through a case presentation. Case presentation. 9 month old male with Pierre Robin diagnosis who was treated with mandibular distractors with subsequent removal 3 months later with excellent postoperative evolution. Later on, a la palatoplasty was performed with no complications, with good respiratory injuries function at 6 month follow up. Conclusions. The management of Pierre Robin syndrome is a challenge for the plastic surgeon, with many surgical options available, with mandíbular distraction currently being the technique of choice because of its confi rmed favorable long term respiratory results

Molecular and Antigenic Characterization of GI-13 and GI-16 Avian Infectious Bronchitis Virus Isolated in Chile from 2009 to 2017 Regarding 4/91 Vaccine Introduction.

The introduction of the 4/91 vaccine against infectious bronchitis in Chile, a lineage not described until that time in the country, led to looking for changes induced by this action. This study considers eight isolates obtained from 2009, 2015 and 2017 and uses a maximum likelihood approach to classify the field isolates. Three isolates were selected to analyze antigenic relationships through a virus neutralization test and to perform protection tests measured trough an RT-qPCR. The isolates from 2009 and 2015 showed a relationship with GI-16 while those from 2017 were related to GI-13. Though the field isolates were classified in two different phylogenetic lineages, all of them showed only minor variations in subtype. The 13885R-17 isolate from 2017 exhibited high antigenic relatedness to the 4/91 vaccine. As expected, 4/91 and Massachusetts vaccines were not antigenically related. Vaccinated birds with the 4/91 vaccine showed less tracheal virus replication for the 13885R-17 from 2017 challenge than for the 12101SP-09 from 2009 and 13347SP-15 from 2015 isolates. The results indicated genetic and antigenic diversity in the most recent infectious bronchitis virus (IBV) isolates in Chile. Moreover, the 4/91 vaccine would be involved in the generation of some current field viruses, which must be considered in vaccination programs and public policies.

Revisión sistemática de modelos de entrenamiento en rinoplastia / Sistematic review of training models in rhinoplasty

Antecedentes y Objetivo. La rinoplastia es uno de los procedimientos más frecuentes y más complejos de la Cirugía Plástica. Residentes de todo el mundo concuerdan en que su entrenamiento en rinoplastia es deficiente y en algunas ocasiones nulo. Algunos dicen no contar con la confianza suficiente para realizarla al finalizar su formación especializada. No todos los países establecen un método de entrenamiento estandarizado para la adquisición de experiencia y habilidades en rinoplastia, y si bien existen algunos modelos, no han sido evaluados y se desconoce su efectividad. Realizamos una revisión sistemática de las publicaciones que describen modelos de entrenamiento para aprendizaje, adquisición y/o mejora de habilidades en rinoplastia. Material y método. Llevamos a cabo una revisión sistemática mediante búsqueda electrónica de la literatura en las diferentes bases de datos: MEDLINE Pubmed (1980 a junio de 2016), EMBASE Ovid (1946 a segunda semana de junio de 2016), LILACS Scielo (1982 a junio de 2016) usando como criterio de selección: estudios descriptivos sobre uso de modelos de entrenamiento en rinoplastia. Resultados. Revisamos 6 modelos de entrenamiento publicados entre 2005-2014; 3 con tejido animal, 1 en cadáveres y 2 con material sintético. Ninguno contaba con evaluación y validación de los modelos propuestos, por lo cual no es posible determinar si funcionan para mejorar las habilidades quirúrgicas durante la formación especializada en Cirugía Plástica. Conclusiones. Aunque está demostrada la eficacia de los modelos de entrenamiento quirúrgico en otras especialidades y su uso es requisito para acreditación en EE. UU., no encontramos evidencia de la existencia de modelos eficaces en rinoplastia. Es por ello que nuestra revisión abre la puerta para la búsqueda de un modelo validado en nuestra especialidad

Background and Objective. Rhinoplasty is one of the most frequent and complex surgeries performed within the Plastic Surgery field. Residents around the world agree on a general deficiency from their rhinoplasty training and, in some cases, the absence of it. Someone, by the end of their training, still feel lack of confidence when performing a rhinoplasty. Currently, not all the countries have established a standardized training method for the acquisition of expertise and skills in rhinoplasty, and although there are several models, they have not been evaluated and therefore their efficiency as a training model is unknown. Methods. We conduct a systematic review performing a systematic review of published articles about the theme. Search strategy included the following database: MEDLINE Pubmed (1980 to June 2016), EMBASE Ovid (1946 to second week of June 2016), LILACS Scielo (1982 to June 2016). Selection criteria used was: descriptive studies reporting the use of training models for rhinoplasty. Results. Six training models, during a period from 2005-2014, were evaluated. Three were based on animal tissue, 2 on synthetic materials and 1 on a cadaveric model. No one had been evaluated or validated as to whether they improve surgical skills of residents in training. Conclusions. Even do, in other medical specialties the effectiveness of surgical training models has been proven and such training is considered a requirement in the USA, within the rhinoplasty field no evidence of the effectiveness from these models was found. This revision delivers a path to continue with their effectiveness evaluation and skills improvement in Plastic Surgery

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OPCML is hypermethylated in a subset of patients with metaplastic changes in their esophagus.

OPCML hypermethylation is considered a promising cancer biomarker. We examined methylation levels in the first exon of OPCML in two patient cohorts within the esophageal adenocarcinoma and gastric adenocarcinoma cascades and in a range of cell-lines using a custom PyroMark CpG assay. Methylation levels were significantly higher in esophageal tissue with histologically confirmed glandular mucosa as compared to tissue from normal esophagi or gastro-esophageal reflux disease. Higher levels of OPCML methylation were absent in the adjacent normal esophageal tissue of patients with glandular mucosa. Higher levels of methylation were confirmed in cell-lines derived from patients with adenocarcinoma, but also detected in two cell-lines with signs of dysplasia. We validated our assay by showing no differences in methylation levels in DNA extracted from blood of patients within the gastric adenocarcinoma cascade. OPCML hypermethylation is present in a subset of patients with metaplastic changes in their esophagus.

Le Fort II Osteotomy and Modified Technique Presentation.

INTRODUCTION: The LeFort II osteotomy has a specific number of indications, thus this is true, there is less experience with the technique. The authors present a modification to the technique and extensive step-by-step procedure explanation in order to share their experience for making a safe surgery. MATERIAL AND METHODS: A clinical report is presented of a nonsyndromatic patient with nasomaxillary hypoplasia, in which the authors make an LeFort II osteotomy with circumvestibular, transcaruncular, and "W"-shaped approaches, with minimal scar showing, in order to offer better aesthetic outcomes as well as functional and skeletal. RESULTS: Patient presenting with an optimal postoperative clinical and skeletal results. Cephalometic measurments in normal ranges. Obtaining during the process of the surgery, description the surgery, and potential complications. CONCLUSION: Using the Le Fort II osteotomy in nonsyndromic nasomaxillary hypoplasia is a helpful and left away technique, because of its complexity. The authors give a step-by-step detailed description of the surgical technique with perioperative management. In summary, the steps provided give unique information about this reproducible and aesthetic technique.

Airway management through submental derivation: a safe and easily reproduced alternative for patients with complex facial trauma.

OBJECTIVES: Airway management in patients with panfacial trauma is complicated. In addition to involving facial lesions, such trauma compromises the airway, and the use of intermaxillary fixation makes it difficult to secure ventilation by usual approaches (nasotracheal or endotracheal intubation). Submental airway derivation is an alternative to tracheostomy and nasotracheal intubation, allowing a permeable airway with minimal complications in complex patients. MATERIALS AND METHODS: This is a descriptive, retrospective study based on a review of medical records of all patients with facial trauma from January 2003 to May 2015. In total, 31 patients with complex factures requiring submental airway derivation were included. No complications such as bleeding, infection, vascular, glandular, or nervous lesions were presented in any of the patients. RESULTS: The use of submental airway derivation is a simple, safe, and easy method to ensure airway management. Moreover, it allows an easier reconstruction. CONCLUSION: Based on these results, we concluded that, if the relevant steps are followed, the use of submental intubation in the treatment of patients with complex facial trauma is a safe and effective option.