The effects of periodontal treatment on mucous membrane thickening in the maxillary sinus

This study was performed to elucidate the effect of periodontal treatment on the sinus mucosa. 21 patients with periodontal lesions of the upper molars and/or premolars and chronic mucous membrane thickening in the maxillary sinus diagnosed radiographically participated in the study. No teeth in the regions studied showed pulpal or periapical changes. Altogether, the patients exhibited 36 maxillary sinuses with mucous membrane thickening. 15-20 months after the final periodontal treatment, a marked reduction of the plaque index, gingival index and probing depth was recorded. Radiographic examination of the sinus mucosa before and after periodontal treatment showed that successful periodontal treatment in all quadrants resulted in normalisation of the sinus mucosa. Periodontal treatment was not successful in 2 quadrants. In one of these cases the thickness of the mucosa was unchanged and in the other case, further thickening of the mucosa seemed to have occurred. The study shows that severe periodontitis of the upper molars and/or premolars may initiate mucous membrane thickening in the maxillary sinus, and that successful periodontal treatment results in normalisation of the sinus mucosa.     

Influence of treatment-induced changes in tissue absorption on treatment volume during interstitial photodynamic therapy

Interstitial photodynamic therapy on thick skin lesions has been shown to induce changes in tissue light transmission as a direct consequence of variations in total blood volume and oxygen saturation. A finite element method was used in order to simulate the fluence rate distribution and total light dose throughout the target tissue for two cases. The first case constitutes a pre-treatment model where the tissue optical properties are assumed constant during the entire treatment. The second situation takes into account observed changes in tissue light transmission, small deviations in fiber insertion depth and a few cases of almost complete loss of source fiber output power possibly as a result of blood accumulation in front of the fiber tip. The pre- and post-treatment models from six clinical treatments are compared in terms of simulated treatment volumes. We conclude that real-time monitoring of the delivered fluence is necessary in order to ascertain a pre-determined light dose to the target tissue. Finally, we speculate on how to also include the sensitizer fluorescence level and tissue oxygenation in the real-time treatment feedback.     

Combined polyurethane foam and hydrogel dressing. Outcome in lesions of diverse etiology

The authors present an observational evaluation on the effectiveness of a dressing included in the Indafoam brand for treatment of skin lesions due to different etiology which have an acute or chronic diagnosis; the authors include some very valuable information for professionals who use combined polyurethane foam and hydrogel dressings in their daily practice. Due to their composition, these dressings may be considered combined dressings having only one structure which maintains a stable temperature at the lesion site; these dressings have a high absorption capacity which prevents maceration of the skin surrounding lesions and protects lesions from contamination by exogenous germs.     

Reconstrucción de la continuidad digestiva tras cirugía de la diverticulitis aguda complicada. Estudio retrospectivo multicéntrico

Introduction The aim

was to analyse the stoma reversal rate after surgery for complicated acute diverticulitis (CAD), and more specifically the end-stoma-reversal, as well as the delay, feasibility, complications and risk factors for stoma maintenance.

Effect of growth hormone and parenteral nutrition on the catabolic phase following major digestive surgery]

The purpose of the present study was to determine if the administration of a biosynthetic human growth hormone (bGH) was able to enhance the efficacy of total parenteral nutrition (PN). Patients (n = 38) who had undergone major gastrointestinal surgery were randomly divided in two groups. Group I (n = 20) treated only with PN and Group II (n = 18) treated as in Group I plus bGH (4 UI/daily). Our study shows that the administration of bGH produces a significant increase in serum levels of growth hormone and Somatomedin-C. It also caused a positive nitrogen balance from the first 24 hours on (p less than 0.01). In Group II on day 12 after operation a statistically significant increase in transferrin (p less than 0.05), albumin (p less than 0.01) and total proteins (p less than 0.02) was observed. Our study suggest that the administration of bGH produces, perhaps through Somatomedin-C as mediator, an increase in protein synthesis.     

Timing, etiology, and location of first infection in first year after heart transplantation

Background

Infections are the leading cause of death in the first year after heart transplantation (HTx) after the postoperative period.

Objective

To describe the timing, etiology, and location of the first infection occurring in the first year after HTx.

Patients and Methods

The study included 604 HTx procedures performed at our center from November 1987 to September 2009. Infections were classified as those requiring hospital admission or that prolonged hospital stay. Infection was established on the basis of clinical findings and supplementary test results. Etiologic diagnosis was established at microbiological culture. Infections were categorized as bacterial, viral, fungal, protozoal, or of unknown origin, and were grouped according to microorganism family. Time to occurrence of infection is given as mean (interquartile range). Locations considered were systemic, pulmonary, genitourinary, cutaneous, oropharyngeal, mediastinal, sternal, gastrointestinal, and other.

Results

Mean (SD) patient age was 51 (12) years, and 83.8% of patients were men. Almost half of all patients (42.9%) experienced some type of infection in the first year after HTx. The most frequently occurring infections were bacterial (49.6%) and viral (38.7%), with fewer fungal (6.3%), protozoal (1.2%), and of unknown origin (4.3%). Staphylococci were the most commonly isolated organisms (10.5%) in bacterial infections, cytomegalovirus (21.1%) in viral infections, and Candida (2.3%) and Aspergillus (2.3%) in fungal infections. Early-onset infections (n = 2; 1-7 days) were caused by Candida spp, and late-onset infections (n = 110; 14-182 days) by a mixed group of bacteria. The sternum was the site of early-onset infections (n = 9; 6-14 days), and the genitourinary tract was the site of late-onset infections (n = 110; 28-180 days).

Conclusions

Nearly half of HTx recipients experience a significant infection during the first year posttransplantation. Early-onset infections occur in critical care units, are caused by nosocomial organisms, and involve the sternum or mediastinum, whereas late- onset infections have a more varied etiology and preferentially affect the skin and genitourinary tract.