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Aportes y modificaciones de técnicas quirúrgicas en cirugía craneofacial pediátrica
Vila Morales,Dadonim; Leyva Mastrapa,Tania; Alonso Fernández,Luis;
Revista Cubana de Estomatolog?-a , 2010,
Abstract: most of he craniofacial deformities are caused by development and growth alterations, traumata and neoplasms. to describe the integral surgical treatment of above deformities and the modifications and contributions carried out to traditional craniofacial techniques, a cross-sectional and descriptive study was conducted in 46 patients seen by the craniofacial surgery multidisciplinary staff from "juán manuel máquez" university children hospital from may, 2003 to march, 2007. mean age of the patients operated on was of 6.3 years. twenty surgical tehniques were performed where the more used was he coronal suturectomy with a mask hemi-advance and frontal cranioplasty for the 15.2 %, followed by the coronal suturectomy with the two above techniques for te 10.9 %. the 8.9 % of patients need lefort iii osteotomy for distraction of half-third. the contributions included: radiate plication of dura mater with the bipolar type in the 75.0 % of craniotomy patients, punctiform incision of dura mater to decompress a transoperative encephalic hypertension or to retract the encephalon for osteotomies on skull base in the 64.3 % of craniotomy patients, greenstick fracture at level of pterion in the mask flap for the marshal's techniques used in the 83.3 % of the brachycephalous or plagiocephaly with advance only of inolved side in the 100 % of plagiocephalies with a modification of marshall's technique among others, for a total o 9 modifications to surgical procedures. there weren't complications associated with these procedures and more than two years of posoperative course.
Aportes y modificaciones de técnicas quirúrgicas en cirugía craneofacial pediátrica Contributions and modifications of surgical techniques in pediatric craniofacial surgery
Dadonim Vila Morales,Tania Leyva Mastrapa,Luis Alonso Fernández
Revista Cubana de Estomatolog?-a , 2010,
Abstract: Las deformidades craneofaciales se deben en su mayoría a alteraciones del crecimiento y desarrollo, traumatismos y neoplasias. Con el objetivo de describir el tratamiento quirúrgico integral de estas y las modificaciones y aportes realizados a las técnicas craneofaciales tradicionales, se realizó un estudio descriptivo transversal en 46 pacientes tratados por el equipo interdisciplinario de cirugía craneofacial del Hospital Pediátrico Universitario "Juan M. Márquez", en el período comprendido entre mayo de 2003 a marzo de 2007. La edad promedio de los pacientes intervenidos fue de 6,3 a os. Se realizó una veintena de técnicas quirúrgicas. La más utilizada fue la suturectomía coronal con hemiavance en antifaz y craneoplastia frontal, para el 15,2 %; seguida de la suturectomía coronal con avance en antifaz y craneoplastia frontal, para el 10,9 %. El 8,9 % de los pacientes necesitó osteotomía Le Fort III para distracción del tercio medio. Los aportes introducidos fueron: la plicatura radiada de la duramadre con bipolar en el 75,0 % de los craneotomizados, incisión puntiforme de la duramadre para descomprimir hipertensión encefálica transoperatoria o retraer encéfalo para osteotomías de base de cráneo en el 64,3 % de los craneotomizados; fractura en tallo verde a nivel del pterium, en el colgajo en antifaz para las técnicas de Marshall, usada en el 83,3 % de los braquicéfalos o plagiocéfalos; el avance sólo del lado afectado en el 100 % de las plagiocefalias, con modificación de la técnica de Marshall, entre otras, para un total de 9 modificaciones a los procederes quirúrgicos. Hubo ausencia de complicaciones asociadas a éstas, con más de 2 a os de evolución posoperatoria. Most of he craniofacial deformities are caused by development and growth alterations, traumata and neoplasms. To describe the integral surgical treatment of above deformities and the modifications and contributions carried out to traditional craniofacial techniques, a cross-sectional and descriptive study was conducted in 46 patients seen by the craniofacial surgery multidisciplinary staff from "Juán Manuel Máquez" University Children Hospital from May, 2003 to March, 2007. Mean age of the patients operated on was of 6.3 years. Twenty Surgical tehniques were performed where the more used was he coronal suturectomy with a mask hemi-advance and frontal cranioplasty for the 15.2 %, followed by the coronal suturectomy with the two above techniques for te 10.9 %. The 8.9 % of patients need LeFort III osteotomy for distraction of half-third. The contributions included: radiate plication of dura
Equipo cubano interdisciplinario de cirugía craneofacial en pediatría: Resultados de un quinquenio Interdisciplinary Cuban staff of craniofacial surgery in Pediatrics: Results from a five-year period
Dadonim Vila Morales,Tania Leyva Mastrapa,Luis Alonso Fernández,Ernesto Sánchez Cabrales
Revista Cubana de Estomatolog?-a , 2010,
Abstract: Las deformidades craneofaciales se deben en su mayoría a alteraciones del crecimiento y desarrollo, traumatismos y neoplasias. Con el objetivo de describir el tratamiento quirúrgico integral de estas, se realizó un estudio descriptivo transversal en 46 pacientes tratados por el Equipo Intertidisciplinario de Cirugía Craneofacial del Hospital Pediátrico Universitario "Juan M. Márquez" en el periodo comprendido entre mayo de 2003 a marzo de 2007. La deformidad más frecuente fue la craneosinostosis (57 %), específicamente la plagiocefalia (17 %). La mayoría de los pacientes fueron de piel blanca (70 %) y se intervinieron entre el 1ro.y 7mo.a os de vida (57 %), con una media de 6,3 a os. En general no hubo predilección por sexo. Se emplearon 18 diferentes técnicas quirúrgicas. Se presentaron cinco complicaciones durante el posoperatorio (11 %), una defunción (2,2 %), una oftalmoplejía (2,2 %), dos salidas de líquido cefalorraquídeo (4,4 %) y una desaturación por depresión del centro respiratorio (2,2 %). Excepto la oftalmoplejía hubo resolución de las complicaciones en un intervalo de 15 días. Los resultados reportados por este equipo, único de su tipo en el país, son relevantes al compararlos con la literatura internacional. Most of the craniofacial deformities are due to alterations of growth, development, traumata and neoplasms. To describe the integral surgical treatment of above deformities, a cross-sectional and descriptive study was conducted in 46 patients treated by the interdisciplinary staff of craniofacial surgery from the "Juan Manuel Márquez" University Children Hospital from May, 2003 to March, 2007. The more frequent deformity was the craniosynostosis (57 %), specifically the plagiocephaly (17 %). Most of patients were of white race (70 %) and were operated don between the first and the seventh year of life (57 %) for a mean of 6,3 years. Generally there wasn't sex predominance. A total of 18 different surgical techniques were used. There were 5 complications during the postoperative period (11 %), a decease (2.2 %), a ophthalmoplegia (2.2 %), two cerebrospinal fluid leakage (4.4 %) and a desaturation by depression of respiratory center (2.2 %). With the exception of ophthalmoplegia there was a resolution of complications in a 15 days interval. Results reported by this unique Cuban staff are outstanding compared with international literature.
Equipo cubano interdisciplinario de cirugía craneofacial en pediatría: Resultados de un quinquenio
Vila Morales,Dadonim; Leyva Mastrapa,Tania; Alonso Fernández,Luis; Sánchez Cabrales,Ernesto; Lazo Montero,Juan Carlos;
Revista Cubana de Estomatolog?-a , 2010,
Abstract: most of the craniofacial deformities are due to alterations of growth, development, traumata and neoplasms. to describe the integral surgical treatment of above deformities, a cross-sectional and descriptive study was conducted in 46 patients treated by the interdisciplinary staff of craniofacial surgery from the "juan manuel márquez" university children hospital from may, 2003 to march, 2007. the more frequent deformity was the craniosynostosis (57 %), specifically the plagiocephaly (17 %). most of patients were of white race (70 %) and were operated don between the first and the seventh year of life (57 %) for a mean of 6,3 years. generally there wasn't sex predominance. a total of 18 different surgical techniques were used. there were 5 complications during the postoperative period (11 %), a decease (2.2 %), a ophthalmoplegia (2.2 %), two cerebrospinal fluid leakage (4.4 %) and a desaturation by depression of respiratory center (2.2 %). with the exception of ophthalmoplegia there was a resolution of complications in a 15 days interval. results reported by this unique cuban staff are outstanding compared with international literature.
Neuroendoscopia pediátrica: análisis preliminar de los primeros 32 casos
Alonso Fernández,Luis; Leyva Mastrapa,Tania; de Jongh Cobo,Enrique;
Revista Cubana de Cirug?-a , 2008,
Abstract: introduction. the endoscopic techniques have been used more frequently in the last years, which is associated with the development of new lens and cameras. in neurosurgery, they are used for the treatment of non-communicating hydrocephaly, biopsy of the intraventricular tumors and the fenestration of intracranial cysts, among other multiple indications. methods. this procedure was carried out in "juan manuel márquez" pediatric teaching hospital from august 2003 to august 2005. the patients were 32 children between 6 days and 15 years old. the basic surgical technique was applied through a hole made by frontal trephination that allowed the access to the ventricular system and the performance of the procedure depending on the diagnosis. the patients were followed up and evaluated by computerized axial tomography at 3, 6 and 12 postoperative months. results. the patients treated mainly suffered from hydrocephaly and intracranial tumors and cysts. the age group 10-15 (13 children, 40 %) predominated. 8 patients were under 1, accounting for 28 % of the total. the most common aetiology was the non-communicating hydrocephaly, which in 15 patients was secondary to an aqueductal stenosis. the most frequent endoscopic procedure was the premammillary ventriculostomy of the third ventricle. it was possible to carry out the communication procedure and the patients's symptoms decreased. the postoperative evolution was successful in 27 patients (84 %) and only 5 patients (16 %) did not resolve. the method did not produce severe complications. conclusions. the neuroendoscopy proved to be an alternative to the derivations in certain patients, specially in children with non-communicating hydrocephaly. it allowed a significant reduction of the expenses in derivative systems and diminished the range of complications, with which the length of hospital stay was considerably shorter
Infección de la derivación ventrículo-peritoneal en recién nacidos con hidrocefalia Infection of ventriculoperitoneal shunt in newborns with hydrocephaly
Manuel Díaz álvarez,Marisol del Rosario Vivas González,Maria Isabel Arango Arias,Tania Leyva Mastrapa
Revista Cubana de Pediatr?-a , 2008,
Abstract: INTRODUCCIóN. En los pacientes hidrocefálicos, la infección es una de las complicaciones más frecuentes de la derivación, y tiene elevada morbilidad y mortalidad. El objetivo de este trabajo fue identificar las características clínico-epidemiológicas de la infección de la derivación ventrículo-peritoneal en neonatos hidrocefálicos. MéTODOS. Se determinaron indicadores de morbilidad y mortalidad, y se identificaron otras características de la infección de la derivación ventrículo-peritoneal en 74 neonatos hidrocefálicos, hospitalizados en el Servicio de Neonatología del Hospital Pediátrico Universitario Juan Manuel Márquez (1992 a 2005). RESULTADOS. Hubo 27/74 neonatos hidrocefálicos operados, con sistemas derivativos infectados (tasa del 36,5 %). En el 48,1 % de los casos, la infección fue causada por Staphylococcus aureus; no hubo diferencias significativas en cuanto al sexo, pero sí en cuanto a la estadía (p < 0,01). Hubo 4 fallecidos, 3 de los cuales estaban infectados (mortalidad 5,4 x 100 operados y letalidad 11,1 x 100 infectados). CONCLUSIONES. Alrededor de la tercera parte de los neonatos hidrocefálicos operados sufren infección de la derivación ventrículo-peritoneal que, y principalmente, es causada por Staphylococcus aureus. Es predominante la supervivencia por infección pero es muy grave. INTRODUCTION. In hydrocephalic patients, infection is one of the most frequent shunt complications and it presents an elevated morbidity and mortality. The purpose of this paper was to identify the clinical and epidemiologic characteristics of the infection of the ventriculoperitoneal shunt in hydrocephalic infants. METHODS. The indicators of morbidity and mortality were determined and others characteristics of the infection of the ventriculoperitoneal shunt were also identified in 74 hydrocephalic newborns admitted in the Neonatology Service of "Juán Manuel Márquez" Children University Hospital (1992-2005). RESULTS. There were 27/74 hydrocephalic newborn infants operated on with infected shunts (rate of 36.5 %). In 48.1 % of the cases, the infection was caused by Staphylococcus aureus; there were no significant differences as to sex, but they were remarkable as regards stay (p < 0,01). There were 4 deaths, 3 of them were infected (mortality was 5.4 x 100 operated on patients, and lethality was 11.1 x 100 infected patients). CONCLUSIONS. Approximately a third of the hydrocephalic newborn infants suffered from infection of the ventriculoperitoneal shunt that is mainly caused by Staphylococcus aureus. Survival from infection is predominant, but it is very se
Infección de la derivación ventrículo-peritoneal en recién nacidos con hidrocefalia
Díaz álvarez,Manuel; Vivas González,Marisol del Rosario; Arango Arias,Maria Isabel; Leyva Mastrapa,Tania; Alonso Fernández,Luis;
Revista Cubana de Pediatr?-a , 2008,
Abstract: introduction. in hydrocephalic patients, infection is one of the most frequent shunt complications and it presents an elevated morbidity and mortality. the purpose of this paper was to identify the clinical and epidemiologic characteristics of the infection of the ventriculoperitoneal shunt in hydrocephalic infants. methods. the indicators of morbidity and mortality were determined and others characteristics of the infection of the ventriculoperitoneal shunt were also identified in 74 hydrocephalic newborns admitted in the neonatology service of "juán manuel márquez" children university hospital (1992-2005). results. there were 27/74 hydrocephalic newborn infants operated on with infected shunts (rate of 36.5 %). in 48.1 % of the cases, the infection was caused by staphylococcus aureus; there were no significant differences as to sex, but they were remarkable as regards stay (p < 0,01). there were 4 deaths, 3 of them were infected (mortality was 5.4 x 100 operated on patients, and lethality was 11.1 x 100 infected patients). conclusions. approximately a third of the hydrocephalic newborn infants suffered from infection of the ventriculoperitoneal shunt that is mainly caused by staphylococcus aureus. survival from infection is predominant, but it is very severe.
Presentación de un modelo antropométrico para la evaluación del paciente sometido a distracción osteogénica mandibular
Vila Morales,Dadonim;
Revista Cubana de Estomatolog?-a , 2009,
Abstract: aim: to propose a anthropometric model allows in a homogenous way to assess the course of patients underwent to mandibular osteogenic distraction. methods: a prior study was carried out which allow us to confirm the lack of a international protocol generalizing the study and the evaluation of results achieved with the mandibular osteogenic distraction and also allows to assess the long-term skeletal relapse. measurements elements include the mcnamara and steiner's angular and linear cephalometry studies as well as the simoes panography. a mathematical model was designed with formulae allowing assessing the distraction achieved in branch and body as well as the effectiveness of treatment and long-term stability. authors propose also a valuation of occlusal changes obtained. results: the anthropometry model proposed is a tool to apply the scientific method in the study and the assessment of patients underwent mandibular osteogenic distraction. conclusions: the anthropometry model proposed is a suitable method to assess in a homogenous way the course of patients underwent mandibular osteogenic distraction.
Apuntes para la historia de la estomatología en Camagüey, Cuba
Vila Morales,Dadonim;
Revista Cubana de Estomatolog?-a , 2010,
Abstract: the stomatology history in each region of our country must to be rescue. thus, in the province of camagüey authors carried out present research in the historical period of viv century from may, 1993 to june, 1994, reviewed and compared in 2010. the primary source of information were historical documents of xix century looked up in the provincial library of camagüey including the capitular minutes from the puerto principe town hall, as well as the newspapers la gaceta de puerto principle, la gaceta, el pueblo, el camagüey and history books gathering the study period. in a documentary way it was possible to demonstrate the progress of stomatology during xix century in this province going from empirical multiple works of the barber-phlebotomist-dentist up to appearance of surgeon-dentist profession dentists participation of this province was significant in the guerra de los diez a?os arising a general and a captain of liberating army and together with other patriotic dentist of this province were sent to prison sheded their blood in the battlefields of this province. the training of the first of camagüey was in the dental schools of united states until the teaching as a discipline began in cuba after the guerra de los diez a?os. at the end of xix the basis were created to found the camagüey dental college in 1907.
Las concepciones de curriculum y su importancia en la elaboración de un doctorado curricular en estomatología
Vila Morales,Dadonim;
Revista Cubana de Estomatolog?-a , 2011,
Abstract: the curricular design is an essential stage of teaching-learning process. depending of the theoretical and epistemologic concept on curriculum, will be the structuring of teaching process and of the type of pedagogy to be applied. in cuba, the stomatology faculty has a broad experience of 110 years in the training of human resources; however it is considered that the postgraduate training in this science must to be strengthened. that is aim of present paper was to assess the curricular concepts applicable to doctoral training of postgraduate in stomatology and to propose a critical location regarding the concept of curriculum, creating theoretical bases for the design of a contributing curricular doctorate in this profession. the curriculum conceptual position of present study was totally coincidental with the concept of the improvement of higher education center of university of la habana, since emphasize the structural-formal plane, where the worked out project is specified expressed in documents, regulations, rules of the official curriculum and at the same time the process-practical plane, that is, the curricular carrying out process identified with the postgraduate educational practice.
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