Abstract In the present paper, we refer to a method of primary closure of congenital defects of the anterior abdominal wall with tensionless viscero-abdominal disproportion. The study group included 10 animals subjected to surgery of the abdominal wall defect closure with bovine pericardium graft preserved in 0.5% formaldehyde, and 5 rabbits of the same breed and weight, in which bovine fascia graft was used as implant, being preserved in 0.5% formaldehyde. The abdominal anterior wall defect was made surgically by excision of the musculo-fascial structures and peritoneum. Bovine pericardium graft and bovine fascia graft were placed and fixed posteriorly to rectus abdominals muscles, having direct contact with the intra-abdominal contents and protected by suturing skin and subcutaneous layer. The purpose of the study was to perform a comparative postoperative evaluation of local macroscopic and microscopic changes that develop after reconstruction of the major abdominal wall defects experimentally induced in rabbits, using bovine pericardium and bovine fascia grafts preserved in 0.5% formaldehyde. In cases of major fascial defects of the anterior abdominal wall, bovine pericardium graft has acceptable strength and biocompatibility, having stabilizing properties of the abdominal wall due to the development of the connective tissue layer located between the implant and the subcutaneous layer. Bovine fascia grafts preserved in formaldehyde have an insignificant irritating and inflammatory action on the intestinal loops compared with bovine pericardium, and do not induce the development of a significant abdominal adhesion process, this allowing their use in the abdominal fascial defects closure with placement in direct contact with the abdominal contents.

/pdf/comparative-cellular-local-response-in-abdominal-defect-1f9w2hzxl3.pdf

Comparative Cellular Local Response in Abdominal Defect Plastic Surgery with Bovine Pericardium and Bovine Fascia Preserved in Formaldehyde in Experimental Rabbits

Complex abdominal wall reconstruction after oncologic resection in a sequalae of giant omphalocele: A case report

The growing complexity and increasing scale of biological data have led scientists to develop novel analytical methods in bioinformatics. Machine learning is a predictive model to learn from a particular dataset, analyze it, and make predictions. However, the technology is complex and relatively new, especially in the basic research on oral diseases. This review surveys machine learning in the research on oral diseases. Articles were extracted from PubMed. Results, key concepts, techniques, benefits, and challenges of machine learning in the basic research on oral diseases are summarized. Future trends are predicted for forthcoming research. 

Machine learning in basic scientific research on oral diseases

Las fisuras orofaciales representan un grupo heterogÃ©neo de malformaciones congÃ©nitas que afectan a distintas estructuras de la cavidad oral y de la cara. Globalmente, los bebÃ©s con estos trastornos presentan una mayor morbilidad y mortalidad a lo largo de su vida en comparaciÃ³n con individuos no afectados. Por ello, los avances en la investigaciÃ³n biomÃ©dica resultan ineludibles. AsÃ­, el objetivo general de este trabajo fue llevar a cabo una revisiÃ³n bibliogrÃ¡fica para analizar narrativamente los 10 principales estudios primarios sobre fisuras orofaciales llevados a cabo en EspaÃ±a, publicados del 2018 hasta la actualidad. SegÃºn esto, a nivel institucional, destaca la Universidad Complutense de Madrid (UCM) con cuatro artÃ­culos publicados por el grupo de investigaciÃ³n UCM 920202. TambiÃ©n sobresale la Universidad Rey Juan Carlos de Madrid, con tres artÃ­culos relacionados con diferentes aspectos de la personalidad y la calidad de vida de los pacientes fisurados, asÃ­ como otras muchas variables cognitivo-emocionales. En relaciÃ³n con la Universidad de Valencia, encontramos dos artÃ­culos llevados a cabo en amplias muestras de pacientes con fisuras. Por Ãºltimo, en Barcelona resulta destacable un estudio observacional sobre problemas otorrinolaringolÃ³gicos en pacientes operados de fisura palatina. En conclusiÃ³n, si bien en los Ãºltimos aÃ±os se han publicado varios artÃ­culos sobre distintos aspectos relacionados con las fisuras, aÃºn queda mucho trabajo por hacer. EspaÃ±a deberÃ­a seguir potenciando proyectos con lÃ­neas de trabajo centradas en estas alteraciones del desarrollo craneofacial. Se necesitan estudios amplios, multicÃ©ntricos y colaborativos, para ahondar en los mecanismos etiolÃ³gicos y, en Ãºltima instancia, en las posibles herramientas para su prevenciÃ³n. Del mismo modo, se necesitan ayudas para dilucidar mejor las cuestiones relacionadas con los tratamientos en todas las dimensiones de la salud, preferentemente a partir de ensayos clÃ­nicos controlados aleatorizados, que faciliten la traslaciÃ³n de conocimientos y su accesibilidad universal dentro del sistema sanitario pÃºblico espaÃ±ol. 

/pdf/investigacion-en-fisuras-faciales-quo-vadis-espana-jput9i40.pdf

Investigación en Fisuras Faciales. Quo Vadis España?

Introduction. The problem of treatment of newborns with congenital malformations of the anterior abdominal wallremains relevant due to the increasing number of malformations such as gastroschisis and omphalocele in newborns as wellas high complications and mortality.The aim of this work is to improve the effectiveness of treatment of newborns suffering from gastroschisis andomphalocele by optimizing pre-, intra- and postoperative management of patients.Material and research methods. The results of examination and treatment of 55 newborns with gastroschisis and 22 newbornswith omphalocele were analyzed for the period from 1993 to 2021. Examination algorithm included: antenatal counseling ofpregnant women, postnatal consultation and transportation of the newborn to the institution where the defect correction, clinical,laboratory and instrumental examination, bacteriological examinations, histological examination of surgical material, measurementof intra-abdominal pressure will be performed to determine adequate surgical correction of the malformation.Results and discussion. Studies in infants suffering from gastroschisis and omphalocele and viscero-abdominaldisproportion have shown an increase in the intra-abdominal pressure at all stages of correction, which significantly affectedthe mechanical properties of the lungs and manifested a decrease in lung distension, increased airway resistance andincreased inspiratory pressure. During surgical correction of viscero-abdominal disproportion at all stages of the study, themechanical properties of the newborn's lungs changed (compliance decreased, airway resistance increased), being directlydependent on the level of intra-abdominal pressure, as evidenced by the main groups of patients suffering from omphalocele.The maximum change in the mechanical properties of the lungs was observed at 24-48 hours after correction of visceroabdominal disproportion and coincided with the maximum figures for the increase in intra-abdominal pressure in newborns.Adequate lung ventilation under conditions of maximum increase in intra-abdominal pressure in newborns was achievedby increasing PIP to high numbers (up to 20-22 cm of water column) at 24-48 hours after correction of viscero-abdominaldisproportion with a gradual moderate decrease and retention of PEEP within the limits of 4-5 cm of water column.In the main groups of patients suffering from gastroschisis and omphalocele, normalization of disturbance of themechanical properties of the lungs (compliance and resistance) was faster than in the comparison groups. This was due to thefact that the level of intra-abdominal hypertension was taken into account when choosing the method of surgical correctionand infusion therapy in the mode of normovolemic hemodilution. In the study of peripheral hemodynamics (abdominal bloodflow) it was found that in the comparison groups in patients suffering from gastroschisis and omphalocele, higher indicesof resistance in the superior mesenteric and renal arteries, indicating impaired blood flow in the above vessels. In the main groups of patients suffering from gastroschisis and omphalocele, these indicators were significantly lower, which indicatesa better abdominal blood flow in patients in whom the choice of surgical correction method was taken into account whenchoosing the method of surgical correction.Intra-abdominal hypertension is one of the important reasons for the development of negative consequences when closingthe malformation of the anterior abdominal wall in newborns suffering from gastroschisis and omphalocele. Therefore,one of the main directions of improving the results of treatment of newborns with congenital malformation of the anteriorabdominal wall is the development and introduction of new methods for diagnosis of intraabdominal hypertension in practicalneonatal surgery and taking measures to prevent abdominal compartment syndrome.Depending on the condition of the child and the type of congenital malformation of the anterior abdominal wall, thetreatment tactics foresaw the following three options:1. Primary radical operation.2. Stage-by-stage surgical treatment.3. Conservative treatment followed by surgery.While analyzing the results of the study, it can be noted that a total of 26 newborns died of congenital defects of theanterior abdominal wall after surgery, including 18 children from the comparison group (1993-2004) and 8 from the mainstudy group (2005-2021), which amounted to 52,94% and 18,60% respectively. The main causes of death were neonatalsepsis, profound prematurity and severe comorbidities.Conclusions:1. Taking into account the results of treatment of newborns suffering from gastroschisis and omphalocele, it can bestated that the reduction of mortality in newborns by 3 times is primarily due to the introduction of neonatal surgery innew approaches to diagnosis, pre- and postoperative management, anesthesia and individualized surgical correction of thispathology.2. Intra-abdominal hypertension in case of congenital malformations of the anterior abdominal wall leads to a significantdeterioration of the mechanical properties of the lungs, hemodynamic disorders, oliguria, intestinal ischemia, decreasedorgan perfusion.3. Increased intra-abdominal hypertension was an indication for a change in surgical tactics - the abandonment of radicalplastic surgery of the abdominal wall and the transition to staged intervention or the use of surgical techniques that increasethe volume of the abdominal cavity.

/pdf/congenital-defects-of-anterior-abdominal-wall-in-newborns-2xhco9yr.pdf

Congenital defects of anterior abdominal wall in newborns: traditions and new tendencies

Abstract Growth alterations have been described in patients operated on for oral clefts. The purpose of this work was to analyze the craniofacial and palate morphology and dimensions of young adults operated on for oral clefts in early childhood in Spain. Eighty-three patients from eight different hospitals were divided into four groups based on their type of cleft: cleft lip (CL, n = 6), unilateral cleft lip and palate (UCLP, n = 37), bilateral cleft lip and palate (BCLP, n = 16), and cleft palate only (CPO, n = 24). A control group was formed of 71 individuals. Three-dimensional (3D) digital models were obtained from all groups with an intraoral scanner, together with cephalometries and frontal, lateral, and submental facial photographs. Measurements were obtained and analyzed statistically. Our results showed craniofacial alterations in the BCLP, UCLP, and CPO groups with an influence on the palate, maxilla, and mandible and a direct impact on facial appearance. This effect was more severe in the BCLP group. Measurements in the CL group were similar to those in the control group. Cleft characteristics and cleft type seem to be the main determining factors of long-term craniofacial growth alterations in these patients. Prospective research is needed to clearly delineate the effects of different treatments on the craniofacial appearance of adult cleft patients. 

https://www.nature.com/articles/s41598-022-23584-0.pdf

Craniofacial and three-dimensional palatal analysis in cleft lip and palate patients treated in Spain

BACKGROUND The survival rate of newborns with severe congenital abdominal wall defects has increased. After successfully addressing life-threatening complications, it is necessary to focus on the cosmetic and functional outcomes of the abdominal wall. METHODS We performed a chart review of five cases treated in our institution. RESULTS Five patients, ranging from seven to 18 years of age, underwent the following surgical approaches: simple approximation of the rectus abdominis fascia, the rectus abdominis sheath turnover flap, the placement of submuscular tissue expanders, mesh repair, or a combination of these techniques depending on the characteristics of each individual case. CONCLUSIONS Patients with severe congenital abdominal wall defects require individualized surgical treatment to address both the aesthetic and functional issues related to the sequelae of their defects.

/pdf/management-of-the-sequelae-of-severe-congenital-abdominal-ieoy8ubji0.pdf

Management of the Sequelae of Severe Congenital Abdominal Wall Defects.

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Craniofacial and three-dimensional palatal analysis in cleft lip and palate patients treated in Spain

Management of the Sequelae of Severe Congenital Abdominal Wall Defects.