Five years of sleep apnea treatment with a mandibular advancement device. Side effects and technical complications

Objective: To determine the variation in prevalence of temporomandibular disorders (TMD), other side effects, and technical complications during 5 years of sleep apnea treatment with a mandibular advancement device. Materials and Methods: Forty patients diagnosed with obstructive sleep apnea received an adjustable appliance at 70% of the maximum protrusion. The protrusion was then progressively increased. TMD (diagnosed according to the Research Diagnostic Criteria for TMD), overjet, overbite, occlusal contacts, subjective side effects, and technical complications were recorded before and a mean of 14, 21, and 58 months after treatment and analyzed by the Wilcoxon test (P Less-than .05). Results: Fifteen patients still used the oral appliance at the 5-year follow-up, and no significant variation in TMD prevalence was observed. Subjective side effects were common, and a significant reduction was found in overjet, overbite, and in the number of occlusal contacts. Furthermore, the patients made a mean of 2.5 unscheduled dental visits per year and a mean of 0.8 appliance repairs/relines per year by a dental technician. The most frequent unscheduled visits were needed during the first year and were a result of acrylic breakage on the lateral telescopic attachment, poor retention, and other adjustments to improve comfort. Conclusions: Five-year oral appliance treatment does not affect TMD prevalence but is associated with permanent occlusal changes in most sleep apnea patients during the first 2 years. Patients seek several unscheduled visits, mainly because of technical complications.

Dead-End Jobs or Career Opportunities? Advancement opportunities in call centers

Employment in call centers has grown significantly throughout the world over the past 15 years. In debates about the quality of these new jobs, there are few studies that specifically address promotion opportunities. Using a survey of over 2400 call centers in 16 countries, this paper documents levels and analyzes factors shaping promotions in call centers, and discusses implications for promotions in the service sector generally. On average, less than 10% of call center agents are promoted in any year--5.7% promoted internally to the call center, and 4% promoted elsewhere in the business. Firms that have more complex labor processes and require agents to have higher levels of firm-specific knowledge tend to also have greater promotion opportunities, which might be expected. There are also unexpected findings, including that increased autonomy in the workplace often provides a ‘substitute' to advancement opportunities, and that unionization is associated with fewer advancement opportunities within call centers, though more advancement opportunities to other parts of the business. Key words: promotions, service industries, call centers.

Comparación en el tratamiento de las fracturas de ángulo mandibular mediante osteosíntesis con una miniplaca versus dos miniplacas

En el present treball hem realitzat un estudi retrospectiu de les fractures d´angle mandibular aïllades tractades mitjançant osteosíntesis amb miniplaques en el Servei de Cirurgia Oral i Màxil•lofacial durant els últims 10 anys. L’objectiu de l’estudi és comparar els resultats funcionals obtinguts i les complicacions sorgides entre els pacients tractats amb una miniplaca i aquells tractats amb dues miniplaques , amb la finalitat de determinar si existeixen diferències en quant al resultat amb alguna de les tècniques.

Gestor de incidencias: Domestic Appliance

Proyecto realizado para la empresa de reparación de aparatos eléctricos Domestic Appliance con el que se se pretende facilitar y mejorar el proceso de gestión de todas las reparaciones que se realizan mediante una aplicación web. A nivel de Pyme, se trata de un sistema básico de CRM (Customer Relationship Management) y de un gestor de incidencias con el que los empleados de la empresa Domestic Appliance podrán mantener un mejor seguimiento de todos los casos abiertos, ver estadísticas y obtener información de todos los clientes. El sistema se completa con la gestión de un correo interno dónde los usuarios se podrán enviar información confidencial entre ellos, actuando como un correo interno.

Teambox Software Appliance

El proyecto consiste en el desarrollo de una distribución Live, que contiene el software colaborativo Teambox. Esta distribución puede ser instalada en un equipo físico y ser puesta en produccion.

Canino mandibular incluido: presentación de un caso atípico de abordaje quirúrgico por vía lingual

Se presenta el caso de un paciente varón que tenía el canino temporal inferior derecho no exfoliado a los 15 años de edad; a la exploración se descubrió que existía el canino permanente totalmente incluído, con la particularidad de que estaba asociado a un quiste folicular y que la posible causa de inclusión era la presencia de un premolar supernumerario también retenido; otra rareza a destacar es que se hizo un abordaje quirúrgico mixto, vestibular para el premolar supernumerario y lingual para el canino permanente siendo esta última eventualidad realmente excepcional. Se discuten los aspectos referentes al diagnóstico y a la estrategia quirúrgica adoptadas en este caso poco habitual.

Computer-aided system for morphometric mandibular index computation (Using dental panoramic radiographs)

Objective: We propose and validate a computer aided system to measure three different mandibular indexes: cortical width, panoramic mandibular index and, mandibular alveolar bone resorption index. Study Design: Repeatability and reproducibility of the measurements are analyzed and compared to the manual estimation of the same indexes. Results: The proposed computerized system exhibits superior repeatability and reproducibility rates compared to standard manual methods. Moreover, the time required to perform the measurements using the proposed method is negligible compared to perform the measurements manually. Conclusions: We have proposed a very user friendly computerized method to measure three different morphometric mandibular indexes. From the results we can conclude that the system provides a practical manner to perform these measurements. It does not require an expert examiner and does not take more than 16 seconds per analysis. Thus, it may be suitable to diagnose osteoporosis using dental panoramic radiographs.

Computer-aided system for morphometric mandibular index computation (Using dental panoramic radiographs)

Objective: We propose and validate a computer aided system to measure three different mandibular indexes: cortical width, panoramic mandibular index and, mandibular alveolar bone resorption index. Study Design: Repeatability and reproducibility of the measurements are analyzed and compared to the manual estimation of the same indexes. Results: The proposed computerized system exhibits superior repeatability and reproducibility rates compared to standard manual methods. Moreover, the time required to perform the measurements using the proposed method is negligible compared to perform the measurements manually. Conclusions: We have proposed a very user friendly computerized method to measure three different morphometric mandibular indexes. From the results we can conclude that the system provides a practical manner to perform these measurements. It does not require an expert examiner and does not take more than 16 seconds per analysis. Thus, it may be suitable to diagnose osteoporosis using dental panoramic radiographs

Sharp mandibular bone irregularities after lower third molar extraction: Incidence, clinical features and risk factors

Objectives: The purpose of this study was to determine the incidence and clinical symptoms associated with sharp mandibular bone irregularities (SMBI) after lower third molar extraction and to identify possible risk factors for this complication. Study Design: A mixed study design was used. A retrospective cohort study of 1432 lower third molar extractions was done to determine the incidence of SMBI and a retrospective case-control study was done to determine potential demographic and etiologic factors by comparing those patients with postoperative SMBI with controls. Results: Twelve SMBI were found (0.84%). Age was the most important risk factor for this complication. The operated side and the presence of an associated radiolucent image were also significantly related to the development of mandibular bone irregularities. The depth of impaction of the tooth might also be an important factor since erupted or nearly erupted third molars were more frequent in the SMBI group. Conclusions: SMBI are a rare postoperative complication after lower third molar removal. Older patients having left side lower third molars removed are more likely to develop this problem. The treatment should be the removal of the irregularity when the patient is symptomatic

How to improve the formal analytic reasoning and scientific motivation in the intellectual training of medical students

A review article of the The New England Journal of Medicine refers that almost a century ago, Abraham Flexner, a research scholar at the Carnegie Foundation for the Advancement of Teaching, undertook an assessment of medical education in 155 medical schools in operation in the United States and Canada. Flexner’s report emphasized the nonscientific approach of American medical schools to preparation for the profession, which contrasted with the university-based system of medical education in Germany. At the core of Flexner’s view was the notion that formal analytic reasoning, the kind of thinking integral to the natural sciences, should hold pride of place in the intellectual training of physicians. This idea was pioneered at Harvard University, the University of Michigan, and the University of Pennsylvania in the 1880s, but was most fully expressed in the educational program at Johns Hopkins University, which Flexner regarded as the ideal for medical education. (...)

Correlación entre los hallazgos anatomopatológicos y los hallazgos clínicos y de laboratorio en pacientes con arteritis de células gigantes

L’arteritis de cèl•lules gegantes (ACG) és una emergència mèdica i una causa comú de ceguesa en la nostra població major, la qual cosa converteix al oftalmòleg en el responsable del diagnòstic precoç i tractament oportú. Realitzem un estudi retrospectiu de 82 pacients amb sospita clínica de ACG, i es va observar la relació entre les troballes de la biòpsia d'artèria temporal (BAT) amb les troballes clíniques i de laboratori. Trobem que la BAT és poc sensible (50%) i altament específica (100%). 20 (40%) pacients van presentar compromís ocular. El símptoma clínic i el paràmetre de laboratori que es va relacionar amb BAT positiva van ser la claudicació mandibular (P=0,003) i la VSG (P= 0,006) respectivament.

Sarcomas mandibulares: experiencia quirúrgica en los últimos diez años (2001-2010)

Els sarcomes de cap i coll són tumors relativament estranys, representant un 2% de tots els tumors de cap i coll i un 4-10% del total dels sarcomes. Per tant els localitzats a la mandíbula representen un percentatge encara menor, no recollits específicament en cap estudi. La histopatologia heterogènia i les diverses localitzacions fan d'ells una entitat difícil d'estudiar. En aquest treball de recerca es pretén descriure l'etiologia i comportament dels sarcomes de cap i coll i recolzar els resultat de la literatura que promulguen la cirurgia com arma terapèutica principal, basant-nos en l'experiència del servei de Cirurgia Oral i Maxil·lofacial de l'Hosptial Vall d'Hebron en els últims 10 anys en el maneig del sarcoma mandibular.

Servidor d'escriptoris remots

El projecte que s'ha dut a terme és un estudi introductori del funcionament de la tecnologia NX fent ús d'una eina lliure com és FreeNX. Aquesta tecnologia està destinada a millorar el rendiment dels processos de comunicació que s'estableixen quan volem accedir a un escriptori remot. El resultat d'aquest estudi s'ha plasmat en un appliance que integra el servidor esmentat juntament amb una aplicació que s'ha desenvolupat per a la gestió d'escriptoris remots utilitzant el servidor FreeNX i els corresponents clients NX. L'appliance s'ha generat amb la distribució de Linux OpenSUSE 12.1 fent ús de l'eina SUSE Studio i s'ha optimitzat per a que faci funcionar l'aplicatiu web desenvolupat en mode kiosk tant bon punt aquest es posa en funcionament conjuntament amb el servidor d'escriptoris remots FreeNX.

Treball Final de Master - Servidor de Comunicacions Unificades

L'objectiu d'aquest projecte és la creació d'una prova de concepte de comunicacions unificades utilitzant productes de programari lliure existents. Aquesta prova de concepte servirà per poder fer demostracions del funcionament general del programari implicat amb el mínim de preparacions, instal·lacions i configuracions prèvies possibles. El projecte es dividirà en dos appliances o LiveCD, creats a traves de Suse Studio, anomenats Comunicacions Unificades i Comunicacions Unificades 2.Els productes de programari lliure que composen el Servidor de Comunicacions Unificades els podem classificar en productes principals, plugins o addons dels productes i productes secundaris.Com a productes principals tenim els següents servidors que cobreixen les necessitats principals del Servidor de Comunicacions Unificades:Asterisk v1.8.3 : Servidor de telefonia amb veu sobre IP (VoIP).FreePBX v2.9.0beta2 : GUI de control i administració d'Asterisk.Openfire v3.7.0 : Servidor de IM basat en el protocol XMPP.BigBlueButton v0.71a : Sistema de conferència web. Pendent finalitzar-ne l'implementació.I els seguents productes principals que cobreixen les necessitats del servidor de Comunicacions Unificades 2:Zimbra v7.0.1 : Servidor de correu electrònic i de calendari. Pendent resoldre conflicte inicialització LDAP.Funambol v9.0.0 : Sincronització Zimbra amb mòbils.Com a plugins o addons del productes tenim, classificats segons el producte:Asterisk addons: chan_jingle i chan_gtalkZimlets: Asterisk, Google Translator, Funambol i SocialsOpenfire pugins: Asterisk, Facebook i GmailCom a productes secundaris tenim els clients necessaris per poder utilitzar l'appliance:Firefox: Navegador web que servirà com a interfície d'usuari per les diferents eines d'administració i la demostració.Pigdin o Spark: Clients de missatgeria instantània, per l'appliance Comunicacions Unificades.A més d'instal·lar aquests productes, s'implementa una interfície web, mitjançant Drupal, en format HTML per enllaçar les diferents eines d'administració dels productes, per a cadascun dels dos appliances i es realitzara un Kiosk appliance per a familiaritzar-se amb l'entorn SuseStudio.

A semantic model of selective dissemination of information for digital libraries

In this paper we present the theoretical and methodologicalfoundations for the development of a multi-agentSelective Dissemination of Information (SDI) servicemodel that applies Semantic Web technologies for specializeddigital libraries. These technologies make possibleachieving more efficient information management,improving agent–user communication processes, andfacilitating accurate access to relevant resources. Othertools used are fuzzy linguistic modelling techniques(which make possible easing the interaction betweenusers and system) and natural language processing(NLP) techniques for semiautomatic thesaurus generation.Also, RSS feeds are used as “current awareness bulletins”to generate personalized bibliographic alerts.