Osteological alterations in the tucuxi Sotalia fluviatilis (cetacea, delphinidae)

We present a description of osteological alterations observed in the tucuxi, Sotalia fluviatilis (Gervais, 1853) from a sample of 43 specimens. Fractures were the most frequent alterations in the sample (16%), occurring in various regions of the skeleton such as the ribs, hyoid apparatus, transverse and neural processes of vertebrae and scapula. We observed three individuals with ankylosis between the cervical vertebrae and two individuals with morphological changes (cranio-caudally elongated hemal arch and flattened cranial margin of the scapula). The only observed pathology was a case of osteomyelitis in the left dentary, which caused the loss of teeth, deformation of the associated alveoli and the formation of a medial fistula (lingual) for drainage of purulent material. This represents the first record of osteomyelitis in S. fluviatilis.

Relación entre la satisfacción versus dolor en la ligamentoplastia del LCA de forma ambulatoria

INTRODUCCIÓ 32 casos de ligamentoplàstia LEA amb plàstia d’isquiotibials autòloga de forma ambulatòria. Es presenta de forma prospectiva els nostres resultats en quan a la correlació dolor-satisfacció. MATERIAL I MÉTODES Es va procedir a anestèsia intradural amb reforç catèter epidural mantingut 24-48h i bloqueig nervi perifèric crural amb catèter perineural estimulable. Reparació via artroscòpica. RESULTATS Per la valoració dels resultats, mantenim contacte telefònic amb el pacient a les 24h i 48h i a consulta al 7º dia. Cap cas de reingrès. DISCUSIÓ i CONCLUSIONS El procedimient de forma ambulatòria amb un correcte procés de selecció, té un lloc important. Es important la detecció precoç del dolor. El pic de dolor màxim se sitúa entre la 1a nit – 2n dia de la cirurgia. Satisfacció a la setmana de 8 punts sobre 10.

Reconstrucción del ligamento cruzado anterior desde el portal anteromedial; evaluación de la fijación femoral en un modelo cadavérico

Objectiu. Valorar el risc de lesió de les estructures posterolaterals del genoll realitzant una reconstrucció del Lligament Encreuat Anterior (LEA) mitjançant plàstia d’isquiotibials i fixació femoral am sistema Cross-Pin. Material. 10 genolls cadavèrics frescs. Reconstrucció artroscòpica del LEA mitjançant túnel anatòmic des del portal anteromedial. Dissecció anatòmica del genoll mesurant distàncies del Cross-Pin al Lligament Col•lateral Lateral (LCL), tendó popliti, nervi peroneo i tendó gastroecnemi lateral. Resultats. LCL i gastroecnemi tenen un alt risc de ser lesionats mitjançant aquest sistema Conclusió. El sistema de fixació Cross-Pin, com l’hem utilitzat, té un alt risc de lesionar les estructures laterals del genoll.

Demyelination in mild cognitive impairment suggests progression path to Alzheimer's disease.

The preclinical Alzheimer's disease (AD) - amnestic mild cognitive impairment (MCI) - is manifested by phenotypes classified into exclusively memory (single-domain) MCI (sMCI) and multiple-domain MCI (mMCI). We suggest that typical MCI-to-AD progression occurs through the sMCI-to-mMCI sequence as a result of the extension of initial pathological processes. To support this hypothesis, we assess myelin content with a Magnetization Transfer Ratio (MTR) in 21 sMCI and 21 mMCI patients and in 42 age-, sex-, and education-matched controls. A conjunction analysis revealed MTR reduction shared by sMCI and mMCI groups in the medial temporal lobe and posterior structures including white matter (WM: splenium, posterior corona radiata) and gray matter (GM: hippocampus; parahippocampal and lingual gyri). A disjunction analysis showed the spread of demyelination to prefrontal WM and insula GM in executive mMCI. Our findings suggest that demyelination starts in the structures affected by neurofibrillary pathology; its presence correlates with the clinical picture and indicates the method of MCI-to-AD progression. In vivo staging of preclinical AD can be developed in terms of WM/GM demyelination.

New insights into pathophysiology of vestibular migraine.

Vestibular migraine (VM) is a common disorder in which genetic, epigenetic, and environmental factors probably contribute to its development. The pathophysiology of VM is unknown; nevertheless in the last few years, several studies are contributing to understand the neurophysiological pathways involved in VM. The current hypotheses are mostly based on the knowledge of migraine itself. The evidence of trigeminal innervation of the labyrinth vessels and the localization of vasoactive neuropeptides in the perivascular afferent terminals of these trigeminal fibers support the involvement of the trigemino-vascular system. The neurogenic inflammation triggered by activation of the trigeminal-vestibulocochlear reflex, with the subsequent inner ear plasma protein extravasation and the release of inflammatory mediators, can contribute to a sustained activation and sensitization of the trigeminal primary afferent neurons explaining VM symptoms. The reciprocal connections between brainstem vestibular nuclei and the structures that modulate trigeminal nociceptive inputs (rostral ventromedial medulla, ventrolateral periaqueductal gray, locus coeruleus, and nucleus raphe magnus) are critical to understand the pathophysiology of VM. Although cortical spreading depression can affect cortical areas involved in processing vestibular information, functional neuroimaging techniques suggest a dysmodulation in the multimodal sensory integration and processing of vestibular and nociceptive information, resulting from a vestibulo-thalamo-cortical dysfunction, as the pathogenic mechanism underlying VM. The elevated prevalence of VM suggests that multiple functional variants may confer a genetic susceptibility leading to a dysregulation of excitatory-inhibitory balance in brain structures involved in the processing of sensory information, vestibular inputs, and pain. The interactions among several functional and structural neural networks could explain the pathogenic mechanisms of VM.

Visual activity predicts auditory recovery from deafness after adult cochlear implantation.

Modern cochlear implantation technologies allow deaf patients to understand auditory speech; however, the implants deliver only a coarse auditory input and patients must use long-term adaptive processes to achieve coherent percepts. In adults with post-lingual deafness, the high progress of speech recovery is observed during the first year after cochlear implantation, but there is a large range of variability in the level of cochlear implant outcomes and the temporal evolution of recovery. It has been proposed that when profoundly deaf subjects receive a cochlear implant, the visual cross-modal reorganization of the brain is deleterious for auditory speech recovery. We tested this hypothesis in post-lingually deaf adults by analysing whether brain activity shortly after implantation correlated with the level of auditory recovery 6 months later. Based on brain activity induced by a speech-processing task, we found strong positive correlations in areas outside the auditory cortex. The highest positive correlations were found in the occipital cortex involved in visual processing, as well as in the posterior-temporal cortex known for audio-visual integration. The other area, which positively correlated with auditory speech recovery, was localized in the left inferior frontal area known for speech processing. Our results demonstrate that the visual modality's functional level is related to the proficiency level of auditory recovery. Based on the positive correlation of visual activity with auditory speech recovery, we suggest that visual modality may facilitate the perception of the word's auditory counterpart in communicative situations. The link demonstrated between visual activity and auditory speech perception indicates that visuoauditory synergy is crucial for cross-modal plasticity and fostering speech-comprehension recovery in adult cochlear-implanted deaf patients.

Verteilung des roten Zahnschmelzes im Gebiss der Soricidae (Mammalia, Insectivora)

The distribution of red, iron-containing enamel in the teeth of shrews (Soricidae) was investigated by optical and scanning electron microscopy in order to determine its function. Transverse and longitudinal sections of crania with mandibles in occlusion demonstrate that the red enamel in molars is restricted to corresponding wear facets (lingual side of upper molars, buccal side of lower molars). The projecting, scissor-like cutting edges produced by wear are composed of iron-containing enamel which wears away more slowly than adjacent white enamel. Therefore, this red enamel must be more resistant to abrasion and serves to prolong the usefullness of cutting edges. Finally, two alternative hypotheses are proposed to explain the secondary loss of the red, iron-bearing enamel in members of the Soricidae which lack this material.

A Neanderthal Lower Incisor from Cova del Gegant (Sitges, Barcelona, Spain)

Cova del Gegant is located near the city of Sitges (Barcelona, Spain). The cave is a small karst system which contains Upper Pleistocene archaeological and paleontological material (DauRa et al., 2005). The site was first excavated in 1954 and then in 1972 and 1974- (Viñas, 1972; Viñas & Villalta, 1975) and in 1985 and 1989 (maRtínez et al., 1985; moRa, 1988; maRtínez et al., 1990). Finally, in 2007, Grup de Recerca del Quaternari has restarted the archaeological research at Cova del Gegant (DauRa, 2008; DauRa et al., 2010). A human mandible was recovered during the first field season in 1954 and was recently published by DauRa et al. (2005). In the present study, we describe a new human tooth (left I2) that appeared, like the mandible, in a revision of the faunal material recovered from the site in 1974-1975. The specimen preserves the entire crown and the cervical two thirds of the root (Figure 1). The lack of the root apex makes it difficult to determine if the tooth was fully developed at the time of death. However, CT analysis reveals a pulp cavity that could be still open, suggesting root formation was incomplete. The specimen shows only slight dental wear corresponding to stage 2 of Molnar (1971 en Hillson, 1996). Morphologically, the crown shows slight shovelling and a lingual tubercle and appears similar to Neandertal incisors. Standard crown measurements (buccolingual diameter=7.7 mm; mesiodistal diameter= 7.3 mm) (Figure 2) suggest a fairly large tooth, particularly in the BL dimension, again resembling Neandertals in this regard. Discriminant analysis classified the Gegant incisor as Neandertal with a 99.8% posterior probability (Table 2). Association of this tooth with the previously described mandible is considered unlikely given the different ages at death estimated for each. Thus, there appear to be two individuals preserved in the sediments of the Gegant cave, one adult and one subadult (around 8-10 years old).

Magnetic resonance imaging correlates of first-episode psychosis in young adult male patients: combined analysis of grey and white matter.

Background: Several patterns of grey and white matter changes have been separately described in young adults with first-episode psychosis. Concomitant investigation of grey and white matter densities in patients with first-episode psychosis without other psychiatric comorbidities that include all relevant imaging markers could provide clues to the neurodevelopmental hypothesis in schizophrenia. Methods: We recruited patients with first-episode psychosis diagnosed according to the DSM-IV-TR and matched controls. All participants underwent magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) analysis and mean diffusivity voxel-based analysis (VBA) were used for grey matter data. Fractional anisotropy and axial, radial and mean diffusivity were analyzed using tract-based spatial statistics (TBSS) for white matter data. Results: We included 15 patients and 16 controls. The mean diffusivity VBA showed significantly greater mean diffusivity in the first-episode psychosis than in the control group in the lingual gyrus bilaterally, the occipital fusiform gyrus bilaterally, the right lateral occipital gyrus and the right inferior temporal gyrus. Moreover, the TBSS analysis revealed a lower fractional anisotropy in the first-episode psychosis than in the control group in the genu of the corpus callosum, minor forceps, corticospinal tract, right superior longitudinal fasciculus, left middle cerebellar peduncle, left inferior longitudinal fasciculus and the posterior part of the fronto-occipital fasciculus. This analysis also revealed greater radial diffusivity in the first-episode psychosis than in the control group in the right corticospinal tract, right superior longitudinal fasciculus and left middle cerebellar peduncle. Limitations: The modest sample size and the absence of women in our series could limit the impact of our results. Conclusion: Our results highlight the structural vulnerability of grey matter in posterior areas of the brain among young adult male patients with first-episode psychosis. Moreover, the concomitant greater radial diffusivity within several regions already revealed by the fractional anisotropy analysis supports the idea of a late myelination in patients with first-episode psychosis.

Molares impactados en la rama ascendente de la mandíbula. Presentación de un caso clínico

Se presenta el caso de una mujer de 23 años de edad que presentaba los molares inferiores permanentes segundo y tercero impactados verticalmente en la rama ascendente de la mandíbula. Las superficies oclusales de ambos dientes se encontraban en contacto. Tras un diagnóstico preciso, que incluyó una tomografía computarizada, se decidió extraer ambos dientes. El conducto del nervio dentario inferior, que en las radiografías se consideró que se encontraba bajo riesgo, no sufrió ningún daño, gracias a una técnica quirúrgica cuidadosa.