Eating through time: Understanding dietary practices across late prehistory in the northeastern Iberian Peninsula.

OBJECTIVE: This study seeks to contribute to the current understanding of dietary variation in the late Prehistory of the northeastern Iberian Peninsula by examining buccal dental microwear patterns alongside archeological data from the same populations. MATERIALS AND METHODS: Teeth from 84 adult individuals from eight distinct samples spanning the Middle-Late Neolithic to the Middle Bronze Age (Cova de l'Avi, Cova de Can Sadurní, Cova de la Guineu, Cova Foradada, Cova del Trader, Roc de les Orenetes, Cova del Gegant, Cova dels Galls Carboners) were analyzed using optical microscopy to examine buccal dental microwear patterns. RESULTS: The analysis did not reveal clear chronological contrasts in the dietary habits of these samples. Nevertheless, significant differences emerged among the samples, leading to their classification into two distinct sets based on the abrasiveness of the diet informed by the microwear patterns. These findings offer similarities and differences among samples in the Iberian Peninsula, shedding light on the diverse lifestyles of these individuals. DISCUSSION: Integrating our new results with other available proxies points to a multifaceted specialization in dietary patterns among these samples, influenced by factors such as habitat, resource selection, and available technology. By contextualizing the results within the broader context of the Iberian Peninsula, this research discerns shared characteristics and distinctive adaptations in the dietary practices and subsistence strategies of these groups. Ultimately, this study contributes to a deeper understanding of the intricate interplay between culture and environment in shaping human diets throughout late Prehistory.

Perturbations of language network connectivity in primary progressive aphasia.

Aphasias are caused by disruption in structural integrity and interconnectivity within a large-scale distributed language network. We investigated the distribution and behavioral consequences of altered functional connectivity in three variants of primary progressive aphasia (PPA). The goal was to clarify relationships among atrophy, resting connectivity, and the resulting behavioral changes in 73 PPA and 33 control participants. Three core regions of the left perisylvian language network: the inferior frontal gyrus (IFG), middle temporal gyrus (MTG), and anterior temporal lobe (ATL) were evaluated in agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S) PPA variants. All PPA groups showed decreased connectivity between IFG and MTG. The PPA-S group also showed additional loss of connectivity strength between ATL and the other language regions. Decreased connectivity between the IFG and MTG nodes in PPA-G remained significant even when controlled for the effect of atrophy. In the PPA group as a whole, IFG-MTG connectivity strength correlated with repetition and grammar scores, whereas MTG-ATL connectivity correlated with picture naming and single-word comprehension. There was no significant change in the connectivity of homologous regions in the right hemisphere. These results show that language impairments in PPA are associated with perturbations of functional connectivity within behaviorally concordant components of the language network. Altered connectivity in PPA may reflect not only the irreversible loss of cortical components indexed by atrophy, but also the dysfunction of remaining neurons.

Refractory traumatic intracranial hypertension: the role of decompressive craniectomy.

Traumatic brain injury according to the World Health Organization estimates that by 2020 will be the third leading cause of morbidity and mortality worldwide. Intracranial hypertension refractory to medical management is the cause of increased mortality in neurotrauma. There are various measures to control intracranial hypertension, including surgical. Decompressive craniectomy has been routinely used to treat intracranial hypertension secondary to cerebral infarction, subarachnoid hemorrhage, intracerebral hemorrhage and trauma. We review the literature to describe the mechanisms, types and indications for this procedure.

El trauma craneoencefálico, según la Organización Mundial de la salud, se estima que para el año 2020 será la tercera causa de morbimortalidad en el mundo. La hipertensión intracraneal refractaria al manejo médico es la causante de la mayor mortalidad en esta población de pacientes. Existen diversas medidas para el control de la hipertensión intracraneal, entre ellas las quirúrgicas. La craniectomía descompresiva ha sido utilizada sistemáticamente para tratar la hipertensión intracraneal secundaria al infarto cerebral, la hemorragia subaracnoidea, la hemorragia intracerebral y el trauma. Se hace una revisión de la literatura para describir los mecanismos fisiopatológicos de la lesión cerebral traumática, así como también los tipos y las indicaciones de este procedimiento.

Iniencephaly: Case Report.

The iniencephaly involves a variable defect in the occipital bone, resulting in a large foramen magnum, partial or total absence of the cervical and thoracic vertebrae, accompanied by incomplete closure of arcs and/or vertebral bodies, significant shortening of the spinal column and hyperextension of the malformed cervicothoracic spine; the individual's face is deviated upward, the mandibular skin is directly continuous with anterior thorax due to the absence of neck. Its incidence is about 1:1000-1:2000 births, so this is a pretty rare neural tube defect. We present a case of iniencephaly in association with cardiovascular, spinal cord, and intracranial malformations that ended demonstrating the low survival of patients affected with this condition.

Memory-endowed US cities and their demographic interactions.

A quantitative understanding of cities' demographic dynamics is becoming a potentially useful tool for planning sustainable growth. The concomitant theory should reveal details of the cities' past and also of its interaction with nearby urban conglomerates for providing a reasonably complete picture. Using the exhaustive database of the Census Bureau in a time window of 170 years, we exhibit here empirical evidence for time and space correlations in the demographic dynamics of US counties, with a characteristic memory time of 25 years and typical distances of interaction of 200 km. These correlations are much larger than those observed in a European country (Spain), indicating more coherent evolution in US cities. We also measure the resilience of US cities to historical events, finding a demographical post-traumatic amnesia after wars (such as the American Civil War) or economic crisis (such as the 1929 Stock Market Crash).

Espasmo hemifacial desencadenado por migraña: un caso más / Migraine-triggered hemifacial spasm: another case study

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Space-time correlations in urban sprawl.

Understanding demographic and migrational patterns constitutes a great challenge. Millions of individual decisions, motivated by economic, political, demographic, rational and/or emotional reasons underlie the high complexity of demographic dynamics. Significant advances in quantitatively understanding such complexity have been registered in recent years, as those involving the growth of cities but many fundamental issues still defy comprehension. We present here compelling empirical evidence of a high level of regularity regarding time and spatial correlations in urban sprawl, unravelling patterns about the inertia in the growth of cities and their interaction with each other. By using one of the world's most exhaustive extant demographic data basis--that of the Spanish Government's Institute INE, with records covering 111 years and (in 2011) 45 million people, distributed among more than 8000 population nuclei--we show that the inertia of city growth has a characteristic time of 15 years, and its interaction with the growth of other cities has a characteristic distance of 80 km. Distance is shown to be the main factor that entangles two cities (60% of total correlations). The power of our current social theories is thereby enhanced.

The workings of the maximum entropy principle in collective human behaviour.

We present an exhaustive study of the rank-distribution of city-population and population-dynamics of the 50 Spanish provinces (more than 8000 municipalities) in a time-window of 15 years (1996-2010). We exhibit compelling evidence regarding how well the MaxEnt principle describes the equilibrium distributions. We show that the microscopic dynamics that governs population growth is the deciding factor that originates the observed macroscopic distributions. The connection between microscopic dynamics and macroscopic distributions is unravelled via MaxEnt.

Diagnostic accuracy of ultrasound for detecting posterior ligamentous complex injuries of the thoracic and lumbar spine: A systematic review and meta-analysis.

BACKGROUND: Posterior ligamentous complex injuries of the thoracolumbar (TL) spine represent a major consideration during surgical decision-making. However, X-ray and computed tomography imaging often does not identify those injuries and sometimes magnetic resonance imaging (MRI) is not available or is contraindicated. OBJECTIVE: To determine the diagnostic accuracy of the ultrasound for detecting posterior ligamentous complex injuries in the TL spine. MATERIALS AND METHODS: A systematic review was carried out through four international databases and proceedings of scientific meetings. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and their 95% confidence intervals (CIs) were estimated, by using weighted averages according to the sample size of each study. Summary receiver operating characteristic was also estimated. RESULTS: A total of four articles were included in the meta-analysis, yielding a summary estimate: Sensitivity, 0.89 (95% CI, 0.86-0.92); specificity, 1.00 (95% CI, 0.98-1.00); positive likelihood ratio, 224.49 (95% CI, 30.43-1656.26); negative likelihood ratio, 0.11 (95% CI, 0.05-0.19); and diagnostic odds ratio, 2,268.13 (95% CI, 265.84-19,351.24). There was no statistically significant heterogeneity among results of included studies. SUMMARY: Receiver operating characteristic (±standard error) was 0.928 ± 0.047. CONCLUSION AND RECOMMENDATION: The present meta-analysis showed that ultrasound has a high accuracy for diagnosing posterior ligamentous complex injuries in patients with flexion distraction, compression, or burst TL fractures. On the basis of present results, ultrasound may be considered as a useful alternative when magnetic resonance imaging (MRI) is unavailable or contraindicated, or when its results are inconclusive.

Estrabismo y diplopías tras la cirugía refractiva / Strabismus and diplopia after refractive surgery

Objetivo: Analizar los factores que pueden incidir en la descompensación del estrabismo o aparición de diplopía en pacientes sometidos a cirugía refractiva. Métodos: Estudio retrospectivo de 19 pacientes remitidos por presentar descompensación de la motilidad ocular y/o de la visión binocular tras cirugía refractiva. La edad media era 38,89 DS±10,26 años (rango 27 a 63). Catorce pacientes eran miopes, cinco hipermétropes. Cinco de ellos presentaban anisometropía intensa. En tres casos la técnica refractiva fue fotoqueratectomía refractiva, en trece de tipo Lasik, en uno LIO+Lasik y en dos LIO bilateral. Resultados: La prevalencia de diplopía poscirugía refractiva fue 0,12% (5 de los 19 procedían de nuestro centro, sobre una base de datos de 4.135 pacientes sometidos a cirugia refractiva, al realizar el estudio). Todos tenían patología binocular previa a la cirugía. Tras esta, once presentaban endoforia o endotropía, tres exoforia o exotropía, dos desviaciones verticales y tres horizontal y vertical. Las causas de descompensación fueron: factor acomodativo residual, hipercorrección refractiva en sentido hipermetrópico, inestabilidad visual, anisoagudeza, descompensación de una foria en el estrabismo del miope magno, pérdida de supresión, cambio de dominancia y presbicia. Frecuentemente varios factores actuaron simultáneamente. Conclusiones: La aparición de diplopía o estrabismo poscirugía refractiva es poco frecuente. Varios factores pueden incidir en la descompensación, fundamentalmente la hipercorrección miópica y los factores acomodativos y visuales, especialmente en edad présbita, en fuertes anisométropes y miopes magnos(AU)

Objective: To evaluate factors that may decompensate a strabismus or lead to diplopia after refractive surgery. Methods: Retrospective study of 19 patients, who presented with binocular decompensation after refractive surgery. Mean age at surgery was 38.89 SD 10.26 (27-63) years. Fourteen patients were myopic, 5 hyperopic, and 5 of them had a marked anisometropia. The photo-refractive keratectomy procedure was used in 3 cases, laser-assisted in situ keratomileusis (LASIK) in 13, posterior chamber-IOL)+LASIK in one of them, and bilateral IOL in 2 cases. Results: There was a prevalence of strabismus of 0.12%. All of our patients had a binocular pathology previous to the refractive surgery. After surgery, 11 patients had an esophoria or esotropia, 3 exophoria or exotropia, 2 vertical deviations, and 3 horizontal and vertical deviations. Several factors often worked simultaneously in the same patient, such as: residual accommodation, refractive overcorrection (hyperopia), visual instability or anisoacuity, high myopia and phoria decompensation, elimination of suppression, dominance change, and a presbyopic age. Conclusions: All of our patients had a previous binocular pathology. Binocularity may decompensate by several factors but mostly by myopic overcorrection, accommodation and visual factors, particularly in patients close to or in presbyopic age, in anisometropia and high myopia(AU)

[Strabismus and diplopia after refractive surgery]. / Estrabismo y diplopías tras la cirugía refractiva.

OBJECTIVE: To evaluate factors that may decompensate a strabismus or lead to diplopia after refractive surgery. METHODS: Retrospective study of 19 patients, who presented with binocular decompensation after refractive surgery. Mean age at surgery was 38.89 SD 10.26 (27-63) years. Fourteen patients were myopic, 5 hyperopic, and 5 of them had a marked anisometropia. The photo-refractive keratectomy procedure was used in 3 cases, laser-assisted in situ keratomileusis (LASIK) in 13, posterior chamber-IOL)+LASIK in one of them, and bilateral IOL in 2 cases. RESULTS: There was a prevalence of strabismus of 0.12%. All of our patients had a binocular pathology previous to the refractive surgery. After surgery, 11 patients had an esophoria or esotropia, 3 exophoria or exotropia, 2 vertical deviations, and 3 horizontal and vertical deviations. Several factors often worked simultaneously in the same patient, such as: residual accommodation, refractive overcorrection (hyperopia), visual instability or anisoacuity, high myopia and phoria decompensation, elimination of suppression, dominance change, and a presbyopic age. CONCLUSIONS: All of our patients had a previous binocular pathology. Binocularity may decompensate by several factors but mostly by myopic overcorrection, accommodation and visual factors, particularly in patients close to or in presbyopic age, in anisometropia and high myopia.

Migraine-triggered hemifacial spasm: three new cases.

BACKGROUND: The occurrence of hemifacial spasm (HFS) during an episode of migraine has been seldom reported. Here we describe three new cases presenting with HFS in association with migraine attacks. CASE RESULTS: Three patients (one woman and two men, aged 31-36 years) developed HFS in close temporal relationship with migraine headaches. All of them started having the muscle spasms after pain onset. Two of them had electromyographic evidence of facial nerve damage, and continued having HFS once the pain abated. CONCLUSIONS: Migraine attacks may be associated with HFS. The appearance of HFS could be related to migraine activity. A mechanism of central hyperexcitability in connection with nociceptive inputs on the trigeminal nucleus caudalis and/or a dilation of vessels compressing the facial nerve at the root exit zone could lead to the development of HFS in predisposed patients. 'Migraine-triggered hemifacial spasm' could possibly be regarded as a complication of migraine.

Isolation of airborne oxacillin-resistant Staphylococcus aureus from culturable air samples of urban residences.

Culturable single-stage impactor samples were collected onto nutrient agar in kitchen and bedroom areas of eight urban and four suburban residences in Philadelphia, Pennsylvania. Staphylococcus aureus colonies were identified by replica plating of the original impactor samples onto Chapman Stone medium followed by isolation of up to eight colonies for coagulase testing. Kirby-Bauer disk diffusion method was utilized to evaluate S. aureus resistance to both oxacillin and cefaclor. The median concentrations of total culturable bacteria observed in bedrooms and trash areas were 300 CFU/m(3) and 253 CFU/m(3), respectively. Median culturable Staphylococcus spp. concentrations in bedrooms and trash areas were 142 CFU/m(3) and 204 CFU/m(3), respectively. A total of 148 individual S. aureus colonies were isolated and tested for antibiotic resistance. Cefaclor resistance was encountered among only 6 of the 148 (4%) colonies. Nearly one-quarter of all S. aureus isolates tested displayed resistance (n = 30) or intermediate resistance (n = 5) to oxacillin. Twenty-six percent (n = 20) of trash area isolates and 21% (n = 15) of bedroom isolates displayed resistance or intermediate resistance to oxacillin. The median difference in percent resistance between trash and bedroom areas was 10% (p = 0.1). Results suggest that there may be a systematic difference in bacterial populations between downtown and suburban residences. Storage of household waste and handling of food may contribute to presence of the organism in the air of residences.

Seasonal changes in airborne fungi and bacteria at a dairy cattle concentrated animal feeding operation in the southwest United States.

The objective of this study was to evaluate a dairy located in the arid southwest United States to determine the concentrations and seasonal variation of airborne fungi and bacteria and to determine the percentage of antibiotic resistant Staphylococcus aureus. The authors used two-stage ambient air sampling systems to measure the culturable airborne fungal organisms and bacteria on a monthly basis. The authors recovered the most fungal, bacterial, and S. aureus organisms during the spring months. The most common fungi identified were Cladosporium, Aspergillus, and Stemphylium, which were most common in the spring and least common in the summer. S. aureus made up 4.2% to 5.5% of the total bacteria, and greater than 50% of this bacteria were found to be resistant to ampicillin, penicillin, or cefaclor, with the greatest incidence of antibiotic resistance occuring in the fall. The incidence of S. aureus resistant to at least two antibiotics ranged from 14% in the spring to 54% in the fall.

Colorectal stenting as an effective therapy for preoperative and palliative treatment of large bowel obstruction: 9 years' experience.

BACKGROUND: Since their introduction, selfextending metal stents (SEMS) have established themselves as an option in the treatment of obstructive colorectal cancer. Thanks to stenting, patients traditionally treated with emergency surgery can now be converted to scheduled surgery with mechanical preparation of the colon and primary anastomosis. Stenting represents a valid one-step surgical alternative for intestinal obstruction of the colon. METHODS: We performed a prospective study of 95 patients (mean age, 68 years; range 48-94) with large bowel obstruction due to colorectal cancer treated with SEMS placed under fluoroscopic guidance, some as a bridge to surgery (group A) and others with palliative intent (group B). Computed tomography was performed for diagnostic purposes and to study the extent of disease. RESULTS: Treatment was palliative in 28 cases (group B) and as a bridge to surgery in 67 (group A). The latter group underwent mechanical preparation of the colon and elective surgery. No patients died as a result of the procedure. In 90 cases (95%), treatment was effective and the obstruction resolved. Complications were 4 cases of perforation, 1 of tenesmus, 4 obstructions and 4 migrations. In 7 cases, a second stent was inserted to allow subsequent scheduled surgery. CONCLUSIONS: Self-extending stents resolve colorectal cancer obstruction and allow optimal patient staging and scheduled surgical treatment. Stenting is also a useful option in advanced or irresectable tumors, avoiding the need for surgery and offering good palliation.

Isolation of Staphylococcus aureus and antibiotic-resistant Staphylococcus aureus from residential indoor bioaerosols.

OBJECTIVE: In this study we evaluated the levels of Staphylococcus aureus and antibiotic-resistant S. aureus in colony-forming units (CFU) per cubic meter of air. DESIGN: We used Andersen two-stage samplers to collect bioaerosol samples from 24 houses in El Paso, Texas, using tryptic soy agar as the collection media, followed by the replicate plate method on Chapman Stone selective medium to isolate S. aureus. The Kirby-Bauer disk diffusion method was used to determine antibiotic resistance to ampicillin, penicillin, and cefaclor, which represent two distinct classes of antibiotics. RESULTS: The average recovered concentration of respirable heterotrophic organisms found outside each home was 345.38 CFU/m3, with an average of 12.63 CFU/m3 for S. aureus. The average recovered concentration of respirable heterotrophic organisms found inside each home was 460.23 CFU/m3, with an average of 15.39 CFU/m3 for S. aureus. The respirable S. aureus recovered from inside each home had an average resistance of 54.59% to ampicillin and 60.46% to penicillin. Presence of cefaclor-resistant and of multidrug-resistant S. aureus was the same, averaging 13.20% per house. The respirable S. aureus recovered from outside each home had an average resistance of 34.42% to ampicillin and 41.81% to penicillin. Presence of cefaclor-resistant and of multidrug-resistant S. aureus was the same, averaging 13.96% per house. CONCLUSIONS: This study indicates that antibiotic-resistant bioaerosols are commonly found within residential homes. Our results also suggest that resistant strains of airborne culturable S. aureus are present in higher concentrations inside the study homes than outside the homes.

Vacunación de los niños inmigrantes: ¿cómo acuden a nuestras consultas? / Vaccination of immigrant children: how do they reach our clinics?

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