Global Vertical Distribution of Water Vapor on Mars: Results From 3.5 Years of ExoMars-TGO/NOMAD Science Operations.

We present water vapor vertical distributions on Mars retrieved from 3.5 years of solar occultation measurements by Nadir and Occultation for Mars Discovery onboard the ExoMars Trace Gas Orbiter, which reveal a strong contrast between aphelion and perihelion water climates. In equinox periods, most of water vapor is confined into the low-middle latitudes. In aphelion periods, water vapor sublimated from the northern polar cap is confined into very low altitudes-water vapor mixing ratios observed at the 0-5 km lower boundary of measurement decrease by an order of magnitude at the approximate altitudes of 15 and 30 km for the latitudes higher than 50°N and 30-50°N, respectively. The vertical confinement of water vapor at northern middle latitudes around aphelion is more pronounced in the morning terminators than evening, perhaps controlled by the diurnal cycle of cloud formation. Water vapor is also observed over the low latitude regions in the aphelion southern hemisphere (0-30°S) mostly below 10-20 km, which suggests north-south transport of water still occurs. In perihelion periods, water vapor sublimated from the southern polar cap directly reaches high altitudes (>80 km) over high southern latitudes, suggesting more effective transport by the meridional circulation without condensation. We show that heating during perihelion, sporadic global dust storms, and regional dust storms occurring annually around 330° of solar longitude (L S) are the main events to supply water vapor to the upper atmosphere above 70 km.

Specialized pro-resolvin mediators induce cell growth and improve wound repair in intestinal epithelial Caco-2 cell cultures.

Specialized pro-resolvin mediators (SPMs) are a superfamily of bioactive molecules synthesized from polyunsaturated fatty acids (arachidonic, eicosapentaenoic and docosahexaenoic acids) that include resolvins, protectins and maresins. These metabolites are important to control the resolution phase of inflammation and the epithelial repair, which is essential in restoring the mucosal barriers. Unfortunately, the effects of SPMs on intestinal epithelial cell growth remain poorly understood. Caco-2 cell were used as intestinal epithelial cell model. Cell growth/DNA synthesis, cell signalling pathways, western blot and wound repair assay were performed. Our data demonstrated that SPMs such as lipoxin LxA4, resolvin (Rv) E1, RvD1, protectin D 1 and maresin 1 were able to enhance intestinal epithelial Caco-2 cell growth and DNA synthesis. Furthermore, our results provide evidence that these effects of RvE1 and RvD1 were associated with a pertussis toxin-sensitive G protein-coupled receptor, and that leukotriene B4 receptor 2 could be involved, at least in part, in these effects of RvE1/RvD1. Moreover, these mitogenic effects induced by SPMs were dependent on the ERK 1/2 and p38 MAPK pathways as well as phospholipase C and protein kinase C activation. Thus, these mitogenic effects of RvE1/RvD1 on intestinal epithelial cells could be involved in this signalling circuit involved in wounded epithelium and the catabasis process.

Martian CO2 Ice Observation at High Spectral Resolution With ExoMars/TGO NOMAD.

The Nadir and Occultation for MArs Discovery (NOMAD) instrument suite aboard ExoMars/Trace Gas Orbiter spacecraft is mainly conceived for the study of minor atmospheric species, but it also offers the opportunity to investigate surface composition and aerosols properties. We investigate the information content of the Limb, Nadir, and Occultation (LNO) infrared channel of NOMAD and demonstrate how spectral orders 169, 189, and 190 can be exploited to detect surface CO2 ice. We study the strong CO2 ice absorption band at 2.7 µm and the shallower band at 2.35 µm taking advantage of observations across Martian Years 34 and 35 (March 2018 to February 2020), straddling a global dust storm. We obtain latitudinal-seasonal maps for CO2 ice in both polar regions, in overall agreement with predictions by a general climate model and with the Mars Express/OMEGA spectrometer Martian Years 27 and 28 observations. We find that the narrow 2.35 µm absorption band, spectrally well covered by LNO order 189, offers the most promising potential for the retrieval of CO2 ice microphysical properties. Occurrences of CO2 ice spectra are also detected at low latitudes and we discuss about their interpretation as daytime high altitude CO2 ice clouds as opposed to surface frost. We find that the clouds hypothesis is preferable on the basis of surface temperature, local time and grain size considerations, resulting in the first detection of CO2 ice clouds through the study of this spectral range. Through radiative transfer considerations on these detections we find that the 2.35 µm absorption feature of CO2 ice clouds is possibly sensitive to nm-sized ice grains.

12(S)-hydroxyheptadeca-5Z,8E,10E-trienoic acid (12-HHT) induces cell growth and improves barrier function through BLT2 interaction in intestinal epithelial Caco-2 cell cultures.

12(S)-hydroxyheptadeca-5Z,8E,10E-trienoic acid (12-HHT) is an unusual product of the cyclooxygenase pathway that is an endogenous ligand of the low-affinity receptor for leukotriene 4 (LTB4), BLT2. Recent findings suggested that BLT2 possibly plays an important role in the healing of intestinal lesions and the regulation of barrier function. Here, we studied the role of 12-HHT on intestinal epithelial cell growth and the paracellular permeability of intestinal epithelium using Caco-2 cell cultures as experimental model. Our results demonstrated that 12-HHT stimulates intestinal epithelial Caco-2 cell growth through 12-HHT-BLT2-p38-PKC axis and improves paracellular permeability in differentiated Caco-2 cell cultures through the regulation of tight junction elements such as myosin light chain phosphorylation through 12-HHT-BLT2-p38-PKC-MYPT1 axis. Thus, 12-HHT-BLT2 interaction can be involved in intestinal epithelial cell growth and consequently in the epithelium regeneration/repair processes, together with an interesting improvement on the paracellular permeability. These effects appoint that 12-HHT/BLT2 axis may be a suitable strategy for treating wound healing epithelium and barrier-disrupted intestinal processes.

TomoEED: fast edge-enhancing denoising of tomographic volumes.

Summary: TomoEED is an optimized software tool for fast feature-preserving noise filtering of large 3D tomographic volumes on CPUs and GPUs. The tool is based on the anisotropic nonlinear diffusion method. It has been developed with special emphasis in the reduction of the computational demands by using different strategies, from the algorithmic to the high performance computing perspectives. TomoEED manages to filter large volumes in a matter of minutes in standard computers. Availability and implementation: TomoEED has been developed in C. It is available for Linux platforms at http://www.cnb.csic.es/%7ejjfernandez/tomoeed. Supplementary information: Supplementary data are available at Bioinformatics online.

Surface changes on comet 67P/Churyumov-Gerasimenko suggest a more active past.

The Rosetta spacecraft spent ~2 years orbiting comet 67P/Churyumov-Gerasimenko, most of it at distances that allowed surface characterization and monitoring at submeter scales. From December 2014 to June 2016, numerous localized changes were observed, which we attribute to cometary-specific weathering, erosion, and transient events driven by exposure to sunlight and other processes. While the localized changes suggest compositional or physical heterogeneity, their scale has not resulted in substantial alterations to the comet's landscape. This suggests that most of the major landforms were created early in the comet's current orbital configuration. They may even date from earlier if the comet had a larger volatile inventory, particularly of CO or CO2 ices, or contained amorphous ice, which could have triggered activity at greater distances from the Sun.

A Mediterranean diet supplemented with extra virgin olive oil or nuts improves endothelial markers involved in blood pressure control in hypertensive women.

PURPOSE: Serum nitric oxide (NO) reduction and increased endothelin-1 (ET-1) play a pivotal role in endothelial dysfunction and hypertension. Considering that traditional Mediterranean diet (TMD) reduces blood pressure (BP), the aim of this study was to analyze whether TMD induced changes on endothelial physiology elements such as NO, ET-1 and ET-1 receptors which are involved in BP control. METHODS: Non-smoking women with moderate hypertension were submitted for 1 year to interventions promoting adherence to the TMD, one supplemented with extra virgin olive oil (EVOO) and the other with nuts versus a control low-fat diet (30 participants/group). BP, NO, ET-1 and related gene expression as well as oxidative stress biomarkers were measured. RESULTS: Serum NO and systolic BP (SBP) or diastolic BP (DBP) were negatively associated at baseline, as well as between NO and ET-1. Our findings also showed a DBP reduction with both interventions. A negative correlation was observed between changes in NO metabolites concentration and SBP or DBP after the intervention with TMD + EVOO (p = 0.033 and p = 0.044, respectively). SBP reduction was related to an impairment of serum ET-1 concentrations after the intervention with TMD + nuts (p = 0.008). We also observed changes in eNOS, caveolin 2 and ET-1 receptors gene expression which are related to NO metabolites levels and BP. CONCLUSIONS: The changes in NO and ET-1 as well as ET-1 receptors gene expression explain, at least partially, the effect of EVOO or nuts on lowering BP among hypertensive women.

Rosetta's comet 67P/Churyumov-Gerasimenko sheds its dusty mantle to reveal its icy nature.

The Rosetta spacecraft has investigated comet 67P/Churyumov-Gerasimenko from large heliocentric distances to its perihelion passage and beyond. We trace the seasonal and diurnal evolution of the colors of the 67P nucleus, finding changes driven by sublimation and recondensation of water ice. The whole nucleus became relatively bluer near perihelion, as increasing activity removed the surface dust, implying that water ice is widespread underneath the surface. We identified large (1500 square meters) ice-rich patches appearing and then vanishing in about 10 days, indicating small-scale heterogeneities on the nucleus. Thin frosts sublimating in a few minutes are observed close to receding shadows, and rapid variations in color are seen on extended areas close to the terminator. These cyclic processes are widespread and lead to continuously, slightly varying surface properties.

Optical and radiometric models of the NOMAD instrument part II: the infrared channels - SO and LNO.

NOMAD is a suite of three spectrometers that will be launched in 2016 as part of the joint ESA-Roscosmos ExoMars Trace Gas Orbiter mission. The instrument contains three channels that cover the IR and UV spectral ranges and can perform solar occultation, nadir and limb observations, to detect and map a wide variety of Martian atmospheric gases and trace species. Part I of this work described the models of the UVIS channel; in this second part, we present the optical models representing the two IR channels, SO (Solar Occultation) and LNO (Limb, Nadir and Occultation), and use them to determine signal to noise ratios (SNRs) for many expected observational cases. In solar occultation mode, both the SO and LNO channel exhibit very high SNRs >5000. SNRs of around 100 were found for the LNO channel in nadir mode, depending on the atmospheric conditions, Martian surface properties, and observation geometry.

Evaluation of rep-PCR/DiversiLab versus PFGE and spa typing in genotyping methicillin-resistant Staphylococcus aureus (MRSA).

Pulsed-field gel electrophoresis (PFGE) is the 'gold standard' for genotyping of methicillin-resistant Staphylococcus aureus (MRSA); however, the DiversiLab (DL) system, based on rep-PCR, is faster, simpler and could be better adapted to daily routine hospital work. We genotyped 100 MRSA isolates using PFGE, DL, and spa typing, and evaluated the discriminatory power of each technique and the correlation between them by Simpson's index(SI) and adjusted Rand coefficient (ARI), respectively. The isolates were from clinical samples from eight hospitals in Extremadura (Spain) during 2010. DL separated the 100 MRSA into 18 patterns, with 69% of the isolates grouped into four predominant patterns. spa typing reported 17 spa types, classifying 69% of MRSA into two major types (t067 and t002). PFGE revealed the existence of 27 patterns, gathering 54% of MRSA into three pulse types (E8a, E7a and E7b). SI values were 0.819, 0.726, 0.887 and 0.460 for DL, spa typing, PFGE and CC-BURP, respectively. ARI values of DL over PFGE, spa typing and CC-BURP were 0.151, 0.321 and 0.071, respectively. DL has less discriminatory power than PFGE but more than spa typing. The concordance of DL with PFGE is low, primarily because DL does not discriminate between the three predominant MRSA pulse types in our environment.

An analysis of the association between genotype and antimicrobial resistance in methicillin-resistant Staphylococcus aureus clinical isolates.

Genotyping methods are useful resources for the surveillance, detection, prevention and control of multidrug-resistant nosocomial agents, such as methicillin-resistant Staphylococcus aureus (MRSA). An understanding of the association between genotype and antibiotic susceptibility in MRSA clones may be useful in the surveillance of MRSA and to avoid inappropriate treatment future resistance. We genotyped MRSA clinical isolates from the Extremadura region of Spain using pulsed field electrophoresis (PFGE) and analyzed the spectrum of antibiotic susceptibility for each isolate to determine whether resistance is associated with specific genotypes. PFGE revealed six major genotypes: E8a (25%), E7b (17%), E7a (12%), E8B (8%), E10 (6%), and E20 (4%). Isolates with the genotypes E8a and E10 exhibit higher resistance ratios for levofloxacin than isolates with the other major pulsotypes. Similar results were obtained for isolates with the E20 pulsotype with respect to mupirocin. Although we identified no vancomycin-, tigecycline-, linezolid- or daptomycin-resistant strains, we observed significant differences in the mean MIC values obtained for some of these drugs among the major genotypes. Specifically, isolates with the E7b, E8b, and E20 genotypes have signif-icantly higher MICs of tigecycline, vancomycin and linezolid, respectively, than the most sensitive pulsotypes. Isolates with the E8b profile also exhibit a significantly higher rate of re-duced vancomycin susceptibility (RVS) (i.e., MIC between 1 and 2 mg/L) than clones with the E10 and E8a profiles. In conclusion, we report associations between genotype and antibiotic sensitivity that should be considered in programs for monitor-ing and controlling MRSA in health care settings.

[State of infection caused by methicillin-resistant Staphylococcus aureus (MRSA) in Extremadura: susceptibility, clonality and role of community-associated MRSA]. / Situación actual de la infección por Staphylococcus aureus resistente a meticilina en Extremadura: sensibilidad, clonalidad, y protagonismo de la adquisición extrahospitalaria.

The correct surveillance and control of infection caused by methicillin-resistant Staphylococcus aureus (MRSA) needs of update knowledge of its specific properties in each place. Our study aims to describe the current characteristics of infection due to MRSA in Extremadura. During 2010, 309 MRSA were collected from clinical samples in our region. A susceptibility test that included 17 antibiotics tested by AST -588 card Vitek 2 ® and E -test method was performed on all isolates. A sample of 100 strains, selected by stratified random sampling, were genotyped by pulsed field electrophoresis (PFGE). The prevalence of MRSA in Extremadura was 20.2%. Don Benito-Villanueva area showed the most prevalence and a higher incidence. Merida reported the most favourable situation, with a relatively low ratios of prevalence and incidence. The community acquired reached 44 % in the region, showing predominantly in less populated areas (Navalmoral and Coria). The most common multiresistant pattern was tobramycin-levofloxacin-erythromycin (44%), followed tobramycin-erythromycin-clindamycin (20%). No linezolid, daptomycin and tigecycline resistant strains were observed, but 42 % of the MRSA strains showed decreased susceptibility vancomycin (DSV). PFGE analysis reported 27 genotypes, with 3 major genotypes: E8a (25%), E7b (17%) and E7a (12%). The post-hoc statistical analysis did not reveal significant differences in the distribution of genotypes between different areas. However it revealed some trends that should be considered.

5-Hydroxyeicosatetraenoic acid and leukotriene D4 increase intestinal epithelial paracellular permeability.

The loss of epithelial barrier function plays a crucial role in the pathogenesis of inflammatory bowel disease, with levels of 5-lipoxygenase metabolites being increased in the mucosa of these patients. The objective of this study was to determine the effect of the eicosanoids produced by the 5-lipoxygenase pathway, leukotriene B4 and D4, and 5-hydroxyeicosatetraenoic acid on epithelial barrier function. Paracellular permeability was estimated from fluorescein isothiocyanate-dextran fluxes and transepithelial electrical resistance in differentiated Caco-2 cells. Our results suggest that leukotriene D4 and 5-hydroxyeicosatetraenoic acid altered both parameters. Identification of the receptors involved in these changes indicated that cysteinyl-leukotriene receptor 1 participates in the effects of leukotriene D4. For both eicosanoids, these effects were mediated by activation of the phospholipase C/Ca(2+)/protein kinase C pathway, in addition to cAMP-independent protein kinase A activation. Furthermore, we observed a correlation between increased paracellular permeability and the redistribution of occludin, and for leukotriene D4, the disorganization of the subapical actin ring and myosin light chain kinase activation. In conclusion, on the basis of our results, we propose that 5-lipoxygenase pathway metabolites participate in the disruption of epithelial barrier function that is characteristic of inflammatory bowel disease.

The effects of polyphenols on oxidative stress and the arachidonic acid cascade. Implications for the prevention/treatment of high prevalence diseases.

Redox state unbalance and the activation of the arachidonic acid (AA) cascade, contribute to the pathogenesis of cardiovascular disease (CVD) and cancer. Inflammatory cells that infiltrate the atheroma plaque or tumor are a major source of reactive oxygen species and eicosanoids. The human antioxidant defense network is complex and interlocking and there is controversy surrounding the beneficial effects of diet-derived antioxidants in vivo. However, epidemiological studies indicate that populations that consume high levels of plant-derived foods containing phenolic compounds have low rates of CVD and cancer. The molecular mechanisms for these effects are multi-faceted. They include the regulation of transcription factors and consequently the modulation of genes (cytokines, growth factors and adhesion molecules), and growth factor-receptor interactions and cell signaling cascades, which determine the expression of genes involved in cell cycle, cell survival and apoptosis, as well as adhesiveness/invasiveness and angiogenesis. The present paper also focuses on the effects of phenolic compounds on AA cascade enzymes (cyclooxygenases and lipoxygenases) and the subsequent synthesis of eicosanoids, which are involved in CVD and cancer. A better understanding of these processes could explain the beneficial effects of polyphenols on the most prevalent diseases in Western societies. This commentary shows that antioxidants under evaluation include structural modifications of low-molecular-mass polyphenols, which could lead to a valuable strategy for modulating the generation of inflammatory mediators involved in these chronic diseases.

Images of asteroid 21 Lutetia: a remnant planetesimal from the early Solar System.

Images obtained by the Optical, Spectroscopic, and Infrared Remote Imaging System (OSIRIS) cameras onboard the Rosetta spacecraft reveal that asteroid 21 Lutetia has a complex geology and one of the highest asteroid densities measured so far, 3.4 ± 0.3 grams per cubic centimeter. The north pole region is covered by a thick layer of regolith, which is seen to flow in major landslides associated with albedo variation. Its geologically complex surface, ancient surface age, and high density suggest that Lutetia is most likely a primordial planetesimal. This contrasts with smaller asteroids visited by previous spacecraft, which are probably shattered bodies, fragments of larger parents, or reaccumulated rubble piles.

Abordaje transparotídeo para la reducción abierta de las fracturas subcondíleas. Técnica quirúrgica y análisis de sus complicaciones / Transparotid approach for the open reduction of subcondylar fractures. Surgical technique and analysis of complications

Introducción: Existen varias opciones para el tratamiento de las fracturas subcondíleas. El abordaje transparotídeo anterior es una de las posibilidades terapéuticas para su reducción abierta y su fijación interna. El objetivo de este artículo es realizar una descripción de la técnica quirúrgica y analizar las complicaciones asociadas. Material y métodos: Se realizó una revisión clínica sobre un total de 31 pacientes con 34 fracturas subcondíleas, todas ellas tratadas quirúrgicamente con un abordaje transparotídeo anterior, usando placas y tornillos de osteosíntesis. Resultados: No se registraron complicaciones de ningún tipo en 22 de los 31 pacientes (70,97%), con buena oclusión posquirúrgica en 28 de ellos (90,32%). Las complicaciones relacionadas con el abordaje en nuestra serie de casos fueron las siguientes: 2 casos de paresia facial (5,88%), que en ambos fue leve y transitoria; 6 casos de fístula salival (17,65%), siendo en todos ellos autolimitadas, y 3 infecciones de la herida quirúrgica (8,82%): 2 resueltas con antibióticos y una que requirió también drenaje quirúrgico. Como complicación no relacionada con el tipo de abordaje sino con el tipo de osteosíntesis, hubo 2 casos de fractura de placa de osteosíntesis (5,88%). Conclusiones: El abordaje transparotídeo anterior es seguro, con un bajo riesgo lesivo para el nervio facial. Esta técnica proporciona un adecuado campo quirúrgico que permite la colocación y la fácil fijación de una segunda placa de osteosíntesis en la parte anterior de la fractura. La cicatriz resultante es estética(AU)

Introduction: Several options exist for the treatment of subcondylar jaw fractures. The anterior transparotid approach is one of the therapeutic options for open reduction and internal fixation. The aim of this communication was to describe the surgical technique and analyze the related complications. Patients and methods: A clinical review was made of 31 patients with 34 subcondylar fractures, all treated surgically via an anterior transparotid approach using osteosynthesis plates and screws. Results: No complications occurred in 22 of 31 patients (70.97%) and the postoperative occlusion was good in 28 patients (90.32%). The complications related with the approach in our case series were: 2 cases of facial paresia (5.88%), both mild and transitory; 6 cases of salivary fistulae (17.65%), all self-limited; and 3 surgical wound infections (8.82%), 2 resolved with antibiotics and one with antibiotics and surgical drainage. Plate fracture, a complication unrelated to the approach but related to the type of osteosynthesis, occurred in 2 cases (5.88%). Conclusions: The anterior transparotid approach is safe, with a low risk of facial nerve injury. The technique gives the surgeon an adequate surgical field that allows the placement and easy fixation of a second osteosynthesis plate in the anterior part of the fracture. The resulting scar is cosmetically acceptable(AU)

Enfermedad por depósito de cristales de pirofosfato cálcico en la articulación temporomandibular con extensión intracraneal. A propósito de un caso / Calcium pyrophosphate deposition disease of the temporomandibular joint with intracranial extension. A case report

Introducción: La articulación temporomandibular (ATM) humana es un conjunto de estructuras que permite la relación anatómica y funcional entre el hueso temporal y la mandíbula. Los síntomas y signos asociados a los procesos neoplásicos-seudotumorales de la ATM son similares a los asociados a los trastornos temporomandibulares. Caso clínico: Presentamos un nuevo caso clínico de enfermedad por depósito de cristales de pirofosfato cálcico deshidratado (EDCPCD) con afectación de la ATM e invasión intracraneal. Se trata de una artropatía microcristalina que comparte características clínicas con la condromatosis sinovial. Se exponen los aspectos claves relativos al diagnóstico y el tratamiento de dicha patología. Discusión: Los tumores que más frecuentemente afectan la ATM son las metástasis de tumores malignos. Entre las lesiones tumorales-seudotumorales que se originan directamente de la membrana sinovial se encuentran la condromatosis sinovial, la sinovitis villo-nodular, el sarcoma sinovial, la gota tofácea y la EDCPCD. Esta última es relativamente común en edades avanzadas, particularmente en la rodilla. El análisis de los cristales es esencial para establecer un diagnóstico de certeza. El tratamiento es eminentemente quirúrgico. Conclusiones: La EDCPCD en la ATM es extremadamente rara. Las masas tumorales que surgen como tumores primarios en la ATM representan un problema diagnóstico desafiante. La variada presentación de estas lesiones a menudo enmascara la patología de base y conlleva su retraso en el diagnóstico(AU)

Introduction: The human temporomandibular joint (TMJ) is the structural complex that supports the functional and anatomic relations between the temporal bone and mandible. Symptoms and signs related to neoplastic or pseudotumoral disease of this joint are similar to the symptoms associated with temporomandibular joint dysfunction. Case report: We report a new case of calcium pyrophosphate deposition disease (CPDD) of the TMJ with intracranial spread. CPDD is a microcrystaline arthropathy with some clinical characteristics of synovial chondromatosis. Key aspects of the diagnosis and treatment of CPDD are discussed. Discussion: The most frequent tumors of the TMJ are metastatic. Among the tumoralpseudotumoral lesions that originate directly on the synovial membrane are synovial chondromatosis, villonodular synovitis, synovial sarcoma, tophaceous gout and CPDD. CPDD is relatively common in elderly patients, especially in the knee. Analysis of the crystals is essential for diagnosis. Surgical treatment is indicated. Conclusions: CPDD is an extremely rare disease in the TMJ. TMJ tumor masses are a diagnostic challenge. The wide variety of presenting symptoms frequently obscures the underlying pathology and delays diagnosis(AU)

[Subcranial approach. Technical aspects and application in craneofacial traumatic pathology]. / Abordaje subcraneal. Consideraciones técnicas y aplicaciones en patología traumática craneofacial.

UNLABELLED: INTRODUCTION. Suitable approach to anterior cranial base is mandatory to get global satisfactory surgical outcomes. In the beginning it depends on the exactly anatomical position into the cranial fossa and tridimensional spread. Surgical approach implies the evaluation of the patient status, reconstructive options and surgical team experience. Subcranial approach is a safe surgical option in the treatment of frontal traumatic pathology. It allows adequate management of frontal sinus and its obliteration with easy radiologic follow-up. OBJECTIVES. To analyse subcranial approach as a treatment option in traumatic pathology of the anterior cranial base and to present our review of subcranial approach. Valuation of surgical technical aspects. and related complications. MATERIAL AND METHODS. Retrospective analysis of 50 patients operated (subcranial approach) from January 2004 to December 2009 by Maxillofacial and Neurosurgery Department, University Hospital 12 de Octubre, Madrid. 34 patients presented craniofacial trauma or postraumatic sequela and 16 patients presented craniofacial tumours. Oncological cases offers experience to discuss surgical aspects. Results are related to traumatic pathology and sequela. Main items review were surgical technique including materials used for frontal sinus obliteration, associated traumatic pathology, hospital stay and complication rates. RESULTS. No perioperatory mortality was found. Patients´ age ranged 15-76 years. 22 were male and 12 female. Description of frontal fractures involved. Frontal sinus obliteration was made with calvarian bone dust. Morbidity rates was 29% in posttraumatic patients. Mean hospital stay was 13 days. CONCLUSIONS: Subcranial approach to anterior cranial base is a safe and reliable treatment option to the pathology of this area. It allows outstanding exposure of the nasal cavity, orbits, ethmoidal cells-sphenoid sinus and great access to anterior fossa without frontal lobe retraction.

Abordaje subcraneal. Consideraciones técnicas y aplicaciones en patología traumática craneofacial / Subcranial approach. Technical aspects and application in craneofacial traumatic pathology

Introducción. La elección del abordaje más adecuado a la base craneal en cada caso es esencial para la obtención de resultados quirúrgicos globales satisfactorios. Inicialmente dependerá de la localización anatómica exacta de la lesión dentro de la base craneal y de su extensión tridimensional, así como de la naturaleza de la misma. Las opciones posibles deben ser depuradas finalmente en función del status global del paciente, planificación reconstructiva y experiencia del equipo quirúrgico. El abordaje subcraneal es una opción terapéutica segura en el tratamiento de la patología traumática frontal. Permite el manejo adecuado del seno frontal y su obliteración si es precisa, favoreciendo el seguimiento radiológico del mismo. Objetivos. Validar el abordaje subcraneal como vía adecuada de acceso en patología traumática de la base craneal anterior. Revisión de nuestra serie clínica. Valoración de aspectos técnicos quirúrgicos. Análisis de complicaciones. Material y métodos. Estudio retrospectivo de 50 pacientes intervenidos desde Enero de 2004 hasta Diciembre 2009 por el Servicio de Cirugía Maxilofacialy Servicio de Neurocirugía del Hospital Universitario 12 de Octubre (Madrid) mediante abordaje subcraneal. 34 pacientes presentaban traumatismos cráneo faciales o secuelas postraumáticas y 16 pacientes presentaban patología oncológica. Se enumeran los casos oncológicos como base de experiencia para la descripción de los aspectos técnicos. La casuística descrita se refiere a la patología traumática y sus secuelas. Los principales parámetros analizados fueron la técnica quirúrgica incluyendo el material de relleno para la obliteración del seno frontal, patología traumática asociada, estancia hospitalaria y tasa de complicaciones. Resultados. No existió mortalidad intra-postoperatoria inmediata. La edad varía entre los 15-76 años siendo 22 varones y 12 mujeres. Se describe el tipo de fracturas frontales (..) (AU)

Introduction. Suitable approach to anterior cranial base is mandatory to get global satisfactory surgical outcomes. In the beginning it depends on the exactly anatomical position into the cranial fossa and tridimensional spread. Surgical approach implies the evaluation of the patient status, reconstructive options and surgicalteam experience. Subcranial approach is a safe surgicaloption in the treatment of frontal traumatic pathology. It allows adequate management of frontal sinus and its obliteration with easy radiologic follow-up. Objectives. To analyse subcranial approach as atreatment option in traumatic pathology of the anteriorcranial base and to present our review of subcranial approach. Valuation of surgical technical aspects. andrelated complications. Material and methods. Retrospective analysis of 50 patients operated (subcranial approach) from January 2004 to December 2009 by Maxillofacial and (..) (AU)

Pseudoartrosis maxilar superior post-cirugía ortognática. A propósito de un caso clínico / Post surgical orthognathic of upper maxilla pseudoarthrosis. Proposed clinical study

Introducción. La introducción de nuevos métodos de fijación rígidaen el tratamiento de fracturas faciales durante los últimos 25 años ha incrementadono sólo el arsenal terapéutico disponible sino también, cuando noes correctamente utilizado, el tipo de complicaciones postquirúrgicas. Materialy métodos. Presentamos un nuevo caso clínico con el diagnóstico depseudoartrosis de maxilar superior tras la realización de una osteotomía convencionaltipo LeFort I en el seno de un procedimiento de cirugía ortognática.Discusión. El retardo de consolidación- pseudoartrosis puede resultartras el tratamiento incorrecto de fracturas faciales con miniplacas-tornillos detitanio. Sin embargo, y tras revisar la literatura existente, el tratamiento dedichas complicaciones no ha variado de forma significativa durante los últimosaños. El objetivo es la inmovilización mecánica en el foco de fracturaafecto. En ocasiones, y dependiendo del tipo de consolidación obtenida, senecesita recurrir a la obtención de injertos óseos antólogos. La clasificaciónclínica de los defectos-consolidaciones óseas anómalas es a menudo arbitraria.Existe un amplio espectro de definiciones que describen condicionesconcurrentes simultáneas e implicaciones funcionales determinadas por lalocalización anatómica. Se discuten los distintos conceptos relacionados conla consolidación ósea. Conclusiones. La estabilización inadecuada de las fracturascon tratamiento conservador o métodos de fijación rígida conduce ainfección, pseudoartrosis o ambos. La solución pasa por por la fijación establede la fractura. Dependiendo del defecto creado, la osteosíntesis o reosteosíntesisque es necesaria debe ser acompañada por un injerto de huesoantólogo esponjoso, restaurando la oclusión dental adecuada(AU)

Introduction. The development of rigid internal fixationin the management of facial fractures over the last 25 years increasednot only the number of available treatments but also, whenincorrectly applied, the types of complications arising. Material andmethods. We present a new case report of upper jaw pseudoarthrosisafter a convencional treatment of orthognatic surgery ( osteotomytype LeFort I). Discussion. Pseudarthrosis-nonunion can result afterincorrect treatment of facial fractures with titanium miniplatesscrews.When we review the publishing literature, we find thatthe correct treatment of this potential pitfalls has not changedsignificantly during last years. The aim is the mechanical immobilityof the created fracture. Sometimes we must harvest cancellous bonegraft to complete the treatment. We discuss the different termsrelated to anomalies in the ossification. Conclusions. Inadequatestabilization of fractures by either conservative or operative methodsoften leads to infection, pseudoarthrosis or both. To promote healingof both infections and pseudarthrosis, absolutely stable fixation ofthe fragments is necessary. Depending on the defect zones thatmay develop, the osteosynthesis or reosteosynthesis that is usuallynecessary must be accompanied by a graft of autogenous cancellousbone(AU)