Evaluation of Reproductive Histology Response of Adult Fasciola hepatica in Goats Vaccinated with Cathepsin L Phage-Exposed Mimotopes.

Fasciolosis, a globally re-emerging zoonotic disease, is mostly caused by the parasitic infection with Fasciola hepatica, often known as the liver fluke. This disease has a considerable impact on livestock productivity. This study aimed to evaluate the fluke burdens and faecal egg counts in goats that were administered phage clones of cathepsin L mimotopes and then infected with F. hepatica metacercariae. Additionally, the impact of vaccination on the histology of the reproductive system, specifically related to egg generation in adult parasites, was examined. A total of twenty-four goats, which were raised in sheds, were divided into four groups consisting of six animals each. These groups were randomly assigned. The goats were then subjected to two rounds of vaccination. Each vaccination involved the administration of 1 × 1013 phage particles containing specific mimotopes for cathepsin L2 (group 1: PPIRNGK), cathepsin L1 (group 2: DPWWLKQ), and cathepsin L1 (group 3: SGTFLFS). The immunisations were carried out on weeks 0 and 4, and the Quil A adjuvant was used in combination with the mimotopes. The control group was administered phosphate-buffered saline (PBS) (group 4). At week 6, all groups were orally infected with 200 metacercariae of F. hepatica. At week 22 following the initial immunisation, the subjects were euthanised, and adult F. hepatica specimens were retrieved from the bile ducts and liver tissue, and subsequently quantified. The specimens underwent whole-mount histology for the examination of the reproductive system, including the testis, ovary, vitellaria, Mehlis' gland, and uterus. The mean fluke burdens following the challenge were seen to decrease by 50.4%, 62.2%, and 75.3% (p < 0.05) in goats that received vaccinations containing cathepsin L2 PPIRNGK, cathepsin L1 DPWWLKQ, and cathepsin L1 SGTFLFS, respectively. Animals that received vaccination exhibited a significant reduction in the production of parasite eggs. The levels of IgG1 and IgG2 isotypes in vaccinated goats were significantly higher than in the control group, indicating that protection is associated with the induction of a mixed Th1/Th2 immune response. The administration of cathepsin L to goats exhibits a modest level of efficacy in inducing histological impairment in the reproductive organs of liver flukes, resulting in a reduction in egg output.

Esquizencefalia de diagnóstico prenatal: reporte de caso / Schizencephaly of prenatal diagnosis: case report

La esquizencefalia es una malformación cerebral congénita del grupo de trastornos de migración neuronal, tiene una prevalencia de 1,54/100 000 nacidos vivos, por lo cual, se considera extremadamente rara. El objetivo de este artículo es presentar un caso de esquizencefalia fetal de labio abierto, el subtipo de peor pronóstico, cuya sospecha diagnóstica se realiza con ecografía prenatal y se confirma mediante la resonancia magnética fetal. Actualmente, en Colombia no se cuenta con este tipo de reporte de casos.

Schizencephaly is a congenital brain malformation, which is part of the group of neuronal migration disorders, which has a prevalence of 1,54/100 000 in live births, which is why it is considered extremely rare in Colombia. The objective of this article is to present a case of open-lip fetal schizencephaly, the subtype with the worst prognosis, whose suspected diagnosis is made with prenatal ultrasound and confirmed by fetal magnetic resonance imaging. Currently, this type of report is not available in Colombia.

Moving the needle on fall prevention: A Geriatric Emergency Care Applied Research (GEAR) Network scoping review and consensus statement.

BACKGROUND: Although falls are common, costly, and often preventable, emergency department (ED)-initiated fall screening and prevention efforts are rare. The Geriatric Emergency Medicine Applied Research Falls core (GEAR-Falls) was created to identify existing research gaps and to prioritize future fall research foci. METHODS: GEAR's 49 transdisciplinary stakeholders included patients, geriatricians, ED physicians, epidemiologists, health services researchers, and nursing scientists. We derived relevant clinical fall ED questions and summarized the applicable research evidence, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. The highest-priority research foci were identified at the GEAR Consensus Conference. RESULTS: We identified two clinical questions for our review (1) fall prevention interventions (32 studies) and (2) risk stratification and falls care plan (19 studies). For (1) 21 of 32 (66%) of interventions were a falls risk screening assessment and 15 of 21 (71%) of these were combined with an exercise program or physical therapy. For (2) 11 fall screening tools were identified, but none were feasible and sufficiently accurate for ED patients. For both questions, the most frequently reported study outcome was recurrent falls, but various process and patient/clinician-centered outcomes were used. Outcome ascertainment relied on self-reported falls in 18 of 32 (56%) studies for (1) and nine of 19 (47%) studies for (2). CONCLUSION: Harmonizing definitions, research methods, and outcomes is needed for direct comparison of studies. The need to identify ED-appropriate fall risk assessment tools and role of emergency medical services (EMS) personnel persists. Multifactorial interventions, especially involving exercise, are more efficacious in reducing recurrent falls, but more studies are needed to compare appropriate bundle combinations. GEAR prioritizes five research priorities: (1) EMS role in improving fall-related outcomes, (2) identifying optimal ED fall assessment tools, (3) clarifying patient-prioritized fall interventions and outcomes, (4) standardizing uniform fall ascertainment and measured outcomes, and (5) exploring ideal intervention components.

Paraplegia due to spinal meningioma during the third trimester of pregnancy: case report and literature review.

INTRODUCTION: Spinal meningiomas represent 25-45% of intradural spinal tumors and ~2% of meningiomas of the central nervous system (CNS), and their occurrence during pregnancy is unusual. We present an updated literature review. CASE REPORT: A 36-year-old woman, at 32.6 weeks of gestation, was hospitalized for urinary tract infection and urinary retention. One month earlier, she had decreased strength in lower limbs, and this weakness rapidly progressed to flaccid paraplegia without sphincters control. Magnetic resonance imaging (MRI) revealed a well-defined intradural extramedullary lesion in T3-T4. Using a posterolateral approach, the tumor was completely removed; however, there was no clinical improvement, and the patient was discharged with an impairment scale (AIS) grade A. Histopathology examination indicated a psammomatous meningioma. DISCUSSION: Meningiomas are benign tumors that are slowly progressive; however, the hemodynamic and hormonal changes of pregnancy are related to their accelerated growth. Reports show that the onset of the symptoms during the third trimester of pregnancy, including early neurological symptoms or signs of spinal cord compression, can be easily attributed to those of pregnancy by both the patient and the doctor. The time to diagnosis and medulla compression time are thus prolonged, which can be further compounded in middle-high income countries due to limitations in obtaining images for evaluation. Although rare, spinal meningiomas should be considered in the differential diagnosis of patients with neurological symptoms during pregnancy. Their early recognition is important to avoid irreversible neurological damage.

Uréter retrocavo e infección recurrente de vías urinarias: A propósito de un caso / Retrocaval Ureter and Recurrent Urinary Tract Infection: Case Report

El uréter retrocavo es una anomalía poco frecuente de etiología congénita, la cual causa sintomatología en pacientes adultos; se caracteriza por hidronefrosis en diferentes grados, además de otras patologías relacionadas con lesión renal. El abordaje terapéutico es principalmente quirúrgico y se aplicará de acuerdo con el grado de disfunción renal. A continuación se presenta el caso de una mujer de 27 años de edad, a quien se le practicó un estudio imaginológico por infección recurrente de vías urinarias que no respondió a la farmacoterapia habitual.

Retrocaval ureter is a rare anomaly of congenital etiology, which causes symptoms in adults and is characterized by hydronephrosis in different degrees, in addition to other diseases related to renal injury. The therapeutic approach is mainly surgical and decided according to degree of related renal dysfunction. We present a case of a woman aged 27 who is sent to the radiology service of Hospital San Rafael Tunja for an imaging study after refractory urinary tract infection that did not respond to standard drug therapy

Cervical Radiculopathy: Incidence and Treatment of 1,420 Consecutive Cases.

STUDY DESIGN: Retrospective case series. PURPOSE: To determine the incidence of cervical radiculopathy requiring operative intervention by level and to report on the methods of treatment. OVERVIEW OF LITERATURE: Cervical radiculopathy is a common cause of pain and can result in progressive neurological deficits. Although the pathology is well understood, the actual incidence of cervical radiculopathy at particular spinal levels ultimately requiring operative intervention is unknown. METHODS: A large consecutive series of patients operated on by a single surgeon were retrospectively analyzed. The incidence of cervical radiculopathy at each level was defined for every patient. Procedures used for operative treatment were noted. Health related quality of life (HRQL) scores were collected both pre-operatively and postoperatively. RESULTS: There were 1305 primary and 115 revision operations performed. The most common primary procedures performed were anterior cervical discectomy and fusion (ACDF, 50%) and anterior cervical corpectomy and fusion (ACCF, 28%). The most commonly affected levels were C6 (66%) and C7 (62%). Reasons for revision were pseudarthrosis (27%), clinical adjacent segment pathology (CASP, 63%), persistent radiculopathy (11%), and hardware-related (2.6%). The most common procedures performed in the revision group were posterior cervical decompression and fusion (PCDF, 42%) and ACDF (40%). The most commonly affected levels were C7 (43%) and C5 (30%). Among patients that had their index surgery at our institution, the revision rate was 6.4%. In both primary and revision cases there was a significant improvement in Neck Disability Index and visual analogue scale scores postoperatively. Postoperative HRQL scores in the revision cases were significantly worse than those in the primary cases (p <0.01). CONCLUSIONS: This study provides the largest description of the incidence of cervical radiculopathy by level and operative outcomes in patients undergoing cervical decompression. The incidence of CASP was 4.2% in 3.3 years in this single institution series.

[Profile of the patient with failed back surgery syndrome in the National Institute of Rehabilitation. Comparative analysis]. / Perfil del paciente con síndrome de columna multioperada en el Instituto Nacional de Rehabilitación. Análisis comparativo.

BACKGROUND: Failed back surgery syndrome is a complication of spine surgery that leads to chronic pain and disability, often with disastrous emotional consequences to the patient. AIM: To compare the profile of patients whose first surgery was performed in our hospital versus a group that underwent first spine surgery in a different centre. METHODS: Retrospective study with 65 patients; 18 formed group I (first spine surgery performed in our institution), and 47 patients in group II (first surgery performed in another hospital). Background, demographic, clinical features and functional status were compared. In group I the majority of the cases had a previous diagnosis of lumbar stenosis (group I 44.4% vs group II 25.5% p = 0.22), whereas disk herniation was the main diagnosis in group II (group I 22.2% vs group II 61.7% p = 0.001). The main cause of the syndrome in group I was technical error during surgery (61.1%), while in group II this cause represented only 6.3% (p=.001). Among the patients of this latter group, misdiagnosis was highly prevalent (57.4%), against no cases in group I (p=.001). The preoperative functional status between both groups and their recovery in the immediate postoperative period was similar (p = 0.68). CONCLUSIONS: This study suggests that the diagnostic and treatment standards are different between healthcare centres, specifically between academic centres vs. private practice.

Influence of depression symptoms on patient expectations and clinical outcomes in the surgical management of spinal stenosis.

OBJECT: This prospective cohort study was designed to determine the influence of depressive symptoms on patient expectations and the clinical outcomes of the surgical management of lumbar spinal stenosis. METHODS: Patients with an age > 45 years, a diagnosis of lumbar spinal stenosis at one level, and an indication for decompressive surgery were included in this study. Data for all of the following parameters were recorded: age, sex, highest level of education, and employment status. Depression symptoms (Beck Depression Inventory), disability (Oswestry Disability Index), and back and leg pain (visual analog scale) were assessed before surgery and at 12 months thereafter. The reasons for surgery and patient expectations (North American Spine Society lumbar spine questionnaire) were noted before surgery. The global effectiveness of surgery (Likert scale) was assessed at the 1-year follow-up. RESULTS: Fifty-eight patients were divided into two groups based on the presence (Group 1) or absence (Group 2) of depressive symptoms preoperatively; each group comprised 29 patients. Demographic data were similar in both groups before surgery. The main reason to undergo surgery was "fear of a worse situation" in 34% of the patients in Group 1 and "to reduce pain" in 24% of the patients in Group 2. The most prevalent expectation was to improve my social life and my mental health in both groups. Surgery had a relieving effect on the depressive symptoms in 14 patients (48%). Thus, in the postoperative period, the number of patients who were free of depressive symptoms was 43 compared with the 15 who were depressed (p = 0.001). The 15 patients with persistent depression symptoms after surgery had a worse clinical outcome compared with the 43 patients free of depression symptoms at the 1-year follow-up in terms of severe back pain (20% vs. 0%, respectively), severe leg pain (40% vs. 2.3%, respectively), and severe disability (53% vs. 9.3%, respectively). Only 33% of patients with persistent depression symptoms after surgery chose the option "surgery helped a lot" compared with 76% of patients without depression symptoms. Moreover, in terms of expectations regarding improvement in back pain, leg pain, walking capacity, independence, physical duties, and social activities, fewer patients were "completely satisfied" in the group with persistent depression symptoms after surgery. CONCLUSIONS: Surgery for spinal stenosis had a relieving effect on preoperative depression symptoms at the 1-year follow-up. The persistence of depressive symptoms after surgery correlated with a worse clinical outcome and a higher rate of unmet expectations. Screening measures to detect and treat depression symptoms in the perioperative period could lead to better clinical results and increased patient satisfaction.

Nivel de conocimientos de los obstetras acerca del diagnóstico y tratamiento de la isoinmunización materna: Estudio de corte transversal en Bogotá (Colombia), 2012-2013 / Level of knowledge among obstetricians regarding diagnosis and treatment of maternal isoimmunization: Cross-sectional study in Bogotá (Colombia), 2012-2013

Objetivo: describir el nivel de conocimientos acerca del diagnóstico, tratamiento y pronóstico de la isoinmunización materna entre los especialistas de Ginecología y Obstetricia afiliados a la Asociación Bogotana de Perinatología (ABP). Materiales y métodos: estudio descriptivo de corte transversal. Entre noviembre de 2012 y marzo de 2013, se aplicó una encuesta elaborada por especialistas en Medicina Materno-Fetal (MMF). Se excluyeron los profesionales que ejercen su actividad fuera del territorio nacional, aquellos que no han practicado la obstetricia durante los últimos diez años y a quienes no suministraron la totalidad de la información requerida. El instrumento estuvo compuesto por 18 preguntas organizadas en tres dominios: características sociodemográficas, información sobre la práctica clínica y conocimientos. Se utilizó estadística descriptiva para el análisis en la materia. Resultados: el instrumento se aplicó a 220 profesionales de los cuales 127 (57,7 %) respondieron la encuesta en su totalidad y fueron incluidos en el análisis. El 32 % de los obstetras y el 45 % de los especialistas en MMF identificaron correctamente el punto de corte para el coombs indirecto. El 43 y 62 % de los obstetras y especialistas en MMF reconocieron el papel de la velocimetría de la arteria cerebral media para el diagnóstico de anemia fetal, y el 82 y 76 % respectivamente la utilizarían en el seguimiento del feto anémico. Tan solo el 76 % de los obstetras y el 66 % de los especialistas en MMF reconocen las indicaciones de culminar la gestación en caso de anemia fetal, en tanto que el 90 y 97 % (respectivamente) identificaron cuándo realizar cordocentesis y transfusión in utero. Finalmente, el 37 % de los obstetras y el 48 % de los especialistas en MMF no reconocen a la curva de Queenan-Liley como una alternativa cuando no hay acceso al Doppler fetal. Conclusión: existe una importante variabilidad con respecto al nivel de conocimientos de los obstetras y especialistas en MMF en cuanto al diagnóstico, tratamiento y seguimiento de las gestantes con isoinmunización. Se requieren más estudios que caractericen la variabilidad en la práctica clínica acerca del diagnóstico y tratamiento de la isoinmunización materna en Colombia.

Objective: To describe the level of knowledge regarding the diagnosis, treatment and prognosis of maternal isoimmunisation among Gynaecology and Obstetrics specialists, members of ABP (Asociación Bogotana de Perinatología). Materials and methods: Cross-sectional descriptive study. A questionnaire prepared by specialists in Maternal and Foetal Medicine (MFM) was administered between November 2012 and March 2013. Professionals practicing outside the national territory, those who had not practiced over the past ten years, and those who did not provide all the information required were excluded. The tool consisted of 18 questions organized in three domains: socio-demographic characteristics, information about clinical practice, and knowledge of the subject. A descriptive statistical analysis was used. Results: Of the 220 practitioners who were given the questionnaire, 127 (57.7%) completed the survey and were included in the analysis. The cut-off point for the indirect Coombs was correctly identified by 32% of the obstetricians and by 45% of the specialists in MFM. The role of middle cerebral artery velocimetry for the diagnosis of foetal anaemia was recognized by 43% and 62% of obstetricians and specialists in MFM, and 82% and 76%, respectively, would use it for the follow-up of foetuses with anaemia. Only 76% of obstetricians and 66% of MFM specialists recognized the indications for delivering the baby in cases of foetal anaemia, whereas 90% and 97%, respectively, identified the timing for cordocentesis and in utero transfusion. Finally, 37% of obstetricians and 48% of MFM specialists did not recognize the Queenan-Liley curve as an option in cases where there is no access to foetal Doppler. Conclusion: There is an important variability in the level of knowledge among obstetricians and MFM specialists regarding the diagnosis, treatment and follow-up of pregnant women with isoimmunisation. Additional studies are required to characterize the variability in clinical practice regarding the diagnosis and treatment of maternal isoimmunisation in Colombia.

Knowledge of skull base anatomy and surgical implications of human sacrifice among pre-Columbian Mesoamerican cultures.

Human sacrifice became a common cultural trait during the advanced phases of Mesoamerican civilizations. This phenomenon, influenced by complex religious beliefs, included several practices such as decapitation, cranial deformation, and the use of human cranial bones for skull mask manufacturing. Archaeological evidence suggests that all of these practices required specialized knowledge of skull base and upper cervical anatomy. The authors conducted a systematic search for information on skull base anatomical and surgical knowledge among Mesoamerican civilizations. A detailed exposition of these results is presented, along with some interesting information extracted from historical documents and pictorial codices to provide a better understanding of skull base surgical practices among these cultures. Paleoforensic evidence from the Great Temple of Tenochtitlan indicates that Aztec priests used a specialized decapitation technique, based on a deep anatomical knowledge. Trophy skulls were submitted through a stepwise technique for skull mask fabrication, based on skull base anatomical landmarks. Understanding pre-Columbian Mesoamerican religions can only be realized by considering them in their own time and according to their own perspective. Several contributions to medical practice might have arisen from anatomical knowledge emerging from human sacrifice and decapitation techniques.

Neanderthal medics? Evidence for food, cooking, and medicinal plants entrapped in dental calculus.

Neanderthals disappeared sometime between 30,000 and 24,000 years ago. Until recently, Neanderthals were understood to have been predominantly meat-eaters; however, a growing body of evidence suggests their diet also included plants. We present the results of a study, in which sequential thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) and pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) were combined with morphological analysis of plant microfossils, to identify material entrapped in dental calculus from five Neanderthal individuals from the north Spanish site of El Sidrón. Our results provide the first molecular evidence for inhalation of wood-fire smoke and bitumen or oil shale and ingestion of a range of cooked plant foods. We also offer the first evidence for the use of medicinal plants by a Neanderthal individual. The varied use of plants that we have identified suggests that the Neanderthal occupants of El Sidrón had a sophisticated knowledge of their natural surroundings which included the ability to select and use certain plants.

Differences in pelvic parameters among Mexican, Caucasian, and Asian populations.

OBJECT: The aim of this study was to describe the pelvic parameters in a sample of healthy Mexican volunteers and to compare them with previously reported data for Caucasian and Asian populations. METHODS: This was a transversal study that included a sample population of healthy Mexican volunteers. Age, sex, and lateral radiographs of the lumbosacral region with the individual standing to obtain the pelvic parameters of pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), and lumbar lordosis (LL) were recorded in each volunteer. The data were compared with those previously published for Caucasian and Asian individuals. RESULTS: In total, 202 Mexican individuals (81 men and 121 women; mean age 46.5 years, range 18-85 years) were included. There were statistically significant differences between the Mexican and Caucasian control group with respect to PT (11.9° vs 15.78°, respectively) and PI (51.91° vs 56.68°, respectively). Comparison with the Asian population showed statistically significant differences in relation to the Mexican group in terms of the PT (11.5° vs 15.78°), PI (47.8° vs 56.68°), and SS (36.3° vs 40.89°). The mean LL was 60.17° for the Mexican group, 52.3° for the Asian group, and 61.3° for the Caucasian group. A significant difference in LL was found between the Mexican and Asian populations (p < 0.0001). CONCLUSIONS: A comparison of the values for pelvic parameters and lumbar lordosis across the different population samples revealed statistically significant differences, which can be attributed to the ethnic origin of the individuals.

An ancestral miR-1304 allele present in Neanderthals regulates genes involved in enamel formation and could explain dental differences with modern humans.

Genetic changes in regulatory elements are likely to result in phenotypic effects that might explain population-specific as well as species-specific traits. MicroRNAs (miRNAs) are posttranscriptional repressors involved in the control of almost every biological process. These small noncoding RNAs are present in various phylogenetic groups, and a large number of them remain highly conserved at the sequence level. MicroRNA-mediated regulation depends on perfect matching between the seven nucleotides of its seed region and the target sequence usually located at the 3' untranslated region of the regulated gene. Hence, even single changes in seed regions are predicted to be deleterious as they may affect miRNA target specificity. In accordance to this, purifying selection has strongly acted on these regions. Comparison between the genomes of present-day humans from various populations, Neanderthal, and other nonhuman primates showed an miRNA, miR-1304, that carries a polymorphism on its seed region. The ancestral allele is found in Neanderthal, nonhuman primates, at low frequency (~5%) in modern Asian populations and rarely in Africans. Using miRNA target site prediction algorithms, we found that the derived allele increases the number of putative target genes for the derived miRNA more than ten-fold, indicating an important functional evolution for miR-1304. Analysis of the predicted targets for derived miR-1304 indicates an association with behavior and nervous system development and function. Two of the predicted target genes for the ancestral miR-1304 allele are important genes for teeth formation, enamelin, and amelotin. MicroRNA overexpression experiments using a luciferase-based assay showed that the ancestral version of miR-1304 reduces the enamelin- and amelotin-associated reporter gene expression by 50%, whereas the derived miR-1304 does not have any effect. Deletion of the corresponding target sites for miR-1304 in these dental genes avoided their repression, which further supports their regulation by the ancestral miR-1304. Morphological studies described several differences in the dentition of Neanderthals and present-day humans like slower dentition timing and thicker enamel for present-day humans. The observed miR-1304-mediated regulation of enamelin and amelotin could at least partially underlie these differences between the two Homo species as well as other still-unraveled phenotypic differences among modern human populations.

[Forestier disease. Case report and literature review]. / Enfermedad de Forestier. Reporte de un caso y revisión bibliográfica.

BACKGROUND: Forestier disease is a systemic disorder characterized by ossification of the anterior spinal longitudinal ligament (ALL) in at least three adjacent vertebrae, and diffuse spinal enthesopathy. Indication for surgical treatment is rare and limited to cases of related myelopathy, fracture or significant dysphagia. Few cases of surgical treatment are reported in the medical literature. Surgical treatment depends on the particular symptoms or complications, and usually involves osteophytectomy through the standard anterior approach. Surgery may bring about complications, such as pharyngeal paralysis, thrombosis, infections and respiratory obstruction. CLINICAL CASE: 79-year old male with dysphagia of 10 years of evolution, and hoarseness and respiratory distress since 8 years ago. Screening studies showed a diffuse calcification of anterior longitudinal ligament along with large cervical osteophytes. Forestier disease and secondary dysphagia were diagnosed. Surgical treatment consisted of resection of bone exostoses in C4 and C5 vertebral bodies. Six months after surgery, the patient reported improvement of esophageal and respiratory symptoms without evidence of recurrence on imaging studies. CONCLUSIONS: Data on Forestier disease's epidemiological nature and impact on life quality in Mexico is unknown. An increase in its occurrence is projected as the Mexican population ages. An observational study is required to identify the characteristics of this disease in Mexico.

Traumatic posterior L4-L5 fracture dislocation of the lumbar spine: a case report.

Study Design Case report. Objective The diagnosis and surgical management of a patient with traumatic bilateral posterior dislocation of L4-L5 is presented with a thorough review of the existing literature. Summary of Background Data Traumatic dislocation of L4-L5 has been reported in the English literature in only five cases; of these, only two were retrolisthesis. Methods A 20-year-old patient was involved in a high-energy vehicular accident and presented with back pain and inability to ambulate. Neurological assessment showed motor strength grade 2/5 in the proximal lower-extremity muscle groups (L1-L3 myotomes) and 0/5 strength distally (L4-S1 myotomes); in addition, incontinence of sphincters was found. X-rays and computed tomography (CT) scan revealed a three-column ligamentous injury with posterior fracture-dislocation of the L4 vertebral body with complete posterior displacement of L4 to L5 vertebral body. The patient underwent posterior approach with reduction, transpedicular fixation, and posterolateral fusion with autologous bone graft. Results At 1-year follow-up, the patient had recovered muscular strength in proximal lower-extremities muscle groups, sphincter function had fully recovered, and he was able to ambulate with crutches. There was no recovery of distal extremity sensorimotor function. Plain radiograph and CT scan showed good alignment and progressive maturation of his fusion procedure. Conclusion Traumatic retrolisthesis of L4-L5 is a high-energy unstable fracture; reduction of the dislocation is challenging because of the heavy forces acting in the lower lumbar spine. Instrumented fusion restores alignment and maintains segmental stability.

Bone remodelling in Neanderthal mandibles from the El Sidrón site (Asturias, Spain).

Skull morphology results from the bone remodelling mechanism that underlies the specific bone growth dynamics. Histological study of the bone surface from Neanderthal mandible specimens of El Sidrón (Spain) provides information about the distribution of the remodelling fields (bone remodelling patterns or BRP) indicative of the bone growth directions. In comparison with other primate species, BRP shows that Neanderthal mandibles from the El Sidrón (Spain) sample present a specific BRP. The interpretation of this map allows inferences concerning the growth directions that explain specific morphological traits of the Neanderthal mandible, such as its quadrangular shape and the posterior location of the mental foramen.

Genetic evidence for patrilocal mating behavior among Neandertal groups.

The remains of 12 Neandertal individuals have been found at the El Sidrón site (Asturias, Spain), consisting of six adults, three adolescents, two juveniles, and one infant. Archaeological, paleontological, and geological evidence indicates that these individuals represent all or part of a contemporaneous social group of Neandertals, who died at around the same time and later were buried together as a result of a collapse of an underground karst. We sequenced phylogenetically informative positions of mtDNA hypervariable regions 1 and 2 from each of the remains. Our results show that the 12 individuals stem from three different maternal lineages, accounting for seven, four, and one individual(s), respectively. Using a Y-chromosome assay to confirm the morphological determination of sex for each individual, we found that, although the three adult males carried the same mtDNA lineage, each of the three adult females carried different mtDNA lineages. These findings provide evidence to indicate that Neandertal groups not only were small and characterized by low genetic diversity but also were likely to have practiced patrilocal mating behavior.

Brief communication: Subvertical grooves on interproximal wear facets from the El Sidrón (Asturias, Spain) Neandertal dental sample.

The distribution of subvertical grooves on interproximal wear dental facets from the El Sidrón (Asturias, Spain) Neandertals is described and analyzed. Out of 93 teeth, 64.5% present subvertical grooves, including a high frequency (50%) on the anterior dentition. Contrary to some studies, subvertical grooves from adjacent facets perfectly overlap each other and do not interdigitate, probably forming small channels. Both the facet and the groove surface share the same polished appearance, suggesting a common origin. Statistical analyses reveal that the number of grooves is neither dependent on the degree of occlusal wear, nor on the position on the tooth or the individual's age. However, facet width is an important factor determining the number of subvertical grooves. The etiology of subvertical grooves formation on Neandertal teeth remains unclear.

A look at Mayan artificial cranial deformation practices: morphological and cultural aspects.

Induced deformation of the cranial vault is one form of permanent alteration of the body that has been performed by human beings from the beginning of history as a way of differentiating from others. These procedures have been observed in different cultures, but were particularly widespread in Mesoamerica. The authors examined and reviewed the historical and anthropological literature of intentional deformation practices in Mayan culture. The Mayans performed different types of cranial deformations and used different techniques and instruments to deform children's heads. The most remarkable morphological alteration is seen in the flattening of the frontal bone. Some archeological investigations link deformation types with specific periods. This article provides a glance at the cultural environment of the Mayans and demonstrates the heterogeneity of this interesting cultural phenomenon, which has changed over time.