A brief summary of the Ordovician conodont faunas from the Iberian Peninsula

Ordovician conodont studies in the Iberian Peninsula were initiated by Fuganti and Serpagli (1968), who recognized 21 morphospecies included in 15 morphogenera in the Upper Ordovician Urbana Limestone from a single locality in the Central Iberian Zone. Two years later Boersma (in Hartevelt, 1970) identified several morphotaxa in the Upper Ordovician Estana Formation of the Central Pyrenees. In the type section of the Upper Ordovician Cystoid Limestone of the Eastern Iberian Cordillera, Carls (1975) recognised 31 conodont morphotaxa. These pioneer findings were followed by the contributions of Kolb (1978), Hafenrichter (1979), Robert (1980), Robardet (1982) and Sanz (1988), who increased the number of taxa and localities with Katian conodonts, mostly attributed to the Amorphognathus ordovicicus Zone. For twenty years, our knowledge on Ordovician conodonts came only from the single ubiquitous limestone unit that occurs in the upper part of many Iberian successions. Nonetheless, these are predominantly composed of terrigenous rocks (shales, siltstones and sandstones) which were deposited at high Gondwanan paleolatitudes near the South Pole (Gutiérrez-Marco et al., 2002, 2004). Then, some of these clastic deposits (siltstones, shales and storm-induced coquinoid lenses, sometimes calcareous) were also sampled for conodonts: while siltstones and shales produced only fragmentary specimens, bioclastic beds in tempestites yielded usually fragmentary, but recognisable, elements.Peer reviewe

Estudio de incidencia y seguimiento del hematoma de glotis en pacientes tratados con acenocumarol Study of incidence and follow-up of glottic haematoma in patients under acenocoumaro/ therapy

Con el objeto de valorar la incidencia y repercusión clínica de complicaciones hemorrágicas que la terapia anticoagulante con acenocumarol genera en la laringe de los pacientes, se desarrolló un estudio prospectivo longitudinal observacional sobre una población así tratada, a la que al menos en una ocasión se le practic6 una exploraci6n endoscópica de laringc, independientemente de que presentaran o no sintomatologfa laríngea. En dos años fueron incluidos un total de 775 pacientes. alcanzando un seguimiento absoluto de 1.238.54 pacientes- año. Fueron detectados 176 desórdenes hemorrágicos en 132 pacientes -el 17,0% del total-, con una incidencia de 14,2/100 pacientes-año. Las manifestaciones hemorrágicas mas frecuentes fueron las epistaxis y las de los tractos genito-urinario y digestivo, quedando en sexto lugar por orden de frecuencia los hematomas laríngeos, con 14 casos -el 7,9% de todas las hemorragias-, con una incidencia de I, 13/100 pacientes-afio. Este tipo de complicación por acenocumarol afectó tfpicamente a pacientes con defectuoso grado de cumplimentaci6n del tratamiento (66.4%), historial previo de otras complicaciones hemorragicas ( 100%), mas alla del primer afio de tratamicnto (78,6%) y con un grado intermedio de desencadenante traumatico (58,2%). La exploraci6n laríngea reveló que el 35,7% de los hematomas de glotis no presentaban sintomatologfa alguna, y cuando lo hadan siempre empezaban con disnea. El 85,7% de los casos evidenció un INR excesivamente prolongado, y hasta el 71.4% de los pacientes mostraba hallaLgos objetivos de laringitis cró- nica. En todos los casos se modific6 la dosis de acenocumarol, llegando a suspcnderse en nueve, y en cinco se procedió al ingreso hospitalario para tratamiento con hemoderivados. Existió un caso en que el hematoma ocluyó por completo la glotis y evolucionó a un desenlace fatal pese a practicar una traqueotomía urgente. El hematoma de glotis no es una complicación inusual del empleo de dicumarfnicos. El mismo debe sospecharse en pacientes con malos controles de su terapeutica anticoagulante, con habito fumador, y descartarse cuando el paciente consulta por disfonía o disnea

Clinical Outcomes of Soft Tissue Preservation Surgery With Hydroxyapatite-Coated Abutments Compared to Traditional Percutaneous Bone Conduction Hearing Implant Surgery-A Pragmatic Multi-Center Randomized Controlled Trial

Background: Soft tissue preservation using a hydroxyapatite-coated abutment in bone conduction hearing implant surgery may lead to improved clinical outcomes over the short (1 year) and long term (3 years). Methods: In this open multi-center, randomized (1:1), controlled clinical trial, subjects with conductive, mixed hearing loss or single-sided sensorineural deafness were randomly assigned to receive the conventional intervention, a titanium abutment with soft tissue reduction surgery (control), or a new intervention, a hydroxyapatite-coated abutment with soft tissue preservation surgery (test). The primary efficacy outcome was the combined endpoint of numbness, pain, peri-abutment dermatitis, and soft tissue thickening/overgrowth after 1 and 3 years. Results: The Intention-to-treat (ITT) population consisted of 52 control subjects and 51 test subjects. The difference between the groups after 1 year of follow-up as measured by the primary efficacy outcome was not statistically significant (p = 0.12) in the ITT population (n = 103), but did reach statistical significance (p = 0.03) in the per-protocol (PP) population (n = 96). It showed an advantage for the test group, with over twice as many subjects (29%) without these medical events during the first year compared to the control group (13%). After 3 years, the difference between the two groups had declined and did not reach statistical significance (24 vs. 10%, ITT p = 0.45). Secondary outcome measures which showed a statistical significant difference during the first year, such as surgical time (15 vs. 25 minutes, p <0.0001), numbness (90 vs. 69% of subjects experienced no numbness at 1 year, p <0.01), neuropathic pain at 3 months (p = 0.0087) and the overall opinion of the esthetic outcome (observer POSAS scale at 3 months, p <0.01) were favorable for the test group. More soft tissue thickening/overgrowth was observed at 3 weeks for the test group (p = 0.016). Similar results were achieved for the long term follow up. Conclusions: Soft tissue preservation with a hydroxyapatite-coated abutment leads to a reduction in the combined occurrence of complications over the first year which is not statistically significant in the ITT population but is in the PP population. This effect decreased for the long-term study follow up of 3 years and did also not reach statistical significance

Clinical Outcomes of Soft Tissue Preservation Surgery With Hydroxyapatite-Coated Abutments Compared to Traditional Percutaneous Bone Conduction Hearing Implant Surgery-A Pragmatic Multi-Center Randomized Controlled Trial

Background: Soft tissue preservation using a hydroxyapatite-coated abutment in bone conduction hearing implant surgery may lead to improved clinical outcomes over the short (1 year) and long term (3 years). Methods: In this open multi-center, randomized (1:1), controlled clinical trial, subjects with conductive, mixed hearing loss or single-sided sensorineural deafness were randomly assigned to receive the conventional intervention, a titanium abutment with soft tissue reduction surgery (control), or a new intervention, a hydroxyapatite-coated abutment with soft tissue preservation surgery (test). The primary efficacy outcome was the combined endpoint of numbness, pain, peri-abutment dermatitis, and soft tissue thickening/overgrowth after 1 and 3 years. Results: The Intention-to-treat (ITT) population consisted of 52 control subjects and 51 test subjects. The difference between the groups after 1 year of follow-up as measured by the primary efficacy outcome was not statistically significant (p = 0.12) in the ITT population (n = 103), but did reach statistical significance (p = 0.03) in the per-protocol (PP) population (n = 96). It showed an advantage for the test group, with over twice as many subjects (29%) without these medical events during the first year compared to the control group (13%). After 3 years, the difference between the two groups had declined and did not reach statistical significance (24 vs. 10%, ITT p = 0.45). Secondary outcome measures which showed a statistical significant difference during the first year, such as surgical time (15 vs. 25 minutes, p <0.0001), numbness (90 vs. 69% of subjects experienced no numbness at 1 year, p <0.01), neuropathic pain at 3 months (p = 0.0087) and the overall opinion of the esthetic outcome (observer POSAS scale at 3 months, p <0.01) were favorable for the test group. More soft tissue thickening/overgrowth was observed at 3 weeks for the test group (p = 0.016). Similar results were achieved for the long term follow up. Conclusions: Soft tissue preservation with a hydroxyapatite-coated abutment leads to a reduction in the combined occurrence of complications over the first year which is not statistically significant in the ITT population but is in the PP population. This effect decreased for the long-term study follow up of 3 years and did also not reach statistical significance