New high resolution calcareous nannofossil analysis across the Danian / Selandian transition at the Zumaia section: comparison with South Tethys and Danish sections

A high resolution calcareous nannofossil biostratigraphic analysis was carried out across the Danian/Selandian transition at the Zumaia section (western Pyrenees). In the studied interval, spanning Varol’s Subzone NTp7a to Zone NTp9, a sequence of 10 distinct calcareous nannofossil events is identified. The recognition of these bioevents confirms the continuous and expanded character of the Zumaia section and allows an accurate biostratigraphic correlation of the D/S transition between Zumaia, the Danish reference sections and the more southerly Tethys sections. According to this correlation, the abrupt transition from the upper Danian limestones (the calcisiltite unit) to the Lellinge Greensand that marks the D/S boundary in the type area correlates with the lithological change from the Aitzgorri Limestone Formation to the Itzurun Formation in Zumaia. The calcareous nannofossil bioevents recorded in connection with the organic-rich layer used to mark the base of the Selandian in the Tethys region were detected in Zumaia ~10 m below the top of the Aitzgorri Limestone Formation. This finding suggests that the organic-rich layer is considerably older than the Danian/Selandian (D/S) boundary at Zumaia and the type area, and thus using it to mark the D/S boundary in Tethys is not appropriate. According to a counting of limestone/marl couplets, which are demonstrated to be the stratigraphic expression of precession cycles throughout the Zumaia section, the organic-rich layer in the Tethys region is ~546 kyr older than the D/S boundary at the type area

Selective internal radiation therapy: an effective treatment for hormonal syndromes in pancreatic neuroendocrine tumors

The hormone secretion in pancreatic neuroendocrine tumors (pNET) causes an important interference in patients' quality of life. We present two cases of pNET metastatic to the liver (a pancreatic endocrine carcinoma with a severe hormonal syndrome and an insulinoma with severe crisis of hypoglycemia and coma) refractory to conventional treatments, which were finally solved with selective internal radiation therapy (SIRT), a nonstandard level 1 therapy. We show two examples of an excellent control of symptoms together with a long survival after treatment with SIRT. The evidence supporting the use of this therapy is level 2. Our case reports strongly support the use of SIRT for the severe clinical syndrome in pNET metastatic to the liver and refractory to somatostatin analogs

Therapeutic embolisation for postoperative haemorrhage after total arthroplasty of the hip and knee

We describe three cases of postoperative haemorrhage, two after total hip and one after total knee replacement, treated by percutaneous embolisation. After diagnostic angiography, this is the preferred method for the treatment of postoperative haemorrhage due to the formation of a false aneurysm, after hip or knee arthroplasty. This procedure, carried out under local anaesthesia, has a low rate of complications and avoids the uncertainty of further surgical exploratio

Técnicas terapéuticas endovasculares

Percutaneous and endovascular techniques have shown their efficacy in the treatment of a great variety of pathologies. The advances in diagnostic imaging as well as the development of new materials have made it possible to carry out new procedures that were unthinkable not many years ago. The irruption of this new form of treating patients has had, is having, and will have a clear impact on the multidisciplinary approach to numerous diseases

Correlation of the Thanetian-Ilerdian turnover of larger foraminifera and the Paleocene-Eocene thermal maximum: confirming evidence from the Campo area (Pyrenees, Spain)

It has long been known that a major larger foraminifera turnover (LFT) occurred at the boundary between the Thanetian and Ilerdian stages, but its possible correlation with the Paleocene-Eocene thermal maximum (PETM) was unsuspected until the work of Baceta (1996), and has been controversial ever since. After summarizing the history of this controversy, we present information from three new sections that conclusively resolve the issue, all of them placed less than 2 km to the east of the classical Campo section in the southern Pyrenees. In these three sections, an up to 7 meter-thick intercalation of continental deposits rich in pedogenic carbonate nodules is sandwiched between uppermost Thanetian and lowermost Ilerdian shallow marine carbonates. The d13C composition of 42 pedogenic nodules collected from two of these sections (San Martín and La Cinglera) ranges between –11.4 and -14.3‰ and averages –12.9‰, values that conclusively represent the PETM and for the first time are recorded in sections where the LFT is clearly represented. Further, a high-resolution lithological correlation between Campo and the three new sections across the P-E interval unquestionably demonstrates that the lowermost marine beds with autochthonous specimens of Alveolina vredenburgi (a tell-tale of the LFT) are laterally interfingered –and are therefore coeval- with the nodule-bearing PETM continental deposits. On the basis of the new evidence, the temporal coincidence of the PETM and the LFT can no longer be doubted

Osteosarcoma: correlation between radiological and histological changes after intra-arterial chemotherapy

The statistical correlation between three different radiological methods (conventional radiography, computed tomography and angiography) and tumor necrosis (TN) of the resected specimen have been studied in a series of 31 patients diagnosed with osteosarcoma (OS). They were treated with a multidisciplinary approach including intraarterial and intravenous chemotherapy followed by limb salvage procedures, plus intraoperative radiotherapy and adjuvant chemotherapy. A clear statistical correlation has been obtained between TN and angiography (p = 0.02) and between TN and two specific radiological signs: 'tumoral stain and neovascularity' (p = 0.02) and 'peritumoral fat planes' (p = 0.05). Conventional radiography, computed tomography and other radiological signs studied (nutrient vessel, soft tissue mass and central peripheral calcifications) did not show any significant correlation with TN. These results seem to suggest that angiography is a method to evaluate TN preoperatively and also to define the efficacy of neoadjuvant chemotherapy in OS

Prevalence and progression of chronic kidney disease after a liver transplant: a prospective, real-life, observational, two-year multicenter study

Introduction: chronic kidney disease is a frequent complication after liver transplantation. The use of calcineurin inhibitors is one of the causes of this complication. Current immunsuppression regimens that reduce the use of calcineurin inhibitors may be associated with an improved preservation of renal function. Objective: the study aimed to assess the evolution of renal function after liver transplantation in the current routine clinical practice. Methods: an observational, prospective, multicenter study in adult liver transplant recipients was performed. Two hundred and thirty patients with a good renal function before transplantation were assessed six months post-transplantation (baseline) and every six months until month 30. Results: at baseline, 32% of the patients had a reduction in the glomerular filtration rate below < 60 ml/min/1.73 m2. The mean glomerular filtration rate increased from 72.3 to 75.6 ml/min/1.73 m2 at baseline and month 30 respectively (p < 0.01). The mean serum creatinine levels (mg/dl) decreased from 1.13 to 1.09 (p < 0.01). The percentage of patients with stage 3 chronic kidney disease decreased from 31.7% to 26.4%, whereas the percentage of patients with stage 4 remained unchanged (0.4% at baseline and 0.5% at month 30). No patients progressed to end-stage kidney disease that required dialysis or renal transplantation. Conclusion: in the routine clinical practice, a moderate deterioration of renal function is frequent after liver transplantation. However, advanced chronic kidney disease is infrequent in patients with a good pre-transplant renal function