Myositis ossificans of the masseter muscle: a rare location. Report of a case and review of literature

Background: Myositis Ossificans is a rare heterotopic bone formation within a muscle being the masticatory muscles exceptionally involved. In most cases there is a previous trauma, bearing in mind that there may be many other etiologies. CT scan and panoramic radiographs along with histological findings are essential diagnostic aids. Case Desciption: we report a rare case of MO of masseter muscle in 49 years-old woman after repetitive wisdom tooth infection with the discussion of clinical, radiological and histological features. Clinical Implications: MO is a rare disease of masticatory muscles being the masseter the most frequently affected. Wide surgical excision with free margins is the treatment of choice although close postoperative monitoring it’s essential to avoid relapses

Manejo de la vía aérea en oncología de cabeza y cuello

ResumenIntroducciónEl manejo de la vía aérea en cirugía de cabeza y cuello presenta varios retos tanto para el cirujano como para el anestesista. El empleo de la traqueostomía electiva es ampliamente usado pero continúan existiendo algunas controversias en la literatura al respecto.Material y métodosSe ha realizado un estudio prospectivo analizando aspectos clínicos, indicaciones y complicaciones en 57 pacientes afectados de enfermedad oncológica de cabeza y cuello que requirieron la realización de una traqueostomía durante el período comprendido entre enero de 2011 y junio de 2012 en el servicio de cirugía oral y maxilofacial del Hospital Universitario Vall d́Hebron de Barcelona.ResultadosEl grupo de pacientes que recibieron una reconstrucción microquirúgica fue el mayoritario que requirió una traqueostomía (40,35%). La tasa de complicaciones asociada con la técnica fue del 22,8%, de las cuales el 7% fueron consideradas mayores y 5,8% menores. La tasa de complicaciones asociadas con los cuidados de la cánula fue del 15,8%.ConclusionesLa traqueostomía es un método simple y efectivo para el manejo de la vía aérea difícil en pacientes oncológicos de cabeza y cuello asociada a una baja tasa de complicaciones.AbstractBackgroundAirway management in head and neck surgery presents several challenges to the surgeon and the anaesthesist. The use of elective tracheostomy is widely used, but there is still some controversy in the literature.MethodsA prospective study analyzing clinical aspects, indications and complications of 57 head and neck patients who underwent tracheostomy was performed from January 2011 to June 2012 in the Oral and Maxillofacial Surgery Department of Vall D́Hebron Hospital, Barcelona, Spain.ResultsMicrovascular reconstruction patients were the most frequent group in which tracheostomy was performed (40.35%). The complications rate associated with the technique was of 22.8%, of which only 7% were considered major, and 5.8% minor.The complication rate in relation to cannula care was 15.8%.ConclusionsWe conclude that tracheostomy is a simple and effective method for airway management in head and neck patients, with a low complication rate

Comparación en el tratamiento de las fracturas de ángulo mandibular mediante osteosíntesis con una miniplaca versus dos miniplacas

En el present treball hem realitzat un estudi retrospectiu de les fractures d'angle mandibular aïllades tractades mitjançant osteosíntesis amb miniplaques en el Servei de Cirurgia Oral i Màxil·lofacial durant els últims 10 anys. L'objectiu de l'estudi és comparar els resultats funcionals obtinguts i les complicacions sorgides entre els pacients tractats amb una miniplaca i aquells tractats amb dues miniplaques , amb la finalitat de determinar si existeixen diferències en quant al resultat amb alguna de les tècniques.En el presente trabajo hemos realizado un estudio retrospectivo de las fracturas de ángulo mandibular aisladas tratadas mediante osteosíntesis con miniplacas en el Servicio de Cirugía Oral y Maxilofacial durante los últimos 10 años. El objetivo del estudio es comparar los resultados funcionales obtenidos y las complicaciones surgidas entre los pacientes tratados con una miniplaca frente a los tratados con dos miniplacas, con el fin de determinar si existen diferencias en el resultado con alguna de dichas técnicas

Outcomes Following Autologous Fat Grafting in Patients with Sequelae of Head and Neck Cancer Treatment

Autologous fat grafting; Quality of life; ReconstructionInjerto autólogo de grasa; Calidad de vida; ReconstrucciónEmpelt autòleg de greix; Qualitat de vida; ReconstruccióA single-center retrospective study was designed to assess the outcomes of autologous fat grafting for improving surgery- and radiotherapy-related sequelae in 40 patients with head and neck cancer. All patients underwent surgical resection of primary tumors and radiotherapy (50–70 Gy) and were followed over 12 months after fat grafting. Eligibility for fat grafting procedures included complete remission after at least 3 years of oncological treatment. The cervical and paramandibular regions were the most frequently treated areas. Injected fat volumes ranged between 7.5 and 120 mL (mean: 23 mL). Esthetic improvement was obtained in 77.5% of patients, being significant in 17.5%, and functional improvement in 89.2%, being significant in 29.7% of patients. Minor complications occurred in three patients. There was a high degree of satisfaction regarding esthetic improvement, global satisfaction, and 92.5% of patients would recommend the procedure. This study confirms the benefits of fat grafting as a volumetric correction reconstructive strategy with successful cosmetic and functional outcomes in patients suffering from sequelae after head and neck cancer treatment

Revealing the last 13,500 years of environmental history from the multiproxy record of a mountain lake (Lago Enol, northern Iberian Peninsula)

This is the author's accepted manuscript. The final publication is available at Springer via http://dx.doi.org/10.1007/s10933-009-9387-7.We present the Holocene sequence from Lago Enol (43°16′N, 4°59′W, 1,070 m a.s.l.), Cantabrian Mountains, northern Spain. A multiproxy analysis provided comprehensive information about regional humidity and temperature changes. The analysis included sedimentological descriptions, physical properties, organic carbon and carbonate content, mineralogy and geochemical composition together with biological proxies including diatom and ostracod assemblages. A detailed pollen study enabled reconstruction of variations in vegetation cover, which were interpreted in the context of climate changes and human impact. Four distinct stages were recognized for the last 13,500 years: (1) a cold and dry episode that includes the Younger Dryas event (13,500–11,600 cal. year BP); (2) a humid and warmer period characterizing the onset of the Holocene (11,600–8,700 cal. year BP); (3) a tendency toward a drier climate during the middle Holocene (8,700–4,650 cal. year BP); and (4) a return to humid conditions following landscape modification by human activity (pastoral activities, deforestation) in the late Holocene (4,650–2,200 cal. year BP). Superimposed on relatively stable landscape conditions (e.g. maintenance of well established forests), the typical environmental variability of the southern European region is observed at this site.The Spanish Inter-Ministry Commission of Science and Technology (CICYT), the Spanish National Parks agency, the European Commission, the Spanish Ministry of Science, and the European Social Fund

Revealing the last 13,500 years of environmental history from the multiproxy record of a mountain lake (Lago Enol, northern Iberian Peninsula)

This is the author's accepted manuscript. The final publication is available at Springer via http://dx.doi.org/10.1007/s10933-009-9387-7.We present the Holocene sequence from Lago Enol (43°16′N, 4°59′W, 1,070 m a.s.l.), Cantabrian Mountains, northern Spain. A multiproxy analysis provided comprehensive information about regional humidity and temperature changes. The analysis included sedimentological descriptions, physical properties, organic carbon and carbonate content, mineralogy and geochemical composition together with biological proxies including diatom and ostracod assemblages. A detailed pollen study enabled reconstruction of variations in vegetation cover, which were interpreted in the context of climate changes and human impact. Four distinct stages were recognized for the last 13,500 years: (1) a cold and dry episode that includes the Younger Dryas event (13,500–11,600 cal. year BP); (2) a humid and warmer period characterizing the onset of the Holocene (11,600–8,700 cal. year BP); (3) a tendency toward a drier climate during the middle Holocene (8,700–4,650 cal. year BP); and (4) a return to humid conditions following landscape modification by human activity (pastoral activities, deforestation) in the late Holocene (4,650–2,200 cal. year BP). Superimposed on relatively stable landscape conditions (e.g. maintenance of well established forests), the typical environmental variability of the southern European region is observed at this site.The Spanish Inter-Ministry Commission of Science and Technology (CICYT), the Spanish National Parks agency, the European Commission, the Spanish Ministry of Science, and the European Social Fund

Overview of Oral Potentially Malignant Disorders:From Risk Factors to Specific Therapies

SIMPLE SUMMARY: Oral potentially malignant disorders (OPMDs) include a group of oral mucosal diseases with different morphological characteristics that are able to progress to oral squamous cell carcinoma (OSCC). Given OSCC’s poor prognosis and high mortality, early diagnosis is a priority step in OSCC. Extrinsic and intrinsic risk factors and etiologies are involved in developing and malignant transformation of oral lesions, and different molecular alterations have been described in early lesions associated with a potential malignant behavior. This review summarizes the information about clinical, morphological and molecular features of OPMDs, with an emphasis on the early detection techniques and an overview of the surgical and systemic therapies’ effectiveness. ABSTRACT: Oral squamous cell carcinoma (OSCC) is a very aggressive cancer, representing one of the most common malignancies worldwide. Oral potentially malignant disorders (OPMDs) regroup a variegate set of different histological lesions, characterized by the potential capacity to transform in OSCC. Most of the risk factors associated with OSCC are present also in OPMDs’ development; however, the molecular mechanisms and steps of malignant transformation are still unknown. Treatment of OSCC, including surgery, systemic therapy and radiotherapy (alone or in combination), has suffered a dramatic change in last years, especially with the introduction of immunotherapy. However, most cases are diagnosed during the advanced stage of the disease, decreasing drastically the survival rate of the patients. Hence, early diagnosis of premalignant conditions (OPMDs) is a priority in oral cancer, as well as a massive education about risk factors, the understanding of mechanisms involved in malignant progression and the development of specific and more efficient therapies. The aim of this article is to review epidemiological, clinical, morphological and molecular features of OPMDs, with the purpose to lay the foundation for an exhaustive comprehension of these lesions and their ability of malignant transformation and for the development of more effective and personalized treatments

Evolución climática y ambiental del Parque Nacional de Picos de Europa desde el último máximo glaciar

17 páginas, 11 figuras.-- Ramírez, L. & Asensio, B. (eds.).[EN]: A multi-proxy study of the Enol Lake sequence (Cantabrian Mountains, Northern Spain) together with detailed geomorphological mapping provides a first record of glacier evolution and climate change over the last 40,000 years in the Picos de Europa National Park. The Enol glacial retreated from its maximum extent prior to 40 kyr BP thus supporting previous evidences that the maximum extent of southern Europe glaciers occurs earlier than in northern Europe mountains. A slight improvement in climate conditions is detected at 26 kyrs ago with the change from proglacial sediments to glaciolacustrine sedimentation and a final step at 18 kyrs ago with the onset of organic-rich sediments. Last deglaciation occurred in two phases ending with a cold and dry episode (13,500-11,600 cal yrs BP) embedding the Younger Dryas event. The Holocene is divided in three intervals: a humid and warmer period (11,600-8700 cal yrs BP); a tendency towards drier climate during the Middle Holocene (8700- 4650 cal yrs BP) and a final recovery of humidity when the landscape is already modified by human activity (pastoral activities, deforestation) (4650-2200 cal yrs BP). Additionally, the impact of the end of the Little Ice Age (LIA) and 20th century warming and the varying influence of anthropogenic activities is evidenced by the integration of sedimentary, geochemical, pollen and diatom data in a 210Pb chronological framework. Multidisciplinary studies focused on exceptional lacustrine records, such as the Lago Enol sequence presented here, allows discerning between the climatic and the anthropogenic influences on the evolution of both the lake system and the catchment area, including the vegetation cover. Thus, since the current state of the environment is the result of those influences, this type of studies is very useful for implementing new policies of conservation within the National Park.[ES]: El análisis de múltiples indicadores en la secuencia sedimentológica del Lago de Enol (Cordillera Cantábrica, Norte de España), junto con la elaboración de una cartografía geomorfológica de detalle, han proporcionado por primera vez, un registro de la evolución glaciar y del cambio climático durante los últimos 40,000 años en el Parque Nacional de Picos de Europa. El glaciar de Enol comenzó a retirarse de su máxima extensión hace más de 40.000 años, apoyando así evidencias anteriores de que la máxima extensión de los glaciares en el sur de Europa ocurrió antes que en las montañas del norte de Europa. Una ligera mejora de las condiciones climáticas se observa ya hace 26.000 años, cuando Enol deja de tener una sedimentación típica de lago proglaciar y pasa a un ambiente glaciolacustre, aunque no es hasta hace unos 18.000 años cuando empiezan a depositarse sedimentos orgánicos. La última deglaciación ocurrió en dos fases, finalizando con un periodo frío y seco (13.500-11.600 años cal. BP) que incluye el evento global conocido como Dryas Reciente. El Holoceno se ha dividido en tres intervalos, comenzando con un periodo húmedo y templado (11.600-8700 años cal. BP), seguido por una tendencia hacia mayor aridez durante el Holoceno Medio (8700-4650 años cal. BP), y una recuperación final de la humedad cuando el paisaje está ya modificado por la actividad humana debido esencialmente al pastoralismo y la deforestación (4650-2200 años cal BP). Además, el estudio integrado de la sedimentología, geoquímica, polen y asociaciones de diatomeas en dos sondeos cortos del Lago de Enol, ha evidenciado el impacto del final de la Pequeña Edad del Hielo (PEH) y del calentamiento global durante el siglo XX, junto a una influencia variable de las actividades antrópicas. Estudios multidisciplinares focalizados en registros lacustres excepcionales, como la secuencia del Lago de Enol (objeto de estudio en este proyecto), han permitido distinguir entre las influencias climáticas y antrópicas en la evolución pasada tanto del sistema lacustre como de sus alrededores, incluyendo la cobertura vegetal. Así, dado que el estado actual del ecosistema es, en gran parte, el resultado de esas influencias, este tipo de estudios ayudará a implementar nuevas políticas de conservación en el Parque Nacional.Este estudio ha sido financiado por el proyecto “Evolución climática y ambiental del Parque Nacional de Picos de Europa desde el último máximo glaciar - ref: 53/2006” del Organismo Autónomo de Parques Nacionales. Adicionalmente, se ha conseguido financiación a través de los proyectos LIMNOCLIBER (REN2003-09130-C02-02), IBERLIMNO (CGL2005-20236-E/CLI) y LIMNOCAL (CGL2006-13327-C04-01) y del proyecto Consolider GRACCIE (CSD2007-00067) del Ministerio de Ciencia y Tecnología.Peer reviewe