Transoral removal of submandibular hilar lithiasis: results on the salivary duct system, glandular parenchyma, and quality-of-life recovery.

OBJECTIVE(S): To confirm that hilar transoral submandibular sialolitectomy (TOSL) is the first treatment option for submandibular hilar lithiasis (SHL) in terms of glandular parenchyma recovery, salivary system restoration, and patient quality of life (QoL) improvement. METHODS: Depending on whether the stone was easily palpable, TOSL was carried out with or without sialendoscopy. For the first time in the literature, Magnetic Resonance Sialography (MR-Si) was performed before and after TOSL, to evaluate stone characteristics, glandular parenchyma status, hilum dilation and main duct recanalization. Radiological data was examined independently by two radiologists. COSQ, a recently validated and specific questionnaire, was used to assess associated QoL. RESULTS: Between 2017 and 2022, 29 TOSL patients were examined. With a high interobserver correlation, MR-Si was confirmed as a very useful radiological test in the pre- and post-surgical evaluation of SHL. The salivary main duct was completely recanalized in all cases. The presence of lithiasis was found in 4 patients (13.8%). After surgery, the majority of patients (79.31%) had hilum dilation. There was a statistically significant improvement in parenchyma status, but no significant progression to glandular atrophy. After surgery, COSQ mean values always improved (22.5 to 4.5). CONCLUSIONS: TOSL is the ideal surgical technique for the management of SHL, resulting in improved parenchymal inflammatory changes, recanalization of Wharton's duct, and enhancement patients' QoL. As a result, before removing the submandibular gland, TOSL should be considered as the first treatment option for SHL.

Epidemiologic, radiologic, and sialendoscopic aspects in chronic obstructive sialadenitis.

PURPOSE: Chronic obstructive sialadenitis (COS) is a recurring inflammation of the salivary gland. To date, there are no known predisposing factors for COS. Given the advances seen in radiology and sialendoscopy, we must update our knowledge of COS, analyzing factors that can favor its development. METHODS: We prospectively analyzed 333 patients who underwent sialendoscopy between 2012 and 2021. Epidemiologic, radiologic, and sialendoscopy-related factors were correlated. Suspected diagnosis was established based on the clinical and radiologic data. The final diagnosis was determined on the basis of sialendoscopic findings. RESULTS: The most common etiology of COS was stricture (40.8%). Lack of papilla distensibility (LPD) was also described as an etiology. COS was related to patient gender and age. Submandibular gland involvement was significantly more associated with lithiasis and LPD, while COS of the parotid gland was most frequently caused by stricture. Radioiodine sialadenitis and Sjögren's syndrome were significantly associated with stricture. MR sialography (MR-Si) showed the best overall sensitivity and specificity. CONCLUSION: In our series, stricture was the most common cause of COS. We describe LPD as a frequent cause of COS in this series; ours is the first study to report this finding. There was a significant association between the salivary gland involved, patient sex and age, and the cause of COS. MR-Si showed the greatest diagnostic yield.

Exploring the relation between plastic ingestion in species and its presence in seafloor bottoms.

In order to have a wider understanding of the impacts of plastics on marine ecosystems, studies should approach different environmental compartments, such as seafloor and biota, at the same time. The aim of this research is to study the relation between microplastic ingestion in species and the amount of seafloor plastics caught in the same bottom trawls hauls of the western Mediterranean Sea to describe a potential overlap between these two indicators of plastic pollution. According to results, 15% of the sampled individuals ingested microplastics with a mean value of 0.30 ± 0.40 microplastics/individuals. Regarding seafloor plastics, these were present in 58% of the hauls with a mean value of 1.31 ± 0.09 kg/km2. The highest overlap between ingestion of microplastic in species and seafloor plastics was observed in the bay of Palma, the most urbanized area, but also in areas close to Marine Protected Areas (MPAs).

The diversity of recent trends for chondrichthyans in the Mediterranean reflects fishing exploitation and a potential evolutionary pressure towards early maturation.

Chondrichthyans are a vulnerable group that has been overexploited for almost half a century in the Mediterranean. Since in this area most chondrichthyans are rarely incorporated into international statistics, the impact of fishing on their populations is difficult to assess. Here, we evaluate temporal trends in order to understand the recent history of chondrichthyans in the western Mediterranean. Fishery-independent data were obtained from scientific surveys carried out from 1994 to 2015 in three geographical sub-areas. Our results reflect fairly stable populations in terms of diversity, with some increase in density and standardized biomass of some species dwelling on the continental shelf, and even for some species dwelling on the slope. In contrast, decreasing trends were observed in some deep-water species. This can be explained by the reduction of the trawling effort on the continental shelf over the last few decades, and the shift of the fleet towards deep waters, along with the greater resilience displayed by some species. Furthermore, a decreasing trend in maturity of Scyliorhinus canicula was detected, suggesting an evolutionary response to overfishing. These results improve scientific knowledge for developing true adaptive management in the Mediterranean that will implement measures to strengthen or initiate the recovery of chondrichthyans.

Anthropogenic particles ingestion in fish species from two areas of the western Mediterranean Sea.

The Mediterranean Sea is one of the most polluted seas in terms of marine debris. To analyze the ingestion of anthropogenic particles in two areas, 197 gastrointestinal tracts from four fish species - Trachurus mediterraneus, Sardina pilchardus, Engraulis encrasicolus and Boops boops - were studied. 127 anthropogenic particles were identified in the gastrointestinal tract of 28% of the samples using visual sorting methods. Individuals from the peninsular coast showed higher ingestion occurrence (36%) than those from the Balearic Islands (12%). Significant differences in the ingestion of anthropogenic particles were found between species with Trachurus mediterraneus identified as the most affected species (43% of the individuals with mean values of 1.13 ±â€¯0.16 particles/individual), and Engraulis encrasicolus, the least affected (2.56% and 0.03 ±â€¯0.16 particles/individual). Moreover, the proportion of ingestion amongst species was similar in both areas, highlighting the importance of studying the same species at different locations as marine debris bioindicators.

Accounting for ocean connectivity and hydroclimate in fish recruitment fluctuations within transboundary metapopulations.

Marine resources stewardships are progressively becoming more receptive to an effective incorporation of both ecosystem and environmental complexities into the analytical frameworks of fisheries assessment. Understanding and predicting marine fish production for spatially and demographically complex populations in changing environmental conditions is however still a difficult task. Indeed, fisheries assessment is mostly based on deterministic models that lack realistic parameterizations of the intricate biological and physical processes shaping recruitment, a cornerstone in population dynamics. We use here a large metapopulation of a harvested fish, the European hake (Merluccius merluccius), managed across transnational boundaries in the northwestern Mediterranean, to model fish recruitment dynamics in terms of physics-dependent drivers related to dispersal and survival. The connectivity among nearby subpopulations is evaluated by simulating multi-annual Lagrangian indices of larval retention, imports, and self-recruitment. Along with a proxy of the regional hydroclimate influencing early life stages survival, we then statistically determine the relative contribution of dispersal and hydroclimate for recruitment across contiguous management units. We show that inter-annual variability of recruitment is well reproduced by hydroclimatic influences and synthetic connectivity estimates. Self-recruitment (i.e., the ratio of retained locally produced larvae to the total number of incoming larvae) is the most powerful metric as it integrates the roles of retained local recruits and immigrants from surrounding subpopulations and is able to capture circulation patterns affecting recruitment at the scale of management units. We also reveal that the climatic impact on recruitment is spatially structured at regional scale due to contrasting biophysical processes not related to dispersal. Self-recruitment calculated for each management unit explains between 19% and 32.9% of the variance of recruitment variability, that is much larger than the one explained by spawning stock biomass alone, supporting an increase of consideration of connectivity processes into stocks assessment. By acknowledging the structural and ecological complexity of marine populations, this study provides the scientific basis to link spatial management and temporal assessment within large marine metapopulations. Our results suggest that fisheries management could be improved by combining information of physical oceanography (from observing systems and operational models), opening new opportunities such as the development of short-term projections and dynamic spatial management.

Transnasal, Transethmoidal Endoscopic Removal of a Foreign Body in the Medial Extraconal Orbital Space.

Intraorbital foreign bodies are located within the orbit but outside the ocular globe. Though not uncommon, removal of these objects poses a challenge for surgeons. External approaches have been the most frequently used but are associated with increased complications and morbidity. An endoscopic endonasal approach can be an appropriate and less complicated technique in these cases. We report a case of a chronic intraorbital foreign body located within the medial extraconal space lateral to the lamina papyracea and behind the lacrimonasal duct, which was successfully removed using a transnasal, transethmoidal endoscopic technique. Neither postoperative complications nor ocular impairment was reported. The patient improved and remains asymptomatic. The transnasal transethmoidal endoscopic approach can be used as a safer and less invasive alternative when removing foreign bodies from the medial orbital compartment.

Sialolithiasis in an Accessory Submandibular Gland Identified by Magnetic Resonance Sialography.

BACKGROUND: Accessory submandibular gland is a very rare anatomical variant. There have been only 6 reported cases of this entity in the English literature, only 1 of which was identified using magnetic resonance imaging. METHODS: We report the case of a 39-year-old female with symptoms of left submandibular sialoadenitis who was diagnosed of sialolithiasis within the left accessory submandibular gland by magnetic resonance sialography (MR-Si). RESULTS: The calculus was palpated near the submandibular papilla and was extracted by an intraoral approach. One-year follow-up revealed no evidence of recurrence. CONCLUSIONS: This is the first case reported to date in the English literature of a patient with sialolithiasis within an accessory submandibular gland diagnosed by MR-Si.

Contrasting Responses to Harvesting and Environmental Drivers of Fast and Slow Life History Species.

According to their main life history traits, organisms can be arranged in a continuum from fast (species with small body size, short lifespan and high fecundity) to slow (species with opposite characteristics). Life history determines the responses of organisms to natural and anthropogenic factors, as slow species are expected to be more sensitive than fast species to perturbations. Owing to their contrasting traits, cephalopods and elasmobranchs are typical examples of fast and slow strategies, respectively. We investigated the responses of these two contrasting strategies to fishing exploitation and environmental conditions (temperature, productivity and depth) using generalized additive models. Our results confirmed the foreseen contrasting responses of cephalopods and elasmobranchs to natural (environment) and anthropogenic (harvesting) influences. Even though a priori foreseen, we did expect neither the clear-cut differential responses between groups nor the homogeneous sensitivity to the same factors within the two taxonomic groups. Apart from depth, which affected both groups equally, cephalopods and elasmobranchs were exclusively affected by environmental conditions and fishing exploitation, respectively. Owing to its short, annual cycle, cephalopods do not have overlapping generations and consequently lack the buffering effects conferred by different age classes observed in multi-aged species such as elasmobranchs. We suggest that cephalopods are sensitive to short-term perturbations, such as seasonal environmental changes, because they lack this buffering effect but they are in turn not influenced by continuous, long-term moderate disturbances such as fishing because of its high population growth and turnover. The contrary would apply to elasmobranchs, whose multi-aged population structure would buffer the seasonal environmental effects, but they would display strong responses to uninterrupted harvesting due to its low population resilience. Besides providing empirical evidence to the theoretically predicted contrasting responses of cephalopods and elasmobranchs to disturbances, our results are useful for the sustainable exploitation of these resources.

Ultrasound evaluation of greater trochanter pain syndrome in patients with spondyloarthritis: are there any specific features?

Although greater trochanter pain syndrome (GTPS) is a prevalent cause of musculoskeletal pain in the general population, there is lack of imaging studies searching for differential features of inflammatory enthesitis in GTPS. We analyzed the features of GTPS using sonography and magnetic resonance imaging (MRI) to identify useful differential signs between spondyloarthritis (SpA) and other inflammatory or non-inflammatory musculoskeletal diseases. All patients with unilateral GTPS attended by our Arthritis Unit between February 2011 and March 2012 were included. Patients were classified as having SpA or mechanical (without inflammatory musculoskeletal disease) GTPS. Rheumatoid arthritis (RA) patients were also included as inflammatory controls. Ultrasound scans of the painful and contralateral, asymptomatic, greater trochanter were made. We assessed the gluteus medius and gluteus minimus tendons for signs suggestive of tendinopathy. Random MRI of the same regions was made in a subgroup of patients to validate the ultrasound findings. A total of 107 patients with unilateral GTPS were included, of whom 96 were female, with a mean age of 61.6 years: 34 had SpA, 48 had non-inflammatory musculoskeletal disease, and 25 had RA. No specific sonographic features for SpA were found. Pathological findings were more frequent in patients without musculoskeletal inflammatory disease (mainly bursitis and erosions). A large number of alterations were found in the asymptomatic side (around 40 % had cortical irregularities and 20 % bursa effusion). Signs of enthesopathy were more prevalent in the gluteus minimus tendon, regardless of the diagnosis (54.2 % had erosions, 39.3 % bursitis, 38.3 % calcifications and 37.4 % tendinosis). No patient had power Doppler signal. Age was the main factor in the appearance of tendinopathy. MRI confirmed the changes detected by ultrasound in all 40 patients evaluated. GTPS in patients with SpA has similar sonographic findings to those observed in patients with RA and patients without musculoskeletal inflammatory disease. Neither sonography nor MRI was clinically useful in classifying GTPS as a manifestation of SpA.