Root microbiome diversity and structure of the Sonoran desert buffelgrass (Pennisetum ciliare L.).

Buffelgrass (Pennisetum ciliare) is an invasive plant introduced into Mexico's Sonoran desert for cattle grazing and has converted large areas of native thorn scrub. One of the invasion mechanisms buffelgrass uses to invade is allelopathy, which consists of the production and secretion of allelochemicals that exert adverse effects on other plants' growth. The plant microbiome also plays a vital role in establishing invasive plants and host growth and development. However, little is known about the buffelgrass root-associated bacteria and the effects of allelochemicals on the microbiome. We used 16S rRNA gene amplicon sequencing to obtain the microbiome of buffelgrass and compare it between samples treated with root exacknudates and aqueous leachates as allelochemical exposure and samples without allelopathic exposure in two different periods. The Shannon diversity values were between H' = 5.1811-5.5709, with 2,164 reported bacterial Amplicon Sequence Variants (ASVs). A total of 24 phyla were found in the buffelgrass microbiome, predominantly Actinobacteria, Proteobacteria, and Acidobacteria. At the genus level, 30 different genera comprised the buffelgrass core microbiome. Our results show that buffelgrass recruits microorganisms capable of thriving under allelochemical conditions and may be able to metabolize them (e.g., Planctomicrobium, Aurantimonas, and Tellurimicrobium). We also found that the community composition of the microbiome changes depending on the developmental state of buffelgrass (p = 0.0366; ANOSIM). These findings provide new insights into the role of the microbiome in the establishment of invasive plant species and offer potential targets for developing strategies to control buffelgrass invasion.

Genomic assessment reveals signal of adaptive selection in populations of the Spotted rose snapper Lutjanus guttatus from the Tropical Eastern Pacific.

Background: The lack of barriers in the marine environment has promoted the idea of panmixia in marine organisms. However, oceanographic conditions and habitat characteristics have recently been linked to genetic structure in marine species. The Tropical Eastern Pacific (TEP) is characterized by dynamic current systems and heterogeneous oceanographic conditions. The Gulf of Panama (part of the equatorial segment for the TEP) is influenced by a complex current system and heterogeneous environment, which has been shown to limit the gene flow for shoreline species. Next Generation Sequencing (NGS) has contributed to detect genetic differences in previously reported panmictic species by the assessment of loci associated with selection and to understand how selection acts affects marine populations. Lutjanus guttatus is a species distributed in the TEP for which previous studies using mitochondrial data recovered a panmictic pattern along its distributional range. In this study, we used SNP data of L. guttatus individuals sampled along its range to evaluate population genetic structure and investigate whether oceanographic factors influence the species' genetic architecture. Finally, we assessed the role of adaptive selection by evaluating the contribution of outlier and neutral loci to genetic divergence. Methods: The RADcap method was used to obtain 24 million paired reads for 123 individuals of L. guttatus covering nearly all its distributional area. Genetic variation was assessed using both spatial and non-spatial methods by comparing three different data sets: (i) a Combined Loci (CL dataset = 2003 SNPs); a search for putative loci under selection allowed the evaluation of (ii) Neutral Loci (NL dataset = 1858 SNPs) and (iii) Outlier Loci (OL dataset = 145 SNPs). We used the estimating effective migration surface (EEMS) approach to detect possible barriers to gene flow. Results: Genetic differences were found in the OL dataset, showing two clusters (Northern and Southern), whereas NL showed no differences. This result may be related to the Selection-Migration balance model. The limit between the Northern and Southern groups was in the Gulf of Panama, which has been previously identified as a barrier to gene flow for other species, mainly due to its heterogeneous oceanographic conditions. The results suggest that selection plays an important role in generating genetic differences in Lutjanus guttatus. A migration corridor was detected that coincides with the Costa Rica Coastal Current that flows from Central America to the Gulf of California, allowing the homogenization of the northern population. In the Southern cluster, a migration corridor was observed with the OL from Panama to Colombia, which could be associated with the currents found in the Gulf of Panama. Genetic variation found in the OL of Lutjanus guttatus highlights the usefulness of NGS data in evaluating the role of selection in population differentiation.

Characterization of the complete mitochondrial genome of the brazilian cownose ray Rhinoptera brasiliensis (Myliobatiformes, Rhinopteridae) in the western Atlantic and its phylogenetic implications.

BACKGROUND: The Brazilian cownose ray, Rhinoptera brasiliensis has undergone a global population reduction and is currently classified by IUCN as Vulnerable. This species is sometimes confused with Rhinoptera bonasus, the only external diagnostic characteristic to distinguish between both species is the number of rows of tooth plates. Both cownose rays overlap geographically from Rio de Janeiro to the western North Atlantic. This calls for a more comprehensive phylogenetic assessment using mitochondria DNA genomes to better understand the relationships and delimitation of these two species. METHODS AND RESULTS: The mitochondrial genome sequences of R. brasiliensis was obtained by next-generation sequencing. The length of the mitochondrial genome was 17,759 bp containing 13 protein-coding genes (PCGs), two ribosomal RNA (rRNA) genes, 22 transfer RNA (tRNA) genes, and a non-coding control region (D-loop). Each PCG was initiated by an authoritative ATG codon, except for COX1 initiated by a GTG codon. Most of the PCGs were terminated by a complete codon (TAA/TAG), while an incomplete termination codon (TA/T) was found in five out of the 13 PCGs. The phylogenetic analysis showed that R. brasiliensis was closely related to R. steindachneri whereas the reported mitogenome as R. steindachneri (GenBank accession number KM364982), differs from multiple mitocondrial DNA sequences of R. steindachneri and is nearly identical to that of R. javanica. CONCLUSION: The new mitogenome determined in this study provides new insight into the phylogenetic relationships in Rhinoptera, while providing new molecular data that can be applied to population genetic studies.

The complete mitochondrial genome of the Mexican blind brotula Typhlias pearsei (Ophidiiformes: Dinematichthydae): an endemic and troglomorphic cavefish from the Yucatán Peninsula karst aquifer.

In this study we report the first complete and annotated mitochondrial genome of the Mexican blind brotula, Typhlias pearsei, a troglobitic cavefish endemic to the Yucatán peninsula karst aquifer in southeastern Mexico. Genomic sequencing was accomplished via next generation sequencing (NGS). The resulting mitogenome is 16,813 bp long and, as in most vertebrates, consists of a total of 37 genes (13 PCGs, 2 rRNAs, 22 tRNAs) and two non-coding regions (control region and origin of the light strand replication). Other than a rearrangement in the position of two tRNAs (shuffling between tRNA-Ile and tRNA-Gln), the mitogenome of T. pearsei exhibits a genomic composition and organization similar to that of most teleost mitogenomes. Besides offering this valuable genomic resource for future studies, the resulting mitogenome was used in a comparative context to test the current higher-level taxonomy of ophidiiform fishes and to examine the phylogenetic position of T. pearsei among viviparous brotulas. Our phylogenetic results confirm those from the most comprehensive molecular phylogenetic study of the group.

The complete mitochondrial genome of the Mexican-endemic cavefish Ophisternoninfernale (Synbranchiformes, Synbranchidae): insights on patterns of selection and implications for synbranchiform phylogenetics.

Ophisternoninfernale is one of the 200+ troglobitic fish species worldwide, and one of the two cave-dwelling fishes endemic to the karstic aquifer of the Yucatán Peninsula, Mexico. Because of its elusive nature and the relative inaccessibility of its habitat, there is virtually no genetic information on this enigmatic fish. Herein we report the complete mitochondrial genome of O.infernale, which overall exhibits a configuration comparable to that of other synbranchiforms as well as of more distantly related teleosts. The KA/KS ratio indicates that most mtDNA PCGs in synbranchiforms have evolved under strong purifying selection, preventing major structural and functional protein changes. The few instances of PCGs under positive selection might be related to adaptation to decreased oxygen availability. Phylogenetic analysis of mtDNA comparative data from synbranchiforms and closely related taxa (including the indostomid Indostomusparadoxus) corroborate the notion that indostomids are more closely related to synbranchiforms than to gasterosteoids, but without rendering the former paraphyletic. Our phylogenetic results also suggest that New World species of Ophisternon might be more closely related to Synbranchus than to the remaining Ophisternon species. This novel phylogenetic hypothesis, however, should be further tested in the context of a comprehensive systematic study of the group.

Genetic differentiation in the genus Characodon: implications for conservation and taxonomy.

The subfamily Goodeinae is a group of fishes endemic to the Mexican highlands. Most of the species are restricted to small and isolated streams or springs. Within this subfamily, the genus Characodon is the earliest diverging lineage of which three species have been described: C. lateralis, C. audax, and C. garmani, with the latter, considered extinct. Characodon lateralis and C. audax are classed as endangered, and have been the subject of taxonomic controversy since their description: previous studies have recognized a genetic differentiation in two groups separated by the El Salto waterfall, but morphological analyses contradict these genetic results. We perform a phylogeographic study using the mitochondrial cytb gene and d-loop region to elucidate the evolutionary history of C. lateralis and C. audax. The results with both markers show the presence of two highly differentiated haplogroups; one distributed north and the other distributed south of the waterfall, with genetic distances of 1.7 and 13.1% with cytb and d-loop respectively, and divergence calculated to have occurred 1.41 Mya. Significant genetic structure was found within each haplogroup and suggests the existence of at least four Evolutionary Significant Units (ESUs) within the examined populations. The possible processes identified as contributing to the formation of differentiated genetic groups are isolation, low population size, recurrent bottlenecks, and the strong sexual selection exhibited by the genus.

Genetic differentiation among populations of the blackfin goodea Goodea atripinnis (Cyprinodontiformes: Goodeidae): implications for its evolutionary history.

Central Mexico is characterized by a complex topography that is the result of historic and contemporary tectonic and climatic factors. These events have influenced the evolutionary history of numerous freshwater fishes in the region. Nonetheless, recent studies have shown that life-history traits and ecological characteristics of species may influence dispersal capabilities and the degree of genetic connectivity. Goodea (Cyprinodontiformes: Goodeidae) is one of the most widely distributed and environmentally tolerant genera of goodeids. In this study, the authors analysed variation in the mitochondrial cytochrome b gene to evaluate the phylogeographic relationships, genetic structure, genetic diversity and demographic history of Goodea from across its distribution range. They found low genetic differentiation and identified shared haplotypes among several regions. Geographic segregation was found in samples southwest and northeast of the Lower Lerma region, with some internal isolated groups showing phylogeographic differentiation and unique haplotypes. The AMOVA best explained genetic structure when grouped by haplogroups rather than when grouped by recognized biogeographic regions. Several regions showed null genetic diversity, raising the possibility of dispersal mediated by humans. Finally, Bayesian Skyline Plot analysis showed a population expansion for the Southwest haplogroup, except for the Armería population and sub-group II of the Northeast haplogroup. All this suggests a recent colonization of Goodea atripinnis throughout some of the biogeographic regions currently inhabited by this species.

Future climate change scenarios in Central America at high spatial resolution.

The objective of this work is to assess the downscaling projections of climate change over Central America at 8-km resolution using the Eta Regional Climate Model, driven by the HadGEM2-ES simulations of RCP4.5 emission scenario. The narrow characteristic of continent supports the use of numerical simulations at very high-horizontal resolution. Prior to assessing climate change, the 30-year baseline period 1961-1990 is evaluated against different sources of observations of precipitation and temperature. The mean seasonal precipitation and temperature distribution show reasonable agreement with observations. Spatial correlation of the Eta, 8-km resolution, simulations against observations show clear advantage over the driver coarse global model simulations. Seasonal cycle of precipitation confirms the added value of the Eta at 8-km over coarser resolution simulations. The Eta simulations show a systematic cold bias in the region. Climate features of the Mid-Summer Drought and the Caribbean Low-Level Jet are well simulated by the Eta model at 8-km resolution. The assessment of the future climate change is based on the 30-year period 2021-2050, under RCP4.5 scenario. Precipitation is generally reduced, in particular during the JJA and SON, the rainy season. Warming is expected over the region, but stronger in the northern portion of the continent. The Mid-Summer Drought may develop in regions that do not occur during the baseline period, and where it occurs the strength may increase in the future scenario. The Caribbean Low-Level Jet shows little change in the future. Extreme temperatures have positive trend within the period 2021-2050, whereas extreme precipitation, measured by R50mm and R90p, shows positive trend in the eastern coast, around Costa Rica, and negative trends in the northern part of the continent. Negative trend in the duration of dry spell, which is an estimate based on evapotranspiration, is projected in most part of the continent. Annual mean water excess has negative trends in most part of the continent, which suggests decreasing water availability in the future scenario.

Pronóstico de empeoramiento tomográfico significativo en pacientes con traumatismo craneoencefálico / Prognosis of significant tomographic worsening in patients with cranio-encephalic traumatism

La realización del monitoreo imagenológico estructural del encéfalo mediante tomografía computarizada de cráneo secuencial es una práctica establecida, aunque se realiza de forma heterogénea en los diferentes contextos por no existir toda la evidencia necesaria para dictar estándares. Determinar los factores predictivos de cambio tomográfico significativo en los pacientes con traumatismo craneoencefálico. Se practicó un estudio cuasi-experimental con todos los lesionados craneales hospitalizados y que fueron estudiados al menos en dos ocasiones en el mismo ingreso con tomografía computarizada de cráneo. Se realizó la sistematización de las indicaciones de la tomografía secuencial, su aplicación y después la evaluación del comportamiento de variables mediante estadística exploratoria, prueba de la X2, ANOVA y regresión logística. Se estudiaron 84 pacientes y el 16, 7 por ciento de la muestra mostró cambios tomográficos significativos en los estudios secuenciales. El grupo de enfermos más relacionados con estos cambios fue el que presentó síntomas persistentes con Marshall inicial III o IV. Las principales variables involucradas en el pronóstico fueron los mecanismos de alta velocidad en la producción del traumatismo, los síntomas persistentes y el puntaje de Rotterdam inicial. De la aplicación del protocolo para la realización de tomografía computarizada secuencial de cráneo en estos lesionados es fundamental tener en cuenta si el mecanismo de producción fue de alta velocidad, la persistencia de los síntomas de los pacientes y la elevación del puntaje de Rotterdam en la tomografía inicial (AU)

The carrying out of the structural imaging study of the brain through a sequential computerized tomography of brain is an established practice although it is conducted in a heterogeneous way in different contexts since there does not exist all the evidence necessary to set the standards. To determine the predictive factors of significant tomographic change in patients with cranio-encephalic traumatism. A quasi-experimental study was conducted with all the cranial-injured patients who had been studied at least twice during the same hospitalization period through a computerized tomography of brain. The systematization of the orders of the sequential tomography, its application, and afterwards the evaluation of the behavior of the variables through an exploratory statistic, the X2 test, ANOVA, and logistic regression, were made. Eighty-four patients were studied and the 16.7 percent of the sample showed significant tomographic changes in the sequential studies. The patients group that presented persistent symptoms with initial Marshall III or IV was more related to these changes. The main variables involved in the prognosis were the high-speed mechanisms in the appearance of the traumatism, the persistent symptoms, and the initial Rotterdam score. When applying the protocol for the carrying out of the sequential computerized tomography of brain in these patients it is really important to take into consideration the persistence of the symptoms of the patients, the increase of the Rotterdam score in the initial tomography, and if the mechanism of appearance was a high-speed one or not (AU)

Pronóstico de empeoramiento tomográfico significativo en pacientes con traumatismo craneoencefálico / Prognosis of significant tomographic worsening in patients with cranio-encephalic traumatism

Fundamento: la realización del monitoreo imagenológico estructural del encéfalo mediante tomografía computarizada de cráneo secuencial es una práctica establecida, aunque se realiza de forma heterogénea en los diferentes contextos por no existir toda la evidencia necesaria para dictar estándares. Objetivo: determinar los factores predictivos de cambio tomográfico significativo en los pacientes con traumatismo craneoencefálico. Métodos: se practicó un estudio cuasi-experimental con todos los lesionados craneales hospitalizados y que fueron estudiados al menos en dos ocasiones en el mismo ingreso con tomografía computarizada de cráneo. Se realizó la sistematización de las indicaciones de la tomografía secuencial, su aplicación y después la evaluación del comportamiento de variables mediante estadística exploratoria, prueba de la X2, ANOVA y regresión logística. Resultados: se estudiaron 84 pacientes y el 16, 7 % de la muestra mostró cambios tomográficos significativos en los estudios secuenciales. El grupo de enfermos más relacionados con estos cambios fue el que presentó síntomas persistentes con Marshall inicial III o IV. Las principales variables involucradas en el pronóstico fueron los mecanismos de alta velocidad en la producción del traumatismo, los síntomas persistentes y el puntaje de Rotterdam inicial. Conclusiones: en la aplicación del protocolo para la realización de tomografía computarizada secuencial de cráneo en estos lesionados es fundamental tener en cuenta si el mecanismo de producción fue de alta velocidad, la persistencia de los síntomas de los pacientes y la elevación del puntaje de Rotterdam en la tomografía inicial.

Background: the carrying out of the structural imaging study of the brain through a sequential computerized tomography of brain is an established practice although it is conducted in a heterogeneous way in different contexts since there does not exist all the evidence necessary to set the standards. Objective: to determine the predictive factors of significant tomographic change in patients with cranio-encephalic traumatism. Method: a quasi-experimental study was conducted with all the cranial-injured patients who had been studied at least twice during the same hospitalization period through a computerized tomography of brain. The systematization of the orders of the sequential tomography, its application, and afterwards the evaluation of the behavior of the variables through an exploratory statistic, the X2 test, ANOVA, and logistic regression, were made. Results: eighty-four patients were studied and the 16.7 % of the sample showed significant tomographic changes in the sequential studies. The patients group that presented persistent symptoms with initial Marshall III or IV was more related to these changes. The main variables involved in the prognosis were the high-speed mechanisms in the appearance of the traumatism, the persistent symptoms, and the initial Rotterdam score. Conclusions: when applying the protocol for the carrying out of the sequential computerized tomography of brain in these patients it is really important to take into consideration the persistence of the symptoms of the patients, the increase of the Rotterdam score in the initial tomography, and if the mechanism of appearance was a high-speed one or not.

Resultados del presillamiento de aneurismas del complejo cerebral anterior-comunicante anterior / Clipping results of complex anterior cerebral aneurysms - anterior communicating

Introducción: Los aneurismas localizados en el complejo arterial cerebral anterior – comunicante anterior cuentan con particularidades que provocan dificultades durante el tratamiento quirúrgico. Se persigue mostrar una panorámica de los principales resultados alcanzados en una serie de pacientes, haciendo énfasis en la determinación de factores de mal pronóstico del tratamiento quirúrgico. Material y métodos: Se practicó un estudio observacional, retrospectivo, analítico y transversal en el servicio de neurocirugía del Hospital Universitario “Manuel Ascunce Domenech”, desde el primero de enero de 2006 hasta el primero de enero de 2011 que incluyó a todos los pacientes sometidos a tratamiento quirúrgico a cielo abierto por aneurismas localizados en el complejo arterial cerebral anterior – comunicante anterior. Las variables se obtuvieron a partir de los expedientes clínicos. Mediante el paquete estadístico S.P.S.S v.15.0 se aplicaron técnicas de estadística exploratoria, chi-cuadrado y regresión logística. Resultados: Se operaron 27 pacientes, el 40, 74 por ciento con edades entre 50 y 59 años y el 55, 55 por ciento perteneció al sexo masculino. Presentaron aneurismas saculares 15 enfermos y 22 pequeños, sin que se demostrara relación entre el tamaño y la configuración. El 29, 9 por ciento de la serie presentó aneurismas múltiples. La mortalidad global fue del 3, 7 por ciento y el principal factor de mal pronóstico fue la ruptura aneurismática transoperatoria. Conclusiones: La cirugía a cielo abierto de estos aneurismas brinda buenos resultados, hecho que valida la utilidad que aún mantiene esta variedad de tratamiento.

Introduction: Aneurysms located in the anterior cerebral and anterior communicating arterial complex has particularities that provoke difficulties during the surgical treatment. It is pursued to show a panoramic of the main results reached in a series of patient, making emphasis in the determination of bad prognosis factors related with the surgical treatment. Material and methods: An observational, retrospective, analytic and traverse study was practiced in the service of neurosurgery of the “Manuel Ascunce Domenech” Teaching Hospital, from the first of January of 2006 until the first of January of 2011, all the patients operated for aneurysms located in anterior cerebral and anterior communicant arterial complex were studied. The variables were obtained from the patient´s clinical files. By means of the statistical package S.P.S.S v.15.0, technical of exploratory statistic, as well as chi-square and logistical regression were applied. Results: 27 patients were operated, the 40, 74 percent with ages between 50 and 59 years and the 55, 55 percent belonged to the masculine sex. Saccular aneurysms were presented in 15 patients and in 22 they were small, no relationship was demonstrated between the size and the configuration, 29, 9 percent of the series presents multiple aneurysms. Global mortality was of 3, 7 percent and the main bad prognostic factor was the trans-operatory rupture of the aneurysm. Conclusions: Open surgery for these aneurysms offers good results, fact that been worth the utility that maintains this kind of treatment.

Valor de la membranectomía parietal radical en el tratamiento del hematoma subdural crónico traumático del adulto / Utility of radical parietal membranectomy in treatment of traumatic chronic subdural hematoma in adults

Objetivo: Analizar las características clínicas y los resultados de una serie de enfermos con hematoma subdural crónico sometidos a craneotomía osteoplástica y membranectomía parietal radical.Métodos: Se realizó un estudio descriptivo de todos los pacientes sometidos a craneotomía osteoplástica con membranectomía parietal radical desde enero de 2005 hasta enero de 2010, en el servicio de Neurocirugía del Hospital Universitario “Manuel Ascunce Domenech” de Camagüey.Resultados: Los siete pacientes sometidos a craneotomía osteoplástica y membranectomía representaron el 5 Por ciento del total de operados por Hematoma Subdural Crónico en el período. En la mayoría de los pacientes se había detectado una recolección del hematoma, existía el antecedente de hipertensión arterial, somnolencia o confusión mental, desplazamientode línea media y densidad mixta del hematoma en la Tomografía Computarizada de cráneo.Conclusiones: La craneotomía osteoplástica con membranectomía parietal radical es una técnica quirúrgica útil para la solución del hematoma subdural crónico recidivante e inclusive como opción de primera línea en casos con calcificación extensa de la cápsula, hemorragias agudas en la cavidad del hematoma o membranas gruesas o tabicadas(AU)

Objective: To analyze the characteristics and results of cases with chronic subdural hematoma treated with osteoplastic craneotomy and radical parietal membranectomy.Methods: A descriptive study was carried out of cases with chronic subdural hematoma treated with osteoplastic craneotomy and radical parietal membranectomy between 2005-2010 years, in neurosurgery service of “Manuel Ascunce Domenech”Universitary Hospital of Camagüey.Results: Seven patients treated with osteoplastic craneotomy and radical parietal membranectomy represents 5 Per Cent of total treated for chronic subdural hematoma in this period. In the majority of this patients is detected a hematoma recollection, arterial hypertension was a remarkable antecedent, somnolence or mental confusion, shift of middle structures and mix densities of hematoma in cranial CT scan.Conclusions: Osteoplastic craneotomy and radical parietal membranectomy is a surgical technique useful for the recidivate chronic subdural hematoma and first line option in cases with important calcification of capsule, acute hemorrhages in cavity or thick/tabicated membranes(AU)

La trayectoria tecnológica del diseño y de la construcción del cabezal para intervenciones neuroquirúrgicas en Camagüey / Design and construction of headstock for neurosurgery in Camagüey

Al describir la trayectoria tecnológica desde el año 1987 al 2006 de un cabezal empleado para intervenciones neuroquirúrgicas de cráneo se hacen explícitas las innovaciones realizadas al mismo; además, se revela el impacto social de su empleo en los servicios de Neurocirugía del Hospital Manuel Ascunce de la provincia de Camagüey. Se valora que el perfeccionamiento de este equipo garantizó una mejor calidad del proceso operatorio y de sus resultados. Enuncian los innovadores la forma de acoplarlo con otras tecnologías quirúrgicas de punta, por ejemplo, con el marco estereotáctico y los separadores cerebrales de Leyla, así como, el uso independiente de una de sus partes en el tratamiento de las luxofracturas cervicales. Todas estas innovaciones, si se comparan con la tecnología inicial, permiten ampliar la gama de explotación del cabezal y lo convierten en un equipo novedoso (AU)

While describing the technological trajectory, from 1987 to 2006, of a bloster used for cranium neurosurgical interventions become explicit the innovations made to it; aldo is revealed the social impact of its use in the Neurosurgery Services of the Manuel Ascunce Dopmenech Hospital of Camaguey province. It is valued that the improvement of this equipment guaranteed a better quality of surgical process and its resuts. The innovators enunciate the way of coupling it with other surgical technologies, such as the stereostatic frame and Leyla ´ s brain separators, as well as the independent use of one of its parts in the treatment of cervical luxofractures. All these innovations, compared to the innitial technology, allow to enlarge the range of explotation of the bloster and transform it into a newsworthy equipment (AU)

La trayectoria tecnológica del diseño y de la construcción del cabezal para intervenciones neuroquirúrgicas en Camagüey / Design and construction of headstock for neurosurgery in Camagüey

Al describir la trayectoria tecnológica desde el año 1987 al 2006 de un cabezal empleado para intervenciones neuroquirúrgicas de cráneo se hacen explícitas las innovaciones realizadas al mismo; además, se revela el impacto social de su empleo en los servicios de Neurocirugía del Hospital Manuel Ascunce de la provincia de Camagüey. Se valora que el perfeccionamiento de este equipo garantizó una mejor calidad del proceso operatorio y de sus resultados. Enuncian los innovadores la forma de acoplarlo con otras tecnologías quirúrgicas de punta, por ejemplo, con el marco estereotáctico y los separadores cerebrales de Leyla, así como, el uso independiente de una de sus partes en el tratamiento de las luxofracturas cervicales. Todas estas innovaciones, si se comparan con la tecnología inicial, permiten ampliar la gama de explotación del cabezal y lo convierten en un equipo novedoso(AU)

La trayectoria tecnológica del diseño y de la construcción del cabezal para intervenciones neuroquirúrgicas en Camagüey / Design and construction of headstock for neurosurgery in Camagüey

Al describir la trayectoria tecnológica desde el año 1987 al 2006 de un cabezal empleado para intervenciones neuroquirúrgicas de cráneo se hacen explícitas las innovaciones realizadas al mismo; además, se revela el impacto social de su empleo en los servicios de Neurocirugía del Hospital Manuel Ascunce de la provincia de Camagüey. Se valora que el perfeccionamiento de este equipo garantizó una mejor calidad del proceso operatorio y de sus resultados. Enuncian los innovadores la forma de acoplarlo con otras tecnologías quirúrgicas de punta, por ejemplo, con el marco estereotáctico y los separadores cerebrales de Leyla, así como, el uso independiente de una de sus partes en el tratamiento de las luxofracturas cervicales. Todas estas innovaciones, si se comparan con la tecnología inicial, permiten ampliar la gama de explotación del cabezal y lo convierten en un equipo novedoso.

While describing the technological trajectory, from 1987 to 2006, of a bloster used for cranium neurosurgical interventions become explicit the innovations made to it; aldo is revealed the social impact of its use in the Neurosurgery Services of the Manuel Ascunce Dopmenech Hospital of Camaguey province. It is valued that the improvement of this equipment guaranteed a better quality of surgical process and its resuts. The innovators enunciate the way of coupling it with other surgical technologies, such as the stereostatic frame and Leyla ´ s brain separators, as well as the independent use of one of its parts in the treatment of cervical luxofractures. All these innovations, compared to the innitial technology, allow to enlarge the range of explotation of the bloster and transform it into a newsworthy equipment.

[Surgical treatment of múltiple intracraneal aneurysms]. / Tratamiento quirúrgico de los anurismas intracraneales múltiples.

INTRODUCTION: Surgical treatment of multiple intracranial aneurysms is always a complex task. OBJECTIVE: To analyze aneurysms characteristics, therapeutic possibilities and surgical outcomes in a series of patients with multiple intracranial aneurysms. PATIENTS AND METHOD: Among 514 patients with intracranial aneurysms, there were 113 with multiple aneurysms (21.5%) and 256 sacs: 244 located at the carotid system and 12 in the vertebrobasilar system. Patients were classified in three groups according to Orz criteria. Surgical treatment was performed in one or two stage operations. Patients were at I or II Grades of the World Federation Scale. The Glasgow Outcome Scale was used for evaluating surgical results. RESULTS: Patients sacs rate was 2.3. The location of aneurysms was high in the posterior communicating artery and very low at the middle cerebral artery. 100% of the lesions in Orz group 1, 82% in group 2 and 33% in group 3 were operated on in one stage operation. Postoperative follow-up showed that 79 % of the patients made a completely recovery. Mortality rate was 4.4%. CONCLUSIONS: Results were determined by the peculiar characteristics of this series, good preoperative condition and high proportion of one-stage operations.

[Combined supra and infratentorial presigmoideo approach for lesions of the petrous and clival regions]. / Abordaje combinado suprainfratentorial presigmoideo en las lesiones de la región petrosa y clival.

INTRODUCTION: Petrous and petroclival lesions may be surgically treated with combinations of suprainfratentorial presigmoideo approach and microsurgical techniques. OBJECTIVE: To demonstrate the utility and to present our surgical experiences with this approach. PATIENTS AND METHODS: Thirteen patients with lesions of the clival, petrous region and of the cerebellopontine angle with extension toward the anterior portion of brainstem were taken to the operative room. There were nine women and four men. Eleven were adults and two children. The main clinical manifestations were headache (100%), dysfunction of cranial nerves (90%), ataxia (90%) hemiparesis (75%). There was papiledema in 45%. Petroclival meningiomas and schwannomas were the more frequent lesions. There were three patients with intraxial brainstem tumors and two arteriovenous malformations. There were not aneurysms. We performed nine retrolaberintic, three translaberintic and one transcochlear approach. RESULTS: There was not severe incapacity, vegetative or dead patients. The surgical complications were facial nerve paresis (31%), cerebrospinal fluid leak (23%), decreased gag reflex (15%), abducens nerve paresis, hemiparesis and Claude Bernard Horner syndrome (8%). 50% of these complications disappeared three months later. CONCLUSIONS: The suprainfratentorial presigmoidal approach and their surgical variations could be utilized to obtaining a low morbimortality, in the treatment of different neoplasm and vascular diseases of the petrous and petroclival region.

Neurotrauma en Camagüey / Situation of neurotrauma in Camagüey

Se reporta que la neurocirugía en Cuba ha considerado como esencial su papel en el manejo de los pacientes con traumatismos craneoencefálicos. Se reseña el manejo de los pacientes con traumatismos craneoencefálicos en el Hospital "Manuel Ascunce Domenech" y se describen los resultados generales obtenidos. En el período de enero de 1996 a enero de 2002 fueron ingresados un total de 1 646 enfermos con una puntuación de 14 o menos en la Escala de Coma de Glasgow. Desde octubre de 1995 este hospital dispone de una Unidad de Politraumatismos con cuidados especiales. Fueron admitidos en esta sala 1 630 (99 por ciento) pacientes con traumatismos craneoencefálicos. No ingresaron en esa dependencia hospitalaria 16 (1 por ciento) enfermos a causa del fallecimiento inmediato en los servicios de urgencias o en el salón de operaciones. La mortalidad por traumatismos craneoencefálicos graves descendió desde el 56 hasta el 38 por ciento. Hubo 1 226 pacientes (74 por ciento) con traumatismos craneoencefálicos moderados y menores. La mortalidad por traumatismos moderados descendió del 12 al 4 por ciento y la mortalidad por lesionados menores se redujo del 3 al 2 por ciento. El 97 por ciento de los traumatismos craneoencefálicos graves recibieron tratamiento neurointensivo y agresivo. Las lesiones de la cabeza constituyen una causa frecuente de muerte e invalidez en personas jóvenes. La integración de todos los niveles de salud, la adecuada organización de los servicios, los protocolos dinámicos de tratamiento, el neurointensivismo, el neuromonitoreo y el manejo quirúrgico precoz y agresivo desempeñan un papel esencial para mejorar los resultados

Abordaje combinado suprainfratentorial presigmoideo en las lesiones de la región petrosa y clival / Combined supra-and infratentorial presigmoideo approach for lesions of the petrous and clival regions

Introducción. Las lesiones de la región petrosa y clival pueden intervenirse quirúrgicamente con la combinación del abordaje suprainfratentorial presigmoideo (ASITPS) y de las actuales técnicas microquirúrgicas. Objetivos. Demostrar la utilidad y presentar nuestras experiencias con este abordaje . Pacientes y métodos. Se llevaron al quirófano 13 pacientes con lesiones de la región clival, petrosa y del ángulo pontocerebeloso con extensión hacia la porción anterior del tronco. Hubo nueve mujeres y cuatro hombres; 11 eran adultos y dos niños. Las principales manifestaciones clínicas fueron la cefalea (100 por ciento), la disfunción de nervios craneales (90 por ciento), la ataxia (90 por ciento) y los déficit motores (75 por ciento). Hubo papiledema en el 45 por ciento. Los meningiomas petroclivales y los schwannomas fueron las lesiones más frecuentes. Hubo tres pacientes con neoplasias intraaxiales de tronco cerebral y dos malformaciones arteriovenosas. No hubo lesiones aneurismáticas. Realizamos nueve abordajes retrolaberínticos, tres translaberínticos y uno transcoclear. Resultados. No hubo pacientes gravemente incapacitados, vegetativos o fallecidos. Las complicaciones quirúrgicas fueron paresia facial periférica (31 por ciento), fístula de LCR (23 por ciento), reducción del reflejo de deglución (15 por ciento), paresia del nervio abducens (8 por ciento), hemiparesia y síndrome de Claude Bernard Horner (8 por ciento). El 50 por ciento de estas complicaciones desaparecieron en menos de tres meses. Conclusiones. El ASITPS y sus variantes quirúrgicas pueden utilizarse en el tratamiento quirúrgico de enfermedades tumorales y vasculares diversas de esa región y obtener una morbimortalidad baja (AU)

Introduction. Petrous and petroclival lesions may be surgically treated with combinations of suprainfratentorial presigmoideo approach and microsurgical techniques. Objectives, To demonstrate the utility and to present our surgical experiences with this approach. Patients and methods. Thirteen patients with lesions of the clival, petrous region and of the cerebellopontine angle with extension toward the anterior portion of brainsteam were taken to the operative room. There were nine women and four men. Eleven were adults and two children. The main clinical manifestations were headache (100%), dysfunction of cranial nerves (90%), ataxia (90%) hemiparesis (75%). There was papiledema in 45%. Petroclival meningiomas and schwannomas were the more frequent lesions. There were three patients with intraxial brainsteam tumors and two arteriovenous malformations. There were not aneurysms. We performed nine retrolaberintic, three translaberintic and one transcochlear approach. Results. There was not severe incapacity, vegetative or dead patients. The surgical complications were facial nerve paresis (31%), cerebrospinal fluid leak (23%), decreased gag reflex (15%), abducens nerve paresis, hemiparesis and Claude Bernard Horner syndrome (8%). 50% of these complications disappeared three months later. Conclusions. The suprainfratentorial presigmoidal approach and their surgical variations could be utilized to obtaining a low morbimortality, in the treatment of different neoplasm and vascular diseases of the petrous and petroclival region (AU

Tratamiento quirúrgico de los aneurismas intracraneales múltiples / Surgical treatment of múltiple intracraneal aneurysms

Introducción: El tratamiento quirúrgico de los aneurismas intracraneales múltiples sigue siendo un problema complejo. Objetivos: Analizar las características de los aneurismas múltiples, las posibilidades terapéuticas y los resultados del tratamiento quirúrgico. Pacientes y Método: De un total de 514 pacientes con aneurismas intracraneales hubo 113 con aneurismas múltiples (21.5 por ciento) y 256 sacos: 244 del sistema carotídeo y 12 del sistema vertebrobasilar. Los pacientes fueron clasificados en tres grupos siguiendo los criterios de Orz. El método de tratamiento fue la intervención quirúrgica en uno o dos tiempos. Los pacientes se encontraban en grado I y II de la Escala de la Federación Mundial. Los resultados se evaluaron con la Escala de Pronósticos de Glasgow. Resultados: El promedio fue de 2.3 sacos por paciente. Fue elevada la proporción de lesiones en la región de la comunicante posterior y baja en la arteria cerebral media. El 54 por ciento de los pacientes correspondió al grupo 1 de Orz, el 35 por ciento al grupo 2 y el 11 por ciento al grupo 3. El 100 por ciento de las lesiones del grupo 1, el 82 por ciento de las lesiones del grupo 2 y el 33 por ciento de las lesiones del grupo 3 se intervinieron en un solo tiempo quirúrgico. El 79 por ciento de los pacientes obtuvieron una recuperación completa. La mortalidad quirúrgica fue del 4.4 por ciento. Conclusiones: Las características particulares de las lesiones aneurismáticas encontradas en esta serie, el buen estado clínico preoperatorio y la elevada proporción de pacientes intervenidos en un solo abordaje determinaron estos resultados (AU)