First assessment of atmospheric pollution by trace elements and particulate matter after a severe collapse of a tailings dam, Minas Gerais, Brazil: An insight into biomonitoring with Tillandsia usneoides and a public health dataset.

In this study, samples of bromeliad Tillandsia usneoides (n = 70) were transplanted and exposed for 15 and 45 days in 35 outdoor residential areas in Brumadinho (Minas Gerais state, Brazil) after one of the most severe mining dam collapses in the world. Trace elements aluminum (Al), arsenic (As), chromium (Cr), copper (Cu), iron (Fe), mercury (Hg), manganese (Mn), nickel (Ni) and zinc (Zn) were quantified by atomic absorption spectrometry. Scanning electron microscope generated surface images of T. usneoides fragments and particulate matter (PM2.5, PM10 and PM > 10). Aluminum, Fe and Mn stood out from the other elements reflecting the regional geological background. Median concentrations in mg kg-1 increased (p < 0.05) between 15 and 45 days for Cr (0.75), Cu (1.23), Fe (474) and Mn (38.1), while Hg (0.18) was higher at 15 days. The exposed-to-control ratio revealed that As and Hg increased 18.1 and 9.4-fold, respectively, not showing a pattern associated only with the most impacted sites. The PM analysis points to a possible influence of the prevailing west wind on the increase of total particles, PM2.5 and PM10 in transplant sites located to the east. Brazilian public health dataset revealed increase in cases of some cardiovascular and respiratory diseases/symptoms in Brumadinho in the year of the dam collapse (1.38 cases per 1000 inhabitants), while Belo Horizonte capital and its metropolitan region recorded 0.97 and 0.37 cases, respectively. Although many studies have been carried out to assess the consequences of the tailings dam failure, until now atmospheric pollution had not yet been evaluated. Furthermore, based on our exploratory analysis of human health dataset, epidemiological studies are required to verify possible risk factors associated with the increase in hospital admissions in the study area.

River Winds and Transport of Forest Volatiles in the Amazonian Riparian Ecoregion.

Volatile organic compounds (VOCs) emitted from forests are important chemical components that affect ecosystem functioning, atmospheric chemistry, and regional climate. Temperature differences between a forest and an adjacent river can induce winds that influence VOC fate and transport. Quantitative observations and scientific understanding, however, remain lacking. Herein, daytime VOC datasets were collected from the surface up to 500 m over the "Rio Negro" river in Amazonia. During time periods of river winds, isoprene, α-pinene, and ß-pinene concentrations increased by 50, 60, and 80% over the river, respectively. The concentrations at 500 m were up to 80% greater compared to those at 100 m because of the transport path of river winds. By comparison, the concentration of methacrolein, a VOC oxidation product, did not depend on river winds or height. The differing observations for primary emissions and oxidation products can be explained by the coupling of timescales among emission, reaction, and transport. This behavior was captured in large-eddy simulations with a coupled chemistry model. The observed and simulated roles of river winds in VOC fate and transport highlight the need for improved representation of these processes in regional models of air quality and chemistry-climate coupling.

First year after the Brumadinho tailings' dam collapse: Spatial and seasonal variation of trace elements in sediments, fishes and macrophytes from the Paraopeba River, Brazil.

On January 2019, the B1 iron ore tailings' dam collapsed in Brumadinho, Brazil, being one of the worst mining-related disasters, with 270 human deaths (11 of them still missing) and 12.106 m3 of tailings released to the environment. The tailings devastated the Córrego do Feijão brook and reached the adjacent Paraopeba River, the region's main watercourse and a major tributary of the São Francisco basin. Although physicochemical parameters of the river were strongly impacted, and acute toxicological effects have been reported from exposure experiments, contamination of aquatic biota had not yet been assessed. Therefore, the aim of this study was to evaluate contamination by trace elements (As, Al, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb and Zn) in sediment, fish and macrophytes along the Paraopeba River, upstream and downstream from the dam failure site, during the dry and wet season. With the exception of Cd and Hg, all elements in sediment samples had lower median concentrations downstream. An inverse pattern was observed for the aquatic biota, with significant higher concentrations of Fe, Mn, Ni and Zn in fishes, and increased concentrations of most elements in macrophytes, indicating an increase in element bioavailability. A significant seasonal variation was observed with increased concentrations of As (dry season) and Pb (wet season) in fish samples, with the same trend occurring in macrophytes. Concentrations of potentially toxic elements in fish samples in wet weight (Cr: 1.80 ± 1.31 mg kg-1, Hg: 0.21 ± 0.11 mg kg-1 and Pb: 0.79 ± 0.80 mg kg-1) were lower than those reported before the disaster. Furthermore, As and Pb concentrations exceeded the safety threshold for fish consumption in 3% and 41% of samples, respectively, representing a matter of concern for public health.

Fluoroquinolones and trace elements in poultry litter: estimation of environmental load based on nitrogen requirement for crops.

Poultry litter soil application contributes to sustainability of agricultural systems and is in accordance with the United Nations Sustainable Development Goals (UN-SDG). Poultry litter recommended rates are based on crop nitrogen (N) needs, however, their application can be a potential source of antibiotics and trace elements overload. The aim of the study was to estimate the role of poultry litter application on soil contamination by fluoroquinolones [enrofloxacin (ENR) and ciprofloxacin (CIP)] and trace elements, based on N requirements for crops. Analytical and sampling techniques were used to estimate the loads from poultry litter application. Only CIP was found in poultry litter samples (283 ± 124 µg kg-1) and its load was estimated to be of 9.89 ± 4.33 g ha-1, for the poultry litter application (35 t ha-1). The estimated loads (g ha-1) of trace elements were: Cr 9.19 ± 3.26, Ni 12.3 ± 4.93, Pb 22.0 ± 8.26, Cu 229 ± 85.6, Mn 691 ± 259 and Zn 1,011 ± 378. These estimates were 900% higher than those recommended by the technical guidance, while N exceeded 600% the recommended application. In order to achieve UN-SDGs, local policies to disseminate knowledge and technologies are required for consolidating sustainable agricultural practices.

Selenium in sediment and food webs of the Tapajós River basin (Brazilian Amazon) and its relation to mercury.

BACKGROUND: We investigated Se levels along the Tapajós River basin - which is an important tributary of the Amazon River - and the possible antagonistic effect of Se in Hg availability. This is the first study to investigate Se transfer from abiotic to biotic compartments and along the food chain in aquatic ecosystems of the Amazon basin. METHODS: Se concentrations were measured in superficial sediment (n = 29), plankton (n = 28) and fishes (n = 121) along two stretches of the Tapajós River basin (Tapup/mi and Taplow), comprising approximately 500 km with different hydrological characteristics. RESULTS: Se concentrations in sediment were significantly higher in the Taplow (345-664 µg kg-1) than in the Tapup/mi (60-424 µg kg-1). The seasonal flooding of the Amazon River probably helps to carry selenium-rich sediment to the Tapajós mouth (Taplow stretch). We suggest that Se in sediment could decrease the bioavailability of Hg resulting in lower MeHg concentrations in fish, as observed in the Taplow (45-934 µg kg-1). Sediment and plankton were positively correlated in relation to their Se concentrations (r = 0.62; p = 0.001) suggesting that sediment can possibly be the main source of Se to plankton. Our data indicate Se uptake by primary consumers, as noted in phytoplankton levels. The decrease of Se concentrations along the food chain was also noteworthy. CONCLUSION: This work elucidates some aspects of Se biogeochemistry in the Amazon basin and shows its importance regarding Hg cycles in aquatic ecosystems.

Impact of biomass burning on a metropolitan area in the Amazon during the 2015 El Niño: The enhancement of carbon monoxide and levoglucosan concentrations.

Extreme droughts associated with changes in the climate have occurred every 5 years in the Amazon during the 21st century, with the most severe being in 2015. The increase in biomass burning (BB) events that occurred during the 2015 drought had several negative socioeconomic and environmental impacts, one of which was a decrease in the air quality. This study is an investigation into the air quality in the Manaus Metropolitan Region (MMR) (central Amazon, Brazil) during the dry (September to October) and wet (April to May) seasons of 2015 and 2016. A strong El Niño event began during the wet season of 2015 and ended during the wet season of 2016. Particulate matter samples were collected in the MMR during 2015 and 2016, and analyses of the satellite-estimated total carbon monoxide (CO) column and observed levoglucosan concentrations were carried out. Levoglucosan has been shown to be significantly correlated with regional fires and is a well-established chemical tracer for the atmospheric particulates emitted by BB, and CO can be treated as a gaseous-phase tracer for BB. The number of BB events increased significantly during the El Niño period when compared to the average number during 2003-2016. Consequently, the total CO column and levoglucosan concentration values in the MMR increased by 15% and 500%, respectively, when compared to the normal conditions. These results indicate that during the period that was analyzed, the impacts of BB were exacerbated during the strong El Niño event as compared to the non-El Niño period. In this study, we provided evidence that the air quality in the MMR will degrade in the future if droughts and BB occurrences continue to increase.

The influence that different urban development models has on PM2.5 elemental and bioaccessible profiles.

Limited studies have reported on in-vitro analysis of PM2.5 but as far as the authors are aware, bioaccessibility of PM2.5 in artificial lysosomal fluid (ALF) has not been linked to urban development models before. The Brazilian cities Manaus (Amazon) and Curitiba (South region) have different geographical locations, climates, and urban development strategies. Manaus drives its industrialization using the free trade zone policy and Curitiba adopted a services centered economy driven by sustainability. Therefore, these two cities were used to illustrate the influence that these different models have on PM2.5 in vitro profile. We compared PM2.5 mass concentrations and the average total elemental and bioaccessible profiles for Cu, Cr, Mn, and Pb. The total average elemental concentrations followed Mn > Pb > Cu > Cr in Manaus and Pb > Mn > Cu > Cr in Curitiba. Mn had the lowest solubility while Cu showed the highest bioaccessibility (100%) and was significantly higher in Curitiba than Manaus. Cr and Pb had higher bioaccessibility in Manaus than Curitiba. Despite similar mass concentrations, the public health risk in Manaus was higher than in Curitiba indicating that the free trade zone had a profound effect on the emission levels and sources of airborne PM. These findings illustrate the importance of adopting sustainable air quality strategies in urban planning.

Intermediate-scale horizontal isoprene concentrations in the near-canopy forest atmosphere and implications for emission heterogeneity.

The emissions, deposition, and chemistry of volatile organic compounds (VOCs) are thought to be influenced by underlying landscape heterogeneity at intermediate horizontal scales of several hundred meters across different forest subtypes within a tropical forest. Quantitative observations and scientific understanding at these scales, however, remain lacking, in large part due to a historical absence of canopy access and suitable observational approaches. Herein, horizontal heterogeneity in VOC concentrations in the near-canopy atmosphere was examined by sampling from an unmanned aerial vehicle (UAV) flown horizontally several hundred meters over the plateau and slope forests in central Amazonia during the morning and early afternoon periods of the wet season of 2018. Unlike terpene concentrations, the isoprene concentrations in the near-canopy atmosphere over the plateau forest were 60% greater than those over the slope forest. A gradient transport model constrained by the data suggests that isoprene emissions differed by 220 to 330% from these forest subtypes, which is in contrast to a 0% difference implemented in most present-day biosphere emissions models (i.e., homogeneous emissions). Quantifying VOC concentrations, emissions, and other processes at intermediate horizontal scales is essential for understanding the ecological and Earth system roles of VOCs and representing them in climate and air quality models.

Low genome-wide homozygosity in 11 Spanish ovine breeds.

The population of Spanish sheep has decreased from 24 to 15 million heads in the last 75 years due to multiple social and economic factors. Such a demographic reduction might have caused an increase in homozygosity and inbreeding, thus limiting the viability of local breeds with excellent adaptations to harsh ecosystems. The main goal of our study was to investigate the homozygosity patterns of 11 Spanish ovine breeds and to elucidate the relationship of these Spanish breeds with reference populations from Europe, Africa and the Near East. By using Ovine SNP50 BeadChip data retrieved from previous publications, we have found that the majority of studied Spanish ovine breeds have close genetic relatedness with other European populations; the one exception is the Canaria de Pelo breed, which is similar to North African breeds. Our analysis has also demonstrated that, with few exceptions, the genomes of Spanish sheep harbor fewer than 50 runs of homozygosity (ROH) with a total length of less than 350 Mb. Moreover, the frequencies of very long ROH (>30 Mb) are very low, and the inbreeding coefficients (FROH ) are generally small (FROH  < 0.10), ranging from 0.008 (Rasa Aragonesa) to 0.086 (Canaria de Pelo). The low levels of homozygosity observed in the 11 Spanish sheep under analysis might be due to their extensive management and the high number of small to medium farms.

Far-reaching cytogenotoxic effects of mine waste from the Fundão dam disaster in Brazil.

On November 2015, one of Brazil's most important watersheds was impacted by the mine waste from Fundão dam collapse in Mariana. The mine waste traveled over 600 km along the Doce River before reaching the sea, causing severe devastation along its way. Here we assessed trace element concentrations and cytogenotoxic effects of the released mine waste. Water samples were collected along the Doce River ten days after the disaster in two impacted sites and one non-impacted site. Sampling points were located hundreds of kilometers downstream of the collapsed dam. Water samples were used for trace element quantification and to run an experiment using Allium cepa to test cytogenotoxicity. We found extremely high concentrations of particulate Fe, Al, and Mn in the impacted sites. We observed cytogenotoxic effects such as alterations in mitotic and phase indexes, and enhanced frequency of chromosomal aberrations. Our results indicate interferences in the cell cycle in impacted sites located hundreds of kilometers downstream of the disaster. The environmental impacts of the dam collapse may not only be far-reaching but also very likely long-lasting, because the mine waste may persist in the Doce River sediment for decades.

Multi-temporal accumulation and risk assessment of available heavy metals in poultry litter fertilized soils from Rio de Janeiro upland region.

Poultry litter is widely used as fertilizer in soils and can be a relevant source of heavy metals for agricultural environments. In this study, poultry litter fertilization of long-term (< 1-30 years) was evaluated in tropical soils. Our main goal was to investigate the occurrence of temporal variation in the available fraction of heavy metals (Cu, Cr, Zn, Pb, Cd, and Mn) in soils, in addition to their environmental loads through new indexes for risk assessment. The highest mean concentrations in poultry litter were the following: 525 mg kg-1 for Mn, 146 mg kg-1 for Zn, and 94.4 mg kg-1 for Cu. For soils, concentrations were higher for the same heavy metals: Mn (906 mg kg-1), Zn (111 mg kg-1), and Cu (26.3 mg kg-1). Significant accumulation (p < 0.05) in fertilized soils was observed for Cu, Cr, and Zn. The high estimates of poultry litter input based on geological background (LIGB) for Cu, Cr, and Zn coincided with the accumulation observed in soils, confirming the effectiveness of the index. The risk of biogeochemical transfer based on fertilized soils (LIFS) decreased for Cu, Cr, and Zn between 10 and 30 years of soil fertilization. For Mn, a very high LIFS was estimated in all long-term fertilized soils. The proposed indices, based on heavy metal concentration, can be used in risk assessments to guide future studies that analyze other environmental matrices possibly impacted by manure and poultry litter fertilization.

Expression patterns and genetic variation of the ovine skeletal muscle transcriptome of sheep from five Spanish meat breeds.

The goal of the current study is to analyse the gene expression profile of the ovine skeletal muscle as well as to characterize the genetic variation of transcripts expressed in such tissue. This aim has been achieved by sequencing the longissimus dorsi transcriptomes of 50 sheep distributed in five pools representing the Canaria de Pelo, Roja Mallorquina, Gallega, Xisqueta and Ripollesa Spanish autochthonous breeds. Approximately, 363 million reads per pool have been produced and 71.9-82.9% have been successfully mapped to the ovine genome in a paired-end mode (2 × 75 bp). The 200 most expressed muscle transcripts (≈1% of the total transcript count) account for 51% (Canaria de Pelo) to 67% (Gallega) of the total ovine skeletal muscle mRNA expression. These highly expressed genes play key roles in pathways related with striated muscle contraction, gluconeogenesis, glycolysis, citric acid cycle and respiratory electron transport. RNA-Sequencing of muscle transcripts has also revealed that ~72% of the SNPs detected with this approach are shared by at least two pools, and 10% of them segregate in the five pools under analysis. Most of the substitutions detected by RNA-Seq are synonymous or missense and only a minority are predicted to have consequences on protein function.

Population structure of eleven Spanish ovine breeds and detection of selective sweeps with BayeScan and hapFLK.

The goals of the current work were to analyse the population structure of 11 Spanish ovine breeds and to detect genomic regions that may have been targeted by selection. A total of 141 individuals were genotyped with the Infinium 50 K Ovine SNP BeadChip (Illumina). We combined this dataset with Spanish ovine data previously reported by the International Sheep Genomics Consortium (N = 229). Multidimensional scaling and Admixture analyses revealed that Canaria de Pelo and, to a lesser extent, Roja Mallorquina, Latxa and Churra are clearly differentiated populations, while the remaining seven breeds (Ojalada, Castellana, Gallega, Xisqueta, Ripollesa, Rasa Aragonesa and Segureña) share a similar genetic background. Performance of a genome scan with BayeScan and hapFLK allowed us identifying three genomic regions that are consistently detected with both methods i.e. Oar3 (150-154 Mb), Oar6 (4-49 Mb) and Oar13 (68-74 Mb). Neighbor-joining trees based on polymorphisms mapping to these three selective sweeps did not show a clustering of breeds according to their predominant productive specialization (except the local tree based on Oar13 SNPs). Such cryptic signatures of selection have been also found in the bovine genome, posing a considerable challenge to understand the biological consequences of artificial selection.

Occurrence of free-living amoebae in streams of the Mexico Basin.

Free-living amoebae (FLA) are protozoa that are widely distributed in nature. They are important in the cycling of nutrients in aquatic food chains, but their distribution in natural aquatic environments is not well known. We conducted a survey to determine the presence and distribution of FLA and their relation to some physicochemical parameters in streams of the Mexico Basin in Central Mexico. Thirty-two sites from 18 streams were sampled. Samples were centrifuged and cultured onto NNA-media to isolate amoebae. Identifications were based on morphology. The pathogenicity of Acanthamoeba isolates was tested. Oxygen saturation, temperature, pH, specific conductance, water flow, dissolved reactive phosphorus, nitrites, nitrates, ammonia, dissolved inorganic nitrogen and coliforms were determined. One hundred-and-twenty FLA representing 18 genera were identified. The most frequent genera were Vannella, Rosculus and Acanthamoeba. The frequency of potentially pathogenic FLA was low and only 3 Acanthamoeba isolates were invasive in mice. The highest species richness of FLA was found in streams located into agriculture activity areas and those close to small villages that discharge wastewater into them. Water temperatures were always below 17°C. Oxygen saturation and pH were within the limits for the growth of most FLA. The presence of Acanthamoeba and Naegleria was low; nevertheless, they include potentially pathogenic species and can act as vectors and reservoirs for microbial pathogens and can produce human infections.

Linear low-density polyethylene and zirconium phosphate nanocomposites: evidence from thermal, thermo-mechanical, morphological and low-field nuclear magnetic resonance techniques.

Lamellar alpha-zirconium phosphate was synthesized by direct precipitation and also directly expanded with octadecylamine, through alcoholic solution. To produce a nanocomposite, it was incorporated in linear low-density polyethylene in the molten state, using a counterrotating twin-screw extruder set at 170-190 degrees C and 100 rpm. The differential scanning calorimetry analysis revealed a decrease in the polyolefin melting temperature and crystallinity degree. The higher onset temperature of the zirconium phosphate modified with octadecylamine and linear low density polyethylene composite indicated an increasing of thermal stability and it suggests that some polyethylene chains entered into the filler's spacing. Dynamic-mechanical analysis evidenced an increase in both moduli (storage and loss). Wide-angle X-ray diffraction showed additional peaks--diffraction angles appeared in the region beneath 12 degrees--which were attributed to partial intercalation of polyethylene chains between filler interlamellar spacing. By hydrogen low-field nuclear magnetic resonance, the two low intensity relaxation time peaks shifted to higher values, strongly suggesting interaction between the octadecylamine and polymer matrix into the filler galleries. From these results, it may be postulated that a partially intercalated and/or exfoliated nanostructure in the zirconium phosphate modified with octadecylamine and linear low density polyethylene composite was achieved.

Spontaneous emission in one-dimensional photonic crystals.

We study the spontaneous emission of an atom embedded in a one-dimensional photonic crystal or superlattice using a classical electrodynamic theory of radiation. The rate of emission is a function of the frequency of the emitted photon, the dipole's position and orientation, as well as the geometric and material parameters of the superlattice. The emission spectrum shows an oscillatory behavior which follows the photonic band structure. For TE modes, there are frequency regions where radiative emission is completely prohibited due to the absence of modes with k//>omega/c; the radiation is then TM polarized. In addition to the radiative modes, there are always evanescent modes with k//>omega/c which are waveguided by the dielectric layers. The evanescent contribution to the spontaneous emission is dominant if a dielectric layer is in the near field region of the dipole. For TM modes, emission rates greatly vary for parallel and perpendicular dipole moments. In a photonic crystal with a high filling fraction of the dielectric and perpendicular dipoles located in the low-index layer, the decay rate can be as much as 76 times the free space value for a single atom and 50 times for a gas of atoms. We also find that the rate of emission presents a strong dependence on the atom's position.

[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.

[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.

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)