Scratches and grazes: a detailed microscopic analysis of trampling phenomena.

Sedimentary abrasion and postdepositional damage to fossil remains are of great interest if considering the possible distortion they could produce in the archaeological and paleontological record. Since their discovery, natural agents such as trampling phenomena have been a topic of great taphonomic interest. Nevertheless, the majority of investigation into these traces has focused almost exclusively on their differentiation from other anthropic agents such as cut marks. In recent years, advances into bone surface modification analysis via geometric morphometrics have proven useful for in-depth characterization of different taphonomic traces; including cut, tooth and percussion marks. Through this, a preliminary study of trampling marks using advanced 3D digital microscopy was able to detect differences between what have since been known as scratch and graze marks. The present study expands from this, developing a more detailed analysis of these traces. Here, we use advanced data science techniques to provide a means of understanding trampling mark variations, contributing to our knowledge of site formation processes. Our results show how scratch and graze marks are a product of progressional decay and changes in cortical hardness, providing a new means of understanding taphonomic processes. LAY DESCRIPTION: The study of microscopic bone surface modifications in archaeology and palaeontology is of great importance, allowing for a detailed reconstruction of the formation of a site and providing a means of interpreting the fossil register. The damage that sedimentary abrasion can produce, however, is likely to distort and influence these studies, thus requiring a detailed understanding of the different traces that can be found on different materials. Here, we use advanced 3D digital microscopy and pattern recognition algorithms to analyse the different marks produced in different sedimentological contexts, also controlling for other variables such as the state of the bone when buried, the type of bone and the time exposed to these types of damages. Through this detailed microscopic analysis of these types of damages, we are able to conclude that morphological variations in trampling marks are product of the state of decay when the bones are buried.

Evaluation of the PREVI® Isola automated seeder system compared to reference manual inoculation for antibiotic susceptibility testing by the disk diffusion method.

The disk diffusion (DD) method remains the most popular manual technique for antibiotic susceptibility testing (AST) in clinical microbiology laboratories. This is because of its simplicity, reproducibility, and limited cost compared to (automated) microdilution systems, which are usually less sensitive at detecting certain important mechanisms of resistance. Here, we evaluate the PREVI® Isola automated seeder system using a new protocol for spreading bacterial suspensions (eight deposits of calibrated inocula of bacteria, followed by two rounds of rotation) in comparison with manual DD reference testing on a large series of clinical and reference strains. The average time required for seeding one agar plate for DD with this new protocol was 51 s per plate, i.e., 70 agar plates/h. Reproducibility and repeatability was assessed on three reference and three randomly chosen clinical strains, as usually requested by the European Committee on Antimicrobial Susceptibility Testing (EUCAST), and was excellent compared to the manual method. The standard deviations of zones of growth inhibition showed no statistical discrimination. The correlation between the two methods, assessed using 294 clinical isolates and a panel of six antibiotics (n = 3,528 zones of growth inhibition measured), was excellent, with a correlation coefficient of 0.977. The new PREVI® Isola protocol adapted for DD had a sensitivity of 99 % and a specificity of 100 % compared to the manual technique for interpreting DD as recommended by the EUCAST.

Longstanding dental pathology in Neandertals from El Sidrón (Asturias, Spain) with a probable familial basis.

Two Neandertal specimens from El Sidrón, northern Spain, show evidence of retained left mandibular deciduous canines. These individuals share the same mitochondrial (mtDNA) haplotype, indicating they are maternally related and suggesting a potential heritable basis for these dental anomalies. Radiographs and medical CT scans provide evidence of further, more extensive dental pathology in one of these specimens. An anomalous deciduous canine crown morphology that developed before birth subsequently suffered a fracture of the crown exposing the pulp sometime after eruption into functional occlusion. This led to death of the tooth, periapical granuloma formation and arrested deciduous canine root growth at an estimated age of 2.5 years. At some point the underlying permanent canine tooth became horizontally displaced and came to lie low in the trabecular bone of the mandibular corpus. A dentigerous cyst then developed around the crown. Anterior growth displacement of the mandible continued around the stationary permanent canine, leaving it posteriorly positioned in the mandibular corpus by the end of the growth period beneath the third permanent molar roots, which, in turn, suggests a largely horizontal growth vector. Subsequent longstanding repeated infections of the expanding cyst cavity are evidenced by bouts of bone deposition and resorption of the boundary walls of the cyst cavity. This resulted in the establishment of two permanent bony drainage sinuses, one through the buccal plate of the alveolar bone anteriorly, immediately beneath the infected deciduous canine root, and the other through the buccal plate anterior to the mesial root of the first permanent molar. It is probable that this complicated temporal sequence of dental pathologies had an initial heritable trigger that progressed in an unusually complex way in one of these individuals. During life, this individual may have been largely unaware of this ongoing pathology.

[SARS-COV-2 myocarditis. An update]. / Myocardite et maladie à COVID-19 : où en est-on ?

The outbreak of the SARS-CoV-2 virus responsible for the COVID-19 disease has given rise to a new disease whose boundaries are still to be discovered. While the first data suggested a purely respiratory infection, the most recent publications highlight a large pleomorphism of the disease, responsible for multiple organ damage, of which cardiac injury seems to be the most represented. This cardiac injury can present as acute myocarditis. Our aim was to discuss the pathophysiological rationale underlying the existence of SARS-CoV-2 myocarditis and to analyze the literature data regarding the diagnosis and treatment of this particular entity.

Skeletal Anomalies in The Neandertal Family of El Sidrón (Spain) Support A Role of Inbreeding in Neandertal Extinction.

Neandertals disappeared from the fossil record around 40,000 bp, after a demographic history of small and isolated groups with high but variable levels of inbreeding, and episodes of interbreeding with other Paleolithic hominins. It is reasonable to expect that high levels of endogamy could be expressed in the skeleton of at least some Neandertal groups. Genetic studies indicate that the 13 individuals from the site of El Sidrón, Spain, dated around 49,000 bp, constituted a closely related kin group, making these Neandertals an appropriate case study for the observation of skeletal signs of inbreeding. We present the complete study of the 1674 identified skeletal specimens from El Sidrón. Altogether, 17 congenital anomalies were observed (narrowing of the internal nasal fossa, retained deciduous canine, clefts of the first cervical vertebra, unilateral hypoplasia of the second cervical vertebra, clefting of the twelfth thoracic vertebra, diminutive thoracic or lumbar rib, os centrale carpi and bipartite scaphoid, tripartite patella, left foot anomaly and cuboid-navicular coalition), with at least four individuals presenting congenital conditions (clefts of the first cervical vertebra). At 49,000 years ago, the Neandertals from El Sidrón, with genetic and skeletal evidence of inbreeding, could be representative of the beginning of the demographic collapse of this hominin phenotype.

[Isolation and composition of a glycoprotein from lamb gastric mucosa]. / Isolement et composition d'une glycoprotéine de muqueuse gastrique d'agneau

A glycoprotein is isolated from lamb gastric mucosa. It is purified first by reduction with dithiothreitol and then by chromatography on CM-Sephadex followed by gelfiltration on Sephadex G-75. Its homogeneity is investigated by disc electrophoresis, immunoelectrophoresis, analytical ultracentrifugation and identification of the carboxy- and amino-terminal amino acids. This glycoprotein contains 56 p. cent carbohydrates, consisting of N-glycolyneuraminic acid, fucose, galactose, and hexosamines. Hexosamines and galactose are in equimolar ratio ; galactosamine and glucosamine in the ratio 1 :2. The amino acid composition shows that threonine, serine and proline account for half of the amino acid residues. The cysteine origin and function are discussed.

[Comparative study of the efficacy of propafenone and amiodarone in the treatment of chronic ventricular extrasystole]. / Etude comparative de l'efficacité de la propafénone et de l'amiodarone dans le traitement des extrasystoles ventriculaires chroniques.

30 patients (mean age 56 +/- 18 years) suffering from multiple ventricular extrasystoles (VES) of various origin, like ischemic, hypertensive, valvular and congenital cardiopathy, and arrhythmogenic ventricular dysplasia, were treated during 12 days by a daily dose of 900 mg of propafenone (15 cases) or 600 mg of amiodarone (15 cases). The study was randomized and a portable ECG was used for 24 h. At the time of entering into the study (H0) the patients were without any therapy. The mean total number of VES was 16,878 +/- 9,212 in the propafenone group (2,062 +/- 2,342 of them being repetitive) and 19,497 +/- 7,930 in the amiodarone group (2,907 +/- 3,615 of them being repetitive). The difference between the two groups was not statistically significant, even with the use of Holter (H1) ECG monitoring one week later. After 12 days of treatment (H2) a significant decrease in the number of total VES was noted: by 78% with propafenone (76% isolated and 89% repetitive VES) and by 77% with amiodarone (74% isolated and 91% repetitive VES). The difference between the effect of the two drugs was not significative. After 12 days of wash-out (H3) the number of VES returned to initial values with propafenone but not with amiodarone where the values were still decreased after 82 days of wash-out (H4). Both drugs produced significant bradycardia which was more apparent and more spread out during the nyctohemeral with amiodarone. Propafenone affected rather the maximal and diurnal frequencies. No correlation was found between the bradycardic and antiarrhythmic effect. Amiodarone was well tolerated and propafenone produced minor digestive and neurosensory troubles in about half the cases, only in one patient a more pronounced arrhythmogenic effect was observed. In conclusion, the efficacy and the good hemodynamic tolerance of the two drugs was found to be similar in the short-term treatment of chronic, isolated or repetitive VES, irrespective of their etiology.

[Sinoatrial and atrioventricular conduction disorders in Lyme disease. Apropos of 2 case reports]. / Troubles conductifs sino-auriculaires et auriculo-ventriculaires de la maladie de Lyme. A propos de deux observations.

Lyme's disease due to Borrelia Burgdorferii is a rare cause of acute atrioventricular block (AVB) which is the commonest cardiac complication. Cutaneous, neurological and articular involvement complete the clinical picture of this condition. These two cases, confirmed by serology, support previously reported data describing the favourable prognosis of these conduction defects (suprahisian and/or hisian in our 2 cases) which regress completely, irrespective of their degree of severity. The authors also describe AVB occurring without extracardiac manifestations of this condition and a documented case of sinoatrial block, indicating a new zone of infestation.

[Treatment of ventricular tachycardia with propafenone. Parallel study of ventricular provocation tests]. / Traitement des tachycardies ventriculaires par la propafénone. Etude "en parallèle " des tests de provocation ventriculaire.

Propafenone (P), a class IC antiarrhythmic drug, was tested intravenously and orally in the curative and preventive treatment of sustained (VTS) and non-sustained (VTNS) ventricular tachycardia. The 16 patients involved included 11 men and 5 women of mean age 49 years. They all had heart disease: ischaemia in 3, right ventricular arrhythmogenic dysplasia in 6, dilated myocardiopathy in 5 and left ventricular aneurysm in 2. Intravenous P in doses of 1.5 mg/kg controlled VT within 2 or 3 minutes on average in 9 out of 12 patients. Following the injection VT could not be reinduced in 2 out of 10 patients; other inductions were harder to obtain or resulted in VTNS instead of VTS (n = 3), or remained unchanged (n = 5). When P was administered orally (mean dose 900 mg) to 14 patients reinduction of VT was no longer possible in 2 cases, more difficult in 1 case, remained unchanged in 7 cases and was easier in 4 cases. Long-term oral therapy at the same dosage level prevented recurrences of VT in 7 out of 14 patients; the drug was discontinued in 2 patients owing to its arrhythmogenic effect on induced VT. The patients were followed up for 5 to 36 months (mean: 16.4 +/- 11.7 months). In this trial the results of long-term treatment could not be predicted from Holter recordings or measurements of plasma levels.(ABSTRACT TRUNCATED AT 250 WORDS)

[Primary angioplasty in acute myocardial infarction. A one-year experience in a small urban community]. / Angioplastie primaire à la phase aiguë de l'infarctus du myocarde. Expérience d'une année d'activité dans une ville de moyenne importance.

The aim of this study was to assess the feasibility, safety and efficacy of primary angioplasty in acute myocardial infarction in a cardiology centre of a small urban community without on-site cardiac surgery. During 1995, 50 patients underwent angioplasty for MI in the first 12 hours. The average age was 66.7 +/- 12.6 years. Eighty six per cent of patients had at least one poor prognostic criteria (32% over 75 years of age, 70% anterior wall infarcts, 30% with heart rates > 100 min on admission). The angiographic result was successful in 45 patients (90%). The time between onset of pain and reopening the vessel was 240 +/- 116 min and between admission to the catheter laboratory and reopening 31 +/- 8 min. A coronary stent was implanted in 24 cases (48%) and intra-aortic balloon pumping was necessary in 14 cases (28%). Ischaemia recurred during the hospital phase in 7 cases (14%), 4 of which (8%) were caused by rethrombosis of the dilated artery: in 3 cases, the ischaemia was in another zone. No emergency coronary bypass surgery was required. The hospital mortality was 10%, always in patients over 80 years of age. The average duration of the hospital stay was 5.8 +/- 2.6 days with 15.7 +/- 7.3 days of convalescence. The average global cost was 61850 +/- 20686 F. These results were comparable to previously reported figures and confirm that primary angioplasty in acute infarction is possible and effective with an acceptable risk in a small urban community without on-site cardiac surgery.

[Isotope angiocardiographic study of 30 cases of ventricular tachycardia with Fourier phase analysis]. / Etude de 30 tachycardies ventriculaires par angiocardiographie isotopique avec analyse de phase de Fourier.

Twenty-seven patients (15 men, 12 women; mean age 48.9 years) suffering from ventricular tachycardia (VT) (n = 30) were studied by radionuclide angiocardiography with Fourier phase analysis, both in sinus rhythm and during tachycardia. VT was spontaneous, electrically inducible, sustained, haemodynamically stable and monomorphous, with a mean rate of 174 beats/min (range: 115-260 beats). Heart diseases responsible for VT were: non-obstructive cardiomyopathy (n = 7), hypertrophic cardiomyopathy (n = 1), ischaemic heart disease (n = 5), probable right ventricular arrhythmogenic dysplasia (n = 4), congenital left ventricular aneurysm (n = 2), sequela of myocarditis (n = 2) and aortic valve regurgitation (n = 1); no heart disease was detectable in 5 patients. On surface electrocardiogram there was good concordance between the initial radionuclide site of VT activation and the configuration and electrical axis of QRS. At Fourier phase analysis all 17 VT of the right lag type originated in the left ventricle, arising from the apical septum (n = 7) or lateral segment (n = 2) in case of left axis, from the basal segment (n = 6) or the lateral segment (n = 1) in case of vertical or right axis, and from the middle left septum (n = 1) in case of normal axis. Nine VT of the left lag type originated in the right ventricle, arising from the basal septum or the latero-basal region in case of vertical or right axis (n = 6), from the apical septum or the inferior-apical region in case of left axis (n = 2) and from the middle septum in case of normal axis (n = 1). Four of our patients (3 with coronary disease and 1 with congenital left ventricular aneurysm) had VT of the left lag type and an initial radionuclide site of activation in the middle part of the left septum in case of left axis (n = 2) and in the basal part of that septum in case of right axis (n = 2). Seven patients were operated upon for recurrent VT: 4 had intra-operative mapping which in every case confirmed the results of radionuclide angiocardiography, a method which in the other 3 patients was the only surgeon's guide. Correlations between the site of origin of VT at radionuclide mapping and kinetic abnormalities visualized at radiological angiography and gamma-ray angiocardiography were common in our study. In one of our patients the same lesion gave birth to 2 VT of different morphologies.(ABSTRACT TRUNCATED AT 400 WORDS)

[Pre- and postoperative study of arrhythmia in atrial septal defects (ostium secundum and sinus venosus)]. / Etude pré et postopératoire des troubles du rythme et de la conduction au cours de la communication interauriculaire (ostium secundum et sinus venosus).

An electrophysiological study was carried out pre- and postoperatively in 25 patients (children and adults) presenting with an atrial septal defect of the ostium secundum type (OSASD). The purposes of the study were to find out whether early electrophysiological abnormalities were present in children, to compare the results obtained in children and in adults and to evaluate the impact of surgery by comparing preoperative and late postoperative electrophysiological data. Patients were divided into two groups. Group I was composed of 11 children (mean age 8.18 +/- 1.03 years) with a mean pulmonary/systemic blood flow ratio of 2.33 +/- 0.24. Group II comprised 14 adults (mean age 36.79 +/- 4.89 years) with a mean pulmonary/systemic blood flow ratio of 3.42 +/- 0.24. Preoperatively, in group I 55 p. 100 of the patients (6/11) had sinus node dysfunction, 18 p. 100 (2/11) had disturbances of atrioventricular conduction, and none had atrial dysrhythmia. Preoperatively, in group II 43 p. 100 of the patients (6/14) had sinus node dysfunction, 36 p. 100 (5/14) had disturbances of atrioventricular conduction, and 36 p. 100 (5/14) had sustained atrial dysrhythmia (flutter or paroxysmal atrial fibrillation). The frequency of sustained atrial dysrhythmia correlated positively with the patient's age and with the presence of sinus node dysfunction. Following surgical closure of the atrial septal defect, the electrophysiological parameters were not significantly modified in both groups. This study confirmed the presence of early electrophysiological abnormalities of sinus node function and atrioventricular conduction in children with OSASD. The most significant finding in adults was the occurrence of atrial dysrhythmias in the oldest patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[Control of the patency of coronary-internal mammary artery bypasses by non-selective angiography]. / Contrôle de la perméabilité des pontages coronaires-artères mammaires internes par angiographie non sélective.

98 successive coronary bypasses using the internal mammary artery were controlled systematically, at an early stage, about the 17th postoperative day, by non selective brachial angiography using a retrograde injection. This control method, simple, quick, reliable and non-aggressive, enables to visualize the internal mammary artery and the bypassed coronary vessel, over its entire length. There were no failure in the control, nor any local or general complication during this examination. The overall patency of such bypasses, evaluated with this method, is 98 p. cent in our series, with however, 12 p. cent of angiographic aspects of a poorly functional bypass. These aspects are related to a slow flow in the by-pass (spindly internal mammary artery, anastomotic stenosis or thin distal bed of the bypassed coronary artery), or to a competitive flow (non significant coronary stenosis). The perfusion of the bypassed coronary, which is not so well studied in the literature, is important to analyze and difficult to evaluate with our technique because of the static views that are used. A similar non-selective angiographic method using a dynamic recording (radio-cinema with dual incidence) is currently being evaluated.

[Effectiveness of atenolol in moderate arterial hypertension. Evaluation by stress test]. / Eficacia del atenolol en la hipertensión arterial moderada. Valoración mediante prueba de esfuerzo.

A study on the effect of atenolol on exercise blood pressure is presented. Twenty-eight patients with blood pressure over 95 mmHg have been studied by maximal or symptom-limited stress testing. The stress testing was repeated with the same protocol after four weeks of treatment with 100 mg of atenolol daily. Systolic blood pressure after treatment fell by 14% at rest, by 9.5% at submaximal effort and by 11% at maximal effort, while diastolic blood pressure by 15%, 11% and 12% respectively (p less than 0.001). This reduction was parallel to that on heart rate. After treatment, diastolic blood pressure fell to normal ranges in 64% of patients at rest and in 56% of them at maximal effort. Exercise tolerance was slightly better after treatment than before it, mean duration of effort raising from 12.6 to 13.03 minutes. Exercise-induced arrhythmias were frequent (46%) and severe in hypertensive patients, two of them having ventricular tachycardia. This rate was dramatically reduced (up to 7%) with atenolol, as well as its severity.

[Clinical evaluation of amiodarone hydrochloride as an anti-arrhythmia agent]. / Valoración clínica del clorhidrato de amiodarona como antiarrítmico

15 patients with ventricular and supraventricular arrhythmias treated with Amiodarone hydrochloride via oral were studied. The results obtained show that in 86'6% of the cases the arrhythmia disappeared immediately, in 6'6% the arrhythmia disappeared late and in only one case the arrhythmia persisted. Statistical significance was found in the reduction of cardiac frequency as well as in the corrected QT interval for the frequency. The latter is an indirect consequence of the mode of action of the drug. The only side effect observed was the appearance of corneal opacification. It was demonstrated that this side effect is negligible when low doses which are equally effective are administered. The conclusion that Amiodarone is an excellent oral antiarrhythmic drug is reached. A daily dose of 400 mg during the first 20 days of each month with a rest of 10 days is recommended. In this way, the corneal opacification is minimal or nil. The possibility that the association of the drug with Quinidine could be effective in maintaining sinus rhythm post D.C. is suggested.

[Postoperative evaluation of Carpentier's mitral rings]. / Valoración postoperatoria de los anillos mitrales de Carpentier

38 patients with Carpentier's ring inserted in the mitral position at surgery, are studied. The grade of the pre and postoperatory mitral murmur is correlated and compared with the radiographic size of the heart and left auricle as well as the pre and postoperatory angiocardiographic study. Only 3 (7'8%) of the 38 patients presented significant elevation of the pulmonary artery sistolic pressure together with important angiographic regurgitation. These three patients had to be operated on again, 60'52% did not present murmurs on these were grade I murmurs, while 76'32% did not present mitral reguritation. Only 8 of 14 patients with grade II sistole murmur in the postoperative period had grade II regurgitation. This no correlation was observed between the intensity of the murmur and the grade of angiocardiographic mitral regurgitation. We conclude that Carpentier's ring restores the mitral valve function to normal in the majority of cases and the angiocardiographic results are favorable.