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La ingestión de cuerpos extraños esofágicos es una situación particularmente frecuente en la práctica clínica. Afecta tanto a la población pediátrica (la mayoría de los cuerpos extraños ingeridos se observan en pacientes de entre 6 meses y 6 años) como a la población adulta. El enclavamiento esofágico es el principal lugar de impactación de los cuerpos extraños ingeridos. La mayoría de ellos pasan de forma espontánea. En la mayoría de los casos, la anamnesis permite establecer el diagnóstico de cuerpo extraño esofágico. Las situaciones diagnósticas difíciles corresponden a aquellas en las que dicha anamnesis es imposible (niños, adultos con deficiencia mental, etc.). No obstante, la clínica, completada en mayor o menor medida con pruebas de imagen, permite establecer el diagnóstico la mayoría de las veces. La urgencia terapéutica depende esencialmente de la tolerancia del paciente al cuerpo extraño, pero también de las características de éste (pila de botón, cuerpos extraños cortantes, etc.). Las modalidades terapéuticas son múltiples (abstención, tratamiento farmacológico, fibroendoscopia o endoscopia rígida) y dependen de las competencias de tratamiento de cada centro, así como de las características del cuerpo extraño. Tanto la presencia como la extracción del cuerpo extraño son una fuente de complicaciones que deben conocerse para proporcionar un tratamiento óptimo. En caso de impactaciones alimentarias repetidas, es necesario realizar un estudio en busca de factores favorecedores.

The Southwest Pacific region is of great importance to global climate variability, but instrumental climate observations before the 1980s lack in numbers and quality. Despite efforts in complementing instrumental records with proxy sea surface temperature (SST) and sea surface salinity (SSS) reconstructions based on coral Sr/Ca and δ18Oswrecords, few of them are longer than a century. This study introduces a northwestern extension to the existing records of South Pacific coral study sites with monthly‐resolved Sr/Ca, δ18O, and δ18Oswreconstructions from Rotuma dating back to 1821. Additionally, we present new monthly‐resolved Sr/Ca and reconstructed δ18Oswfrom a coral from Tonga dating back to 1848. Results reveal 1.5°C warming in the Western Pacific Warm Pool, while the adjacent coral from Tonga shows 1°C warming over the twentieth century. The Rotuma Sr/Ca record reveals thermal stress events impacting the Sr/Ca‐SST relationship in the following months. Coral δ18Oswresults reveal significant freshening of 0.45 Sp(practical salinity unit) in Tonga since the early twentieth century, suggesting the southeastward expansion of the South Pacific Convergence Zone salinity front. The δ18Oswinferred SSS provides a valuable extension into the past considering the short and inconsistent instrumental records available. This study demonstrates the utility of coral‐based reconstructions in capturing long‐term and regional climate variations in the Southwest Pacific and the necessity of expanding replicated studies to other underrepresented areas to enhance our understanding of regional climate dynamics. The Southwest Pacific has limited historical climate data. This makes studying anthropogenic climate change, and how it is changing our oceans, very challenging. This study addresses this gap by using massive tropical corals from Rotuma and Tonga to reconstruct climatic key parameters back to the mid‐1800s. Our findings show that the Western Pacific Warm Pool (WPWP) has warmed by 1.2°C, much more than the adjacent subtropical waters around Tonga (0.5°C) between 1850 and 1998. The Rotuma coral record is one of the rare long records from the WPWP area where the average annual temperatures are very high (29°C). It reveals the coral was repeatedly affected by temperature stress, and probably unreported bleaching episodes throughout history. We also observe a significant freshening of 0.45 Spin Tonga, indicating that fresher waters from the South Pacific Convergence Zone are spreading southeastward. Our coral‐derived records provide valuable historical perspectives in the absence of consistent instrumental records. Our study emphasizes the reliability of coral‐based reconstructions as indicators of local to regional conditions in the Southwest Pacific and the need for more research to better understand and address climate variability of this key area for Pacific‐wide climate. Rotuma coral Sr/Ca and δ18Oswrecords provide the first reconstructions of surface seawater temperature and salinity from this locationCoral Sr/Ca‐SST shows long‐term warming in the Southwest Pacific, with higher rates in the Western Pacific Warm Pool, compared to subtropicsδ18Osw‐SSS reconstruction from Tonga shows significant long‐term freshening Rotuma coral Sr/Ca and δ18Oswrecords provide the first reconstructions of surface seawater temperature and salinity from this location Coral Sr/Ca‐SST shows long‐term warming in the Southwest Pacific, with higher rates in the Western Pacific Warm Pool, compared to subtropics δ18Osw‐SSS reconstruction from Tonga shows significant long‐term freshening

Las exostosis del conducto auditivo externo (CAE) afectan esencialmente a las personas que practican de forma intensiva deportes náuticos. Las indicaciones quirúrgicas se basan en la sintomatología del paciente, la repetición de las otitis y la repercusión audiométrica. El estudio preoperatorio de las pruebas de imagen es esencial para limitar los riesgos y las complicaciones. La cirugía requiere un fresado prudente de las exostosis después de la movilización de colgajos cutáneos. Esto se puede realizar según la técnica de la «cáscara de huevo» o por fresado de medial a lateral. También se puede efectuar una resección mediante osteótomos. Las complicaciones son infrecuentes. Se trata esencialmente de traumatismos timpanoosiculares o de trastornos de cicatrización postoperatorios. En la mayoría de los casos, la cirugía de las exostosis del CAE permite mejorar la calidad de vida de los pacientes, así como la audiometría tonal postoperatoria en los casos en los que la indicación corresponda a una sordera.

La meatoplastica si riferisce alla chirurgia destinata ad allargare il canale uditivo esterno nella sua porzione fibrocartilaginosa. L’obiettivo della meatoplastica è di far corrispondere il diametro del dotto fibrocartilagineo con quello del dotto osseo. L’indicazione principale è la chiusura delle cavità di svuotamento a seguito di un intervento chirurgico per colesteatoma.

L’ingestione di corpi estranei esofagei è una situazione particolarmente frequente nella pratica clinica. Interessa tanto la popolazione pediatrica (la maggior parte dei corpi estranei ingeriti lo è da soggetti di età compresa tra i 6 mesi e i 6 anni) quanto la popolazione adulta. Il sito di blocco esofageo è il sito principale di blocco dei corpi estranei ingeriti. La maggior parte di essi passa spontaneamente. L’interrogatorio consente, nella maggior parte dei casi, di porre la diagnosi di corpi estranei dell’esofago, e le situazioni diagnostiche difficili sono rappresentate dalle situazioni in cui l’interrogatorio è impossibile (bambino, adulto con deficit mentale, ecc.). La clinica, più o meno integrata dalla diagnostica per immagini, consente tuttavia di formulare la diagnosi nella maggior parte dei casi. L’urgenza terapeutica dipende essenzialmente dalla tolleranza del paziente al corpo estraneo, ma anche dalla natura di tale corpo (batteria a bottone, corpi estranei taglienti, ecc.). Le modalità terapeutiche sono molteplici (astensione, trattamento farmacologico, fibroscopia flessibile o endoscopia rigida) e dipendono dalle competenze locali ma anche dalla natura del corpo estraneo. La presenza ma anche l’estrazione del corpo estraneo sono all’origine di complicanze la cui esistenza deve essere conosciuta per una gestione ottimale. In caso di ripetuti blocchi alimentari, è necessario realizzare un bilancio, alla ricerca di fattori favorenti.

L’objectif principal de cette étude rétrospective était l’évaluation des résultats fonctionnels de la chirurgie endoscopique du diverticule de Zenker. Les objectifs secondaires étaient d’évaluer la sécurité de la procédure, d’identifier les facteurs de risque de récidive et d’en déterminer leur conduite en cas de récidive.

L’ingestione di corpi estranei esofagei è una situazione particolarmente comune nella pratica clinica. Interessa sia la popolazione pediatrica (la maggior parte dei corpi estranei viene ingerita tra i 6 mesi e i 6 anni) che la popolazione adulta. Il sito di maggiore ristrettezza esofagea è il sito di principale incastro dei corpi estranei ingeriti. La maggior parte di essi passa spontaneamente. L’anamnesi permette, nella maggior parte dei casi, la diagnosi di corpo estraneo esofageo e situazioni diagnostiche difficili sono rappresentate da quelle situazioni in cui l’anamnesi è impossibile (bambino, adulto con handicap mentale, ecc.). La clinica, più o meno completata dalla diagnostica per immagini, permette, tuttavia, di porre diagnosi nella maggioranza dei casi. L’urgenza terapeutica dipende in gran parte dalla tolleranza del paziente al corpo estraneo, ma anche dalla natura di questo corpo (pila a bottone, corpi estranei taglienti, ecc.). Le modalità di trattamento sono molteplici (astensione, trattamento medico, fibroscopia flessibile o endoscopia rigida) e dipendono dalle competenze locali nella gestione, ma anche dalla natura del corpo estraneo. La presenza ma anche l’estrazione del corpo estraneo sono una fonte di complicanze di cui bisogna conoscere l’esistenza per una gestione ottimale.

Archaeologists often come across ancient human burials during excavations. Less often, however, do human burials come across archaeological excavations. This happened though, at a site in southeastern Turkey a few years ago. When a funeral procession interrupted operations on the mound of Ziyaret Tepe, archaeologists confronted the dilemma of maintaining an excavation site as a scientific space in real-world contexts that are anything but sterile (void of contemporary meaning) or controlled (void of competing claims). The funeral event exposed the salience of the mound as both a sacred and scientific landmark, and brought to the fore numerous historical, political and cultural factors that rarely receive acknowledgement in the field or in publication. We outline these various influences on archaeological practice at Ziyaret Tepe, and use this unexpected funeral to advocate for a community archaeology that broadens the value of excavation by respecting a site's valence as something other than a scientific space.

Modified urinary fluid shear stress (FSS) induced by variations of urinary fluid flow and composition is observed in early phases of most kidney diseases. Recently, we reported that renal tubular FSS promotes endothelial cell activation and subsequent adhesion of human monocytes, thereby suggesting that changes in urinary FSS can induce the development of inflammation (Miravète M, Klein J, Besse-Patin A, Gonzalez J, Pecher C, Bascands JL, Mercier-Bonin M, Schanstra JP, Buffin-Meyer B, BBRC407: 813–817, 2011). Here, we evaluated the influence of tubular FSS on monocytes as they play an important role in the progression of inflammation in nephropathies. Human renal tubular cells (HK-2) were exposed to FSS 0.01 Pa for 30 min or 5 h. Treatment of human THP-1 monocytes with the resulting conditioned medium (FSS-CM) modified the expression of macrophage differentiation markers, suggesting differentiation toward the inflammatory M1-type macrophage. The effect was confirmed in freshly isolated human monocytes. In contrast to endothelial cells, the activation of monocytes by FSS-CM did not require TNF-α. Cytokine array analysis of FSS-CM showed that FSS modified secretion of cytokines by HK-2 cells, particularly by increasing secretion of TGF-β and by decreasing secretion of C-C chemokine ligand 2 (CCL2). Neutralization of TGF-β or CCL2 supplementation attenuated the effect of FSS-CM on macrophage differentiation. Finally, FSS-injured HK-2 cells expressed and secreted early biomarkers of tubular damage such as kidney injury molecule 1 and neutrophil gelatinase-associated lipocalin. In conclusion, changes in urinary FSS should now also be considered as potential insults for tubular cells that initiate/perpetuate interstitial inflammation.

The article offers information on the 19th-century wallpaper collection of The Historic New Orleans Collection (THNOC). Topics covered include the wallpaper acquired by THNOC from the Hermann-Grima and Gallier Historic Houses in 2015, the many fragments in the collection, and THNOC's continued acquisition of wallpapers from various historic homes throughout New Orleans, Louisiana.

La meatoplastia es la cirugía de ampliación de la porción fibrocartilaginosa del conducto auditivo externo. El objetivo de la meatoplastia es adaptar el diámetro del conducto fibrocartilaginoso al del conducto óseo. La indicación principal es el cierre de las cavidades de vaciamiento después de una cirugía del colesteatoma.