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Hydrocephalus, altering cerebrospinal fluid (CSF) dynamics, affects 175 per 100,000 adults worldwide. Ventriculoperitoneal shunts (VPS) manage symptomatic hydrocephalus, with 125,000 cases annually. Despite efficacy, VPS face complications, necessitating interventions.

Este documento de posicionamiento describe los aspectos más importantes de la ecografía clínica en el ámbito de la Medicina Interna, desde sus indicaciones fundamentales hasta el período de formación recomendado. Actualmente ya no quedan dudas sobre la gran utilidad de esta herramienta para la práctica clínica habitual del internista en múltiples escenarios clínicos y ámbitos de actuación (urgencias, planta de hospitalización, consulta general y específica y atención domiciliaria). Su uso tiene un impacto relevante en la capacidad de resolución del profesional, al aumentar su fiabilidad y seguridad diagnóstica, además de proporcionar información pronóstica y evolutiva importante. Además, en los últimos años se ha incorporado como una herramienta en la enseñanza pregrado con excelentes resultados. Por tanto, es necesario generalizar su uso y para ello se debe fomentar la formación estructurada y la adquisición de equipos. El documento ha sido elaborado por el Grupo de Trabajo de Ecografía Clínica y avalado por la Sociedad Española de Medicina Interna.

Bone is a specialized connective tissue with a calcified extracellular matrix in which cells are embedded. Besides providing the internal support of the body and protection for vital organs, bone also has several important metabolic functions, especially in mineral homeostasis. Far from being a passive tissue, it is continuously being resorbed and formed again throughout life, by a process known as bone remodeling. Bone development and remodeling are influenced by many factors, some of which may be modifiable in the early steps of life. Several studies have shown that environmental factors in uterus and in infancy may modify the skeletal growth pattern, influencing the risk of bone disease in later life. On the other hand, bone remodeling is a highly orchestrated multicellular process that requires the sequential and balanced events of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. These processes are accompanied by specific gene expression patterns which are responsible for the differentiation of the mesenchymal and hematopoietic precursors of osteoblasts and osteoclasts, respectively, and the activity of differentiated bone cells. This review summarizes the current understanding of how epigenetic mechanisms influence these processes and their possible role in common skeletal diseases.

Quartz geodes and nodular chert have been found within middle–upper Campanian carbonate sediments from the Laño and Tubilla del Agua sections of the Basque-Cantabrian Basin, northern Spain. The morphology of geodes together with the presence of anhydrite laths included in megaquartz crystals and spherulitic fibrous quartz (quartzine-lutecite), suggest an origin from previous anhydrite nodules. The anhydrite nodules at Laño were produced by the percolation of marine brines, during a period corresponding to a sedimentary gap, with δ³⁴S and δ¹⁸O mean values of 18.8‰ and 13.6‰ respectively, consistent with Upper Cretaceous seawater sulphate values. Higher δ³⁴S and δ¹⁸O mean values of 21.2‰ and 21.8‰ recorded in the Tubilla del Agua section are interpreted as being due to a partial bacterial sulphate reduction process in a more restricted marine environment. The idea that sulphates may have originated from the leaching of previously deposited Keuper sulphate evaporites with subsequent precipitation as anhydrite, is rejected because the δ³⁴S, δ¹⁸O and ⁸⁷Sr/⁸⁶Sr values of anhydrite laths observed at both the Tubilla del Agua and Laño sections suggest an origin from younger marine brines. Later calcite replacement and precipitation of geode-filling calcite is recorded in both sections, with δ¹³C and δ¹⁸O values indicating the participation of meteoric waters. Synsedimentary activity of the Peñacerrada diapir, which lies close to the Laño section, played a significant role in the local shallowing of the basin and the formation of quartz geodes. In contrast, eustatic shallowing of the inner marine series of the Tubilla del Agua section led to the generation of morphologically similar quartz geodes. Copyright © 2002 John Wiley & Sons, Ltd.

Fish-bearing beds of early Cretaceous age crop out in the Arratia Valley, province of Biscay, along the nucleus of the Bilbao Anticlinorium in the Basque-Cantabrian Basin, northern Spain. Teleost fossils have been found in several stratigraphic levels, dated as Valanginian–Barremian, in the Villaro Member of the Villaro Formation. The Villaro Member is a 1100-m-thick succession of black shales, sandstones and scattered limestones that represent deposition in a shallow lacustrine system periodically fed by delta prograding bars and channels. Deposition took place in a restricted freshwater–brackish environment that was occasionally affected by marine incursions. The first new taxon from the Arratia Valley, described here, isEzkutuberezi carmenigen. nov., sp. nov., a deep-bodied clupeomorph whose autapomorphies include: a posterior supramaxilla with a long anterior process forming an angle of 90° with the main body of the bone; a hypertrophied, claw-shaped last dorsal scute; only two epurals; and hypural 3 with a submedian longitudinal crest. The morphology of the dorsal scutes supports its assignment to the paraclupeid subfamily Paraclupeinae within the order Ellimmichthyiformes. The new taxon is the oldest European clupeomorph, and the first articulated vertebrate fossil to be described from the Basque-Cantabrian Basin.

AbstractNodular chert from the Cueva-Bed?n carbonate platform (late Turonian-earliest Coniacian) occurs above the type 1 sequence boundary and in association with a transgressive systems tract deposit. It formed by selective replacement of grainstones-packstones, and Thalassinoidesburrow fillings. Other minor types of selective silicification include the replacement of anhydrite nodules, forming quartz geodes, and the partial or total replacement of oysters and inoceramids. The chert nodules consist predominantly of microquartz with volumetrically minor fibrous quartz (length-fast chalcedony) and megaquartz. The silica has a mainly biogenic source (siliceous sponge spicules and radiolarians). Lepisphere textures that are indicative of an intermediate opal-CT precursor are evident in chert nodules, which indicates the chert formed by a maturation process from opalA to opal-CT to quartz. The ? 18O values of microquartz suggest a precipitation from marine fluids. The fabric of quartz geodes consists of irregular bands of heterometric megaquartz, quartzine and lutecite spherulites, and a well developed band of petaloidal megaquartz that contains small anhydrite inclusions. Bivalve shells are replaced mainly by fibrousquartz (quartzine-lutecite), which forms extensive beekite rings. The silica source of the replaced fossils is also biogenic, but silicification couldhave occurred by direct quartz replacement without an opal-CT precursor. Field and petrographic evidence indicate that silicification was an early diagenetic process that affected both uncompacted and compacted sediments, andwas inhibited when the dolomitization began. There seems to exist a syncrony in age (late Turonian-earliest Coniacian) between the nodular chert in the Cueva-Bed?n carbonate platform and the bedded and nodular chert ofthe Plentzia carbonate turbidites in the deeper Basque Arc.

Inoceramid bivalve shells from the upper part of the Plentzia Formation (middle Cenomanian to lower Santonian) of the Basque-Cantabrian Region were tested for post-depositional, diagenetic alteration. From field relations, petrography and cathodoluminescence (CL) observations, the coarsely prismatic calcitic ostracum of the shells seem to be most affected by chemical diagenetic processes, but without textural changes in the prismatic microstructure, with the exception of some selective silicification by quartzine-lutecite rims at the margin of the shells and small euhedral calcite crystals (1-2μm across) infilling possible organic filament ducts. CL is a bright red-yellowish colour owing to a relatively high MnO content, 0.28% vs. 0.03% (wt) in the whole rock. Theδ18O isotopic values obtained from the shell prisms range from −1.76‰ to −4.70‰ [Pee Dee Belemnite (PDB)], with a mean value of −3.03±0.69‰ (PDB). The clearest evidence of diagenetic alteration is inferred from both whole-shell geochemistry and microprobe analysis. In fact, a complementary zonation in the distribution of ‘diagenetic tracers’ can be detected from internal to external surfaces of inoceramid shells, together with a rare earth element (REE) enrichment in the shells which have lighterδ18O values. Comparison between REE mean values of the marly host rock and those of inoceramid shells reinforces the idea of chemical diagenetic alteration of shell carbonate.

An isolated intra-articular and adjacent shaft fracture of the distal ulna is described. A 38-old-year woman driver sustained an automobile accident with subsequent airbag deployment injuring her left wrist. Imaging studies showed displacement of a radiovolar fragment and deformity of the ulnar articular surface. The fracture was reduced and internally fixed with 3, 3.5-mm, cannulated screws to avoid future difficulties in forearm rotation, ulnocarpal impaction, and late posttraumatic arthritis. The final outcome was excellent. Careful clinical and radiologic examination is strongly recommended for this type of fracture, which seems to be a part of the spectrum of upper limb injuries associated with airbag deployment. Such injuries can be expected to occur more frequently with the increasing use of airbags.

In this paper, we describe the optical imaging data processing pipeline developed for the Subaru Telescope’s Hyper Suprime-Cam (HSC) instrument. The HSC Pipeline builds on the prototype pipeline being developed by the Large Synoptic Survey Telescope’s Data Management system, adding customizations for HSC, large-scale processing capabilities, and novel algorithms that have since been reincorporated into the LSST codebase. While designed primarily to reduce HSC Subaru Strategic Program (SSP) data, it is also the recommended pipeline for reducing general-observer HSC data. The HSC pipeline includes high-level processing steps that generate coadded images and science-ready catalogs as well as low-level detrending and image characterizations.

We present the results from a search for new Milky Way (MW) satellites from the first two years of data from the Hyper Suprime-Cam (HSC) Subaru Strategic Program (SSP) ∼300 deg2and report the discovery of a highly compelling ultra-faint dwarf galaxy candidate in Cetus. This is the second ultra-faint dwarf we have discovered after Virgo I reported in our previous paper. This satellite, Cetus III, has been identified as a statistically significant (10.7 σ) spatial overdensity of star-like objects, which are selected from a relevant isochrone filter designed for a metal-poor and old stellar population. This stellar system is located at a heliocentric distance of 251$^{+24}_{-11}\:$kpc with a most likely absolute magnitude of MV= −2.4 ± 0.6 mag estimated from a Monte Carlo analysis. Cetus III is extended with a half-light radius of $r_h = 90^{+42}_{-17}\:$pc, suggesting that this is a faint dwarf satellite in the MW located beyond the detection limit of the Sloan Digital Sky Survey. Further spectroscopic studies are needed to assess the nature of this stellar system. We also revisit and update the parameters for Virgo I, finding $M_V = -0.33^{+0.75}_{-0.87}\:$mag and $r_h = 47^{+19}_{-13}\:$pc. Using simulations of Λ-dominated cold dark matter models, we predict that we should find one or two new MW satellites from ∼300 deg2HSC-SSP data, in rough agreement with the discovery rate so far. The further survey and completion of HSC-SSP over ∼1400 deg2will provide robust insights into the missing satellites problem.