E. platyacanthus CZ Dottor Arroyo, NL. This is the largest of all barrel cacti, it is grey-blue and nice when small, but areoles merge and forms a continuous. Echinocactus platyacanthus (Giant Barrel Cactus) is a slow-growing cactus, up to feet ( m) tall, up to 5 feet ( m) wide and can. Echinocactus platyacanthus. Common Name(s): Giant Barrel Cactus, Large Barrel Cactus Synonym(s): Echinocactus karwinskii, Echinocactus ingens.

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Cactaceae Cactus Family Scientific Name: Back to Echinocactus index. The importance of these platyacanthjs increases with the aridity of the land and its inadequacy for agriculture Del Castillo and Trujillo Regardless of the name, this huge plant makes a spectacular specimen when full grown. This Cactaceae article is a stub. Echinocactus are vulnerable to pests including aphids, mealy bugs, scale, and white fly.

Echinocacfus platyacanthus Photo by: Seedling establishment of Echinocactus platyacanthus is very low in habitat, because initial growth in the field is slow, two-years-old seedlings may be only 2. Ribs extremely variable in number, in young plants, later increasing to or more, acute, vertically oriented, more or less tuberculate and nice when small, later hight and even-edged.

Livestock also disturb the fragile soil causing platyacnathus loss of suitable microhabitat for the establishment of new individuals. Their diurnaltubular flowers bloom at the end of spring to summer and are a vivid yellow color, they grow about 2 centimetres 0. Native to central Mexico in the Chihuahuan Desert.

The apex of the cactus is flat and covered with a yellow felt-like substance. To repot a cacti, make sure echioncactus soil is dry before repotting, then gently remove the pot.

Echinocactus platyacanthus

They grow best in well-drained soil and a platyacantus in full sunwhich will help to maintain the lustre of the spines and longevity of the flowers. They also tend to lean to the south or southwest so that the spines can better protect the body of the plant from the harsh desert sun.

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They are numerous, diurnal, self-compatible, about 2 cm in height and opening fairly wide, cm long, cm wide, long-woolly, vivid yellow.

A pale brown spined specimen. Articles with ‘species’ microformats Commons category link is on Wikidata All stub articles.

It is found from 1, to 2, metres above sea level. Young plants are prone to mealy bug and red spider mite. The juveniles initially have a blue gray body slowly changing to green, frequently with purple chevrons between the ribs platyacathus the adults have deep green bodies with much wool at the crown.

Echinocactus platyacanthus – Wikipedia

Stigma-lobes 10 open, spreading. Raimondo Paladini This is one of the largest cactus, nearly globular, broadly columnar, or barrel shaped, often very massive stems 0. The apex of the cactus is flat and covered with a yellow felt-like substance.

Photo of conspecific taxa, varieties, forms and cultivars of Echinocactus platyacanthus. Playacanthus of these uses are a threat to this slow-growing species. Each fruit contains numerous black seeds approximately 1. Downloaded on 31 May They grow best in well-drained soil and a position in full sun, which will help to maintain the lustre of the spines and longevity of the flowers.

The flowers appear from the end of spring to summer and also in autumn, only on larger mature specimens receiving enough full sun, but rarely echinocacus in cultivation. Outer perianth-segments lanceolate, mucronate; inner perianth-segments broad, obtuse, yellow, the outer ones tappering to narrow brownish points.

Besides, it performs wonderfully in containers, Container media should be coarse as well. Besides, it performs wonderfully in containers, Container media should be coarse as well. Copiapoa macracanth, Echinocactus arachnoideus, Echinocactus aulacogonus, Echinocactus edulis, Echinocactus ghiesbreghtianus, Echinocactus grandis, Echinocactus helophorus, Echinocactus ingens, Echinocactus irroratus, Echinocactus karwinskii, Echinocactus macracanthus, Echinocactus minax, Echinocactus oligacanthus, Echinocactus platyceras, Platyacsnthus saltillensis, Echinocactus tuberculatus, Echinocactus viznaga, Echinofossulocactus helophorus, Echinofossulocactus karwinskianus, Echinofossulocactus macracanthus, Echinofossulocactus platyceras, Melocactus ingens, Melocactus platyacanthus, Melocactus tuberculatus.

Echinocactus platyacanthus i nitially has a blue gray body when young slowly changing to light or medium green, and then morphing into a giant barrel with green body as an adult. Sometimes the plants body is purple banded when juvenile. Choose an option 3 in 6 in Clear. Retrieved from ” https: The species name “platyacanthus” comes from the Greek for “with wide thorns”. How to Echinocactuw and Care for Echinocactus. From Wikipedia, the free encyclopedia. Together with Ferocactus histrix this is the most abundant and widespread barrel cactus in Mexico.

Echinocactus platyacanthus (Giant Barrel Cactus)

Descriptions and Illustrations of Plants of the Cactus Family. In other projects Wikimedia Commons Wikispecies. Nearly globular, broadly columnar, or barrel shaped, often very massive echinocactuw.

Past, present and future. Echinocactus platyacanthus, Miquihuana, Tamaulipas Photo by: Knock away the old soil from the roots, making sure to remove any rotted or dead roots in the process… — See more at: A purple banded specimen.

This page was last edited on 27 Octoberat Plants that flower in the spring and autumn, produce fruits in summer and winter respectively.


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Get cutting-edge science videos from J o VE sent straight to your inbox every month. It has the advantage over a goniophotometer for measuring the light produced by a source that total power can be obtained in a single measurement. Absolute measurements of instance luminous flux can then be done by measuring a known light source and determining the transfer function or calibration curve. With this chamber we can make an IP5X eafera to check if the fittings with this degree of tightness are protected against dust penetration.

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Repita los fantasmas paso 6. Contact Supplier Ulbrichtt Order. An integrating sphere also known as an Ulbricht sphere is an optical component consisting of a hollow spherical cavity with its interior covered with a diffuse white reflective coating, with small holes for entrance and exit ports. Fill out the form below to receive a free trial or learn more about access:. Shenzhen Lite Technology Limited. This page was last edited on 4 Novemberat Wooden package, good protection.

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Recitation of this highly Sacred and Secret Lalita Sahasra-naama Stotra is that time would provide far-reaching fruits of worship of which Devi Sahasranama is. Lalitha [email protected] _ pdf Significance of Chanting Sree Lalitha Sahasra Nama Lalitopakhyana: The story of. Listen to the Phala Sruthi song by Yamini Sisters from the movie Sri Lalitha Sahasranamam. Download the Phala Sruthi song online at.

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Com easytouse keyword analysis tool that allows you quickly get tellugu and valuable data about the keyword lalitha sahasranamam phala Shruti simanta sirurikruta padabja dhulika. There are ten important names out of these thousand names, And all these are praise worthy are praise worthy. Having thighs which steal the heart of Shiva Kameshwara, Having knees which looked like crowns made of precious gems, having voluptuous legs, having upper part of the feet resembling the back of tortoise, Having feet which resembled the lamps made of gems which could dispel worries from the mind of devotees and a body with the golden red colour.

For attracting the king, face the palace of the king, And read the thousand names tslugu on the Goddess, And then the king would be under your control, would ride a horse or elephant, Come to your side, would salute and serve you, And offer you his country or a state of ssahasranamam country.

Naanena sadrusam stotram sarva thanthreshu vidhyathe, Thasmad upasako nithyam keerthyedhida madarath, One crore times the good effect of doing all these matchless blessings, Would be got even by chanting one name out of the one thousand secret names. Teluguu is an incarnation of Vishnu with the horse head and is believed to be the storehouse of knowledge.

Vidhyasu kuruthe sahassranamam yo vidwan nama jaapeena, Thasya vak sthambhanam sadhya karothi Nakuleshwari. He who has fever, if he lalutha his head and chants the thousand names, At that moment the fever would descend away from the head and vanish.

Thadsmai preenaathi Lalitha swasamrajyam prayachathi. In the family life it is important to sing the names of VishnuBut better than singing names of Vishnu is singing names of Shiva.

Meditating on Goddess Lakshmi and goddess Lalithambika, If the thousand names are read, effect of poison will vanish.

Phala sruthi of Lalitha Sahasranamam

Lakshya romalata bharata samunneya madhyama. Pratha snathwa vidhathena sandhya karma samapya cha, Pooja gruhe thatho gathwa chakra rajam samarchayeth 5. Lalitha sahastranamam prologue and trishati. Vishnu audio released the year free listen download high quality original cdrip kbps vishnu songs music deva. Oh, Sage born out of the pot, please hear the results, Of reading these in the middle of life by devotees. On a jeweled platform. Bahunathra kimukthena srunu thwam kalasi sutha, Aathraika namne yaa shakthi pathakaanaam nivarthathe, Thannivarthya magham karthum naalam loka schadurdasa.

Better than the thousand names of Shiva are the names of the Devi, And Oh Agasthya, the thousand names of Devi are one crore times better.

Gangadhi sarva theertheshu ya snayath koti janmasu, Koti linga prathishtam thu ya kuryadh vimukthake. On Navami or on Chathurdasi or Fridays of the waxing moon, And on the full moon day singing this is very special.

ParaShakthi rode in the center on the chariot of Sri Chakra.

Phala sruthi lalitha sahasranama the effect reciting the thousand names lalitha translated p. That devotee who worships her on mahanavami day, On the Sri Chakra using these thousand names, Would certainly attain salvation.

Hanuman, who is also known as Vanara God, was born on this day and Hanuman Jayanti is celebrated to commemorate the birth of Hanuman. The learned in Vedasif they do not recite these names at least once, The Sri Vidhya would be kept secret from them, Oh sage.

This is also called the Rahasya Nama Sahasra the thousand secret names. Phala sruthi lalitha sahasranamam lyrics telugu phala sruthi telugu pdf phala stuthi lyrics telugu prabhum prananatham vibhum vishwanatham sp.

The Yogis would be very angry with them, For this would lead them to problems, And that lyyrics why these secret thousand names, Are kept as great secret from every one. He who reads these thousand names daily for six months with devotion. At his request Hayagreeva taught him the most holy names of Lalitha.

Lalitha Sahasranama & Phala Sruthi | Shri Devi Mahathmyam

These names which were told, Oh Agasthya, Are secret of the secrets and are very dear to Lalitha. May April March February In the center of Srinagara is the Maha Padma Vana The great lotus forest and within it the Chintamani Griha The house of holy thought ,In its north east is the Chid agni kunda and on both sides of its eastern gate are the houses of Manthrini and Dhandini. In the sixteenth lives Varahi alias Dandini who is her commander in chief.

Stotrapriya stutimati shruti sanstuta vaibhava jun lalitha sahasranamam stotram lyrics. It sacred text the hindu worshippers the goddess lalita devi i. That devotee who worships her on mahanavami day, On the Sri Chakra using these thousand names, Would certainly attain salvation.

Read sri lalita sahasranama english book reviews author phaal and more amazon.

Lalitha Sahasranamam Phala Sruthi Lyrics | Hindu Devotional Blog

Phala sruthi lalitha sahasranama. For attracting the king, face the palace of the king, And read the thousand names meditating on the Goddess, And then the king would be under your control, would ride a horse or elephant, Come to your side, would salute and serve you, On offer you his country or a state of his country. Sindhuraruna vigraham trinayanam manikya mouli spurath Thara Nayaga sekaram smitha mukhi mapina vakshoruham, Panibhayam alipoorna ratna chashakam rakthothpalam vibhrathim, Soumyam ratna gatastha raktha charanam, dhyayeth paramambikam.

Lalitha sahasranamam phala sruthi lyrics in hindi lalitha-sahasranamam-phala-sruthi-lyrics-in-hindi.

Free download lalitha sahasranamam phala sruthi lyrics telugu pdf mp3 for free sri lalitha sahasranama stothram and phalasruthi. Yo vethi naama sahaasram thasmai dheyam dwijanmane, Annam vasthram dhanam dhanyam nanyebhyasthu kada chana. Lyrids is a cure for all types of fever, and gives rise to long life, It gives son that too first son and phzla three types of wealth.

Remember my login on this computer Register. Nishkama keerthayedhyasthu nama Sahasramuthamam, Brahma jnana mavapnothi yena muchyathe bandanath. She was extremely beautiful, having dark thick long hair with scent of Champaka, Asoka and Punnaga flowers, having the musk thilaka on her forehead, Having eyelids which appeared as if it is the gate of the house of God of love ,having eyes which were like fish playing in the beauteous lake of her face, Having nose with studs which shined more than the stars, Having ears with sun and moon as studs, having cheeks which were like mirror of Padmaraga, Having beautiful rows of white teeth, Chewing Thamboola with camphor, having voice sweeter than the sound emanating from Veena of Sarswathi, Having such a beautiful smile that Lord Shiva himself could not take his eyes off, Wearing Mangala soothra and necklaces with beautiful shining dollars, Having breasts which were capable of buying the invaluable love of Kameswara Lord Shivahaving row of faint beautiful hair raising from her belly, having stomach with three pretty folds, wearing red silk tied with a string with red bells.

Kalou papaika bahule dharmanushtana varjathe, Namanu keerthanam mukthwa nrunaam nanya paraayanam. Oh sage Agasthya, please hear from me how most people would get free, By chanting according to their capability for getting rid of sins, For these, without any doubt would remove sins committed in the fourteen lokas. Com raja thathas blogs books compiledtranslated home stotras prayer hymns devi stotras lalita sahasra nama phala sruthi lalita sahasra nama phala sruthi.

For getting rid of lyrisc touch holy ash and chant the thousand names, And by wearing that ash all diseases would immediately be cured.


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Les Villes invisibles

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Just a moment while we sign you in to your Goodreads account. Rarely does the eye light on a thing, and then only when it has recognized that thing as the sign of another thing: January December The majority of the book consists of brief describing 55 fictitious cities that are narrated by Polo to prove the expanse of Khan’s empire, but which are all actually inviskbles descriptions of one city, Venice.

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Lingashtakam Lyrics – Brahma Murari Surarchita Lingam Devotional Song Lyrics. has been done by english ruler also,in every ruling religion when they judge. Jun 16, Murari Surarchita Lingam Song Lyrics In English. Brahma Murari Surarchitha Lingam. Nirmala Bhashitha Shobhitha Lingam. Brahma murari. Song (Meaning, Translation Lingashtakam Lyrics. k. Lingastakam lyrics, Lingashtakam lyrics Pdf Download Lingashtakam lyrics in English.

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It gives me very happy and Peaceful day.

Sakti Rath brhama August at May God give you buddhi, vidya vinayam and vivekam. You have no respect for women. Rashmi Prakash 26 June at Posted by Devotional Songs at I bow before that Sada Shiva Linga, which is adored by Brahma, Vishnu and other Gods, which is praised by pure and brqhma speeches and which destroys the cycle of births and deaths. My day never starts without listening to this devotional song Baghdad.

Lingashtakam Lyrics

It is a beautiful song. Roopa Sherkar 17 July at Thanks for providing it.

LingashtakamLord Shiva. Moralpolice 22 December at Its nice that lyrics were put down here with the good intention of ppl usage.

Moralpolice send your phone number because I will explain whose god of shiva okay. Who ever you are, you are a fool.

Devotional Songs Lyrics : Bramha Murari Surarchita Lingam Song Lyrics In English

Vicky Rathaur 9 February at Newer Post Older Post Home. Kavya Shree 6 March at Request you to correct the lyrics, bhakti ,vinaashana ,kanaka ,kumkuma,phanipati,parampadam at appropriate places. Yam Aym 16 March at I bow before that Sada Shiva Linga, destroyer of all poverty and misery in its eight aspects, which is the cause of all creation and which stands on the eight petalled Lotus.

Indrajeet B 5 February at Swapna Rajput 16 February at I bow before that Sada Shiva Linga which is the Transcendent Being and the Supreme Self, worshipped by all Suras and their preceptor Brhaspathiwith innumerable flowers from the celestial gardens. Devotional Songs 26 March at M Gopi 9 May at Mootthavan 5 November at You have a backward thinking.

Good effort taken to post very good information, ignore for others what they says badly about your good work. Unknown 18 January at Bikasita Das surzrchita August at Devotional Songs 13 January at Devotional Surrarchita 16 August at Unknown 6 March at Bpatil 13 February at Bloody idiot good for nothing fellow I bow before that Sada Shiva Linga, which is the destroyer of desires, which the Devas and the sages worship, which is infinitely compassionate and which subdued the pride of Raavana.

Devotional Songs 8 September at I bow before that Sada Shiva Linga, which is smeared with saffron and sandal paste, which is lyeics with lotus garlands and which wipes out all accumulated sins.

“LINGASHTAKAM” LYRICS by ASHIT DESAI: Brahma Murari surarchita Lingam

Sri Lingashtakam Lyrics Meanings. Unknown 22 December at I bow before that Sada Shiva Linga, the destroyer of Dakshas sacrifice, which is decorated with various ornaments, studded with different gems and rubies and which glows with the garland of the serpent Lord coiled around it.

Sri Lingashtakam is a popular 8-canto hymn chanted during the worship of Lord Shiva. Unknown 7 March at May be someone ditched you engljsh you are taking it on all the women and the caste as well. Feels like I am ljngam complete serenity and deep solace.

Muniyappar 23 January at The lyrics are as below. Ganesh Venkataraman 21 February at Sai Suman 12 January at


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Then we come to John Dos Passos’s entry in the race, a series of three novels originally published separately — The 42nd Parallel (). If The 42nd Parallel, the first novel in John Dos Passos’ formerly revered, now oft- forgotten trilogy U.S.A. lacks the psychological, nuanced. The 42nd Parallel is the first volume of Dos Passos’ famous U.S.A. Trilogy. This is structurally one of the most challenging of forms. It is the story of the U.S.A.

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The meat, though, is the individual stories that wend their way through. Scott Fitzgerald or the 442nd style of either a William Faulkner or an Ernest Hemingway, this might have served as the basis for a real classic, maybe even a Great American Novel.

The 42nd Parallel, 1930

They are not conspicuously concerned with upward social mobility and an envy of high society elites.

Almost everyone in this book is planning a revolution, including many of the characters who are most zealous in scheming about ways of making a buck.

Dos Passos’ legacy, if there is one, is largely understated or forgotten, and, in my view, not necessarily through any major fault of his. I can only hope that my feelings will be intact. He made things work. By the late summer ofhe had completed a draft of his first novel and, at the same time, he had to report for duty in the U.

Want to Read saving…. These are often abstract, stream-of-consciousness bits of writing.

Ben Clague on John Dos Passos’ The 42nd Parallel – Kristiania

Others are destroyed, crushed by capitalism, and ground underfoot. Plain folk offer comments such as: At night, head swimming with wants, he walks by himself alone. He wasn’t a mathematician. Dos Passos isn’t trying to give the reader an idea of how the times were experienced on an individual level, he is more interested in the collective experience. Coherent quotes from newspaper articles are often woven into the biographies as well, calling into question the strict separation between them and the “Newsreel” sections.

Often reflecting the American experience of the era, certain works in literature would either solidify their place in the ever-changing Literary Canon or they would appear and disappear within the time it took to decide on the next list.

The linear character development is regularly interrupted with sections called Newsreel and Camera Eye, among others. Andrew Carnegie became the richest man in the world an “Andrew Carnegie started out buying Paesos Express and Pullman stock when they were in a slump; he had confidence in railroads, he had confidence in communications, he had confidence in transportation, he believed in iron. The most interesting thing for me is seeing labor and unions portrayed in such a positive light.

Or, if they do, they are so battered and shattered pasos the process that they might have been better off selling out with the rest of their generation.

John Dos Passos: U.S.A. | Library of America

They are all hard working people trying to find their place in this world. There is a bygone romance. Now The Library of America presents an exclusive one-volume edition of this enduring masterwork by John Dos Passos, including for the first time detailed notes and a chronicle of the 42nf events that serve as a backdrop.

The most often anthologized of these biographies is “The Body of an American”, which tells the story of an unknown soldier who was killed in World War I which concludes Nineteen Nineteen. Dos Passos calls his style “contemporary chronicle. Pasoss our books Subscribe. There isn’t a lot of high falutent language, it’s just stuff happening To any reader out there seeking an American chronicle that captures multiple perspectives, understands diversity of experience, and gives voice to its people, read Studs Terkel.

“But Dos Passos does not stop there” How 42nd Parallel Lives on Today

The 42nd Parallel is the first of three novels that make up the U. Overall, we follow twelve characters, six men and six women, through the trilogy. About John Dos Passos.

Characters who have some money want to get more. A table of pacifists ignore the song, and an agitated crowd begins to form around them. I had high hopes for this ‘classic’ but they were quickly dashed. It pxssos make it, I think, compared to some of the other contenders.


Ingrid Persaud on why Felipe Alfau’s Locos is the best book of Part of Granta’s best book of a year series. Locos: A Comedy of Gestures (American Literature (Dalkey Archive)) [Felipe Alfau, Mary McCarthy] on *FREE* shipping on qualifying offers. Locos: A Comedy of Gestures. Felipe Alfau, Author, Mary McCarthy, Designed by Dalkey Archive Press $ (p) ISBN

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They are a map. I am not a professional writer. Only by necessity have I ever received payment for my work. Dalkey Archive Press offered money for my two novels but I refused to accept it. The truth is, I was never oocos in writing, nor did Celipe ever dream of making a living at my craft. I hate full-time authors.

I hate intellectuals that make a living from abstractions and evasions. The art of writing has turned into an excess. Today, literature is a waste. It should be abolished, at least in the form we know: Yet I know you first submitted Locos to a New York publisher for financial reasons.


You wrote it in English because you needed money. And when I got a job, a stable job, I took the manuscript back. It was scheduled for publication under the title Madrilenos.

I changed my mind and asked the editor to return the text. I had a wife and a daughter, and enough to support them. You come from a family of journalists, translators, and fiction writers.

Your father was involved with several newspapers, at least on this side of the Atlantic. One of your other sisters, Jesusa Alfau de Solalinde, who married a professor and lived in Wisconsin, wrote a very well-received novel, Los debilesbefore she turned twenty.

Jesusa and her husband, the philologist Antonio Solalinde, did like my first novel. I remember that a magazine in Wisconsin published an article about it, a very scholarly one, back in the forties.

But all that is now lost.

Felipe Alfau

Jesusa and the others were all very serious about their work. I see a contradiction here. No, they were journalists, translators, and people devoted to their art.

On the contrary, they wrote and if money came, it was welcome.

The world has changed for the worse, there is no question about that. Even in the early thirties, your style, your views of literature were not very commercial.

Sorry to put it this way, but how could you ever dream of getting some money, even a little, from the sale of a manuscript? But you are right. I am always surprised when I see positive reactions to my two novels. My editor is obstinate. He sends me only those reviews that celebrate my work. I have repeatedly asked him to send me the negative ones but he silently refuses. Those are the ones that interest me, the negative reviews. What I really need to know is what I did wrong. And that can only come from negative comments.

No, everybody here is a little crazy. Like me, they have lived too long. Once in a while I talk to someone about politics, but the result is always predictable. As you know, I have been interviewing friends you had a long time ago because I am contemplating the idea of writing your biography. I will find that out for myself. Besides, you gave me your permission and Dalkey Archive Press wants to publish the biography as soon as possible.

One of the editors told me that when Locos was published, the company was in serious financial trouble. Locos helped them recover. I am more than ready to leave this boring, repetitive universe.

Do you believe in God? Why not commit suicide? You share with me similar values. Will you commit suicide if you reach my age and turn out to be as bored as I am?

I think I would, not withstanding the offense I would inflict on my beloved ones. If and when the day comes, I only hope to be brave enough.

As for me, I am a skeptic, as you said. I cannot but have doubts regarding the afterlife. What if there is a God? What if we are punished for our sins? You have lived more than seventy years of your life in the United States. Do you still feel Iberian, a citizen from Spain? Or are you now an American like everybody else around here?

Neither one nor the other. I guess I am a frontier man that belongs to a world that is no more. I am a traditionalist stubbornly loyal to what some would think are outmoded principles.

I think democracy is a disgrace. Machiavelli was absolutely right: I always thought Generalisimo Francisco Franco was a trustworthy ruler of Spain, and thus supported him. Since his death, the Iberian peninsula is in complete chaos. You wrote poems included in Sentimental Songs in Spanish, but everything else you wrote in English.

Did you ever write any prose in Spanish? In fact, I am wrong. Thank God, all that rubbish is now forgotten. The poems I wrote in my mother tongue because poetry is too close to the heart, whereas fiction is a mental activity, an invention, something foreign, distant.

The fact that you switched from Spanish to English is puzzling to me. I can think of only a handul of other writers who have mastered a second language and used it to write their oeuvre: Was if hard to switch from one language to another?

It took a while. I never studied English in school. My parents, after a life of wandering in the Philippines, the Caribbean, and several cities on the Iberian peninsula, emigrated to the United States. I arrived when I was fourteen, in A child picks up new linguistic patterns rather easily.

A Conversation with Felipe Alfau By Ilan Stavans | Dalkey Archive Press

An adolescent has a harder time, locoa an adult may never accomplish the task of mastering a second language. I took some courses of philosophy at Columbia University, but by and large, I was a self-educated man. I always wanted to be an orchestra conductor. That interest led me to the study of music. I was also in love with mathematics and with physics. As you can see, my novels are evidence of loos lifelong passions.

Did the fact that you spoke and wrote in a language other than your mother tongue ever give you a feeling of being an exile? By mere chance we are born in a specific geography and time. I always wished to travel through time, to gelipe a life beyond my individual boundaries.

Unfortunately, I never succeeded. And the explanation is very simple: Man is alone on this planet. Our projects, our goals regarding the children we bear are often transformed by unforseen circumstances, by forces beyond our control. The only thing we are accountable for is our own self. Gustavo Perez-Firmat, a Cuban poet who teaches at Duke University, once wrote a poem; I have forgotten all its lines, but I do remember one stanza: In a conversation with Joseph Brodsky, he told me Firmat is mistaken.

Language is only a vehicle through which we verbalize thoughts. When I read the lousy Spanish translation, made in Barcelona, of ChromosI thought my message had been deformed, my intentions inverted. The translator often misunderstands a sentence. Unfortunately, the mistakes are not rare.


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Technical Note and Case Report. University of Puerto Rico. San Juan, Puerto Rico. The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management. The maxillofacial trauma can cause serious disturbances of the soft and hard tissues of the anatomical components of the upper airway and often with little external evidence of deformity.

The submental intubation is a procedure that was reported to avoid tracheostomy and allow for the concomitant restoration of occlusion and reduction of facial fractures in patients with craniomaxillofacial trauma ineligibles for nasotracheal intubation.

We described a modification of the original technique by performing a retrograde submental intubation assisted by direct laryngoscope video in a maxillofacial trauma patient with inttubacion mouth opening.

In addition, the surgical anatomy of the technique is detailed described. The maxillofacial trauma can cause serious disturbances of the soft and hard tissues of the anatomical components of the upper airway and often with little external evidence of deformity Arya et al. Several airway management techniques have been described, including: Each technique has its indications with advantages and disadvantages.

The submental intubation is a procedure that was reported to avoid tracheostomy and allow for the concomitant restoration of occlusion and reduction of facial fractures in patients with craniomaxillofacial trauma, ineligible for nasotracheal intubation due to the potential risk of creating a false passage to the cranial cavity Intbuacion et al.

This technique was first described in by Francisco Hernandez Altemir and since its first description 10 articles have been published outlining modifications to the original technique primarily aimed at reducing complications Altemir, ; Jundt et al. The original surgical procedure consists in the externalization of the endotracheal tube from the mouth through the floor of the mouth and the submental triangle. A skin incision of 2 cm in rftrograda submental, paramedian retrograxa and with blunt dissection toward the floor of mouth until the mucosa was tented with a hemostat after which another 2 cm incision is made in the mucosa Fig.

The breathing circuit is briefly disconnected as the tube is externalized and reconnected to the circuit and then secured to the patient Fig. Many features rftrograda the submental intubation very useful in several clinical scenarios including craniomaxillofacial trauma, orthognathic surgery and pathology.

In a literature review conducted intuacion Jundt et al. The main objective of this study is to describe a modification retrigrada the original technique by performing a retrograde submental intubation assisted by direct laryngoscope video in a maxillofacial trauma patient with restricted mouth opening.

In addition, the surgical anatomy of the technique is described in detail. Mandible border blue lineskin incision yellow linecenter region of geniohyoid and genioglossus muscles red area ; B. Endotracheal tube in position fixed to skin.

On initial evaluation the patient was in non-acute distress, alert, awake and oriented, with a Glascow coma score of The patient had suffered trauma to the midface.

Alba Bombarelli

Examination of the face revealed periorbital and nasal swelling, traumatic telecanthus, nasal deformity, epistaxis and bilateral subconjuntival hemorrhage. There was midface mobility, malocclusion and mouth opening was restricted.

Further clinical examination did not reveal any other traumatic injury. Radiologic examination confirmed the presence of Le Fort II fracture, naso-orbitoethmoid fracture, bilateral zygomaticomaxillary complex fractures and left mandible subcondylar fracture.

After preoxygenation and intravenous induction of anesthesia, submental region and anterior neck is disinfected and draped as usual sterile fashion. Then using Seldinger technique the malleable wire Spring-Wire Guide: The appropriate reinforced endotracheal tube size was passed which connector was previously removed through with the malleable wire as guidance, when the distal end of the endotracheal tube meets the resistance at the level of the cricothyroid membrane against the wirethe wire was cut at the puncture site and the endotracheal tube passed, the remaining wire removed through the tube.

The endotracheal tube was secured and adequate end tidal carbon dioxide curve was observed. Throat pack was placed. A closed Kelly hemostatic forceps was introduced through the incision until the tip of the hemostat tented the mucosa of the floor of the mouth staying close to the lingual surface of mandible and lateral to the sublingual caruncle to avoid injury to the submandibular duct and lingual nerve.

The tented oral mucosa was incised to make a small opening and the blades of the hemostat were opened to allow the entrance of the reinforced endotraqueal tube. The endotracheal tube was disconnected from the breathing circuit and the connector removed the anesthesiologist stabilized at this moment the endotracheal tube with Magill’s forceps to avoid extubation. Afterwards the pilot balloon was grasped with the hemostat and pulled out gently through the passage, then the hemostat was reinserted through the passage to grasp the proximal end of the endotracheal tube to be brought out with controlled rotational movements.

The connector and breathing system were reattached and the cuff reinflated.

Alba Bombarelli on Prezi

The endotracheal tubes now reetrograda on the floor of the mouth between the tongue and the mandible. The anesthesiologist reassures the adequate end tidal carbon dioxide curve and auscultation of the chest for correct position of the tube.

Finally, the endotracheal tube is fixed to skin with sutures to prevent accidental displacement Fig. The open reduction and internal fixation of the facial fractures could then be performed as planned and the occlusion checked with intermaxillary fixation. At the end of the surgery the tube was disconnected, pulled back into the oral retrogrsda and reconnected. Extraorally the wound was sutured and the patient was extubated without complications. Guide wire insertion through cricothyroid membrane; B.

Guide wire red dotted line passed through larynx to oral cavity; B.


Reinforced endotracheal tube fixed to skin. Since the first application of this technique, less than thirty years ago, many authors have studied the clinical use of this procedure.

Very low rates of complications have been reported. Many trials have shown the submental route to be a simple, quick and safe approach to airway management Caubi et al. Submental intubation combines the advantages of nasotracheal intubation, which allows the mobilization of the dental occlusion, and those of orotracheal intubation, which allows access to naso-orbito-ethmoidal fractures Caubi et al.

There have been several articles in the literature describing and modifying the technique Altemir; Jundt et al. However, adequate mouth opening is a prerequisite for the technique. Submental intubation or its modification as retrograde submental intubation was first described in a patient with restricted mouth opening by Arya et al.

Nevertheless, we report for the first time the retrograde submental intubation technique using direct video laryngoscopy. It was decided to use retrograde intubation technique in the present case due to the restricted mouth opening, and the difficulty to maintain a clear airway with the submandibular incision bleeding or other invasive manipulation. The Insertion of the wire guide through the cricothyroid membrane helps to place correctly the endotracheal tube and also counting with the assistance of the direct video laryngoscopy, where the complete mouth opening is not necessary.

The limitation of this technique is for patients who also present a neurological deficit or thoracic trauma and need more than 7 days of postoperative ventilator support Jundt et al. In such cases a tracheostomy is the indicated procedure. In our case where the patient only presented midface isolated trauma with need of intraoperative intermaxillary fixation, submental intubation was the correct choice for intraoperative airway.

In comparing submental intubation and tracheostomy, submental intubation has no significant reported major complications Jundt et al. The mortality rate of tracheostomy has been reported to range from 0. In addition to fewer reported minor complications infection, fistula, hypertrophic scarring, mucocelesubmental intubation requires less time than a tracheostomy, costs less and results in an aesthetically well tolerated scar Jundt et al.

In conclusion, submental intubation is a safe and effective technique for establishing a secure airway in patients requiring facial reconstructive surgery where traditional oral and nasotracheal intubation are contraindicated.

Additional research is necessary to validate new modifications reported in the literature. In choosing a potential modification, the surgeon should inform the anesthesiologist of their intended sequence.

Communication between the surgeon and anesthesiologist is extremely important for the safety of the patient and the success of the procedure. The submental route for endo-tracheal intubation. Retrograde submental intubation by pharyngeal loop technique in a patient with faciomaxillary trauma and restricted mouth opening.

Submental intubation in oral maxillofacial surgery: Submental intubation versus tracheostomy. Perimortem intracranial orogastric tube in pediatric trauma patient with a basilar skull fracture.

Intracranial malposition of nasopharyngeal airway. Pasaje Republica de Honduras interior