European Registry on Helicobacter pylori Management: Effectiveness of First and Second-Line Treatment in Spain

The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was developed, including patients from 2013 until June 2019. Effectiveness was evaluated descriptively and through a multivariate analysis concerning age, gender, presence of ulcer, proton-pump inhibitor (PPI) dose, therapy duration and compliance. Overall, 53 Spanish hospitals were included, and 10,267 patients received a first-line therapy. The best results were obtained with the 10-day bismuth single-capsule therapy (95% cure rate by intention-to-treat) and with both the 14-day bismuth-clarithromycin quadruple (PPI-bismuth-clarithromycin-amoxicillin, 91%) and the 14-day non-bismuth quadruple concomitant (PPI-clarithromycin-amoxicillin-metronidazole, 92%) therapies. Second-line therapies were prescribed to 2448 patients, with most-effective therapies being the triple quinolone (PPI-amoxicillin-levofloxacin/moxifloxacin) and the bismuth-levofloxacin quadruple schemes (PPI-bismuth-levofloxacin-amoxicillin) prescribed for 14 days (92%, 89% and 90% effectiveness, respectively), and the bismuth single-capsule (10 days, 88.5%). Compliance, longer duration and higher acid inhibition were associated with higher effectiveness. "Optimized" H. pylori therapies achieve over 90% success in Spain

Quantum gravity phenomenology at the dawn of the multi-messenger era—A review

The exploration of the universe has recently entered a new era thanks to the multi-messenger paradigm, characterized by a continuous increase in the quantity and quality of experimental data that is obtained by the detection of the various cosmic messengers (photons, neutrinos, cosmic rays and gravitational waves) from numerous origins. They give us information about their sources in the universe and the properties of the intergalactic medium. Moreover, multi-messenger astronomy opens up the possibility to search for phenomenological signatures of quantum gravity. On the one hand, the most energetic events allow us to test our physical theories at energy regimes which are not directly accessible in accelerators; on the other hand, tiny effects in the propagation of very high energy particles could be amplified by cosmological distances. After decades of merely theoretical investigations, the possibility of obtaining phenomenological indications of Planck-scale effects is a revolutionary step in the quest for a quantum theory of gravity, but it requires cooperation between different communities of physicists (both theoretical and experimental). This review, prepared within the COST Action CA18108 “Quantum gravity phenomenology in the multi-messenger approach”, is aimed at promoting this cooperation by giving a state-of-the art account of the interdisciplinary expertise that is needed in the effective search of quantum gravity footprints in the production, propagation and detection of cosmic messengers.publishedVersio

Quantum gravity phenomenology at the dawn of the multi-messenger era -- A review

The exploration of the universe has recently entered a new era thanks to the multi-messenger paradigm, characterized by a continuous increase in the quantity and quality of experimental data that is obtained by the detection of the various cosmic messengers (photons, neutrinos, cosmic rays and gravitational waves) from numerous origins. They give us information about their sources in the universe and the properties of the intergalactic medium. Moreover, multi-messenger astronomy opens up the possibility to search for phenomenological signatures of quantum gravity. On the one hand, the most energetic events allow us to test our physical theories at energy regimes which are not directly accessible in accelerators; on the other hand, tiny effects in the propagation of very high energy particles could be amplified by cosmological distances. After decades of merely theoretical investigations, the possibility of obtaining phenomenological indications of Planck-scale effects is a revolutionary step in the quest for a quantum theory of gravity, but it requires cooperation between different communities of physicists (both theoretical and experimental). This review is aimed at promoting this cooperation by giving a state-of-the art account of the interdisciplinary expertise that is needed in the effective search of quantum gravity footprints in the production, propagation and detection of cosmic messengers

Picadura por escolopendra

A centipede bite is very painful and can be accompanied by generalized symptoms.A case of a scolopendra sting,with typical signs and an uncomplicated course,is presented.La picadura de ciempiés es muy dolorosa y puede acompañarse de síntomas generales. Presentamos un caso de picadurapor escolopendra, con signos típicos y evolución favorable

Exostosis subungueal en la infancia

Subungual exostosis is a benign bony tumor, uncommon in childhood, and it is clinically manifests as a subungual tumor thatassociates variable degree of nail plate or periungular soft tissues alteration. It generally consists of an isolated lesion thatmainly affects first toe terminal phalanx. Its exact etiology is still unknown. Clinical suspicion is confirmed by the radiographicfinding of a distinct trabecular bone growth arising from the dorsal aspect of the phalanx of the affected digit.Surgical excisionis the treatment of choice.We report a case of a 9 years old boy with subungual exostosis.La exostosis subungueal es un tumor óseo benigno, infrecuente en la infancia, que se manifiesta clínicamente comouna tumoración subungueal acompañada por diferentes grados de alteración de la lámina ungueal o de los tejidosadyacentes. Generalmente es una lesión única, localizada en la falange distal del primer dedo del pie. Su etiología noestá completamente aclarada. El diagnóstico es principalmente clínico y la radiografía lo confirma con el hallazgo deuna imagen excrecente redondeada radio-opaca, yuxtapuesta a la cara dorsal de la falange del dedo afectado, quecorresponde a hueso trabecular. La resección quirúrgica es el tratamiento de elección. Se describe el caso deexostosis subungueal en un niño de 9 años