Dermatitis crónica por sensibilización al níquel en un paciente con fractura del astrágalo tratada mediante osteosíntesis

Se presenta un varón de 25 años, con fractura del astrágalo izquierdo tratada mediante osteosíntesis con 2 tornillos de acero inoxidable con un contenido en níquel del 12-14%. A los 4 meses de la intervención, el paciente desarrolló una dermatitis pruriginosa en cara lateral externa del pie, en la zona cutánea supra-adyacente al lugar de la osteosíntesis. La lesión no cedió con el tratamiento tópico convencional a base de corticoides. Las pruebas epicutáneas realizadas con la batería estándar del Grupo Español de Investigación en Dermatitis de Contacto revelaron un parche positivo vesiculoso (+ +) al sulfato de níquel al 2,5% y al cloruro de cobalto al 1%, ambos aplicados en vaselina, en la lectura a las 48 y 96 horas. En vista de que las lesiones permanecían estables al mes de tratamiento con un potente corticoide en cura oclusiva y antihistamínicos sistémicos, se procedió a retirar los tornillos de osteosíntesis. A los pocos días de la intervención comenzó a desaparecer el prurito y, en el curso de 2 semanas, se produjo la curación completa de la dermatitisSe presenta un varón de 25 años, con fractura del astrágalo izquierdo tratada mediante osteosíntesis con 2 tornillos de acero inoxidable con un contenido en níquel del 12-14%. A los 4 meses de la intervención, el paciente desarrolló una dermatitis pruriginosa en cara lateral externa del pie, en la zona cutánea supra-adyacente al lugar de la osteosíntesis. La lesión no cedió con el tratamiento tópico convencional a base de corticoides. Las pruebas epicutáneas realizadas con la batería estándar del Grupo Español de Investigación en Dermatitis de Contacto revelaron un parche positivo vesiculoso (+ +) al sulfato de níquel al 2,5% y al cloruro de cobalto al 1%, ambos aplicados en vaselina, en la lectura a las 48 y 96 horas. En vista de que las lesiones permanecían estables al mes de tratamiento con un potente corticoide en cura oclusiva y antihistamínicos sistémicos, se procedió a retirar los tornillos de osteosíntesis. A los pocos días de la intervención comenzó a desaparecer el prurito y, en el curso de 2 semanas, se produjo la curación completa de la dermatitis

Neglected Plant Genetic Resources with a Landscape and Cultural Importance in Spain

Spain is one of the richest Mediterranean countries in plant genetic resources. According to data extracted from Flora Europea (Tutin et al., 1964), the flora of the Iberian Peninsula (Portugal and Spain) includes 15 endemic genera and 986 endemic species of which 684 present only in Spain. These data exclude the rich flora of the Spanish Mediterranean islands (César Gómez Campo, 1985). From Spain four different centers involved in plant genetic resources activities have been contacted for this Consultation Meeting

Metodología cartográfica submarina orientada a la gestión y conservación del medio litoral: mapa de las comunidades bentónicas del frente litoral norte del estrecho de Gibraltar

La cartografía de las comunidades bentónicas es esencial, actualmente, para promover actuaciones eficientes de uso, gestión y conservación de las zonas litorales, especialmente en el ámbito de grandes espacios litorales protegidos. En cada uno de éstos, la cartografía resulta determinante para la elaboración de un mapa de zonificación de usos, condicionado, en gran medida, por los distintos valores ecológicos que puedan asignarse a las diferentes comunidades bentónicas establecidas y a sus distribuciones geográficas locales. La metodología utilizada en la elaboración del mapa de las comunidades bentónicas del estrecho de Gibraltar (en el intervalo batimétrico 0-30 m y de 40 km de extensión litoral aproximada), dada la complejidad que reviste este tipo de objetivos, supone una aproximación a la cartografía de la biota sésil sumergida, en tramos litorales amplios contenidos en áreas protegidas. Se han combinado, mediante superposición de información, datos físicos de batimetría y tipos de fondo, obtenidos mediante técnicas acústicas y convenientemente cartografiados, con datos biológicos de las comunidades bentónicas, obtenidos en campaña intensiva de buceo científico (con la toma de imágenes en sustrato duro, para su ulterior análisis) y mediante dragado (con registros de granulometría y fauna endobentónica en sustrato blando). La información ha sido georreferenciada adecuadamente para su introducción, como capas independientes, en un sistema de información geográfica (SIG).The cartography of benthic communities is, today, essential to promoting adequate strategies for the use, management and conservation of littoral areas, especially if they are large protected zones. In each zone, cartography is necessary to elaborate a management zoning map, depending on the ecological value of the different benthic communities established and on the local geographical distribution. The methodology used in the elaboration of a map including the benthic communities of the Straits of Gibraltar (0-30 m depth; 40 km of littoral extension), in spite of the complexity of these kinds of objectives, represents an approach to the cartography of the submarine sessile biota of large littoral zones of protected ar- eas. The present study combines physical data (bathymetry and type of substrate), collected using acoustic techniques, and biological data (benthic communities), collected during an intensive sampling programme using scuba (hard bottom: image analysis) and dredging (soft bottom: granulometry and benthic fauna). The information has been geoindexed to be inserted, as different layers, into a Geographic Information System (GIS)

Penetración y degradación de la terbutilazina en el suelo. Efectos del riego de incorporación

En este experimento se trató de ver el comportamiento (degradación y lixiviación) de la terbutilazina en el suelo, bajo seis diferentes manejos de la combinación tratamiento-riego. Se observa en general, como dicho herbicida se adsorbe en los primeros cm del suelo, así como su elevada persistencia. Las mayores acumulaciones del producto al inicio del experimento se manifiestan con la herbigación, mientras que al final del mismo tiende a ser igual la acumulación de terbutilazina en los seis tipos diferentes de combinación tratamiento-riego

Attitudes and burden in relatives of patients with schizophrenia in a middle income country

BACKGROUND: Most studies of family attitudes and burden have been conducted in developed countries. Thus it is important to test the generalizability of this research in other contexts where social conditions and extended family involvement may be different. The aim of this study was to assess the relationship between the attitudes of caregivers and the burden they experience in such a context, namely Arica, a town located in the northernmost region of Chile, close to the border with Peru and Bolivia. METHODS: We assessed attitudes towards schizophrenia (including affective, cognitive and behavioural components) and burden (including subjective distress, rejection and competence) in 41 main caregivers of patients with schizophrenia, all of whom were users of Public Mental Health Services in Arica. RESULTS: Attitude measures differed significantly according to socio-demographic variables, with parents (mainly mothers) exhibiting a more negative attitude towards the environment than the rest of the family (t = 4.04; p = 0.000).This was also the case for caregivers with a low educational level (t = 3.27; p < 0.003), for the oldest caregivers (r = 0.546; p = 0.000) and for those who had spent more time with the patient (r = 0.377; p = 0.015). Although attitudes had significant association with burden, their explanatory power was modest (R2 = .104, F = 4,55; p = .039). CONCLUSIONS: Similar to finding developed countries, the current study revealed a positive and significant relationship between the attitudes of caregivers and their burden. These findings emphasize the need to support the families of patients with schizophrenia in this social context

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population

Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group