Linfoma angiocéntrico centrofacial

El linfoma angiocéntrico centrofacial es una neoplasia linfoide rara, con un diagnóstico a menudo difícil, debido al cuadro clínico inespecífico y a que muchas veces son necesarias varias biopsias para llegar a un diagnóstico correcto. Se trata de un linfoma no Hodgkin(LNH) agresivo, de localización preferente en el tracto respiratorio superior (sobre todo en cavidad nasal), y con un pronóstico ominoso, ya que la supervivencia media es de 12-18 meses aproximadamente(1). Predomina en orientales y sudamericanos, entre los 50-60 años de edad, y con ligera preferencia por el sexo masculino (2:1). Se presenta el caso de una paciente ecuatoriana que acude a nuestro servicio con edema hemifacial, rinorrea achocolatada y obstrucción respiratoria nasal de 1 mes de evolución, sin respuesta al tratamiento antibiótico y antiinflamatorio, que tras realizar varias pruebas diagnósticas se evidenció histológicamente la presencia de un linfoma T extranodal de tipo nasal (también llamado linfoma de células T angiocéntrico).The centrofacial angiocentric lymphoma is a rare lymphoid neoplasm, with an often-difficult diagnosis due to the non-specific clinical picture. On many occasions it is necessary to perform various biopsies to reach the correct diagnosis. This lymphoma is an aggressive Non-Hodgkin's (NHL) type, which is normally found in the upper respiratory tract (predominantly in the nasal cavity), and has an ominous prognosis, as the average survival rate is between 12 and 18 months (1). It is predominantly found in subjects of oriental and South American extraction, who are between the ages of 50 and 60 years and with a slight tendency towards males (2:1). This is the case study of a female Ecuadorian patient who was referred to our department with a hemifacial edema, chocolate- like rhinorrhea and nasal respiratory obstruction, which had been treated with antibiotics and anti-inflammatories for a month without success. After performing a number of diagnostic tests, it was found histologically that the patient had an extranodal T-cell lymphoma of the nasal type (also known as T-cell angiocentric lymphoma)

The late-Variscan peraluminous Valdepeñas pluton (southern Central Iberian Zone)

The Valdepeñas pluton is the easternmost outcrop of the Cáceres-Valdepeñas magmatic alignment (southern Central Iberian Zone). This massif is constituted by a cordierite-bearing porphyritic monzogranite and may be grouped within the so-called “Serie Mixta” granitoids. The Valdepeñas monzogranite is of magnesian [FeOt/(FeOt+MgO)~0.76], alkali-calcic [(Na2O+K2O)–CaO=7.8–8.5] and peraluminous (A/CNK=1.14–1.20). Multielemental- and REE-normalized patterns are comparable to those of similar rocks in the Nisa- Alburquerque-Los Pedroches magmatic alignment, and slightly differ from those of the Montes de Toledo batholith, both in the southern Central Iberian Zone. The U-Pb zircon age of 303±3Ma is consistent with the late-orogenic character of the intrusion and is in accordance with most of the granitic peraluminous intrusions in the southern Central Iberian Zone.  86Sr/87Sr300Ma ratios (0.707424–0.711253), εNd300Mavalues (-5.53 to -6.68) and whole-rock major and trace element compositions of the studied rocks, suggest that the parental magma of the Valdepeñas monzogranite could derive from a crustal metaigneous source. The U-Pb ages (552–650Ma) of inherited zircon cores found in Valdepeñas monzogranite samples match those often found in Lower Paleozoic metavolcanics and granitic orthogneisses of Central Iberia and, furthermore, point to Upper Neoproterozoic metaigneous basement rocks as possible protoliths at the magma source. Based on the solubility of monazite in peraluminous melts, the estimated emplacement temperature of the studied monzogranite is 742–762ºC. The results obtained in this work would contribute to a better understanding of the origin of the “Serie Mixta” granitoids

Chronostratigraphy and new vertebrate sites from the upper Maastrichtian of Huesca (Spain), and their relation with the K/Pg boundary

The transitional-continental facies of the Tremp Formation within the South-Pyrenean Central Unit (Spain) contain one of the best continental vertebrate records of the Upper Cretaceous in Europe. This Pyrenean area is therefore an exceptional place to study the extinction of continental vertebrates across the Cretaceous/Paleogene (K/Pg) boundary, being one of the few places in Europe that has a relatively continuous record ranging from the upper Campanian to lower Eocene. The Serraduy area, located on the northwest flank of the Tremp syncline, has seen the discovery of abundant vertebrate remains in recent years, highlights being the presence of hadrosaurid dinosaurs and eusuchian crocodylomorphs. Nevertheless, although these deposits have been provisionally assigned a Maastrichtian age, they have not previously been dated with absolute or relative methods. This paper presents a detailed stratigraphic, magnetostratigraphic and biostratigraphic study for the first time in this area, making it possible to assign most vertebrate sites from the Serraduy area a late Maastrichtian age, specifically within polarity chron C29r. These results confirm that the vertebrate sites from Serraduy are among the most modern of the Upper Cretaceous in Europe, being very close to the K/Pg boundary.Spanish Ministry of Economy and Competitiveness (grant numbers CGL2014-53548-P, CGL2015-64422-P and CGL2017-85038-P), cofinanced by the European Regional Development Fund; and by the Department of Education and Science of the Aragonese Government (grant numbers DGA groups H54 and E05), cofinanced by the European Social Fund (ESF). The paleomagnetic study was possible thanks to the complementary grants (beneficiaries of FPU, grant number CGL2010-16447/BTE: Brief Stays and Temporary Transfers, year 2015) supported by the Spanish Ministry of Culture, Education and Sports; and the Laboratory of paleomagnetism of the University of Burgos (Spain). Eduardo Puértolas Pascual is the recipient of a postdoctoral grant (SFRH/BPD/116759/2016) funded by the Fundação para a Ciência e Tecnologia (FCT-MCTES)

Low-cost inorganic cation exchange membrane for electrodialysis: optimum processing temperature for the cation exchanger

The optimum temperature for fixing zirconium phosphate, obtained by precipitation, on a low-cost ceramic support was determined in order to obtain an inorganic cation exchange membrane for electrodialysis. Zirconium phosphate ion exchange capacity maximised between 450 and 550°C, thus it was considered the optimum processing temperature. The origin of this maximum was investigated by means of X-ray diffraction and termogravimetry and evolved gas analysis. Zirconium phosphate formation by precipitation in the porous network of the support was verified by scanning electron microscopy and energy dispersive X-ray analysis and mercury intrusion porosimetry. The membrane obtained after thermal treatment at 450°C displayed selectivity to the cations present in the spent rinse water of the chromium plating process. This property allows the recovery of chromium by removing the cations through the cation exchange ceramic membrane.The authors wish to express their gratitude to the Spanish Ministry of Science and Innovation for the support given to the research study (National Basic Research Programme, Ref. CTQ2008-06750-C02-02), as well as for the FPU student grant awarded to one of the authors (Ref.: AP2009-4409).Mestre, S.; Sales, S.; Palacios, M.; Lorente, M.; Mallol, G.; Pérez-Herranz, V. (2013). Low-cost inorganic cation exchange membrane for electrodialysis: optimum processing temperature for the cation exchanger. Desalination and Water Treatment. 51(16-18):3317-3324. https://doi.org/10.1080/19443994.2012.749177S331733245116-18Strathmann, H. (2010). Electromembrane Processes: Basic Aspects and Applications. Comprehensive Membrane Science and Engineering, 391-429. doi:10.1016/b978-0-08-093250-7.00048-7Drioli, E., & Fontananova, E. (s. f.). Integrated Membrane Processes. Membrane Operations, 265-283. doi:10.1002/9783527626779.ch12Strathmann, H. (s. f.). Fundamentals in Electromembrane Separation Processes. Membrane Operations, 83-119. doi:10.1002/9783527626779.ch5Alberti, G., Casciola, M., Costantino, U., & Levi, G. (1978). Inorganic ion exchange membranes consisting of microcrystals of zirconium phosphate supported by Kynar®. Journal of Membrane Science, 3(2), 179-190. doi:10.1016/s0376-7388(00)83021-5Semiat, R., & Hasson, D. (s. f.). Seawater and Brackish-Water Desalination with Membrane Operations. Membrane Operations, 221-243. doi:10.1002/9783527626779.ch10Bregman, J. ., & Braman, R. . (1965). Inorganic ion exchange membranes. Journal of Colloid Science, 20(9), 913-922. doi:10.1016/0095-8522(65)90064-4Bishop, H. K., Bittles, J. A., & Guter, G. A. (1969). Investigation of inorganic ion exchange membranes for electrodialysis. Desalination, 6(3), 369-380. doi:10.1016/s0011-9164(00)80226-xRajan, K. S., Boies, D. B., Casolo, A. J., & Bregman, J. . (1966). Inorganic ion-exchange membranes and their application to electrodialysis. Desalination, 1(3), 231-246. doi:10.1016/s0011-9164(00)80255-6INAMUDDIN, KHAN, S., SIDDIQUI, W., & KHAN, A. (2007). Synthesis, characterization and ion-exchange properties of a new and novel ‘organic–inorganic’ hybrid cation-exchanger: Nylon-6,6, Zr(IV) phosphate. Talanta, 71(2), 841-847. doi:10.1016/j.talanta.2006.05.042HELEN, M., VISWANATHAN, B., & MURTHY, S. (2007). Synthesis and characterization of composite membranes based on α-zirconium phosphate and silicotungstic acid. Journal of Membrane Science, 292(1-2), 98-105. doi:10.1016/j.memsci.2007.01.018Yu.S. Dzyaz’ko, V.N. Belyakov, N.V. Stefanyak, S.L. Vasilyuk, Anion-exchange properties of composite ceramic membranes containing hydrated zirconium dioxide, Russ. J. Appl. Chem. 79 (2006) 769–773.Linkov, V. ., & Belyakov, V. . (2001). Novel ceramic membranes for electrodialysis. Separation and Purification Technology, 25(1-3), 57-63. doi:10.1016/s1383-5866(01)00090-9Linkov, V. M., Dzyaz’ko, Y. S., Belyakov, V. N., & Atamanyuk, V. Y. (2007). Inorganic composite membranes for electrodialytic desaltination. Russian Journal of Applied Chemistry, 80(4), 576-581. doi:10.1134/s1070427207040118El-Sourougy, M. R., Zaki, E. E., & Aly, H. F. (1997). Transport characteristics of ceramic supported zirconium phosphate membrane. Journal of Membrane Science, 126(1), 107-113. doi:10.1016/s0376-7388(96)00273-6Sánchez, E., Mestre, S., Pérez-Herranz, V., & García-Gabaldón, M. (2005). Síntesis de membranas cerámicas para la regeneración de baños de cromado agotados. Boletín de la Sociedad Española de Cerámica y Vidrio, 44(6), 409-414. doi:10.3989/cyv.2005.v44.i6.340Sánchez, E., Mestre, S., Pérez-Herranz, V., Reyes, H., & Añó, E. (2006). Membrane electrochemical reactor for continuous regeneration of spent chromium plating baths. Desalination, 200(1-3), 668-670. doi:10.1016/j.desal.2006.03.475Alberti, G., Casciola, M., Costantino, U., & Vivani, R. (1996). Layered and pillared metal(IV) phosphates and phosphonates. Advanced Materials, 8(4), 291-303. doi:10.1002/adma.19960080405Alberti, G., & Torracca, E. (1968). Crystalline insoluble salts of polybasic metals - II. Synthesis of crystalline zirconium or titanium phosphate by direct precipitation. Journal of Inorganic and Nuclear Chemistry, 30(1), 317-318. doi:10.1016/0022-1902(68)80096-xTrobajo, C., Khainakov, S. A., Espina, A., & García, J. R. (2000). On the Synthesis of α-Zirconium Phosphate. Chemistry of Materials, 12(6), 1787-1790. doi:10.1021/cm0010093Alberti, G. (1978). Syntheses, crystalline structure, and ion-exchange properties of insoluble acid salts of tetravalent metals and their salt forms. Accounts of Chemical Research, 11(4), 163-170. doi:10.1021/ar50124a007Rajeh, A. O., & szirtes, L. (1995). Investigations of crystalline structure of gamma-zirconium phosphate. Journal of Radioanalytical and Nuclear Chemistry Articles, 196(2), 319-322. doi:10.1007/bf02038050Krogh Andersen, A. M., Norby, P., Hanson, J. C., & Vogt, T. (1998). Preparation and Characterization of a New 3-Dimensional Zirconium Hydrogen Phosphate, τ-Zr(HPO4)2. Determination of the Complete Crystal Structure Combining Synchrotron X-ray Single-Crystal Diffraction and Neutron Powder Diffraction. Inorganic Chemistry, 37(5), 876-881. doi:10.1021/ic971060hFeng, Y., He, W., Zhang, X., Jia, X., & Zhao, H. (2007). The preparation of nanoparticle zirconium phosphate. Materials Letters, 61(14-15), 3258-3261. doi:10.1016/j.matlet.2006.11.132Clearfield, A. (2000). INORGANIC ION EXCHANGERS, PAST, PRESENT, AND FUTURE. Solvent Extraction and Ion Exchange, 18(4), 655-678. doi:10.1080/07366290008934702Szirtes, L., Shakshooki, S. K., Szeleczky, A. M., & Rajeh, A. O. (1998). Thermoanalyncal Investigation of Some Layered Zirconium Salts and Their Various Derivatives I. Journal of Thermal Analysis and Calorimetry, 51(2), 503-515. doi:10.1007/bf03340188Al-Othman, A., Tremblay, A. Y., Pell, W., Letaief, S., Burchell, T. J., Peppley, B. A., & Ternan, M. (2010). Zirconium phosphate as the proton conducting material in direct hydrocarbon polymer electrolyte membrane fuel cells operating above the boiling point of water. Journal of Power Sources, 195(9), 2520-2525. doi:10.1016/j.jpowsour.2009.11.052Thakkar, R., Patel, H., & Chudasama, U. (2007). A comparative study of proton transport properties of zirconium phosphate and its metal exchanged phases. Bulletin of Materials Science, 30(3), 205-209. doi:10.1007/s12034-007-0036-3Jiang, P., Pan, B., Pan, B., Zhang, W., & Zhang, Q. (2008). A comparative study on lead sorption by amorphous and crystalline zirconium phosphates. Colloids and Surfaces A: Physicochemical and Engineering Aspects, 322(1-3), 108-112. doi:10.1016/j.colsurfa.2008.02.035García-Gabaldón, M., Pérez-Herranz, V., García-Antón, J., & Guiñón, J. L. (2009). Use of ion-exchange membranes for the removal of tin from spent activating solutions. Desalination and Water Treatment, 3(1-3), 150-156. doi:10.5004/dwt.2009.453García-Gabaldón, M., Pérez-Herranz, V., García-Antón, J., & Guiñón, J. L. (2009). Effect of hydrochloric acid on the transport properties of tin through ion-exchange membranes. Desalination and Water Treatment, 10(1-3), 73-79. doi:10.5004/dwt.2009.69

Patients receiving a high burden of antibiotics in the community in Spain: a cross-sectional study

Some patients in the community receive a high burden of antibiotics. We aimed at describing the characteristics of these patients, antibiotics used, and conditions for which they received antibiotics. We carried out a cross-sectional study. Setting: Thirty Health Primary Care Areas from 12 regions in Spain, covering 5, 960, 191 inhabitants. Patients having at least 30 packages of antibacterials for systemic use dispensed in 2017 were considered. Main outcome measures: Prevalence of antibiotic use, conditions for which antibiotics were prescribed, clinical characteristics of patients, comorbidities, concomitant treatments, and microbiological isolates. Patient''s average age was 70 years; 52% were men; 60% smokers/ex-smokers; 54% obese. Overall, 93% of patients had, at least, one chronic condition, and four comorbidities on average. Most common comorbidities were cardiovascular and/or hypertension (67%), respiratory diseases (62%), neurological/mental conditions (32%), diabetes (23%), and urological diseases (21%); 29% were immunosuppressed, 10% were dead at the time of data collection. Patients received three antibiotic treatments per year, mainly fluoroquinolones (28%), macrolides (21%), penicillins (19%), or cephalosporins (12%). Most frequently treated conditions were lower respiratory tract (infections or prophylaxis) (48%), urinary (27%), and skin/soft tissue infections (11%). Thirty-five percent have been guided by a microbiological diagnosis, being Pseudomonas aeruginosa (30%) and Escherichia coli (16%) the most frequent isolates. In conclusion, high antibiotic consumers in the community were basically elder, with multimorbidity and polymedication. They frequently received broad-spectrum antibiotics for long periods of time. The approach to infections in high consumers should be differentiated from healthy patients receiving antibiotics occasionally

Recommendations for ophthalmologic practice during the easing of COVID-19 control measures

In the context of the COVID-19 pandemic, this paper provides recommendations for medical eye care during the easing of control measures after lockdown. The guidelines presented are based on a literature review and consensus among all Spanish Ophthalmology Societies regarding protection measures recommended for the ophthalmologic care of patients with or without confirmed COVID-19 in outpatient, inpatient, emergency and surgery settings. We recommend that all measures be adapted to the circumstances and availability of personal protective equipment at each centre and also highlight the need to periodically update recommendations as we may need to readopt more restrictive measures depending on the local epidemiology of the virus. These guidelines are designed to avoid the transmission of SARS-CoV-2 among both patients and healthcare staff as we gradually return to normal medical practice, to prevent postoperative complications and try to reduce possible deficiencies in the diagnosis, treatment and follow-up of the ophthalmic diseases. With this update (5th) the Spanish Society of Ophthalmology is placed as one of the major ophthalmology societies providing periodic and systematized recommendations for ophthalmic care during the COVID-19 pandemic

Acceptability and feasibility of a virtual community of practice to primary care professionals regarding patient empowerment : A qualitative pilot study

Background: Virtual communities of practice (vCoPs) facilitate online learning via the exchange of experiences and knowledge between interested participants. Compared to other communities, vCoPs need to overcome technological structures and specific barriers. Our objective was to pilot the acceptability and feasibility of a vCoP aimed at improving the attitudes of primary care professionals to the empowerment of patients with chronic conditions. Methods: We used a qualitative approach based on 2 focus groups: one composed of 6 general practitioners and the other of 6 practice nurses. Discussion guidelines on the topics to be investigated were provided to the moderator. Sessions were audio-recorded and transcribed verbatim. Thematic analysis was performed using the ATLAS-ti software. Results: The available operating systems and browsers and the lack of suitable spaces and time were reported as the main difficulties with the vCoP. The vCoP was perceived to be a flexible learning mode that provided up-to-date resources applicable to routine practice and offered a space for the exchange of experiences and approaches. Conclusions: The results from this pilot study show that the vCoP was considered useful for learning how to empower patients. However, while vCoPs have the potential to facilitate learning and as shown create professional awareness regarding patient empowerment, attention needs to be paid to technological and access issues and the time demands on professionals. We collected relevant inputs to improve the features, content and educational methods to be included in further vCoP implementation. Trial registration: ClinicalTrials.gov, NCT02757781. Registered on 25 April 2016

Carbapenem-resistant Citrobacter spp. isolated in Spain from 2013 to 2015 produced a variety of carbapenemases including VIM-1, OXA-48, KPC-2, NDM-1 and VIM-2

Objectives: There is little information about carbapenemase-producing (CP) Citrobacter spp.We studied the molecular epidemiology and microbiological features of CP Citrobacter spp. isolates collected in Spain (2013-15). Methods: In total, 119 isolates suspected of being CP by the EUCAST screening cut-off values were analysed. Carbapenemases and ESBLs were characterized using PCR and sequencing. The genetic relationship among Citrobacter freundii isolates was studied by PFGE. Results: Of the 119 isolates, 63 (52.9%) produced carbapenemases, of which 37 (58.7%) produced VIM-1, 20 (31.7%) produced OXA-48, 12 (19%) produced KPC-2, 2 (3.2%) produced NDM-1 and 1 (1.6%) produced VIM- 2; 9 C. freundii isolates co-produced VIM-1 plus OXA-48. Fourteen isolates (22.2%) also carried ESBLs: 8 CTX-M-9 plus SHV-12, 2 CTX-M-9, 2 SHV-12 and 2 CTX-M-15. Fifty-seven isolates (90.5%) were C. freundii, 4 (6.3%) were Citrobacter koseri, 1 (1.6%) was Citrobacter amalonaticus and 1 (1.6%) was Citrobacter braakii. By EUCAST breakpoints, eight (12.7%) of the CP isolates were susceptible to the four carbapenems tested. In the 53 CP C. freundii analysed by PFGE, a total of 44 different band patterns were observed. Four PFGE clusters were identified: cluster 1 included eight isolates co-producing VIM-1 and OXA-48; blaVIM-1 was carried in a class 1 integron (intI-blaVIM-1 - aacA4-dfrB1-aadA1-catB2-qacE¿1/sul1) and blaOXA-48 was carried in a Tn1999.2 transposon. Conclusions: We observed the clonal and polyclonal spread of CP Citrobacter spp. across several Spanish geographical areas. Four species of Citrobacter spp. produced up to five carbapenemase types, including coproduction of VIM-1 plus OXA-48. Some CP Citrobacter spp. isolates were susceptible to the four carbapenems tested, a finding with potential clinical implications