La Ortopantomografía como método para la detección de las placas de ateroma calcificadas: revisión de la literatura

Los accidentes cerebrovasculares (ACV) constituyen la tercera causa de muerte en los países industrializados, tras la cardiopatía isquémica y el cáncer. Se trata pues de un importante problema de Salud pública, no sólo por su elevada incidencia, sino también por el alto costo que genera la rehabilitación física y psicológica de estos pacientes. El Odontoestomatólogo, como profesional de la salud, debe implicarse ante esta situación y contribuir, dentro de sus posibilidades, a la detección precoz de los pacientes con riesgo de sufrir un ACV. Desde la década de los ochenta, distintos autores han descrito la posibilidad de detectar las placas de ateroma calcificadas localizadas en la bifurcación de la arteria carótida a través de la ortopantomografía (OPG). De este modo, las posibilidades del Odontoestomatólogo en este campo han sido ampliadas. Esta nueva aplicación de la OPG, sin embargo, debe superar ciertos obstáculos antes de poder afianzarse como una nueva medida de cribaje de pacientes con riesgo de sufrir un ACV. Entre éstos estaría, por una parte, la valoración del auténtico significado clínico, a nivel pronóstico, de la calcificación de las placas de ateroma al igual que su utilidad como factor predictor de aparición de cuadros de ACV y por otra, el realizar un correcto diagnóstico diferencial con otras estructuras calcificadas que pueden aparecer en la ortopantomografía.Cerebrovascular accident (CVA) is the third cause of death in industrialized countries, following cardiovascular disease and cancer. It is therefore a significant public health issue, not only due to its high incidence, but also to the high costs involved in the physical and psychological rehabilitation of these patients. Dental Practitioners, as health care providers, ought to play their part in this issue and contribute, within their means, to the early detection of patients at risk of having a CVA. Since the eighties, different authors have described the possibility of detecting calcified atheroma plaques located at carotid artery bifurcation through panoramic radiograph. In this way, the Dental Practitioner's possibilities in this field have been extended. However, this new use of panoramic radiograph must overcome certain obstacles before it is implemented as a new screening method for patients at risk of having a CVA. Amongst these, we would have, on the one hand, the assessment of the real clinical significance, as regards prognosis, of atheroma plaque calcification as well as its usefulness as a factor for predicting the appearance of CVA symptoms and, on the other hand, the possibility of making a correct differential diagnosis regarding other calcified structures that may appear on panoramic radiograph

Using numerical methods for map the spatiotemporal geogenic and anthropogenic influences on the groundwater in a detrital aquifer in south Spain

The presence of trace elements in water for domestic supply or irrigation could pose a significant toxic risk for health, due to direct consumption or bioaccumulation through the ingestion of vegetables irrigated with this water. This paper studies the presence of 41 trace elements plus nitrate and bromate in groundwater, using a multivariate statistical tool based on Principal Component Analysis and a geostatistical Kriging method to map the results. Principal Component Analysis revealed 11 significant principal components, which account for 82% and 81% of the total variance (information) respectively for the two dates analysed. Ordinary Kriging was applied to draw maps of the trace elements and PC scores. This research breaks new ground in terms of the large number of parameters used and in terms of the analysis of spatiotemporal variations in these parameters. The results obtained indicate that PC1 represents the natural quality of the aquifer (geogenic) and that there is little change in the average PC1 value between the two dates studied (June near the peak recharge point and November at the end of summer). Agriculture is the human activity that causes the greatest variations in the quality of the groundwater due to the use of fertilizers and due to watering crops with wastewater (PC7_J and PC5_N, June and November, respectively). Other elements of industrial origin, which are dangerous for human health, such as Pb, Cu and Cd, are grouped together in other principal components. The results show that the decline, or even complete absence, of natural recharge during the summer months leads to an increase in the TEs produced by human activity. This indicates that a temporary reduction in the natural recharge could worsen the quality of water resources. Based on the interpretation of the estimated maps, a synthetic map was created to show the spatial distribution of the areas affected by geogenic and anthropogenic factors. Studies with a global approach like this one are necessary in that the possible sources of pollution that could alter the quality of the groundwater and the amount of trace elements and other potentially harmful substances could increase as time goes by. The main advantage of the methodology proposed here is that it reduces the number of parameters, so simplifying the results. This makes it easier to interpret the results and manage the quality of the water.Research Group RNM-122 of the Junta de Andalucía (Spain

Panoramic radiograph as a method for detecting calcified atheroma plaques : Review of literature

Los accidentes cerebrovasculares (ACV) constituyen la tercera causa de muerte en los países industrializados, tras la cardiopatía isquémica y el cáncer. Se trata pues de un importante problema de Salud pública, no sólo por su elevada incidencia, sino también por el alto costo que genera la rehabilitación física y psicológica de estos pacientes. El Odontoestomatólogo, como profesional de la salud, debe implicarse ante esta situación y contribuir, dentro de sus posibilidades, a la detección precoz de los pacientes con riesgo de sufrir un ACV. Desde la década de los ochenta, distintos autores han descrito la posibilidad de detectar las placas de ateroma calcificadas localizadas en la bifurcación de la arteria carótida a través de la ortopantomografía (OPG). De este modo, las posibilidades del Odontoestomatólogo en este campo han sido ampliadas. Esta nueva aplicación de la OPG, sin embargo, debe superar ciertos obstáculos antes de poder afianzarse como una nueva medida de cribaje de pacientes con riesgo de sufrir un ACV. Entre éstos estaría, por una parte, la valoración del auténtico significado clínico, a nivel pronóstico, de la calcificación de las placas de ateroma al igual que su utilidad como factor predictor de aparición de cuadros de ACV y por otra, el realizar un correcto diagnóstico diferencial con otras estructuras calcificadas que pueden aparecer en la ortopantomografía

Valoración de la mucositis secundaria a tratamiento oncohematológico mediante distintas escalas: revisión

La mucositis oral es la inflamación que tiene lugar en el epitelio oral, a consecuencia de los tratamientos antineoplásicos tales como la radioterapia, la quimioterapia o el transplante de médula ósea, siendo muy frecuente en los tratamientos de los procesos oncohematológicos. Las consecuencias de esta inflamación, no sólo afectan a la calidad de vida del paciente, sino que además puede suponer una limitación en la aplicación del tratamiento, así como un aumento de la estancia hospitalaria y de los gastos terapéuticos. Un obstáculo principal a la hora de estudiar la mucositis, ha sido la falta de un sistema adecuado para su valoración mediante el examen oral. Los métodos desarrollados para medir y cuantificar los cambios producidos en el epitelio oral, como consecuencia del tratamiento del cáncer, van desde los más sencillos, tales como escalas generales con cuatro o cinco grados de severidad que permiten relacionar la mucositis con el estado de salud oral, hasta llegar a las escalas específicas de tratamiento, en las que se distingue el tipo de tratamiento antineoplásico que dio lugar a la mucositis, pasando por las escalas de múltiples variables, en las que se valoran distintos aspectos y se estudia su correspondencia con el estado de salud oral y su función, obteniendo una puntuación global de severidad de la mucositis; es importante el establecimiento de una escala común para la valoración de la mucositis, no sólo con fines clínicos sino también para la investigación del grado de toxicidad de los distintos regímenes terapéuticos que dan lugar a mucositis.Oral mucositis is the inflammation that takes place in the oral epithelium, as a result of antineoplastic treatments such as radiotherapy, chemotherapy or bone marrow transplant, being very frequent in these treatments for oncohematologic disease. The consequences of this inflammation, not only affect the quality of life of the patient, but can also suppose a limitation in the application of the treatment, as well as an increase in the hospital stay and therapeutic costs. A main obstacle for the study of the mucositis, has been the lack of a system adapted for its valuation by means of the oral examination. Methods developed to measure and quantify the changes produced in oral epithelium as a result of treatment of cancer can be very varied from more simple methods, such as general scales with four or five degrees of severity that link the mucositis to the state of oral health, to specific scales of treatment. In this last type of scale the type of antineoplastic treatment that gave rise to the mucositis is identified giving a global severity score for the mucositis. The establishment of a common scale for the evaluation of mucositis is important, not only for clinical purposes but also for the investigation of the degree of toxicity of the different therapeutic regimes that give rise to the mucositis

Nuevos retos en el estudio de los acuíferos costeros desde la modelación numérica. El caso del acuífero Motril-Salobreña

Coastal aquifers are frequently complex systems with highly heterogeneous geological charac teristics, specific flow patterns, presence of fluids with different densities, high risk of contamina tion both by salinization and by other pollutants, and highly modified by anthropic activity. Given this situation, numerical modeling becomes the most appropriate tool to determine the potential impact of global change on marine intrusion in this kind of aquifers. The mathematical models traditionally used in coastal aquifers have been those of flow and mass transport with variable density, which allow obtaining a distribution of salinities in the aquifer and reproducing the flow pattern in the area of discharge to the sea. In addition to these models, another type of numerical modeling can be applied that could also provide information on specific aspects of this type of aquifers. The study of the Motril-Salobreña coastal aquifer shows, for example, how heat trans port models allow quantifying the recharge that occurs from rivers that frequently interact with coastal aquifers; as well as the age transport models provide data on the preferential groundwa ter circulation paths and its residence time, very relevant information in these frequently hetero geneous and anisotropic aquifers. Future challenges are directed towards determining the ef fects of sea level rise on marine intrusion and establishing the degree of equilibrium of the freshwater-saltwater contact with the current situationProyecto CGL2016-77503-R financiado por el Ministerio de Ciencia e InnovaciónGrupo de investigación de la Junta de Andalucía RNM-36

Groundwater-Surface Water Interactions in “La Charca de Suárez” Wetlands, Spain

La Charca de Suárez (LCS) is a Protected Nature Reserve encompassing 4 lagoons located 300 m from the Mediterranean coast in southern Spain. LCS is a highly anthropized area, and its conservation is closely linked to the human use of water resources in its surroundings and within the reserve. Different methodologies were applied to determine the hydrodynamics of the lagoons and their connection to the Motril-Salobreña aquifer. Fieldwork was carried out to estimate the water balance of the lagoon complex, the groundwater flow directions, the lagoons-aquifer exchange flow and the hydrochemical characteristics of the water. The study focussed on the changes that take place during dry-wet periods that were detected in a 7-month period when measurements were collected. The lagoons were connected to the aquifer with a flow-through functioning under normal conditions. However, the predominant inlet to the system was the anthropic supply of surface water which fed one of the lagoons and produced changes in its flow pattern. Sea wave storms also altered the hydrodynamic of the lagoon complex and manifested a future threat to the conservation status of the wetland according to predicted climate change scenarios. This research presents the first study on this wetland and reveals the complex hydrological functioning of the system with high spatially and temporally variability controlled by climate conditions and human activity, setting a corner stone for future studies.This study was supported by grant CGL2016-77503-R from the Ministry of Economy and Competitiveness (MINECO), cofounded by the European Regional Development Fund (ERDF) of the European Union (EU), and the RNM-369 research group of the regional government of Andalusia

Validity of applying Theis and Cooper-Jacob analytical solutions in pumping tests carried out in coastal aquifers

Two pumping tests were performed in the unconfined detrital Motril-Salobreña aquifer in a 250 metre-deep artesian well 300 m from the coastline containing both freshwater and saltwater. The two observation wells where the drawdowns are measured record the influence of tidal fluctuations and a high vertical heterogeneity in the aquifer. The Theis and Cooper-Jacob approaches give average T and S values of 1,460 m2/d and 0.027, respectively. Numerical modelling in a synthetic model was applied to analyse the sensitivity of the Theis and Cooper-Jacob approaches to the usual boundary conditions in coastal aquifers. The T and S values calculated from the numerical modelling drawdowns indicate that the regional flow, variable pumping flows, and tidal effect produce an error of under 10% in results obtained with classic methods. Fluids of different density (freshwater and saltwater) cause an error of 20% in estimating T and of over 100% in calculating S. The factor most affecting T and S results in the pumping test interpretation is vertical heterogeneity in sediments, which can produce errors of over 100% in both parametersEn el acuífero costero Motril-Salobreña se realizaron dos ensayos de bombeo en un sondeo surgente de 250 m de profundidad localizado a 300 m del borde costero en el que se detectó la presencia de agua dulce y agua salada y una fuerte heterogeneidad vertical. En los dos piezómetros donde se miden los descensos, se registra la influencia de las oscilaciones mareales. La aplicación de las soluciones analíticas de Theis y Cooper-Jacob da valores medios de T y S de 1.460 m2/d y 0,027, respectivamente. Para analizar la sensibilidad de las aproximaciones de Theis y Cooper-Jacob ante condiciones de contorno que suelen aparecer en acuíferos costeros se ha aplicado un modelo matemático sintético. Los valores de T y S calculados a partir de los descensos resultantes del modelo indican que la existencia de un flujo regional, un caudal de bombeo variable y el efecto de las mareas producirá un error inferior al 10% en los resultados obtenidos con los métodos clásicos. La presencia de fluidos de diferente densidad provocará un error del 20% para T y mayor del 100% para S. El factor que más afecta a los resultados de T y S en la interpretación de ensayos de bombeo es la heterogeneidad vertical de los sedimentos que pueden dar errores superiores al 100% para ambos parámetro

Groundwater contamination in caves: four case studies in Spain

Groundwater quality was monitored in four Spanish caves using concentrations of nitrate, potassium, phosphorus and in some cases total organic carbon. Three of the caves are located in NW Spain and contain prehistoric cave paintings and hence have special conservation interest. Of these, two are open show caves (Tito Bustillo and Pindal Caves), while the other one (Herrerías Cave) is not managed for tours and is partially closed off to public access. The fourth cave (Las Maravillas Cave) is located in SW Spain and is opened to the public because of its geological features and natural beauty. In this paper, we compare two sampling methodologies used in the four caves. In Pindal and Herrerias Cave high temporal resolution is achieved with a dripwater collector that collects discrete samples every 48 hours. In Tito Bustillo and Las Maravillas Caves a higher spatial resolution is achieved (16 sampling points in each one), but with a frequency of sampling ranging from 15 days to 6 months. Wastewater and livestock waste appear to be the principal sources of contamination to cave waters. Caves with concentrated livestock (stables) or urban and residential wastewater systems directly situated above the cave exhibit the highest level of contamination detected in elevated concentrations of nitrogen species and in some cases depressed oxygen availability in waters