Unidades de protección ambiental en la comarca del Anoia

La comarca de l'Anoia pot resumir-se amb els elements biogeogràfics següents: • Altiplà segarrenc, eix de penetració nord-sud d'espècies eurosiberianes. • Serralada Prelitoral, eix nord-est, sud-est que inclou gran diversitat de comunitats. • Riu Anoia, perpendicular, important connector entre els sistemes litorals i la depressió central. Partint d'aquest reconeixement del territori, ens plantegem una metodologia per avaluar i protegir el medi natural de la comarca. Definim els espais i ecosistemes que requereixen d'una especial protecció, els corredors que connectin aquest espais, les zones que ajudin a aturar la fragmentació del territori i a cohesionar el creixement urbà i, per últim, aquells elements singulars que tenen valor local. Així doncs, delimitem les unitats territorials següents: • Unitats de protecció integra: parc natural de la Muntanya de Montserrat, Roques Blanques, Miralles Queralt, Ancosa-Montagut, Carbasí, escata del Bruc, puig Agullera, flandes de Piera i guixeres d'Òdena. • Unitats de protecció parcial: Llobregòs-Castelltallat, conca alta de l'Anoia, riera de Carme, tram baix de l'Anoia. • Unitats de connexió: congost de la Pobla-Capellades, corredor Bellprat-Tous, corredor Rubió Montserrat, xarxa fluvial de l'Anoia. • Unitats de possible creixement urbanístic: conca d'Òdena, zona de Piera i Masquefa.The Anoia sub-region can be defined by the following bio-geographical elements: • Segarra Plateau, axis of the North-South penetration of euro-siberian species. • Pre-littoral Range, Northeast-Southeast axis, which includes a large variety of communities. • The river Anoia, perpendicular, an important connector between the littoral systems and the central depression. Starting from this territorial recognition, we are introducing a methodology to assess and protect the natural environment of the sub-region. We define the spaces and the ecosystems requiring special protection, the corridors connecting these spaces, the areas helping to stop the fragmentation of the territory and to cohere the urban growth, and finally the singular elements having a local value. Therefore, we define the boundaries of the following territorial units: • Integral Protection Units: Natural Park of the Montserrat Mountain, Roques Blanques (White Rocks), Miralles-Queralt, Ancosa-Montagut, Carbasí, Bruc tectonic slice, Aguilera peak, Flandes of Piera and Òdena's gypsum quarries. • Partial Protection Units: Llobregòs-Castelltallat, high Anoia basin, the Carme river, lower section of the Anoia river. • Connecting Units: La Pobla-Capellades gorge, Bellprat-Tous corridor, Rubió-Montserrat corridor, Anoia fluvial network. • Units for Potential Urban Growth: Òdena basin, Piera and Masquefa areas.La comarca del Anoia se puede resumir con los elementos biogeográficos siguientes: • Altiplano segarrense, eje de penetración norte sur de especies eurosiberianas. • Cordillera Prelitoral, eje nordeste, sudeste que incluye gran diversidad de comunidades. • Río Anoia, perpendicular, importante conectador entre los sistemas litorales i la depresión central. A partir de este reconocimiento del territorio, nos planteamos una metodología para evaluar y proteger el medio natural de la comarca. Definimos los espacios y ecosistemas que requieren de una especial protección, los corredores que conecten estos espacios, las zonas que ayuden a parar la fragmentación del territorio y a cohesionar él crecimiento urbano y, por último, aquellos elementos singulares que tienen valor local. Así pues, delimitamos las unidades territoriales siguientes: • Unidades de protección íntegra: parque natural de la Montaña de Montserrat, Rocas Blancas, Miralles-Queralt, Ancosa-Montagut, Carbasí, escama del Bruc, monte Aguilera, flandes de Piera y yeseras de Òdena. • Unidades de protección parcial: Llobregòs-Castelltallat, cuenca alta del Anoia, riera de Carme, tramo bajo del Anoia. • Unidades de conexión: desfiladero de la Pobla-Capellades, corredor Bellprat-Tous, corredor Rubió-Montserrat, red fluvial del Anoia. • Unidades de posible crecimiento urbanístico: cuenca de Òdena, zona de Piera y Masquefa

Adrenohepatic fusion: Adhesion or invasion in primary virilizant giant adrenal carcinoma? Implications for surgical resection. Two case report and review of the literature

Introduction: Adrenohepatic fusion means union between the adrenal gland and the liver, intermingling its parenchymas. It is not possible to identify this condition by image tests. Its presence implies radical and multidisciplinar approach. Presentation of cases: We report two female cases of 45 and 50 years old with clinical virilization and palpable mass on the abdominal right upper quadrant corresponding to adrenocortical carcinoma with hepatic fusion. The contrast-enhanced tomography showed an indistinguishable mass involving the liver and the right adrenal gland. In the first case, the patient had a two-time operation, the former removing only the adrenal carcinoma, and the second performing a radical surgery after an early relapse. In the second case, a radical right en bloc adrenohepatectomy was performed. Both cases were pathologically reported as liver-infiltrating adrenal carcinoma. Only in the second case the surgery was radical effective as first intention to treat, with 3 years of disease-free survival. Discussion: ACC is a rare entity with poor prognosis. The major indicators of malignancy are tumour diameter over 6 cm, local invasion or metastasis, secretion of corticosteroids, virilization and hypertension and hypokalaemia. The parenchymal fusion of the adrenal cortical layer can be misdiagnosed as hepatocellular carcinoma with adhesion with the Glisson capsule. AHF in such cases may be misinterpreted during surgery, what may impair its resectability, and therefore the survival. The surgical treatment must be performed en bloc, often using liver vascular control. Postoperative treatment must be offered immediately after surgery. Conclusion: We report two consecutive rare cases of adrenohepatic fusion in giant right adrenocortical carcinoma, not detectable by imaging, what has important implications for the surgical decision-making. As radical surgery is the best choice to offer a curative treatment, it has to be performed by a multidisciplinary well-assembled team, counting with endocrine and liver surgeons, and transplant surgeons in case of vena cava involvement, in order to maximize the disease-free survival

Els primers mesos de vida: consells de puericultura

Recomanacions; Cura; NadonsRecomendaciones; Cuidado; BebésRecommendations; Care; BabyFullet que ofereix recomanacions per ajudar en la cura dels nadons: l'alletament, la higiene, les malalties, el xumet, etc.Folleto que ofrece recomendaciones para ayudar en el cuidado de los bebés; la lactancia, la higiene, las enfermedades, el chupete, etc

COVID-19 Outbreak: Infection Control and Management Protocol for Vascular and Interventional Radiology Departments-Consensus Document.

COVID-19 (SARS-CoV-2 virus) pandemic was recently declared by the WHO as a global health emergency. A group of interventional radiology senior experts developed a consensus document for infection control and management of patients with COVID-19 in interventional radiology (IR) departments. This consensus statement has been brought together at short notice with the help of different protocols developed by governmental entities and scientific societies to be adapted to the current reality and needs of IR Departments. Recommendations are the specific strategies to follow in IR departments, preventive measures and regulations, step by step for donning and doffing personal protective equipment, specific IR procedures which can not be delayed, and aerosol-generating procedures in IR with COVID-19 patients. It is advisable with this document to be adapted to local workplace policies