Serum P-glycoprotein level: a potential biomarker of DMARD failure in patients with rheumatoid arthritis.

OBJECTIVES: To evaluate the utility of elevated serum P-glycoprotein (P-gp) as a risk marker of therapeutic response failure in rheumatoid arthritis (RA) patients treated with disease-modifying antirheumatic drugs (DMARDs). METHODS: A cross-sectional study was conducted in 151 RA patients. Patients were classified into two groups according to the response achieved in terms of the disease activity score (DAS)28 after ≥ 6 months: (1) patients with a therapeutic response to DMARDs, with DAS28 < 3.2; and (2) patients without a response to DMARDs, with persistent DAS28 ≥ 3.2. We explored a wide group of clinical factors associated with therapeutic resistance. Serum P-gp levels were measured by ELISA. The risk of P-gp elevation as a marker of failure to achieve a therapeutic response to DMARDs was computed using multivariate logistic regression. RESULTS: Serum P-gp levels were significantly higher in RA patients (n = 151) than in the controls (n = 30) (158.70 ± 182.71 ng/mL vs. 14.12 ± 8.97 ng/mL, p < 0.001). The P-gp level was correlated with the DAS28 score (r = 0.39, p < 0.001). RA patients with DMARD failure had higher serum P-gp levels than patients with a therapeutic response (206 ± 21.47 ng/mL vs 120.60 ± 15.70 ng/mL; p = 0.001). High P-gp levels increased the risk of DMARD failure (OR 3.36, 95% CI 1.54-7.27, p = 0.001). After adjusting for confounding variables, elevated P-gp remained associated with DMARD failure (OR 2.64, 95% CI 1.29-5.40, p = 0.01). CONCLUSION: Elevated serum P-gp is associated with DMARD failure. The P-gp level can be considered a clinical tool for evaluating the risk of DMARD failure in patients; however, future prospective studies should be performed to evaluate the utility of this marker in predicting long-term responses.

Low-voltage chest CT: another way to reduce the radiation dose in asbestos-exposed patients.

AIM: To assess whether low voltage chest computed tomography (CT) can be used to successfully diagnose disease in patients with asbestos exposure. MATERIALS AND METHODS: Fifty-six former employees of the shipbuilding industry, who were candidates to receive a standard-dose chest CT due to their occupational exposure to asbestos, underwent a routine CT. Immediately after this initial CT, they underwent a second acquisition using low-dose chest CT parameters, based on a low potential (80 kV) and limited tube current. The findings of the two CT protocols were compared based on typical diseases associated with asbestos exposure. The kappa coefficient for each parameter and for an overall rating (grouping them based on mediastinal, pleural, and pulmonary findings) were calculated in order to test for correlations between the two protocols. RESULTS: A good correlation between routine and low-dose CT was demonstrated for most parameters with a mean radiation dose reduction of up to 83% of the effective dose based on the dose-length product between protocols. CONCLUSIONS: Low-dose chest CT, based on a limited tube potential, is useful for patients with an asbestos exposure background. Low-dose chest CT can be successfully used to minimise the radiation dose received by patients, as this protocol produced an estimated mean effective dose similar to that of an abdominal or pelvis plain film.

Pd2 and CoPd dimers/N-doped graphene sensors with enhanced sensitivity for CO detection: A first-principles study.

CONTEXT: The detection and monitoring of CO gas are essential to avoid human health problems. Therefore, the CO adsorption on Pd2 and PdCo dimers deposited on pyridinic Nx-doped graphene (PNxG; x = 1 - 3) was investigated employing the auxiliary density functional theory. In the most stable arrangements for the Pd2 dimer supported on PNxG, a Pd atom is in the PNxG vacancy, and the other Pd atom is placed on C atoms. For the PdCo dimer deposited on PNxG, the most stable interaction is like Pd2 dimer supported on PNxG, but with the Co atom centered over the vacancy site. Concerning the stability of the Pd2 and PdCo dimers supported on PNxG, the interaction energies (Eint) of the PdCo dimer deposited on PNxG are higher than those obtained with the Pd2 dimer. Also, the Eint of Pd2 and PdCo dimers deposited on PNxG are higher than those supported on pristine graphene. The CO adsorption energies on Pd2/PNxG and PdCo/PNxG composites are higher than those reported in the literature for pristine graphene, showing that the Pd2/PNxG and PdCo/PNxG composites have a good sensitivity toward the CO molecule. METHODS: All electronic structure calculations were performed using the auxiliary density functional theory implemented in the deMon2k program. For exchange and correlation functional, the revised PBE was used. The Pd atoms were treated with an 18-electron QECP|SD basis set, while the remaining atoms were subjected to a DZVP-GGA basis set. The GEN-A2* auxiliary-function-set was used for all computations.

Comparison of different field tests to assess the physical capacity of post-COVID-19 patients.

BACKGROUND: In coronavirus disease (COVID-19), physical capacity is one of the most impaired sequelae. Due to their simplicity and low cost, field tests such as the six-minute walk test (6MWT) are widely used However, in many places it is difficult to perform them and alternatives can be used such as the 1 min sit-to-stand test (1min-STST) or the Chester step test (CST). Therefore, our objective was to compare the 6MWT, 1min-STST and the CST in post-COVID-19 patients. METHODS: We conducted a cross-sectional analysis in post-COVID-19 patients, compared with matched controls (CG). Demographic characteristics and comorbidities were collected. We analysed oxygen saturation (SpO2), heart rate (HR), and the modified Borg scale in the 6MWT, 1min-STST, and CST. Additionally, the correlations between tests were analysed. RESULTS: We recruited 27 post-COVID-19 patients and 27 matched controls. The median age was 48 (IQR 43-59) years old (44% female). The median distance walked in 6MWT was 461 (IQR 415-506) m in post-COVID-patients and 517 (IQR 461-560) m in CG (p = 0.001). In 1min-STST, the repetitions were 21.9 ± 6.7 and 28.3 ± 7.1 in the post-COVID-19 group and CG, respectively (p = 0.001). In the CST, the post-COVID-19 group performed 150 (86-204) steps vs the CG with 250 (250-250) steps (p < 0.001). We found correlations between the 6MWT with the 1min-STST in COVID-19 patients (r = 0.681, p < 0.001) and CG (r = 0.668, p < 0.001), and between the 6MWT and the CST in COVID-19 patients (r = 0.692, p < 0.001). CONCLUSION: The 1min-STST and the CST correlated significantly with the 6MWT in patients post-COVID-19 being alternatives if the 6MWT cannot be performed.

Response of nitrogen metabolism to boron toxicity in tomato plants.

Boron (B) toxicity has become important in areas close to the Mediterranean Sea where intensive agriculture has been developed. The objective of this research was to study the effects of B toxicity (0.5 mM and 2.0 mM B) on nitrogen (N) assimilation of two tomato cultivars that are often used in these areas. Leaf biomass, relative leaf growth rate (RGR(L)), concentration of B, nitrate (NO(3) (-)), ammonium (NH(4) (+)), organic N, amino acids and soluble proteins, as well as nitrate reductase (NR), nitrite reductase (NiR), glutamine synthase (GS), glutamate synthetase (GOGAT) and glutamate dehydrogenase (GDH) activities were analysed in leaves. Boron toxicity significantly decreased leaf biomass, RGR(L), organic N, soluble proteins, and NR and NiR activities. The lowest NO(3) (-) and NH(4) (+) concentration in leaves was recorded when plants were supplied with 2.0 mM B in the root medium. Total B, amino acids, activities of GS, GOGAT and GDH increased under B toxicity. Data from the present study prove that B toxicity causes inhibition of NO(3) (-) reduction and increases NH(4) (+) assimilation in tomato plants.

Involvement of lignification and membrane permeability in the tomato root response to boron toxicity.

To gain an insight into the role of lignification and membrane permeability in the root response to boron (B) toxicity, lignification-related enzymes and a number of physiological and oxidative stress parameters were analyzed in two tomato (Solanum lycopersicum L.) cultivars (Kosaco and Josefina) subjected to 0.05 (control), 0.5 and 2mM B during 16 days. 2mM B supply inhibited root growth and increased the root B concentration in both tomato cultivars. Although excess B increased the hydrogen peroxide (H2O2) concentration in Kosaco, no major changes were observed in other oxidative-stress-related parameters. High levels of B supply also induced higher lignin deposition in Kosaco roots but did not in Josefina ones. The latter result was associated with an increase of the polyphenol oxidase (PPO), guaiacol peroxidase (GPOX) and soluble syringaldazine peroxidase (SPOX) activity in Kosaco roots. Boron toxicity did not induce lipid peroxidation but increased the leakage of K(+) and the passive efflux of B in tomato roots. We conclude that high concentrations of B do not cause major oxidative or membrane damage in tomato roots. The data also indicate that high levels of B supply induce a higher lignin deposition in Kosaco roots but not in Josefina ones. This phenomenon suggests that lignification is not an essential factor reducing root growth in tomato plants, however, it proves that exist a high genotypic variation in response to excess B at root level.

Current management of acute idiopathic pancreatitis and acute recurrent pancreatitis. / Manejo actual de la pancreatitis aguda idiopática y la pancreatitis aguda recurrente.

Acute pancreatitis is an entity of notable importance due to its high incidence and its non-negligible morbidity and mortality. Idiopathic acute pancreatitis is that in which the cause of the clinical condition cannot be determined after an initial basic study. Understanding the underlying aetiology enables clinicians to propose a targeted treatment to reduce the risk of recurrence. Endoscopic ultrasonography and magnetic resonance cholangiopancreatography are the tests of choice to deepen the aetiological study. The main cause is undiagnosed lithiasic disease in the initial study, whose treatment of choice is cholecystectomy. Moreover, recurrent acute pancreatitis is diagnosed after 2 or more episodes of acute pancreatitis. The objective of this review is to provide an updated approach for these 2 entities, reviewing aspects of their epidemiology, diagnosis and available alternative therapies.

Radiation protection knowledge among radiologists in northwest Spain. / Conocimientos en materia de radioprotección en radiólogos del noroeste de España.

OBJECTIVES: To estimate radiologists level of knowledge of and their implication in radioprotection. METHODS: An anonymous and supervised survey was conducted during a work meeting. RESULTS: Of the 65 questionnaires handed out, 63 were returned. In general, the radiologists surveyed considered their level of knowledge to be low, and it was statistically demonstrated (P = 0.018) that the level of knowledge they believed they had was related to the number of correct answers. The level of knowledge that radiologists believed they had was also related (p < 0.05) with the years of experience, and it was higher in the more experienced radiologists. CONCLUSIONS: There is an important margin of improvement in knowledge about radiation protection.

Cuticle and pore plug properties in the table egg.

Food safety of table eggs is vital since many pathogens can contaminate the unfertilized egg, leading to increased risk of foodborne illness for consumers. The eggshell cuticle is the first line of defense to restrict the entry of egg-associated pathogens, such as Salmonella Enteritidis. The thickness and completeness of coverage of the cuticle layer are heritable traits that are strongly associated with egg resistance to bacterial penetration. The present study characterizes the chemical composition of the eggshell cuticle and structure of pore plugs from table eggs. Eggs collected from both brown and white egg laying Lohmann flocks (early, mid, and late lay) were either unwashed or washed. Pore plugs were characterized using scanning electron microscopy (SEM), and elemental composition was determined using energy-dispersive x-ray spectroscopy (EDS). SEM observations confirmed that the plug formed by the cuticle layer within the eggshell pore remains firmly lodged throughout the commercial washing process. The eggshell thickness and cuticle pore length visualized in brown eggs was significantly higher than in white eggs in hens of all ages. EDS analysis revealed that the pore inner surface was enriched in phosphorus and chemically different from the surrounding bulk eggshell mineral. Detailed assessment of the cuticle chemical composition was performed by Fourier transform infrared spectroscopy (FTIR). Washing of eggs removed cuticle from the eggshell surface. There was a trend of lower cuticle coverage with increasing hen age for white eggs. A significant reduction in the amount of proteins and phosphates and polysaccharides was observed in the cuticle of brown unwashed eggs with hen age. In white unwashed eggs, amides and lipids decreased with hen age; by contrast, the amount of sulfate was highest at mid-lay. The results from our research will assist selective breeding programs that target cuticle integrity and pore plug stability to enhance egg resistance to pathogen penetration and improve food safety.

[Importance of the forensic autopsy in the diagnosis of septic shock: a case report]. / Importancia de la autopsia forense en el diagnóstico del shock séptico: a propósito de un caso.

Septic shock sometimes starts with unspecific symptoms that hamper the clinical diagnosis and, therefore an appropriate treatment. When the septic shock follows a fulminating course with a fatal outcome, the etiological diagnosis has to be conducted post-mortem. Sudden unexpected deaths in children and young adults are frequently the object of medico-legal autopsies. Some sudden unexpected deaths have an infectious origin, which requires further analyses, including microbiology, to establish the cause of death. Here, the case of a fatal septic shock in a 19-month old male infant is presented. After a mild foot injury, an infection by Streptococcus pyogenes progressed to septic shock with a fatal outcome as post-mortem studies demonstrated.

Chiral bidentate [N,S]-ferrocene ligands based on a thiazoline framework. Synthesis and use in palladium-catalyzed asymmetric allylic alkylation.

An efficient method to obtain chiral 1,2-disubstituted ferrocenyl ligands has been developed. The introduction of planar chirality was accomplished by using 2-thiazoline as an ortho-directing lithiation group, and moreover, these kinds of ligands possess a central chirality from the amino alcohol used in their synthesis. The X-ray analysis and DFT calculations confirmed the diastereoselectivity of ortho-lithiation and the configuration of the planar chirality. The ability of these new bidentate [N,S]-ferrocene ligands to act in Pd-catalyzed asymmetric allylic alkylation has also been demonstrated and compared with their oxazoline counterparts.

Accumulation of free polyamines enhances the antioxidant response in fruits of grafted tomato plants under water stress.

Polyamines, small aliphatic polycations, have been suggested to play key roles in a number of biological processes. In this paper, attempts were made to investigate the possibility of improving antioxidant response of tomato fruits in relation with endogenous free polyamines content. We studied the reactive oxygen species and polyamines content, and antioxidant and polyamine-biosynthesis enzyme activities in fruits of ungrafted and grafted tomato plants under moderate water stress. We used a drought-tolerant cultivar (Zarina) and drought-sensitive cultivar (Josefina) to obtain reciprocal graft, selfgraft and ungraft plants. Fruits contained higher endogenous polyamine content during the course of the experiment relative to the control, coupled with higher arginine decarboxylase and spermine synthase activities in Zarina ungrafted and ZarxJos. In these cultivars, tomato fruits showed a lower reactive oxygen species generation and higher catalase and superoxide dismutase activities, suggesting that a higher content in polyamines (especially spermine) exerted a positive effect on antioxidant systems. All of these data suggest that spermine leads to more effective reactive oxygen species scavenging (less tissue damage) in tomato fruits, which may function collectively to enhance dehydration tolerance.

[Hyperbaric oxygenation therapy, basic concepts]. / Terapia con oxigenación hiperbárica, conceptos básicos.

Hyperbaric oxygen therapy (HBO) is defined as a treatment in which a patient breathes 100% oxygen in a pressurized environment of at least 1.4 absolute atmospheres. The first written reports data from the 15th century, when it was used to treat respiratory diseases. For some time its applications lacked scientific support until the second half of this century when scientific publications were carried out using current methodology. This type of therapy is grounded basically in three gas laws: Henry's Law, Dalton's Law and Boyle's Law. The beneficial effects are: wound healing enhancement; increased neutrophil bactericidal capacity; direct toxic effect against some microorganisms; arteriolar vasoconstriction with subsequent edema reduction and decreased ischemia/reperfusion injury, among others. These are the result of increased environmental pressure and high oxygen tension in body tissues. Currently there are 13 accepted conditions to be treated with HBO and others are still under investigation. Following UHMS-accepted treatment protocols, complications and/or adverse effects are limited.

Genotype differences in the metabolism of proline and polyamines under moderate drought in tomato plants.

Water stress is one of the most important factors limiting the growth and productivity of crops. The implication of compatible osmolytes such as proline and polyamines in osmotic adjustment has been widely described in numerous plants species under stress conditions. In the present study, we investigated the response of five cherry tomato cultivars (Solanum lycopersicum L.) subjected to moderate water stress in order to shed light on the involvement of proline and polyamine metabolism in the mechanisms of tolerance to moderate water stress. Our results indicate that the most water stress-resistant cultivar (Zarina) had increased degradation of proline associated with increased polyamine synthesis, with a higher concentration of spermidine and spermine under stress conditions. In contrast, Josefina, the cultivar most sensitive to water stress, showed a proline accumulation associated with increased synthesis after being subjected to stress. In turn, in this cultivar, no rise in polyamine synthesis was detected. Therefore, all the data appear to indicate that polyamine metabolism is more involved in the tolerance response to moderate water stress.

Diferencias funcionales entre trabajadores de astilleros expuestos al amianto del noroeste de la Península Ibérica / Functional differences between shipbuilding workers with an asbestos exposure in the northwest of the iberian peninsula

Objetivos: Se ha teorizado previamente sobre los distintos riesgos en función del tipo de construcción naval secundario a la exposición a amianto en los trabajadores de astilleros, asociando mayor exposición a la construcción militar. Pretendemos evaluar si realmente existen diferencias funcionales en ex-trabajadores de astilleros de una misma región según su afiliación laboral previa. Material y métodos: Presentamos una serie de pacientes remitidos desde la consulta específica de vigilancia post-ocupacional de los que hemos recabado datos de su historia laboral, diferenciando por astilleros su afiliación y sus resultados en la espirometría. Resultados: De los 54 pacientes en que se obtuvieron datos, aquellos que referían haber trabajado en un astillero dedicado en exclusiva a la construcción civil obtenían mejores resultados en las pruebas funcionales respecto al resto de ex-trabajadores, presentando un menor descenso en el porcentaje de la Capacidad Vital Forzada (FVC) con leve significación estadística (p= 0,02), pese al escaso número de pacientes de nuestra muestra. Conclusiones: Los resultados funcionales respiratorios agrupados según los astilleros en que habían trabajado los pacientes, especialmente dada la mayor edad media (casi diez años superior) en los ex-trabajadores del astillero civil, sugieren menor daño funcional para ese tipo de construcción naval. En nuestro conocimiento este es el primer estudio que aporta datos similares en la población de una misma región

Introduction: One of the population with higher exposure to asbestos is composed by shipyart's workers. Different risks have been theorized according to the type of naval construction, relating higher exposures to military construction. The objective of this research was to evaluate whether there were real differences between former shipbuilding employees of the same region by their previous labour affiliation. Material and methods: A series of patients coming from the specific post-occupational surveillance consultation is presented, with historical working data taking into account their membership, according to shipyard industries, and their spirometry values. Results: Information on 54 patients was gathered. Those who had been working in a shipyard exclusively dedicated to civil construction showed better results in the functional tests than the rest of the former workers, having a lower drop in the Forced Vital Capacity (FVC) percentage with a minor statistical relevance (p= 0,02), besides the small number of patients in this population. Conclusions: The results during the respiratory functional tests gathered by the shipyard where the patients had previously worked, specially due to a higher average age (almost ten years higher) in the former workers in civil shipyards, suggest a lower functional damage in this type of naval construction. To our knowledge, this is the first research ever providing such data in a population within the same area

Painometer v2(R): una aplicación móvil certificada para monitorizar a los pacientes con dolor / Painometer v2(R): a certified mobile application to monitorize patients with pain

El uso de dispositivos móviles inteligentes y aplicaciones para la evaluación y tratamiento de los pacientes con dolor crónico se está extendiendo. Las importantes ventajas de estas alternativas tecnológicas contribuyen a este proceso, entre ellas facilitar el acceso a los tratamientos, incluso desde lugares remotos y con difícil acceso a los recursos sanitarios, ayudar a mejorar los procedimientos clínicos así como a reducir los costes. En este trabajo presentamos Painometer v2(R), una aplicación móvil validada científicamente y gratuita, que sirve para medir y registrar la intensidad del dolor a lo largo del tiempo; la única aplicación sobre dolor disponible en español con un sello de calidad. Se describen las características de esta aplicación, las alternativas de uso que brinda y los resultados obtenidos hasta la fecha tanto en las pruebas de usabilidad y accesibilidad como respecto de sus propiedades psicométricas. Finalmente, se valora el estado de desarrollo de la aplicación y se plantean algunas líneas de investigación futuras

The use of smart mobile devices and apps for the evaluation and treatment of patients with chronic pain is spreading. The important advantages of these technological gadgets contribute to this process, including: facilitating access to treatments, even from remote places and with difficult access to health resources, helping to improve clinical procedures as well as reducing costs. In this work, we introduce Painometer v(R), a free and scientifically validated mobile application that is used to measure and record the intensity of pain over time; the only pain-related application available in Spanish with a quality seal. This paper describes the characteristics of the application, the ways in which it can be used, the results obtained to date in usability and accessibility tests, and its psychometric properties. Finally, the development status of the application is appraised and some future lines of research are suggested

Psicología y dolor crónico infantil / No disponible

Los conocimientos derivados de la Psicología y las contribuciones de los psicólogos han sido fundamentales en el progreso del estudio, evaluación y tratamiento del dolor infantil, particularmente del dolor crónico. El objetivo de este artículo es realizar una aproximación a algunas de las parcelas en las cuales los conocimientos de la Psicología y el trabajo de los psicólogos revisten especial interés en relación con el dolor crónico infantil. Y, así, en estas páginas se resumen los hallazgos más relevantes relacionados con el estudio de los factores de riesgo de la cronificación del dolor, el tratamiento psicológico y, en especial, las intervenciones cognitivo-conductuales cuando se utilizan en población infantil y la incorporación de las tecnologías de la información y la comunicación, particularmente la tecnología móvil inteligente para la evaluación y tratamiento de los jóvenes con dolor crónico

Psychology-based knowledge, along with the contributions of psychologists, has been instrumental for the progress of the study, assessment, and treatment of pediatric pain, particularly pediatric chronic pain. The objective of this article is to provide a brief analysis of some of the areas in which psychological-related knowledge and the work of psychologists are of special interest in relation to pediatric chronic pain. Here, we summarize the most relevant findings related to the study of risk factors for the development of pediatric chronic pain, psychological treatment, and especially cognitive-behavioral interventions when used with youths with chronic pain, and the incorporation of information and communication technologies, particularly mobile technology for the evaluation and treatment of young people with chronic pain

Shock séptico por Streptococcus pyogenes en un niño. ¿Es posible el diagnóstico en patología forense? / Septic shock by Streptococcus pyogenes in a child. Is diagnosis possible in forensic pathology?

El shock séptico es el final de numerosos procesos infecciosos que ponen en peligro la vida y que son catalogados como muertes súbitas, de mayor repercusión legal en niños y adultos jóvenes, por lo que son objeto de autopsias forenses. Normalmente son consecuencia de patógenos que en general producen enfermedades leves, pero que en determinadas circunstancias pueden evolucionar a cuadros graves que terminan en el fallecimiento y pueden plantear problemas médico-legales, sobre todo en su detección y diagnóstico. Presentamos el caso de un varón de 20 meses de edad que, tras un cuadro banal de herida en el pie, evolucionó hasta shock séptico y fallecimiento a consecuencia de sepsis por Streptococcus pyogenes, como se evidenció en estudios complementarios especiales post mortem con los que no está familiarizado el patólogo forense

Septic shock is the final common route of numerous life-threatening infectious processes, which are classified as sudden deaths of major legal repercussion in children and young adults and are the subject of forensic autopsies. They are usually the result of pathogens that usually have mild and banal diseases, but in certain circumstances can evolve into severe conditions that end in death and can pose medical problems, especially in detection and diagnosis. We present the case of a 20-month-old male who, after a common foot injury, evolved to septic shock and death as a consequence of streptococcus pyogenes sepsis, as evidenced in special postmortem studies with which the forensic pathologist is unfamiliar

Neumoconiosis por aglomerados de cuarzo: hallazgo de autopsia en un suicidio / Pneumoconiosis quartz agglomerates: autopsy finding of suicide

La silicosis sigue siendo un problema de salud actual renovado por al aumento en la demanda del uso en el hogar de encimeras de aglomerados de cuarzo en nuestro país. Dichas encimeras contienen cuarzo (sílice cristalina), provocando que dicho polvo inorgánico dé lugar a su depósito en el intersticio pulmonar de los trabajadores que no realicen las medidas de protección adecuadas en el ámbito laboral. Es trabajo de las empresas encargadas de la prevención de riesgos laborales la información de la problemática futura en la salud de aquellos que no opten por utilizar los medios de prevención, así como responsabilidad directa de los encargados de dichas empresas facilitar el material y los medios adecuados para llevarlas a cabo. Presentamos el caso de un varón cuya autopsia reveló el hallazgo casual de neumoconiosis por sílice, confirmándose con posterioridad en la entrevista con la familia que desempeñaba su trabajo en una empresa de mármol artificial y la producción de una enfermedad profesional (AU)

Silicosis is still a current health problem by the renewed increase in demand for use in the home countertops quartz agglomerates in Spain. These countertops contain quartz (crystalline silica), causing said inorganic powder from place to deposit in the lung interstitium of workers not performing the appropriate protection measures in the workplace. It is a work of the companies in charge of the prevention of labor risks the information of the future problematics in the health of those that they do not choose to use the means of prevention as well as direct responsibility of the managers of the above mentioned companies of facilitating the material and the means adapted to carry out them. We report the case of a man whose autopsy revealed the incidental finding of pneumoconiosis silica, confirming later in the interview with the family who held his job at a company producing artificial marble and an occupational disease (AU)

Manejo actual de la pancreatitis aguda idiopática y la pancreatitis aguda recurrente / Current management of acute idiopathic pancreatitis and acute recurrent pancreatitis

La pancreatitis aguda es una entidad de notable importancia debido a su elevada incidencia y a su no desdeñable morbimortalidad. Se conoce como pancreatitis aguda idiopática aquella en la que no se consigue determinar la causa del cuadro tras un estudio básico inicial. Conocer la etiología subyacente permite plantear un tratamiento dirigido para así disminuir el riesgo de recurrencia. La ecoendoscopia y la colangiografía por resonancia magnética son las pruebas de elección para profundizar en el estudio etiológico. La principal causa es la enfermedad litiásica no diagnosticada en el estudio inicial, cuyo tratamiento de elección es la colecistectomía. Por otra parte, la pancreatitis aguda recurrente se diagnostica tras la existencia de 2 o más episodios de pancreatitis aguda. El objetivo de esta revisión es proporcionar una aproximación actualizada de estas 2 entidades, repasando aspectos de su epidemiología, diagnóstico y alternativas terapéuticas disponibles

Acute pancreatitis is an entity of notable importance due to its high incidence and its non-negligible morbidity and mortality. Idiopathic acute pancreatitis is that in which the cause of the clinical condition cannot be determined after an initial basic study. Understanding the underlying aetiology enables clinicians to propose a targeted treatment to reduce the risk of recurrence. Endoscopic ultrasonography and magnetic resonance cholangiopancreatography are the tests of choice to deepen the aetiological study. The main cause is undiagnosed lithiasic disease in the initial study, whose treatment of choice is cholecystectomy. Moreover, recurrent acute pancreatitis is diagnosed after 2 or more episodes of acute pancreatitis. The objective of this review is to provide an updated approach for these 2 entities, reviewing aspects of their epidemiology, diagnosis and available alternative therapies