Doppler ultrasound study and venous mapping in chronic venous insufficiency.

Chronic venous insufficiency of the lower limbs is very prevalent. In recent decades, Doppler ultrasound has become the method of choice to study this condition, and it is considered essential when surgery is indicated. This article aims to establish a method for the examination, including venous mapping and preoperative marking. To this end, we review the venous anatomy of the lower limbs and the pathophysiology of chronic venous insufficiency and explain the basic hemodynamic concepts and the terminology required to elaborate a radiological report that will enable appropriate treatment planning and communication with other specialists. We briefly explain the CHIVA (the acronym for the French term "cure conservatrice et hémodynamique de l'insuffisance veineuse en ambulatoire"=conservative hemodynamic treatment for chronic venous insufficiency) strategy, a minimally invasive surgical strategy that aims to restore correct venous hemodynamics without resecting the saphenous vein.

Lamotrigine induced subacute cutaneous lupus erythematous.

A 48-year-old woman developed drug-induced subacute lupus erythematosus while taking lamotrigine. The eruption resolved after discontinuance of lamotrigine, suggesting this drug as the cause.

In situ Raman characterization of minerals and degradation processes in a variety of cultural and geological heritage sites.

We test the capabilities of in situ Raman spectroscopy for non-destructive analysis of degradation processes in invaluable masterpieces, as well as for the characterization of minerals and prehistoric rock-art in caves. To this end, we have studied the mechanism of decay suffered by the 15th-century limestone sculptures that decorate the retro-choir of Burgos Cathedral (N Spain). In situ Raman probe detected hydrated sulfate and nitrate minerals on the sculptures, which are responsible for the decay of the original limestone. In addition, in situ Raman analyses were performed on unique speleothems in El Soplao Cave (Cantabria, N Spain) and in the Gruta de las Maravillas (Aracena, SW Spain). Unusual cave minerals were detected in El Soplao Cave, such as hydromagnesite (Mg5(CO3)4(OH)2·4H2O), as well as ferromanganese oxides in the black biogenic speleothems recently discovered in this cavern. In the Gruta de las Maravillas, gypsum (CaSO4·2H2O) was identified for the first time, as part of the oldest cave materials, so providing additional evidence of hypogenic mechanisms that occurred in this cave during earlier stages of its formation. Finally, we present preliminary analyses of several cave paintings in the renowned "Polychrome Hall" of Altamira Cave (Cantabria, N. Spain). Hematite (Fe2O3) is the most abundant mineral phase, which provides the characteristic ochre-reddish color to the Altamira bison and deer paintings. Thus, portable Raman spectroscopy is demonstrated to be an analytical technique compatible with preserving our cultural and natural heritage, since the analysis does not require physical contact between the Raman head and the analyzed items.

The Volitional Questionnaire: psychometric development and practical use.

This article describes the Volitional Questionnaire and presents recent empirical efforts to develop and validate this instrument. The Volitional Questionnaire is an observational method of gathering data on motivation that is designed for persons who are unable to self-report their own motives. Studies to date suggest that the instrument can provide a valid measure of volition, though a number of limitations of the tool are noted. Implications for use of the Volitional Questionnaire in practice and for further refinement and future research are discussed.

[Nutrition, bone disease and alcoholic cirrhosis]. / Nutrición, enfermedad ósea y cirrosis alcohólica.

OBJECTIVES: To know the prevalence of osteopenia and osteoporosis in alcoholic cirrhotic males from 45 to 65 years old. To prove if the nutritional state is involved in the loss of bone mass in the hepatic disease. STUDY POPULATION: 52 alcoholic cirrhotic males from 45 to 65 years old, with normal kidney function, non-sedentary and with no treatment that could alterate the study. Design and variables: transversal descriptive study finished in 2 years. The nutritional state was evaluated by means of classic anthropometric parameters (weight, height, perimeter of the arm and skin folds) and total body densitometry (DPX plus LUNAR-DEXA with dual energy X-ray absorptiometry. STATISTICAL ANALYSIS: Mc Intosh computer (Filemaker PRO program). T Student was used to compare groups and p was significant if alpha alpha < or = 0.05. Clinical severity of cirrhosis: Child-Turcotte classification. RESULTS: Osteopenia was diagnosed if bone mineral density (BMD) was higher than 1 standard deviation (SD) but lower than 3 SD below T score (mean values for adult women) and osteoporosis (OP) if BMD was higher than 3 SD or vertebral compression fractures appeared in simple radiographies. The prevalence of bone disease was 58%. The percentages of fat obtained by means of anthropometric and densitometric measures were higher in non-osteopenic patients. DISCUSSION: The prevalence of bone disease was higher than another studies. The total body densitometry is a more exact method to measure the percentage of body fat. The percentages of fat obtained with both methods were not related to the loss of bone mass. The nutritional state as an isolated factor does not lead to bone disease in these patients.

U-series dating of Paleolithic art in 11 caves in Spain.

Paleolithic cave art is an exceptional archive of early human symbolic behavior, but because obtaining reliable dates has been difficult, its chronology is still poorly understood after more than a century of study. We present uranium-series disequilibrium dates of calcite deposits overlying or underlying art found in 11 caves, including the United Nations Educational, Scientific, and Cultural Organization (UNESCO) World Heritage sites of Altamira, El Castillo, and Tito Bustillo, Spain. The results demonstrate that the tradition of decorating caves extends back at least to the Early Aurignacian period, with minimum ages of 40.8 thousand years for a red disk, 37.3 thousand years for a hand stencil, and 35.6 thousand years for a claviform-like symbol. These minimum ages reveal either that cave art was a part of the cultural repertoire of the first anatomically modern humans in Europe or that perhaps Neandertals also engaged in painting caves.

[Molluscum contagiosum: descriptive study]. / Molusco contagioso: estudio descriptivo.

INTRODUCTION: Molluscum contagiosum is a cutaneous viral infection that often requires assistance. The aim of our study is to review the cases admitted in our clinic, evaluate the epidemiological features and the treatment prescribed. PATIENTS AND METHODS: We conducted a descriptive survey of the patients diagnosed of molluscum contagiosum in our clinic (Complexo Hospitalario Arquitecto Marcide-Novoa Santos, Ferrol, Spain) between June 16th 2008 and January 15th 2009. The following dates were recorded in all cases: age, sex, personal history of atopy, swimming pool attendance, number of lesions and treatment prescribed. RESULTS: 140 cases of molluscum contagiosum were included in the study. Average age was 10.7 years. 51.43% of patients had a personal history of atopy and 72.1% used to attendance swimming-pool. Average number of lesions was 13.3, with a higher number of them in males, atopic and swimming-pool attendants. Curettage was the treatment performed in 86.4% of cases. CONCLUSIONS: Atopic dermatitis and swimming-pool attendance were associated in our study with a higher frequency and number of molluscum contagiosum. Although different therapeutic options must be evaluated depending on the patient and clinical skills, curettage is the most frequent treatment performed by dermatologists.

[Isolated anterior cervical hypertrichosis]. / Hipertricosis cervical anterior esporádica.

Anterior cervical hypertrichosis was described by Trattner and coworkers in 1991. It consists of a <> of hair at the anterior cervical level just above the laryngeal prominence. To date, only 28 cases of anterior cervical hypertrichosis have been reported. Although it is normally an isolated finding, it may be associated with mental retardation, hallux valgus, retinal disorders, other hair disorders, facial dysmorphism, or sensory and motor peripheral neuropathy. We report the case of a 27-year-old woman who presented with this condition as an isolated finding.

[Scrofuloderma with osteoarticular tuberculosis in the Ferrol health district]. / Escrofulodermia con tuberculosis osteoarticular en el área sanitaria de Ferrol.

INTRODUCTION: Scrofuloderma results from direct extension of an underlying tuberculous focus such as bone, joint or even the epididymis to the overlying skin, but is more frequent over a lymph node, mainly in the cervical region. METHODS: We analysed all cases of scrofuloderma with a bone or joint focus evaluated in the sanitary area of Ferrol, with a current population of 220,000, during a 15-year period. We describe the clinical, histopathological, and microbiological data of patients. RESULTS: We found 6 cases of scrofuloderma with osteoarticular tuberculosis. This series includes five men and one woman, aged 37 to 80. Visceral involvement was found in 3 patients (50 %). CONCLUSION: Osteoarticular tuberculosis comprises 10 % of all extrapulmonary tuberculous infections. There is a high probability of visceral involvement in patients with scrofuloderma. Underlying bone involvement should be rule out in all patients with scrofuloderma, especially in those with incomplete response to medical treatment.

[Porokeratosis in a patient with dermatomyositis]. / Poroqueratosis en una paciente con dermatomiositis.

There are several reports of porokeratosis in the context of immmunosuppressive diseases. These mainly include organ transplant, HIV infection, lymphomas and some inflammatory and autoimmune diseases commonly treated with immunosuppresive drugs or chemotherapy. Disseminated superficial actinic porokeratosis is the clinical variant of porokeratosis that most frequently develops in immunosuppressive states. We report a case of porokeratosis in a woman with dermatomyositis.