COVID-19 pandemic: Impact on the rate of viral conjunctivitis.

OBJECTIVE: The COVID-19 pandemic led Spain to order a state of alert with the cessation of non-essential activities on 14 March 2020, and to implement public health interventions (such as home confinement) and other health recommendations to prevent the spread of the SARS-CoV-2 virus (hand washing and the obligation to wear face-masks). These factors could have influenced the rate of viral conjunctivitis. METHOD: In this retrospective, noninterventional, descriptive study, the incidence of viral conjunctivitis in an emergency department of a national hospital is compared over two distinct time periods: pre-COVID (13 March-30 September 2019, one year before the start of the pandemic) and COVID (13 March-30 September 2020). RESULTS: In the first period there were 436 cases of conjunctivitis, of which 168 (38.5%) were confirmed cases of viral conjunctivitis 168 (38.5%), while in the second period there were 121 recorded cases, of which the most frequent were allergic and traumatic (23 cases; 19% each group), bacterial (15 cases; 12.3%) and viral (15 cases; 12.3%). The diagnosis of viral conjunctivitis is the one that suffered the most significant relative reduction (48.5%), while other types of conjunctivitis hardly changed their relative frequency between these two periods of time. CONCLUSIONS: Viral conjunctivitis is the most frequent infectious disease of the eye and has a transmission rate similar to that of coronavirus, so the measures implemented could positively affect its incidence.

Pandemia COVID-19: impacto sobre la tasa de conjuntivitis virales / COVID-19 pandemic: Impact on the rate of viral conjunctivitis

Objetivo: La pandemia COVID-19 condujo a España al decreto de estado de alarma con cese de actividades no esenciales el 14 de marzo de 2020 y a intervenciones de salud pública, como el confinamiento domiciliario y otras recomendaciones sanitarias para evitar la propagación del virus SARS-CoV-2: la higiene de manos y la obligatoriedad de portar mascarillas. Estos factores podrían haber influido en la tasa de conjuntivitis virales. Método: En este estudio descriptivo retrospectivo no intervencionista se compara la incidencia de conjuntivitis virales en un servicio de urgencias de un hospital nacional sobre dos periodos de tiempo: pre-COVID (13 de marzo a 30 de septiembre de 2019, un año antes del inicio de la pandemia) y COVID (13 de marzo a 30 de septiembre de 2020). Resultados: En el primer periodo hubo 436 conjuntivitis, de las cuales 168 (38,5%) fueron casos confirmados de conjuntivitis viral 168 (38,5%), mientras que en el segundo periodo hubo 121 registros, de los cuales los más frecuentes fueron las conjuntivitis alérgicas y las traumáticas, con 23 casos (19% cada grupo); las conjuntivitis bacterianas, con 15 casos (12,3%), y las conjuntivitis virales, con 15 casos (12,3%). El diagnóstico de conjuntivitis viral es el que experimenta una reducción relativa más importante (48,5%), mientras que otros tipos de conjuntivitis apenas cambian su frecuencia relativa entre estos dos periodos de tiempo. Conclusiones: La conjuntivitis viral, como patología infecciosa más frecuente del ojo, tiene una transmisión similar a la del coronavirus, por lo que las medidas implantadas podrían afectar positivamente a su incidencia.

Objective: The COVID-19 pandemic led Spain to order a state of alert with the cessation of non-essential activities on 14 March 2020, and to implement public health interventions (such as home confinement) and other health recommendations to prevent the spread of the SARS-CoV-2 virus (hand washing and the obligation to wear face-masks). These factors could have influenced the rate of viral conjunctivitis.Method: In this retrospective, noninterventional, descriptive study, the incidence of viral conjunctivitis in an emergency department of a national hospital is compared over two distinct time periods: pre-COVID (13 March-30 September 2019, one year before the start of the pandemic) and COVID (13 March-30 September 2020).Results: In the first period there were 436 cases of conjunctivitis, of which 168 (38.5%) were confirmed cases of viral conjunctivitis 168 (38.5%), while in the second period there were 121 recorded cases, of which the most frequent were allergic and traumatic (23 cases; 19% each group), bacterial (15 cases; 12.3%) and viral (15 cases; 12.3%). The diagnosis of viral conjunctivitis is the one that suffered the most significant relative reduction (48.5%), while other types of conjunctivitis hardly changed their relative frequency between these two periods of time.Conclusions: Viral conjunctivitis is the most frequent infectious disease of the eye and has a transmission rate similar to that of coronavirus, so the measures implemented could positively affect its incidence.

[COVID-19 pandemic: Impact on the rate of viral conjunctivitis]. / Pandemia COVID-19: impacto sobre la tasa de conjuntivitis virales.

OBJECTIVE: The COVID-19 pandemic led Spain to order a state of alert with the cessation of non-essential activities on 14 March 2020, and to implement public health interventions (such as home confinement) and other health recommendations to prevent the spread of the SARS-CoV-2 virus (hand washing and the obligation to wear face-masks). These factors could have influenced the rate of viral conjunctivitis. METHOD: In this retrospective, noninterventional, descriptive study, the incidence of viral conjunctivitis in an emergency department of a national hospital is compared over two distinct time periods: pre-COVID (13 March-30 September 2019, one year before the start of the pandemic) and COVID (13 March-30 September 2020). RESULTS: In the first period there were 436 cases of conjunctivitis, of which 168 (38.5%) were confirmed cases of viral conjunctivitis 168 (38.5%), while in the second period there were 121 recorded cases, of which the most frequent were allergic and traumatic (23 cases; 19% each group), bacterial (15 cases; 12.3%) and viral (15 cases; 12.3%). The diagnosis of viral conjunctivitis is the one that suffered the most significant relative reduction (48.5%), while other types of conjunctivitis hardly changed their relative frequency between these two periods of time. CONCLUSIONS: Viral conjunctivitis is the most frequent infectious disease of the eye and has a transmission rate similar to that of coronavirus, so the measures implemented could positively affect its incidence.

Vertical cutoff methods in serum protein electrophoresis for the measurement of monoclonal protein concentrations: Which is best?

BACKGROUND: Monoclonal protein (M-protein) concentrations are measured by serum protein electrophoresis (SPE). Two methods are used for demarcating the M-protein area in the electropherogram: perpendicular drop (PD) and tangent skimming (TS). The aim of this study was tocompare both methods and to establish which is the most accurate and precise. METHODS: We studied 24 sera containing M-protein (5-44 g/L). The systematic error (SE) was evaluated in a dilution series of 12 sera. Within-day, between-day, and interobserver variability were assessed. SPE was performed by capillary and agarose gel electrophoresis. M-protein concentrations were measured using both cutoff methods. RESULTS: The PD method shows a constant SE ranged 1.00-2.27 g/L, while constant SE for TS is ranged -0.30--0.57 g/L. None of the cutoff methods or electrophoretic methods showed a proportional SE, with the exception of the TS method in capillary electrophoresis for ß-migrating M-protein. The PD method was more precise than the TS method in all three estimates of imprecision. An increased CV for concentrations < 10 g/L in between-day imprecision was observed with the TS method. Interobserver imprecision was greater for M-protein concentrations < 17 g/L for both cutoff methods (14.85%, 26.42% respectively). CONCLUSIONS: Despite being less precise, the TS method provides a more accurate measurement of M-protein concentration.

SURVEILLANCE OF ENVIRONMENTAL DOSE RATE WITH THE COVARIANCE MATRIX.

The objective of this study is the operational verification of an environmental dose rate monitoring network composed by several sensors. The verification of the study has been tested on the CIEMAT's Radiological Network, establishing a records quality assurance of the detectors using the covariance matrix and the eigenvalues. The technique has revealed an underlying records malfunction, which have not been appreciated by applying conventional surveillance. In this sense, the malfunction has economic and security consequences, which can be minimized with an alternative methodology, which guarantees the radiological protection of a local area according to the Regulatory Agency.

USING THE HERMITE POLYNOMIALS IN RADIOLOGICAL MONITORING NETWORKS.

The most interesting events in Radiological Monitoring Network correspond to higher values of H*(10). The higher doses cause skewness in the probability density function (PDF) of the records, which there are not Gaussian anymore. Within this work the probability of having a dose >2 standard deviations is proposed as surveillance of higher doses. Such probability is estimated by using the Hermite polynomials for reconstructing the PDF. The result is that the probability is ~6 ± 1%, much >2.5% corresponding to Gaussian PDFs, which may be of interest in the design of alarm level for higher doses.

ADVANCED SURVEILLANCE OF ENVIROMENTAL RADIATION IN AUTOMATIC NETWORKS.

The objective of this study is the verification of the operation of a radiation monitoring network conformed by several sensors. The malfunction of a surveillance network has security and economic consequences, which derive from its maintenance and could be avoided with an early detection. The proposed method is based on a kind of multivariate distance, and the verification for the methodology has been tested at CIEMAT's local radiological early warning network.

Susceptibilidade de duas linhagens comerciais de frango de corte no desenvolvimento de dermatite necrótica e possível relação dos genes iss e iutA de Escherichia coli com a reprodução experimental da doença / Susceptibility of two commercial lineages of broilers in the development of necrotic dermatitis and relationship of iss and iutA genes from Escherichia coli with the experimental reproduction of the disease

Celulite aviária é uma enfermidade de grande importância para a avicultura mundial, sendo relacionada principalmente à Escherichia coli (E. coli). Neste estudo foi comparada a susceptibilidade de duas linhagens de aves no desenvolvimento da celulite diante do desafio com diferentes concentrações de E. coli. Além disso, foi avaliada a relação dos genes iss e iutA com a patogenicidade de amostras de E. coli de diferentes origens (fecal/casos clínicos) em pintinhos e com a reprodução experimental da doença em aves de 35 dias de idade. Através da inoculação de frangos de corte (Cobb/Ross) com diferentes níveis de desafio (105 a 108 UFC/mL) de E. coli, não foram observadas diferenças significativas entre as linhagens quanto à sensibilidade à dermatite necrótica para a mesma dosagem (p≤0,05). A detecção dos genes iss e iutA demonstrou que estes estiveram presentes somente nas amostras provenientes de casos clínicos. Da mesma forma, estes isolados foram considerados de alta patogenicidade para pintinhos (>80% letalidade), levando a formação de áreas de lesão mais extensas (≥3cm2) em aves de 35 dias, quando comparado às amostras de origem fecal (p≤0,05). Ainda, as diferenças com relação ao tamanho de lesão foram constatadas também entre os isolados de mesma origem (p≤0,05). Desta forma, a linhagem não pode ser considerada um fator primordial para o desenvolvimento de dermatite necrótica em frangos. Ainda, sugere-se que os genes iss e iutA, quando presentes em conjunto ou isoladamente, poderiam ser considerados marcadores de virulência em cepas de E. coli causadoras de celulite aviária.(AU)

Avian cellulitis is a disease of great importance for the global poultry industry, being mainly related to Escherichia coli. In this study the susceptibility of two lineages of broilers in the development of cellulite was compared to the challenge with different concentrations of E. coli. In addition, it evaluated the relationship of the iss and iutA genes with pathogenicity of E. coli samples from different origins (fecal/clinical cases) in chicks and with the experimental reproduction of disease in 35-day-old broilers. By inoculating broilers (Cobb/Ross) with different levels of challenge (105-108 CFU/mL) of E. coli, no significant differences had been observed between strains for sensitivity to necrotic dermatitis for the same dosage (p≤0.05). Detection of the iss and iutA genes showed that they were only present in samples from clinical cases. Likewise, these strains were considered high pathogenicity for chickens (>80% lethality), leading to the formation of more extensive lesion areas (≥3cm2) at 35 days of birds compared to the samples from fecal origin (p≤0.05). Still, the differences with respect to lesion size were also found among isolates of the same origin (p≤0,05). Thus, the lineage can not be considered a primary factor in the development of necrotic dermatitis in broilers. Furthermore, it is suggested that iss and iutA genes, when present together or separately, could be considered as virulence markers for E. coli strains that cause avian cellulite.(AU)

The Influence of Radon (Gas and Progeny) and Weather Conditions on Ambient Dose Equivalent Rate.

The purpose of this study is to identify the influence of radon (gas and progeny) on the ambient dose equivalent rate measured at the reference station ESMERALDA, where continuous measurements of the ambient dose equivalent rate (every 10 min) combined with activity concentration measurements of radon gas and radon progeny as well as meteorological parameters have been collected. This study has been performed using a correlation study based on a principal components analysis and the Spearman's rank correlation coefficient.

Three millennia of heavy rainfalls in Western Mediterranean: frequency, seasonality and atmospheric drivers.

Documenting subdecadal-scale heavy rainfall (HR) variability over several millennia can rarely be accomplished due to the paucity of high resolution, homogeneous and continuous proxy records. Here, using a unique, seasonally resolved lake record from southern Europe, we quantify temporal changes in extreme HR events for the last 2,800 years in this region and their correlation with negative phases of the Mediterranean Oscillation (MO). Notably, scarce HR dominated by a persistent positive MO mode characterizes the so-called Migration period (CE 370-670). Large hydroclimatic variability, particularly between CE 1012 and 1164, singles out the Medieval Climatic Anomaly, whereas more stationary HR conditions occurred between CE 1537 and 1805 coinciding with the Little Ice Age. This exceptional paleohydrological record highlights that the present-day trend towards strengthened hydrological deficit and less HR in the western Mediterranean is neither acute nor unusual in the context of Late Holocene hydrometeorological variability at centennial to decadal time scales.

First phylogenetic analysis of avipoxvirus (APV) in Brazil / Primeira análise filogenética de avipoxvirus (APV) no Brasil

This study represents the first phylogenetic analysis of avian poxvirus recovered from turkeys in Brazil. The clinical disorders related to fowlpox herein described occurred in a turkey housing system. The birds displaying characteristic pox lesions which were observed on the neck, eyelids and beak of the turkeys. Four affected turkeys were randomly chosen, euthanized and necropsied. Tissues samples were submitted for histopathological analysis and total DNA was further extracted, amplified by conventional PCR, sequenced and phylogenetically analyzed. Avian poxviruses specific PCR was performed based on P4b core protein gene sequence. The histological analysis revealed dermal inflammatory process, granulation tissue, hyperplasia of epithelial cells and inclusion bodies. The P4b gene was detected in all samples. Sequencing revealed a 100% nucleotide and amino acid sequence identity among the samples, and the sequences were deposited in GenBank®. The four Avian poxviruses fragments sequenced in this study clustered along the A1 clade of avipoxviruses, and were classified as Avipoxvirus (APV). Additional studies, such as virus isolation, PCR and sequencing includinga large number of specimens from the Brazilian turkey production must be conducted due to the hazardous risk that poxvirus infections may cause to the Brazilian poultry production scenario, given that Brazil's turkey production attracts attention due to its economic importance worldwide. Our findings point to the need to identify the prevalence of APV in Brazilian turkey production, to perform risk assessment studies and continued surveillance of APV infections in both wild and commercial avian species.

Este trabalho representa a primeira análise filogenética de Poxvirus aviário detectado em perus no Brasil. Os distúrbios clínicos relacionados com bouba aviária aqui descritos ocorreram em um sistema de alojamento de perus. As aves apresentaram lesões características de varíola observadas no pescoço, pálpebras e bico das aves. Quatro perus com sinais característicos foram escolhidos aleatoriamente, sacrificados e submetidos à autópsia. Amostras de tecido foram submetidas à análise histopatológica e o DNA total foi extraído, amplificado por PCR convencional e os amplicons foram sequenciados e analisados ​​filogeneticamente. A PCR específica para Poxvírus aviário foi realizada com base na seqüência do gene da proteína do núcleo P4b. A análise histológica revelou um processo inflamatório dérmico, tecido de granulação, hiperplasia de células epiteliais e corpúsculos de inclusão. O gene P4b foi detectado em todas as amostras. O sequenciamento revelou uma identidade entre nucleotídeos e aminoácido de 100% entre as amostras e as sequências foram depositadas no GenBank®. Os quatro fragmentos de poxvírus aviário sequenciado neste estudo foram agrupados no clado A1 de avipoxvirus e foram classificados como Avipoxvirus (APV). Estudos adicionais, como isolamento viral, PCR e sequenciamento, incluindo um grande número de perus da produção brasileira devem ser conduzidos devido ao grave risco que a infecção por poxvírus pode causar ao cenário de produção avícola brasileira, tendo em vista que a produção brasileira de perus atrai atenção devido a sua importância mundial. Nossos resultados apontam para a necessidade de identificar a prevalência da APV na produção de peru no Brasil, para realizar estudos de avaliação de risco e continuada monitoração de infecções por APV nas espécies de aves comerciais e silvestres.

Comparison of Antibiotic Resistance and Virulence Factors among Escherichia coli Isolated from Conventional and Free-Range Poultry.

Microbiological contamination in commercial poultry production has caused concerns for human health because of both the presence of pathogenic microorganisms and the increase in antimicrobial resistance in bacterial strains that can cause treatment failure of human infections. The aim of our study was to analyze the profile of antimicrobial resistance and virulence factors of E. coli isolates from chicken carcasses obtained from different farming systems (conventional and free-range poultry). A total of 156 E. coli strains were isolated and characterized for genes encoding virulence factors described in extraintestinal pathogenic E. coli (ExPEC). Antimicrobial susceptibility testing was performed for 15 antimicrobials, and strains were confirmed as extended spectrum of ß-lactamases- (ESBLs-) producing E. coli by phenotypic and genotypic tests. The results indicated that strains from free-range poultry have fewer virulence factors than strains from conventional poultry. Strains from conventionally raised chickens had a higher frequency of antimicrobial resistance for all antibiotics tested and also exhibited genes encoding ESBL and AmpC, unlike free-range poultry isolates, which did not. Group 2 CTX-M and CIT were the most prevalent ESBL and AmpC genes, respectively. The farming systems of poultries can be related with the frequency of virulence factors and resistance to antimicrobials in bacteria.

Evaluation of the Antibiotic Resistance and Virulence of Escherichia coli Strains Isolated from Chicken Carcasses in 2007 and 2013 from Paraná, Brazil.

The frequent use of antimicrobials in commercial poultry production has raised concerns regarding the potential impact of antimicrobials on human health due to selection for resistant bacteria. Several studies have reported similarities between extraintestinal pathogenic Escherichia coli (ExPEC) strains isolated from birds and humans, indicating that these contaminant bacteria in poultry may be linked to human disease. The aim of our study was to analyze the frequency of antimicrobial resistance and virulence factors among E. coli strains isolated from commercial chicken carcasses in Paraná, Brazil, in 2007 and 2013. A total of 84 E. coli strains were isolated from chicken carcasses in 2007, and 121 E. coli strains were isolated in 2013. Polymerase chain reaction was used to detect virulence genes (hlyF, iss, ompT, iron, and iutA) and to determine phylogenetic classification. Antimicrobial susceptibility testing was performed using 15 antimicrobials. The strains were also confirmed as extended-spectrum ß-lactamase (ESBL)-producing E. coli with phenotypic and genotypic tests. The results indicated that our strains harbored virulence genes characteristic of ExPEC, with the iutA gene being the most prevalent. The phylogenetic groups D and B1 were the most prevalent among the strains isolated in 2007 and 2013, respectively. There was an increase in the frequency of resistance to a majority of antimicrobials tested. An important finding in this study was the large number of ESBL-producing E. coli strains isolated from chicken carcasses in 2013, primarily for the group 2 cefotaximase (CTX-M) enzyme. ESBL production confers broad-spectrum resistance and is a health risk because ESBL genes are transferable from food-producing animals to humans via poultry meat. These findings suggest that our strains harbored virulence and resistance genes, which are often associated with plasmids that can facilitate their transmission between bacteria derived from different hosts, suggesting zoonotic risks.

Detecção de fatores de virulência de Escherichia coli e análise de Salmonella spp. em psitacídeos / Detection of virulence factors in Escherichia coli and analysis of Salmonella spp. in psittacines

The enteric flora of psittacines is mainly composed of Gram positive bacteria. Gram negative bacteria, like Escherichia coli and Salmonella spp., have a high pathogenic potential and can be considerate as an indicative of management problems that may culminate in disease manifestation due to stress factors, poor diets and overcrowding, in combination with a high bacterial load on the environment. The objective of this study was evaluated the presence of Salmonella spp., Escherichia coli and the virulence genes iss and iutA from E. coli isolates. Forty-four samples were analyzed from psittacines living in captivity, which fifteen samples were from organs fragments of necropsied birds, and twenty-nine were from cloacal and crop swabs of red-spectacled parrots (Amazona pretrei) keeping in captivity. No samples were positive for Salmonella spp. In the samples in which E. coli was detected, both virulence factors (genes iss and iutA) were present.

A flora entérica dos psitacídeos é composta principalmente por bactérias Gram positivas. Bactérias Gram negativas, como Escherichia coli e Salmonella spp., apresentam elevado potencial patogênico, sendo consideradas indicativo de problemas de manejo, que poderão culminar em manifestação de doenças em decorrência de fatores estressantes, dietas deficientes e superlotação, combinados com alta carga bacteriana no ambiente. O objetivo deste trabalho foi avaliar a presença de Salmonella spp., Escherichia coli e os fatores de virulência dos genes iss e iutA dos isolados de E. coli. Analisou-se um total de 44 amostras provenientes de psitacídeos criados em cativeiro, sendo estas 15 fragmentos de órgãos de aves submetidas a exame de necropsia e também 29 amostras de swabs de cloaca e inglúvio de papagaios-charão (Amazona pretrei) criados em cativeiro. Nenhuma amostra foi positiva para Salmonella spp. Nas amostras de E. coli detectou-se ambos os fatores de virulência pesquisados.

Combined therapy versus usual care for the treatment of depression in oncologic patients: a randomized controlled trial.

OBJECTIVE: To compare narrative therapy (NT) plus escitalopram versus escitalopram plus usual care on quality of life and depressive symptomatology of depressed patients with oncologic disease. METHODS: A total of 72 subjects (mean age 54.6 years), predominantly female with non-metastatic breast, lung and colon cancer and depressive disorder (DSM-IV-TR) were randomized to receive treatment with NT plus escitalopram (n=39) or escitalopram (10-20 mg QD) plus usual care (n=33). Main endpoints were improvement in dimensions of quality of life measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 and reduction of depressive symptoms using the Hospital Anxiety and Depression Scale at weeks 12 and 24. RESULTS: The combined therapy group showed significantly greater improvement in all the functioning dimensions (p<0.01), pain scale (p=0.02), global health (p=0.02), and global quality of life (p=0.007) at weeks 12 and 24. There were no statistically significant differences in depressive symptomatology between the groups. From week 12 to week 24 study retention was higher in the combined treatment group (p=0.01). CONCLUSIONS: Brief NT in combination with escitalopram was superior to usual care and escitalopram in improving functioning dimensions of quality life.

Epidemiologic analysis of the laboratory-confirmed cases of influenza A(H1N1)v in Colombia.

From 2 May to 16 July 2009, a total of 183 laboratory-confirmed cases of influenza A(H1N1)v were reported in Colombia, 117 (63.9%) of these had travelled outside the country. Hospital admission was necessary in 26 (14.21%) cases and seven patients died (fatality-case ratio: 3.8%). The infection affected younger age-groups and the symptoms most frequently reported were cough, fever and sore throat. Our findings are consistent with recent reports from other countries.

Functionalisation of glass with iron oxide nanoparticles produced by laser pyrolysis.

In the present work, a new process for depositing nanoparticle layers onto glass has been developed by using one of the most interesting nanoparticle generation technologies at the moment, which is based on the pyrolysis induced by laser of vapours combined with CVD of the particles onto glass. Nanoparticles prepared by this method were deposited into a hot silica substrate obtaining new nanocomposites with unique properties. The coated glasses present new specific functionalities such as colour, and interesting magnetic and optical properties. Control of the thickness and the iron oxide phase, either magnetic or not, has been achieved by adjusting the experimental conditions. Thus, thickness is controlled by the glass and the precursor temperature, while the iron phase is controlled by the precursor temperature and the nature and the flow of the carrier gas. This process is inexpensive, adaptable to current glass production technologies and takes place at atmospheric pressure.

Floods from tailings dam failures.

This paper compiles the available information on historic tailings dam failures with the purpose to establish simple correlations between tailings ponds geometric parameters (e.g., dam height, tailings volume) and the hydraulic characteristics of floods resulting from released tailings. Following the collapse of a mining waste dam, only a part of tailings and polluted water stored at the dam is released, and this outflow volume is difficult to estimate prior the incident. In this study, tailings' volume stored at the time of failure was shown to have a good correlation (r2=0.86) with the tailings outflow volume, and the volume of spilled tailings was correlated with its run-out distance (r2=0.57). An envelope curve was drawn encompassing the majority of data points indicating the potential maximum downstream distance affected by a tailings' spill. The application of the described regression equations for prediction purposes needs to be treated with caution and with support of on-site measurement and observations. However, they may provide a universal baseline approximation on tailing outflow characteristics (even if detailed dam information is unavailable), which is of a great importance for risk analysis purposes.

Reported tailings dam failures. A review of the European incidents in the worldwide context.

A detailed search and re-evaluation of the known historical cases of tailings dam failure was carried out. A corpus of 147 cases of worldwide tailings dam disasters, from which 26 located in Europe, was compiled in a database. This contains six sections, including dam location, its physical and constructive characteristics, actual and putative failure cause, sludge hydrodynamics, socio-economical consequences and environmental impacts. Europe ranks in second place in reported accidents (18%), more than one third of them in dams 10-20 m high. In Europe, the most common cause of failure is related to unusual rain, whereas there is a lack of occurrences associated with seismic liquefaction, which is the second cause of tailings dam breakage elsewhere in the world. Moreover, over 90% of incidents occurred in active mines, and only 10% refer to abandoned ponds. The results reached by this preliminary analysis show an urgent need for EU regulations regarding technical standards of tailings disposal.

Dolor de origen muscular: dolor miofascial y fibromialgia / Muscular pain: myofascial pain síndrome and fibromyalgia

El dolor miofascial es una importante fuente de alteraciones para todos los sujetos que la padecen. Su prevalencia es muy elevada en atención primaria, aunque es aún mayor en los centros de atención especializada, siendo muy variables las cifras que se encuentran en la literatura. Para el estudio de esta entidad es necesario conocer dos conceptos básicos: tensión muscular y “trigger points”. No existe ninguna teoría totalmente aceptada en la actualidad, aunque parece que existe un componente autonómico y otro de sensibilización central. Un minucioso examen físico y una completa historia clínica son los dos elementos fundamentales para llegar al diagnóstico. El dolor miofascial comprende un heterogéneo grupo de enfermedades que requiere un tratamiento multidisciplinar. El tratamiento de elección es la terapia física, en especial los ejercicios de estiramiento diseñados para recuperar la longitud del músculo. La fibromialgia es una entidad que se caracteriza por dolor crónico generalizado y la presencia de puntos sensibles o “tender points”. El origen de esta enfermedad continúa, aún hoy día por dilucidarse. Se han elaborado múltiples teorías, pero en la actualidad no hay ninguna completamente aceptada. Los pacientes presentan rigidez matutina y dolores articulares generalizados, aunque esta enfermedad no es articular. También aparece cefalea crónica, fatiga, trastornos del sueño, parestesias, ansiedad y colon irritable. El diagnóstico se apoya en los criterios de clasificación del Colegio Americano de Reumatología de 1990. Hay que comentar con los enfermos que el tratamiento se instaurará para mejorar la funcionalidad y la calidad de vida, aunque lo más probable es que se consiga sólo de forma parcial. La terapia con antidepresivos tricíclicos mejorará el estado de ánimo y los trastornos del sueño, ambos factores de vital importancia en esta patología. El tratamiento no farmacológico con programas de estiramiento y relajación junto a la terapia psicológica, ayudarán a disminuir la intensidad de los síntomas

Myofascial pain syndromes have a very high prevalence. Two concepts are essential: muscular tension and trigger points. Autonomous and central sensitization components are implicated. Physical examination and a complete clinical history are mandatory. It requires a multidisciplinary treatment, especially with physical therapy. Fibromyalgia is characterized by chronic widespread pain and the presence of tender points. In its origin numerous theories exist, but none is totally accepted. Patients present morning rigidity, chronic fatigue, cephalalgia, sleep disturbances, paresthesia, mood disorders, irritable bowel and joint pain. The diagnosis is based upon the classification criteria of the American College of Rheumatology 1990. The treatment aims to recover functionality and quality of life, at least partially. Tricyclic antidepressants therapy will improve depression and sleep disturbances. The non pharmacological treatment with stretching and relaxation programs alongside psychological therapy will help to reduce the intensity of symptoms