Recent and historical pollution legacy in high altitude Lake Marboré (Central Pyrenees): A record of mining and smelting since pre-Roman times in the Iberian Peninsula.

We have analyzed potential harmful trace elements (PHTE; Pb, Hg, Zn, As and Cu) on sediment cores retrieved from lake Marboré (LM) (2612 m a.s.l, 42°41'N; 0° 2'E). PHTE variability allowed us to reconstruct the timing and magnitude of trace metal pollutants fluxes over the last 3000 years in the Central Pyrenees. A statistical treatment of the dataset (PCA) enabled us to discern the depositional processes of PHTE, that reach the lake via direct atmospheric deposition. Indeed, the location of LM above the atmospheric boundary layer makes this lake an exceptional site to record the long-range transport of atmospheric pollutants in the free troposphere. Air masses back-trajectories analyses enabled us to understand the transport pathways of atmospheric pollutants while lead isotopic analyses contributed to evaluate the source areas of metal pollution in SW Europe during the Late Holocene. PHTE variability, shows a clear agreement with the main exploitation phases of metal resources in Southern Europe during the Pre-Industrial Period. We observed an abrupt lead enrichment from 20 to 375 yrs CE mostly associated to silver and lead mining and smelting practices in Southern Iberia during the Roman Empire. This geochemical data suggests that regional atmospheric metal pollution during the Roman times rivalled the Industrial Period. PHTE also increased during the High and Late Middle Ages (10-15th centuries) associated to a reactivation of mining and metallurgy activities in high altitude Pyrenean mining sites during climate amelioration phases. Atmospheric mercury deposition in the Lake Marboré record mostly reflects global emissions, particularly from Almadén mines (central Spain) and slightly fluctuates during the last three millennia with a significant increase during the last five centuries. Our findings reveal a strong mining-related pollution legacy in alpine lakes and watersheds that needs to be considered in management plans for mountain ecosystems as global warming and human pressure effects may contribute to their future degradation.

Impact of the lavender rhizosphere on the mercury uptake in field conditions.

Lavender plants as well as their rhizosphere and bulk soil were sampled on a wide range of soils with different land use within the Almadén mercury mining district. The aim of this work is to evaluate the role of the rhizosphere on mercury behavior in soil-lavender plant system including chemometric analysis. The edaphic parameters that significantly differed between lavender rhizosphere and bulk soil were: total Hg; easily available Hg; electrical conductivity; organic matter; cation exchange capacity; soluble ions (Cl(-); SO(4)(2-); PO(4)(3-); NO(3)(-); Al(+); Mn(2+); Ca(2+) and Mg(2+)). The most important variable in the differentiation is electrical conductivity. Furthermore, both organic matter and Mn(2+) in rhizosphere soil seem to block Hg availability to plant. However, the presence of sulfates seems to favor it. Regarding other relationships, Hg seems to block Pb uptake by lavender plants and, on the other hand, the presence of Mn(2+) seems to favor it. Furthermore, Hg root uptake by lavender and its distribution throughout the plant have been studied. The more available Hg in rhizosphere soil, the more Hg is translocated to aerial part and less Hg is retained by root. In all cases, the Hg concentration in the root was higher than in the aerial part.

Grupos de mejora como herramienta de calidad en atención primaria. Nuestra experiencia

La dirección y coordinación de personas es, a menudo, una tarea difícil. La peculiaridad del entorno laboral en atención primaria, donde comparten su trabajo un grupo habitualmente de 20-30 personas de diferentes profesiones, no seleccionadas previamente por quien las va a dirigir, repartidas en ocasiones en turnos diferentes y con posibilidades de cambio por motivos ajenos a la organización del equipo, hace que los encargados de dirigirlas a menudo fracasen en el intento, especialmente si tampoco reciben la formación, las contraprestaciones oportunas ni el reconocimiento adecuado. Presentamos una experiencia de organización que implica a todos los trabajadores y que centra la gestión y búsqueda de oportunidades de mejora dentro de los integrantes del propio equipo. La creación de un grupo de mejora formado por representantes de los trabajadores con el respaldo de los directivos es una opción válida y fructífera de dirigir o coordinar un centro de salud. Para el correcto funcionamiento y supervivencia de este grupo de mejora es necesario planificar y cuidar su gestión, especialmente sus reuniones de trabajo. Las conclusiones obtenidas y las actuaciones de mejora han de transmitirse adecuadamente al resto del equipo, para su discusión e implementación. Organizar periódicamente una "parada técnica", en la que se exima a todos los profesionales de sus tareas habituales para que puedan dedicar una jornada completa a trabajar en mejorar su trabajo, además de sus indudables efectos en la "salud" del grupo, va a impulsar y reforzar la vitalidad del grupo de mejora (AU)

Cirugía y traumatología menor, ¿podemos?, ¿podremos? / Surgery and minor traumatology. Can we? Will we be able to?

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¿Traumatología 'menor' en atención primaria? / 'Minor' traumatology in primary care?

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[Clinical evaluation of the stool culture in acute diarrhea]. / Valoración clínica del coprocultivo en las diarreas agudas.

173 children hospitalized with acute diarrhea are studied retrospectively with the object of finding clinico-analytic parameters suggestive of bacterial etiology. The 88 boys and 85 girls varied in age between 3 months and 10 years (only 20% were under a year). The children were divided into 2 groups: group D (+) were 39 children with positive stool cultures (salmonellas, 64%; campylobacter, 25%, and shigellas, 11%), and group D (-) were 134 children with negative stool cultures, and served as a control group. Various parameters were analyzed in order to define the socio-economic and nutritional status, and psychomotor development. Careful analysis was made of the patients' histories and exploratory findings, with special emphasis on the characteristics of the feces. Using the chi-square statistical analysis, significant differences between the two groups were found in relation to length of hospital stay, which was longer in group D (+) (p less than 0.001), the appearance of blood in stool, more often in group D (+) (p less than 0.05) and in the number of children of group D (+) with band forms greater than 10% (p less than 0.05). In accordance with our findings, the practice of stool cultures should be limited to those patients with acute febrile diarrhea presenting macroscopic blood in stool and leukocytosis with neutrophilia (excepting children under 3 months of age, those in a critical or malnourished state, immunodepressed or in a particular epidemic situation). In this way the number of stool cultures and medical assistance costs would be markedly reduced and a more adequate cost/benefit relation would be obtained.

[Abdominal echography in recurrent abdominal pain: study in 100 cases]. / Ecografía abdominal en el dolor abdominal recurrente: estudio en 100 casos.

Abdominal ultrasound imaging performed in 100 children with recurrent abdominal pain have been reviewed. Organic abnormalities were found in 7% of cases. It is emphasized the importance of a careful clinical history, physical examination as well as biological and bacteriological investigations before abdominal echography. In spite of that we believe abdominal ultrasonography is useful in this type of patients, even when non-organic causes are suspected, because of its harmlessness. If the study were normal, others more aggressive explorations could be avoided.

[Calcification of the intervertebral disk in children]. / Calcificación del disco intervertebral en el niño.

Authors present two cases of calcification of the intervertebral disc. They provide an analysis of etiology, symptoms, and roentgenographic clinic course, as well as a review of cases which have been reported in literature.

[Congenital heart block and pacemaker implantation (author's transl)]. / Bloqueo cardíaco congénito con implantación de marcapaso

A six years old boy was sent to our service due to a loss of conscience spell. He had no preceding history E.K.G. showed a complete A-V block. Laboratory findings were within normal limits. Cardiac catheterism was performed and it ruled out any antomic abnormality, making evident a good contraction ability. To decide pacemaker implantation we evaluted: 1. That cardiac frequency was not increased by exercise neither by action of pharmacologyc agents (atropine, insoproterenol).-2. The existence of wide and bizarre QRS ocmplex.-3. And dizziness spels. The patient has been controlled during the past two years. Parasistolia has appeared, not showing modification till today.